Prostate Cancer Diet
Diet is perhaps the most important factor that can be controlled by an individual. Increasing attention is being devoted to understanding the role of diet and nutrition in relation to the development and progression of prostate cancer.
Obesity and Dietary Fat
Many studies have shown that obese men have a greater risk of dying from prostate cancer, developing a more aggressive cancer, and experiencing disease recurrence after surgery or radiation therapy. The Cancer Prevention Study demonstrated that men with a body mass index (BMI) of greater than 32.5 kg/m2 were 35% more likely to die of prostate cancer than men whose BMI was less than 25. Interestingly, many studies of survival rates after prostate cancer treatment have found that most patients die from causes other than prostate cancer, most commonly cardiovascular disease. This would suggest that dietary measures to reduce obesity and thus cardiovascular disease would also help to maximize the benefit from undergoing prostate cancer treatment.
Per-capita fat consumption is highest in North American and Western European men; rates of prostate-cancer deaths are also highest in these groups. Conversely, countries in the Pacific Rim have the lowest death rates and the lowest fat consumption. Interestingly, with the introduction of a more “Western” diet in Japan, where the traditional diet is low in fat, there has been an increase in the incidence of aggressive prostate cancer. Whittemore et al studied the relationship of diet, physical activity, and body size in black, white, and Asian men living in North America. The only factor that correlated with prostate cancer was the amount of dietary fat. In another study by Giovannucci et al, it was found that men who consumed high levels of fat were more likely not only to develop prostate cancer but also to develop a more aggressive form of the disease.
Dietary Nutrients and Supplements
There are a variety of dietary nutrients and supplements that may reduce the risk of developing prostate cancer. They are readily available in foods and are generally thought to be better if ingested as food rather than as an artificial supplement
Carotenoids are micronutrient antioxidants found in orange or yellow fruits and vegetables. The most common dietary carotenoids include beta-carotene, alpha-carotene, beta-cryptoxanthin, lutein, zeaxanthin, and lycopene. Lycopene is the most efficient antioxidant in this group and is the predominant carotenoid in the plasma and in various tissues, including the prostate. It is found in watermelon, tomato, and all tomato-based products, pink grapefruit, apricots, papaya, guava and persimmons. Carrots contain high levels of carotene, but contain little lycopene. Some studies have shown a decreased risk of developing advanced prostate cancer with a high intake of tomato products (> 10 serving per week). Cooked tomato products seem to have a greater effect than raw tomato products.
Broccoli, cauliflower, Brussel sprouts, bok choy, cabbage and kale contain high levels of sulforaphane and indole-3 carbinol, which possess anticarcinogenic properties. These nutrients can induce the production of antioxidant enzymes that can protect cells from oxidative damage. They have also been shown to induce apoptosis in damaged cells as well as exhibiting antiproliferative and antimetastatic properties.
Vitamins and minerals
Some early studies suggested a benefit to Vitamin E, is a lipid-soluble antioxidant, and Selenium, is a trace element that is a component of multiple antioxidant enzymes in the prevention of prostate cancer. The SELECT trial, was a large randomized placebo-controlled trial involving over 35,000 men in which subjects were given high dose vitamin E and/or selenium to study the effects of these supplements on the risk of developing of prostate cancer. Recently reported results of this trial showed no beneficial effect of either vitamin E or selenium and in fact, in certain subgroups of patients, there was an increased risk of developing prostate cancer. Vitamin D deficiency has also been correlated with increased risk of cancer incidence and mortality. The major and most important source of vitamin D is sunlight but is also contained in dairy products, eggs, vitamin D–fortified cereals, and fatty fish such as salmon and tuna. Many men are vitamin D deficient, and this substance can readily be measured in the serum.
Soy is a rich source for the isoflavones genistein, daidzein, and equol, which have been shown to affect cell-growth pathways and angiogenesis. Isoflavones have also been shown to affect the production and metabolism of androgen and estrogens, which play an important role in the development and progression of prostate cancer. The traditional Western diet entails minimal soy consumption, and few epidemiologic studies that provide useful recommendations have been performed as a result. Isoflavones studied in animal studies indicate a beneficial effect in the prevention and reduction in the growth rate of prostate cancer.
Polyphenols are found in varying amounts in most fruits and vegetables, as well as green tea and red wine. These agents act via antioxidant, antiproliferative, and antiangiogenesis pathways. Some of the more popular polyphenols have been the catechins in green tea, which have been shown to inhibit cancer-cell growth in both animal and epidemiologic studies.
Prostate Cancer and Diet Summary
Although diet and nutrition appear to play a role in the development of prostate cancer, no specific diet has been shown to prevent or alter the growth of an existing cancer. Most recommendations for a prostate healthy diet, however, are very similar to a heart healthy diet and would be beneficial to most men. Although there are many supplements that are pharmacologically or synthetically produced containing the above mentioned micronutrients, consumption in their naturally occurring state in food is likely to be of greatest benefit. You should discuss your diet and any supplements you are taking with your doctors before, during and after any treatment for your prostate cancer.
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