Body fat distribution linked to higher risk of aggressive prostate cancer

[pjoshea13]

New study below [1] [2].

Some may recall that I have been going on about visceral fat for some years (this includes dangerous periprostatic fat.)

Visceral fat acts as though it were a gland in the endocrine system. It secretes hormones & these can help spur PCa aggressiveness.

Many studies link high BMI to poorer survival after diagnosis. There are a couple of things wrong with these studies, IMO. (i) the emphasis on obesity (as though overweight is OK) & (ii) the fact that BMI isn't useful for some body types - & does not always correlate with visceral fat. Some researchers make it clear that BMI is used as a surrogate because it is easy to calculate. Visceral fat can only be measured via a scan.

...

"The accumulation of fat in specific areas--such as visceral fat (deep in the abdomen, surrounding the organs) and thigh subcutaneous fat (just beneath the skin)--was associated with the risk of advanced and fatal prostate cancer."

""Interestingly, when we looked separately at men with a high BMI versus low BMI, we found that the association between visceral fat and advanced and fatal prostate cancer was stronger among men with a lower BMI."

...

I suppose that some men will further reduce fat intake, but visceral fat deposits are often due to triglycerides from high-carb diets.

-Patrick

[1] eurekalert.org/pub_releases...

In the first prospective study of directly measured body fat distribution and prostate cancer risk, investigators found that higher levels of abdominal and thigh fat are associated with an increased risk of aggressive prostate cancer. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings may lead to a better understanding of the relationship between obesity and prostate cancer and provide new insights for treatment.

Previous studies have shown that obesity is associated with an elevated risk of advanced prostate cancer and a poorer prognosis after diagnosis. Also, emerging evidence suggests that the specific distribution of fat in the body may be an important factor.

To provide high quality evidence, Barbra Dickerman, PhD, of the Harvard T.H. Chan School of Public Health, and her colleagues analyzed body fat distribution using the gold-standard measure of computed tomography imaging and assessed the risk of being diagnosed with, and dying from, prostate cancer among 1,832 Icelandic men who were followed for up to 13 years.

During the study, 172 men developed prostate cancer and 31 died from the disease. The accumulation of fat in specific areas--such as visceral fat (deep in the abdomen, surrounding the organs) and thigh subcutaneous fat (just beneath the skin)--was associated with the risk of advanced and fatal prostate cancer. High body mass index (BMI) and high waist circumference were also associated with higher risks of advanced and fatal prostate cancer.

"Interestingly, when we looked separately at men with a high BMI versus low BMI, we found that the association between visceral fat and advanced and fatal prostate cancer was stronger among men with a lower BMI. The precision of these estimates was limited in this subgroup analysis, but this is an intriguing signal for future research," Dickerman noted.

Additional studies are needed to investigate the role of fat distribution in the development and progression of prostate cancer and how changes in fat stores over time may affect patients' health. "Ultimately, identifying the patterns of fat distribution that are associated with the highest risk of clinically significant prostate cancer may help to elucidate the mechanisms linking obesity with aggressive disease and target men for intervention strategies," said Dickerman.

An accompanying editorial notes that lifestyle interventions--such as diet and exercise--that target fat loss may also reduce the risk of prostate cancer.

[2] onlinelibrary.wiley.com/doi...

Background

The World Cancer Research Fund classifies as “strong evidence” the link between obesity and the risk of advanced prostate cancer. In light of the different hormonal profiles associated with where adipose is stored, this study investigated the role of objectively measured body fat distribution and the risk of clinically relevant prostate cancer.

Methods

This was a prospective study of 1832 men in the Age, Gene/Environment Susceptibility–Reykjavik study. From 2002 to 2006, participants underwent baseline computed tomography imaging of fat deposition, bioelectric impedance analysis, and measurement of body mass index (BMI) and waist circumference. Men were followed through linkage with nationwide cancer registries for the incidence of total (n = 172), high‐grade (Gleason grade ≥8; n = 43), advanced (≥cT3b/N1/M1 at diagnosis or fatal prostate cancer over follow‐up; n = 41), and fatal prostate cancer (n = 31) through 2015. Cox regression was used to evaluate the association between adiposity measures and prostate cancer outcomes.

Results

Among all men, visceral fat (hazard ratio [HR], 1.31 per 1–standard deviation [SD] increase; 95% confidence interval [CI], 1.00‐1.72) and thigh subcutaneous fat (HR, 1.37 per 1‐SD increase; 95% CI, 1.00‐1.88) were associated with risk of advanced and fatal disease, respectively. Among men who were leaner based on BMI, visceral fat was associated with both advanced and fatal disease. BMI and waist circumference were associated with a higher risk of advanced and fatal disease. No adiposity measures were associated with total or high‐grade disease.

Conclusions

Specific fat depots as well as BMI and waist circumference were associated with the risk of aggressive prostate cancer, which may help to elucidate underlying mechanisms and target intervention strategies.

[cesanon]

"Interestingly, when we looked separately at men with a high BMI versus low BMI, we found that the association between visceral fat and advanced and fatal prostate cancer was stronger among men with a lower BMI."

...

I suppose that some men will further reduce fat intake, but visceral fat deposits are often due to triglycerides from high-carb diets"

Very very interesting.

One more reason to stay away from bread and sweet food.

[Hidden in reply to cesanon]

Man I love good bread.

[Frigataflyer]

Thanks Patrick.

[Hidden]

My husband lost about 20 pounds, also a lot of visceral fat, now he has about 21 BMI and 11% body fat, visceral fat 4. And he is on a wfpb diet, mostly vegan, quite low fat (but some olive oil and some nuts). His cholesterol and triglyceride levels dropped A LOT on this diet, this before taking statin and metformin! So I am not sure about this low carb theory.

But yes: no sugar, little bread and only whole grains, but still fruits (also bananas), oats.

Now what I don't know is if his prostate cancer did not contribute to his fat loss (since he is not on ADT yet).

Unfortunately he changed his lifestyle only 1-2 years before diagnosis, before he had high cholesterol, high triglycerides, being diary (he loves cheese) and white bread and a lack of sport probably the culprit for his advanced prostate cancer (Gleason 9) and also atherosclerosis.... He had also gout (even with very low meat consumption and no alcohol), low levels of vitamin D and high blood pressure and a lot of stress.

[pjoshea13 in reply to Hidden]

Inflammation again:

"Gout, a painful and potentially debilitating form of inflammatory arthritis, develops when tiny, needle-shaped crystals of uric acid (a biological waste product) accumulate in the joints."

Tart cherry:

"Fights inflammation and arthritis pain. Research shows that the antioxidants in tart cherry juice can reduce pain and inflammation from osteoarthritis (OA). A 2012 study showed that drinking cherry juice twice a day for 21 days reduced the pain felt by people with OA."

Tart cherry extract:

swansonvitamins.com/swanson...

Friends have used tart cherry extracts, & they do work. One guy went back to his gout med - we don't know why.

-Patrick

[Hidden in reply to Hidden]

Sounds like a hard working guy that didn’t take the time to worry about hisself. Probably the majority of us.

[Schwah]

How does one test their visceral fat? What other tests do you recommend. Thx so much for your post.

Schwah

[Hidden in reply to Schwah]

To take an accurate measurement, you'd need a costly CT scan . But you can also buy a bioelectrical impedance machine which use an electrical current that can differentiate between fat tissues. This is the most accurate method of measuring visceral fat at home.

Costs can vary between 80USD and 600USD.

[JavaMan in reply to Hidden]

Isn’t waist circumference a decent, no cost proxy for visceral fat levels?

[pjoshea13 in reply to JavaMan]

Some studies use the hip:waist ratio, but visceral fat (around internal organs) is invisible from the outside & can be quite high in slim people with good ratios.

BMI & hip:waist ratio are widely used as surrogates for visceral fat. Good enough for associations at the group level, but not for an individual, IMO.

Men with high BMI are no doubt concerned about the constant stream of PCa studies that report poor survival, but I feel that had those studies measured visceral fat, the reports would have been bleaker.

-Patrick

[pjoshea13]

My rule of thumb is that triglycerides =< HDL-cholesterol is ideal. Shows good insulin sensitivity. Extremely difficult to maintain while on ADT (or while hypogonadal), IMO.

-Patrick

[cigafred in reply to pjoshea13]

But possible--my latest trig 89, hdl 97. on ADT 2.5 years.

[bobdc6]

Unfortunately we live in a sea of chemicals and plastic in our food and the air we breathe, there's no escape, even for skinny people.

[Schwah in reply to bobdc6]

Do chemicals and plastic impact our visceral fat or are you saying that’s another risk factor ?

[bobdc6]

Another, ever present, inescapable, risk factor, but it's probably in our visceral fat plus every cell in our body too.

[yamobedeh]

Thank you for this. I was diagnosed with G 4+4, and one bone met in 12/16. Treated at Dattoli Cancer Center in 6/17 with RT, brachy and followup RT to pelvic lymph nodes, and triple blockade ADT. So far, blood work is good. I was 30-35 lb overweight, with elevated triglycerides LDL, and BP, and with no testosterone, had no luck trying to lose weight, despite resistance workouts and lots of cycling & walking. Started Crestor 6 months ago and recently been on keto diet, and have lost 30lb, (mostly belly) going for maybe 5 more before I return to a healthy heart balanced diet. After reading your post, I'm thinking a scan for deeper fat and rechecking metabolic blood labs would be a good idea.

[j-o-h-n]

Giggling........9.5 on the Giggle Meter... Thanks

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 06/11/2019 5:20 PM DST

[j-o-h-n]

My XL tee shirts says "I beat anorexia"

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 06/11/2019 5:26 PM DST

[SeosamhM in reply to j-o-h-n]

Just when the day seems darkest and hot fudge sundaes are off the menu.....j-o-h-n to the rescue!