Consuming a Mediterranean Diet was modestly associated with favorable time to grade group progression in men with Prostate Cancer who were on Active Surveillance.
There are many questions about the benefits of a healthy diet that might provide men with prostate cancer, including the value of a Mediterranean diet. According to the results of a study recently presented during the 2020 European Association of Urology Virtual Congress, men on Active Surveillance for prostate cancer may benefit from adherence to Mediterranean diet principles. The study was conducted by investigators from the University of Texas MD Anderson Cancer Center, Houston.
The research evaluated Gleason Grade group progression in men with newly diagnosed localized prostate cancer enrolled in a prospective Active Surveillance trial. A Mediterranean Diet score (MDS) was calculated for each participant who completed a baseline food frequency questionnaire. The reporting population was divided into tertiles based on their MDS. A higher MDS reflects greater adherence to the Mediterranean dietary pattern.
The study had a median follow-up of 36 months. During the study period, seventy-six (76) men (18.5%) had their prostate cancer progress.
The study showed that individuals with the highest MDS had a modest grade group progression advantage (less progression) compared to the group of men in the lowest MDS tertile.
The study also showed little difference in the risk of progression over time for men in the middle MDS range.
The authors concluded that higher MDS adherence appeared to be associated with a lower risk of grade progression.
The investigators stated that further work is needed to identify subgroups who may benefit from diet interventions based upon consuming a Mediterranean diet.
The study in which the data were collected was started at MD Anderson Cancer Center in 2005. The study enrolled about 1000 men. The analysis of the association of MDS and prostate cancer progression included only 410 men who had baseline dietary information from the food frequency questionnaire that provided data to determine the MDS.
Gabriel Haas, MD, moderated the virtual session. He commented that he was surprised by study results indicating the benefit of Mediterranean diet adherence in healthier patients or those who did not have diabetes or hypercholesterolemia. —but not in men who had diabetes or who were statin users.
Offering an explanation for the data, Gregg stated the need to be cautious interpreting the diabetic cohort's findings because of its relatively small size. Nevertheless, he suggested that the results are consistent with the idea that a Mediterranean diet can affect prostate cancer progression by lowering systemic inflammation.
"The possibility that someone who has diabetes already has a high level of inflammation that cannot be counterbalanced by the Mediterranean diet may be a hypothesis worth looking at," Gregg said.
Addressing the association with statin use, Gregg said, "The Mediterranean diet may have more potential impact among men who are not taking a medication that affects inflammation."
Reference
1. Gregg JR, Zhang X, Zheng J, et al. Association of Mediterranean diet score and disease progression among localized prostate cancer patients on active surveillance. 2020 European Association of Urology Virtual Congress. July 17-26, 2020. Abstract PT157
