TY - JOUR
T1 - Adherence to the Mediterranean diet and grade group progression in localized prostate cancer
T2 - An active surveillance cohort
AU - Gregg, Justin Robert
AU - Zhang, Xiaotao
AU - Chapin, Brian Francis
AU - Ward, John F
AU - Kim, Jeri
AU - Davis, John W.
AU - Daniel, Carrie R.
N1 - Funding Information:
Justin R. Gregg is funded (in part) by an early career award from the Prostate Cancer Research Program of the US Department of Defense (grant W81XWH‐18‐1‐0173; principal investigator Justin R. Gregg) and by an MD Anderson Cancer Center Specialized Program of Research Excellence career enhancement award from the National Cancer Institute (grant P50 CA140388; principal investigator Christopher J. Logothetis). Xiaotao Zhang is funded (in part) by a research training award from the Cancer Prevention Post‐Graduate Training Program in Integrative Epidemiology of the Cancer Prevention and Research Institute of Texas (grant RP160097; principal investigator Margaret R. Spitz). Carrie R. Daniel is funded (in part) by a National Cancer Institute Cancer Center Support Grant (CCSG 5P30 CA016672‐37) to MD Anderson (principal investigator Peter W. T. Pisters).
Funding Information:
John W. Davis reports grants from Janssen and GenomeDx and personal fees from Intuitive Surgical outside the submitted work. The other authors made no disclosures.
PY - 2021
Y1 - 2021
N2 - BACKGROUND: The Mediterranean diet (MD) may be beneficial for men with localized prostate cancer (PCa) on active surveillance (AS) because of its anti-inflammatory, antilipidemic, and chemopreventive properties. This study prospectively investigated adherence to the MD with Gleason score progression and explored associations by diabetes status, statin use, and other factors. METHODS: Men with newly diagnosed PCa on an AS protocol (n = 410) completed a baseline food frequency questionnaire, and the MD score was calculated across 9 energy-adjusted food groups. Cox proportional hazards models were fit to evaluate multivariable-adjusted associations of the MD score with progression-free survival; progression was defined as an increase in the Gleason grade group (GG) score over a biennial monitoring regimen. RESULTS: In this cohort, 15% of the men were diabetic, 44% of the men used statins, and 76 men progressed (median follow-up, 36 months). After adjustments for clinical factors, higher adherence to the MD was associated with a lower risk of GG progression among all men (hazard ratio [HR] per 1-unit increase in MD score, 0.88; 95% confidence interval [CI], 0.77-1.01), non-White men (HR per 1-unit increase in MD score, 0.64; 95% CI, 0.45-0.92; P for interaction =.07), and men without diabetes (HR per 1-unit increase in MD score, 0.82; 95% CI, 0.71-0.96; P for interaction =.03). When joint effects of the MD score and statin use were examined, a similar risk reduction was observed among men with high MD scores who did not use statins in comparison with men with low/moderate MD scores with no statin use. CONCLUSIONS: The MD is associated with a lower risk of GG progression in men on AS, and this is consistent with prior reports about the MD and reduced cancer morbidity and mortality.
AB - BACKGROUND: The Mediterranean diet (MD) may be beneficial for men with localized prostate cancer (PCa) on active surveillance (AS) because of its anti-inflammatory, antilipidemic, and chemopreventive properties. This study prospectively investigated adherence to the MD with Gleason score progression and explored associations by diabetes status, statin use, and other factors. METHODS: Men with newly diagnosed PCa on an AS protocol (n = 410) completed a baseline food frequency questionnaire, and the MD score was calculated across 9 energy-adjusted food groups. Cox proportional hazards models were fit to evaluate multivariable-adjusted associations of the MD score with progression-free survival; progression was defined as an increase in the Gleason grade group (GG) score over a biennial monitoring regimen. RESULTS: In this cohort, 15% of the men were diabetic, 44% of the men used statins, and 76 men progressed (median follow-up, 36 months). After adjustments for clinical factors, higher adherence to the MD was associated with a lower risk of GG progression among all men (hazard ratio [HR] per 1-unit increase in MD score, 0.88; 95% confidence interval [CI], 0.77-1.01), non-White men (HR per 1-unit increase in MD score, 0.64; 95% CI, 0.45-0.92; P for interaction =.07), and men without diabetes (HR per 1-unit increase in MD score, 0.82; 95% CI, 0.71-0.96; P for interaction =.03). When joint effects of the MD score and statin use were examined, a similar risk reduction was observed among men with high MD scores who did not use statins in comparison with men with low/moderate MD scores with no statin use. CONCLUSIONS: The MD is associated with a lower risk of GG progression in men on AS, and this is consistent with prior reports about the MD and reduced cancer morbidity and mortality.
KW - Mediterranean diet score
KW - progression
KW - prostatic neoplasms
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U2 - 10.1002/cncr.33182
DO - 10.1002/cncr.33182
M3 - Article
AN - SCOPUS:85099032277
JO - Cancer
JF - Cancer
SN - 0008-543X
ER -