title: Pilot study to explore effects of low-fat, flaxseed-supplemented diet on proliferation of benign prostatic epithelium and prostate-specific antigen.
abstract: OBJECTIVE
  Dietary factors may influence the prostate and have an impact on prostatic growth and disease. A small number of studies have suggested that flaxseed-supplemented, fat-restricted diets may thwart prostate cancer growth in both animals and humans. Unknown, however, is the potential effect of such a diet on benign prostatic epithelium.
  
  
  METHODS
  We undertook a pilot study to explore whether a flaxseed-supplemented, fat-restricted diet affects the proliferation rates in benign epithelium. We also explored the effects on circulating levels of prostate-specific antigen (PSA), total testosterone, and cholesterol. Fifteen men who were scheduled to undergo repeat prostate biopsy were instructed to follow a low-fat (less than 20% kcal), flaxseed-supplemented (30 g/day) diet and were provided with a supply of flaxseed to last throughout the 6-month intervention period. The PSA, total testosterone, and cholesterol levels were determined at baseline and at 6 months of follow-up. Reports from the original and repeat biopsies were compared, and proliferation (MIB-1) rates were quantified in the benign prostatic epithelium.
  
  
  RESULTS
  Statistically significant decreases in PSA (8.47 +/- 3.82 to 5.72 +/- 3.16 ng/mL; P = 0.0002) and cholesterol (241.1 +/- 30.8 to 213.3 +/- 51.2 mg/dL; P = 0.012) were observed. No statistically significant change was seen in total testosterone (434.5 +/- 143.6 to 428.3 +/- 92.5 ng/dL). Although 6-month repeat biopsies were not performed in 2 cases because of PSA normalization, of the 13 men who underwent repeat biopsy, the proliferation rates in the benign epithelium decreased significantly from 0.022 +/- 0.027 at baseline to 0.007 +/- 0.014 at 6 months of follow-up (P = 0.0168).
  
  
  CONCLUSIONS
  These pilot data suggest that a flaxseed-supplemented, fat-restricted diet may affect the biology of the prostate and associated biomarkers. A randomized controlled trial is needed to determine whether flaxseed supplementation, a low-fat diet, or a combination of the two regimens may be of use in controlling overall prostatic growth.
authors.affiliation: Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Demark-Wahnefried
authors.forename: Cary N
authors.initials: CN
authors.lastname: Robertson
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Walther
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Polascik
authors.forename: David F
authors.initials: DF
authors.lastname: Paulson
authors.forename: Robin T
authors.initials: RT
authors.lastname: Vollmer
mesh_terms: D001706:Biopsy; D018752:Diet, Fat-Restricted; D019587:Dietary Supplements; D019597:Flax; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000178:diet therapy* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000178:diet therapy* / Q000473:pathology
chemical_list: D017430:Prostate-Specific Antigen