You be the judge.

Foods, you be the judge.......

jamanetwork.com/journals/ja...

[Break60]

Wow! What should we believe regarding what to eat? One thing that’s certain is that eating too much of anything is probably not good for you if it causes obesity.

[pjoshea13]

There is no cure for metastatic PCa. Therefore, it is natural for men with mPCa (or even non-mPCa, unsure of the future) to reconsider every aspect of their lifestyles in an attempt to improve survival.

Diet is often the first lifestyle variable to be reconsidered. There are too many diet gurus to mention here - all claiming to have the answer. My approach 15 years ago was to ignore gurus who claimed that their diets were good for all cancer patients - regardless of cancer type. What nourishes a healthy cell may also help cancer cells thrive.

It seemed to me that epidemiological PCa studies offered the best clues to dietary choices that might affect PCa survival or overall survival. I know that association does not prove causality, & it is tiresome to have that repeatedly pointed out, as though epidemiological studies are worthless & ought to be ignored, except by hypothesis-building researchers.

Will there ever be a PCa randomized trial along the lines of the PREDIMED trial (Prevención con Dieta Mediterránea)? I think not. & yet we are told to wait until such a trial occurs.

The negativity of such advice dismays me. I reject the view that we should put our lives entirely in the hands of health care professionals & stop playing 'doctor'. I have seen the statistics & I don't like them.

John P. A. Ioannidis, MD, DSc writes:

"The most promising large trial to date, Prevención con Dieta Mediterránea (PREDIMED), a trial of Mediterranean diet, had shown a benefit on a composite end point but was recently retracted and republished after it was realized that there were multiple subversions of randomization. Findings from the reanalysis showed results similar to those of the initially reported findings; however, the study should no longer be considered a randomized trial. Regardless, the trial showed no survival benefit."

I expect that many reading that would make a mental note to ignore PREDIMED.

The authors explain why they had to rework the PREDIMED numbers:

"We subsequently identified protocol deviations, including enrollment of household members without randomization, assignment to a study group without randomization of some participants at 1 of 11 study sites, and apparent inconsistent use of randomization tables at another site."

"Results were similar after the omission of 1,588 participants whose study-group assignments were known or suspected to have departed from the protocol."

"In this study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet."

We often read than men with PCa usually die with the disease, rather than of it. About a dozen years ago, I asked what then do we die of. The answer isn't a secret these days: cardiovascular disease mostly. Even those not on ADT. Ultimately, I came to view PCa as a metabolic disease.

Mark Moyad has long claimed that what's good for the heart is good for the prostate.

Dr. Myers started out with the idea that low-fat diets would be beneficial for PCa, but found that patients on a high-carb diet didn't do as well. He has now long been a promoter of the (40% fat) Mediterranean diet. At first, I thought it unlike him to assume that the Med diet would be good for PCa patients. But, he has said that most of his new patients were in danger of imminent death from heart disease, not PCa, and the only diet shown to reduce the risk of cardiovascular disease is the Med diet.

Ultimately when I began to view PCa almost as one of the symptoms of the metabolic syndrome, the Med diet began to make sense. I hate to see the PREDIMED trial [1] dismissd so lightly.

See Dr. Myers [2a] [2b].

-Patrick

[1] nejm.org/doi/10.1056/NEJMoa...

[2a] nejm.org/doi/10.1056/NEJMoa...

[2b] nejm.org/doi/10.1056/NEJMoa...

[jmurgia]

OK, 12 years for 12 hazelnuts a day. 12 years for coffee 3 times a day.

So 24 years for hazelnut coffee 3 times a day???

Joe

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

That sounds nuts.....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 08/13/2019 5:56 PM DST

[Muffin2019]

A healthy diet in moderation, I do low fat due to cholesteral, a heart healthy diet, excercise and alcohol in moderation .