A nutrient-wide study for risk of PCa in the European Prospective Investigation into Cancer and Nutrition and the Netherlands Cohort Study.

[pjoshea13]

New paper below [1]. Big international study - 42 co-authors.

Many men with PCa make dietary changes following diagnosis. The new study looked at the association with PCa incidence & fatality. I suspect that many of our dietary changes reflect the advice we have been bombarded with for fifty years: avoid saturated fat; avoid fat; eat more grains; cut down on sugar but eat fruit, etc, etc. Advice we ignored in the past, perhaps. Advice we took to be based on strong science - alas.

And so, we "know" the "bad" foods that must be avoided & the "good" foods that must replace them. But there is little in the new study to support such bias.

***

"The evidence from the literature regarding the association of dietary factors and risk of prostate cancer is inconclusive."

"A nutrient-wide association study was conducted to systematically and comprehensively evaluate the associations between 92 foods or nutrients and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)."

"A total of 5916 ... incident cases of prostate cancer were diagnosed during a mean follow-up of 14 ... years in EPIC... None of the dietary factors was associated with the risk of total prostate cancer..."

"Null associations were also observed by disease stage, grade and fatality, except for positive associations observed for intake of dry cakes/biscuits with low-grade and butter with aggressive prostate cancer, respectively...

"A total of ... 3842 incident cases of prostate cancer were diagnosed during a mean follow-up of ... 20 years in {the Netherlands Cohort} NLCS...

"The association with "the intake of dry cakes/biscuits was replicated in the NLCS."

***

I have to admit to disappointment with the butter finding. But lard is OK! LOL.

"Biscuits" = "cookies", presumably.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/317...

Eur J Nutr. 2019 Nov 8. doi: 10.1007/s00394-019-02132-z. [Epub ahead of print]

A nutrient-wide association study for risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition and the Netherlands Cohort Study.

Papadimitriou N1,2, Muller D3, van den Brandt PA4, Geybels M4, Patel CJ5, Gunter MJ2, Lopez DS6,7, Key TJ8, Perez-Cornago A8, Ferrari P2, Vineis P3,9, Weiderpass E2, Boeing H10, Agudo A11, Sánchez MJ12,13,14, Overvad K15, Kühn T16, Fortner RT16, Palli D17, Drake I18, Bjartell A19,20, Santiuste C14,21, Bueno-de-Mesquita BH3,22,23,24, Krogh V25, Tjønneland A26,27, Lauritzen DF27, Gurrea AB14,28,29, Quirós JR30, Stattin P31, Trichopoulou A32,33, Martimianaki G32, Karakatsani A32,34, Thysell E35, Johansson I36, Ricceri F37, Tumino R38, Larrañaga N39, Khaw KT40, Riboli E3, Tzoulaki I1,3, Tsilidis KK41,42.

Author information

1

Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.

2

International Agency for Research on Cancer, Lyon, France.

3

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK.

4

Department of Epidemiology, GROW School for Oncology and Developmental Biology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.

5

Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.

6

Department of Preventive Medicine and Community Health, UTMB School of Medicine, Galveston, TX, USA.

7

Division of Urology, UTHealth McGovern Medical School, Houston, TX, USA.

8

Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, Oxford, UK.

9

Italian Institute for Genomic Medicine (IIGM), Turin, Italy.

10

Department of Epidemiology, German Institute for Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.

11

Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.

12

Escuela Andaluza de Salud Pública, Granada, Spain.

13

Universidad de Granada. ibs.GRANADA, Granada, Spain.

14

CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.

15

Department of Public Health, Aarhus University, Aarhus, Denmark.

16

Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.

17

Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy.

18

Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.

19

Department of Urology, Lund University, Malmö, Sweden.

20

Department of Clinical Sciences, Lund University, Malmö, Sweden.

21

Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.

22

Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.

23

Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands.

24

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

25

Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.

26

Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.

27

Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

28

Navarra Public Health Institute, Pamplona, Spain.

29

Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.

30

Public Health Directorate, Asturias, Spain.

31

Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

32

Hellenic Health Foundation, Athens, Greece.

33

WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

34

2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece.

35

Department of Medical Biosciences, Pathology, Department of Biobank Research, Umeå University, Umeå, Sweden.

36

Departments of Odontology, Section of Cardiology, Biobank Research, Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

37

Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy.

38

Cancer Registry and Histopathology Unit, "M.P.Arezzo" Hospital, Ragusa, Italy.

39

Epidemiology and Health Information, Public Health Division of Gipuzkoa, Basque Regional Health Department, San Sebastian, Spain.

40

Clinical Gerontology Unit, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.

41

Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. [e-mail].

42

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK. [e-mail].

Abstract

PURPOSE:

The evidence from the literature regarding the association of dietary factors and risk of prostate cancer is inconclusive.

METHODS:

A nutrient-wide association study was conducted to systematically and comprehensively evaluate the associations between 92 foods or nutrients and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cox proportional hazard regression models adjusted for total energy intake, smoking status, body mass index, physical activity, diabetes and education were used to estimate hazard ratios and 95% confidence intervals for standardized dietary intakes. As in genome-wide association studies, correction for multiple comparisons was applied using the false discovery rate (FDR < 5%) method and suggested results were replicated in an independent cohort, the Netherlands Cohort Study (NLCS).

RESULTS:

A total of 5916 and 3842 incident cases of prostate cancer were diagnosed during a mean follow-up of 14 and 20 years in EPIC and NLCS, respectively. None of the dietary factors was associated with the risk of total prostate cancer in EPIC (minimum FDR-corrected P, 0.37). Null associations were also observed by disease stage, grade and fatality, except for positive associations observed for intake of dry cakes/biscuits with low-grade and butter with aggressive prostate cancer, respectively, out of which the intake of dry cakes/biscuits was replicated in the NLCS.

CONCLUSIONS:

Our findings provide little support for an association for the majority of the 92 examined dietary factors and risk of prostate cancer. The association of dry cakes/biscuits with low-grade prostate cancer warrants further replication given the scarcity in the literature.

KEYWORDS:

Cohort study; Diet; Epidemiology; Nutrition; Prostate cancer

PMID: 31705265 DOI: 10.1007/s00394-019-02132-z

[Graham49]

Thanks Patrick. Do you know what a nutrient wide association study consists of? Does it mean the participants kept a diary of what they eat? This seems a big ask for 14 or 20 years.

[pjoshea13 in reply to Graham49]

Graham,

The European Prospective Investigation into Cancer and Nutrition [EPIC] has been going a long time. There are 1,261 hits on PubMed:

ncbi.nlm.nih.gov/pubmed/?te...

Somewhere in there, is an answer to your question.

Questionnaire-based studies are always going to be problematic, but I'm a fan of EPIC. Here are the 62 hits for PCa:

ncbi.nlm.nih.gov/pubmed/?te...

-Patrick

[Graham49 in reply to pjoshea13]

I've skimmed a couple of the epic reports it seems most of the dietary information is based on a questionnaire completed at the start of the study. Also the foods appear to be grouped together fairly crudely. I saw no mention of fish. There's quite a difference in fat content in meats and nutrients in fruit and vegetables, and how foods are cooked is important isn't it ? My tentative impression is that there is likely to be so much noise in the results of this study that many subtle effects of food , good or bad are bound to be lost in the statistical analysis.

[Hidden]

Good data but I'm not convinced. ncbi.nlm.nih.gov/pubmed/234... indicates cancer and all-mortality risk is increased with processed and red meat. But how much of this is from a healthy user bias?

[pjoshea13 in reply to Hidden]

The new EPIC study is PCa-specific. The EPIC study you cite has many references to "cancer" in the full text [1], but no breakdown by cancer type. As though the risk is similar for all cancers.

From the Conclusion section: "The results of our analysis support a moderate positive association between processed meat consumption and mortality ..."

i.e. no mention of red meat - any association is presumably too weak to mention. {"After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR = 1.18 ...)} & the association with processed meat (+18%) is described as "moderate".

I believe that there is a PCa case to be made for avoiding deli meats, & a case for limiting fresh meat portions (not just red meat).

-Patrick

[1] ncbi.nlm.nih.gov/pmc/articl...

[Hidden in reply to pjoshea13]

True. The case against red meat in general had a positive hazard ratio but not when measurement error was factored in.

And you are correct that it only looked at cancer in general, cardiac disease and all-mortality risk. Since most of us PrC patients die from cardiac disease I like to look at that in addition to just PrC risk. I think what you look at depends on the aggressiveness of your cancer and what stage it's at. My PSA is <0.01 and has been since 6 weeks after surger (I'm on high testosterone and I wouldn't have expected <0.01 PSA - no DHT blocker because I wanted confirmation of cancer - I didn't get it).

[tom67inMA]

Wow, 92 foods with a 95% confidence interval, you'd think there would be 4.6 (5% of 92) significant correlations just based on random luck.

[LearnAll]

I do not trust these sensational, crazy studies. I suspect big pharma and medical industrial complex finances them either directly or indirectly to fool and mislead an average ,gullible person. The message is ...go ahead eat all your junk..don't worry..we will treat you with chemo, radiation, fancy extremely expensive methods...this way we will make billions of dollar ,buy big yatcht and buy islands and mansions. and practice pedophilia

A man with minimum common sense understand that there are foods which are helathy and there are foods which are not good for health...These same greedy profiteers made the world smoke cigarettes for decades...and shamelessly testified in senate that cigarettes are not addictive.

Do you think these greedy profiteers will not bring fake studies to mislead you. Do not buy this b s as food does have effect on your health. We are here to stay healthy and not here to pad the bottomlines of medical industrial complex. They have become dishonest just like military industrial complex....create more wars so more weapons, fighter jets and submarines can be sold. Live and let die ! what a shame.

That's it...END OF RANT.

[tom67inMA in reply to LearnAll]

Wow... pedophilia? I better go off treatment to stop that

I've seen members on this board not change their diet and live well for over a decade. I've seen other members make radical dietary changes and travel the globe looking for the best treatments and die in a year or two.

This is not to say that diet isn't important, only that it seems to takes years or even decades of eating healthy to make a significant difference in outcomes. I think the food industry has done more than big pharma to damage the modern diet.

Big Pharma makes huge profits on drugs that manage conditions such as advanced cancers for the life of the patient. They make more money the longer people live, so it would be in their interest for us to eat healthy and exercise. Can't sell much Nubeqa to a guy who is going to have a heart attack next week.

If you're going to rant against Big Pharma, rant about them putting all their research into life extending cancer therapies and ignoring antibiotic research that will protect us against the next super-bug. Antibiotics are usually curative in about a month, there's no profit in that.

ncbi.nlm.nih.gov/pmc/articl...

"The antibiotic resistance crisis has been attributed to the overuse and misuse of these medications, as well as a lack of new drug development by the pharmaceutical industry due to reduced economic incentives and challenging regulatory requirements."

[monte1111 in reply to tom67inMA]

Pedophilia? I've heard there are pescatarians on this site. What a world, what a world.

[j-o-h-n in reply to monte1111]

I knew an anti-gringo who's name was Pedro Fillia....he played guitar in a group named "Hanky Spanky and the minors"......

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 11/12/2019 7:33 PM EST

[GeorgesCalvez]

It begs the question, how many biscuits do you have to eat to elevate your risk of prostate cancer?

[MateoBeach]

Damn biscuits! Other than that it supports my suspicion that prostate "cancer cells like to eat well too" (take nourishment from good foods similar to healthy cells)

[pjoshea13 in reply to MateoBeach]

Some men seem to think that cancer cells can be coaxed back to normalcy via a "healthy" diet. I tend to think that selective malnourishment is the way to go. The body will produce less IGF-I if one of the essential amino acids to make protein is in short supply. And so on. Need not be too tough on normal tissue.

Unfortunately, the diet most easily manipulated in this way is vegan.

-Patrick

[2dee]

Does this study ignore such things as growth hormones or antibiotics that have crept into our food system?

It has been shown that obesity and poor health do affect our immune systems I believe. Food and Food lifestyle naturally figure in.

Confusing when you look around at all the obese and unhealthy individuals still happily plugging along?

I radically changed diet in 2002 after bypass surgery.

That diet did nothing to stop stage 4, PCa Dx in 2018 with aggressive 2

1300+ PSA growing at a point a day.

I've gotten even more diet crazy since. PSA now slowly growing from a low of 1.3 a few months back up to 2.8 now.

Food not doing much to affect the uptick but it MAY be?

2Dee

[j-o-h-n]

Chocolate chip ice cream (two scoops)...

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 11/12/2019 7:24 PM EST