title: The relation of alpha-linolenic acid to the risk of prostate cancer: a systematic review and meta-analysis.
abstract: BACKGROUND
  alpha-Linolenic acid (ALA; 18:3n-3) has been associated inconsistently with an increased risk of prostate cancer. Additional studies have become available since the publication of 2 previous meta-analyses.
  
  
  OBJECTIVE
  The objective was to review the published data on the relation between ALA and prostate cancer.
  
  
  METHODS
  We conducted a systematic review to identify studies that included data on ALA and risk of prostate cancer. Data were pooled from studies that compared the highest ALA quantile with the lowest ALA quantile, and risk estimates were combined by using a random-effects model.
  
  
  RESULTS
  The relation between ALA and prostate cancer is inconsistent across studies. We pooled data from 8 case-control and 8 prospective studies. The summary estimate revealed that high ALA dietary intakes or tissue concentrations are weakly associated with prostate cancer risk (relative risk [RR]: 1.20; 95% CI: 1.01, 1.43). When examined by study type (ie, retrospective compared with prospective or dietary ALA compared with tissue concentration) or by decade of publication, only the 6 studies examining blood or tissue ALA concentrations revealed a statistically significant association. With the exception of these studies, there was significant heterogeneity and evidence of publication bias. After adjustment for publication bias, there was no association between ALA and prostate cancer (RR: 0.96; 95% CI: 0.79, 1.17).
  
  
  CONCLUSIONS
  Studies examining the relation between ALA and prostate cancer have produced inconsistent findings. High ALA intakes or high blood and adipose tissue concentrations of ALA may be associated with a small increased risk of prostate cancer. However, these conclusions are qualified because of the heterogeneity across studies and the likelihood of publication bias.
authors.affiliation: General Internal Medicine Section, Medical Service, Veterans Affairs Medical Center, San Francisco, CA, USA. joel.simon@ucsf.edu
authors.forename: Joel A
authors.initials: JA
authors.lastname: Simon
authors.forename: Yea-Hung
authors.initials: YH
authors.lastname: Chen
authors.forename: Stephen
authors.initials: S
authors.lastname: Bent