Dietary intervention strategies to modulate prostate cancer risk and prognosis.
OBJECTIVE
There is increasing interest in complementary and holistic approaches for cancer prevention and management. We sought to review the latest literature regarding dietary interventions for prostate cancer with a special emphasis on dietary fat and carbohydrate intake for modulating prognosis among men with prostate cancer.


RESULTS
Several recent prospective trials have investigated various dietary and lifestyle investigations on malignant prostate tissue biology. These interventions included a very low-fat (12% fat kcals) vegan diet with various supplements and lifestyle changes, a more traditional low-fat diet (25% fat kcals) with flaxseed supplementation, and a low-glycemic index diet. Low-glycemic index and very low-fat vegan diets (with supplements and lifestyle changes) alter tumor biology as assessed by tumor gene expression changes, with a common mechanism perhaps being weight loss whereas no effects were seen with a traditional low-fat diet. In mice, either very low-fat or low-carbohydrate diets significantly slow tumor growth independent of weight loss. Epidemiologic and preclinical data also suggest cholesterol intake and serum cholesterol levels may be linked with the development and progression of prostate cancer.


CONCLUSIONS
Small clinical trials suggest that tumor biology can be altered by either a vegan low-fat diet or eliminating simple carbohydrates accompanied by weight loss. Larger and longer term studies are needed to determine the clinical relevance of these findings.
Freedland
Stephen J
SJ
Department of Surgery, Durham VA Medical Center, Durham, North Carolina, USA. steve.freedland@duke.edu
Aronson
William J
WJ
D000818:Animals; D050528:Diet, Carbohydrate-Restricted; D018752:Diet, Fat-Restricted; D014676:Diet, Vegetarian; D004195:Disease Models, Animal; D018450:Disease Progression; D006801:Humans; D008297:Male; D051379:Mice; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000178:diet therapy* / Q000517:prevention & control; D012307:Risk Factors