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J Urol. 2018 Feb;199(2):430-437. doi: 10.1016/j.juro.2017.08.087. Epub 2017 Aug 23.

Mediterranean Dietary Pattern is Associated with Low Risk of Aggressive Prostate Cancer: MCC-Spain Study.

Author information

1
Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health, Instituto de Salud Carlos III, Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain. Electronic address: acastello@isciii.es.
2
Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health, Instituto de Salud Carlos III, Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain.
3
Consortium for Biomedical Research in Epidemiology and Public Health, Instituto de Salud Carlos III, Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Public Health Division of Gipuzkoa, BioDonostia Research Health Institute, San Sebastian, Spain.
4
ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona, Spain; Medical Research Institute, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain.
5
Universidad de Cantabria-IDIVAL, Santander, Spain.
6
Consortium for Biomedical Research in Epidemiology and Public Health, Instituto de Salud Carlos III, Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana FISABIO-Salud Pública, Valencia, Spain.
7
Consortium for Biomedical Research in Epidemiology and Public Health, Instituto de Salud Carlos III, Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Instituto de Investigación Biosanitaria de Granada and Department of Preventive Medicine and Public Health, School of Medicine. University of Granada, Granada, Spain.
8
Centro de Investigación en Salud y Medio Ambiente. Universidad de Huelva, Huelva, Spain.
9
Consortium for Biomedical Research in Epidemiology and Public Health, Instituto de Salud Carlos III, Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Facultad de Medicina, Instituto Universitario de Oncología, Universidad de Oviedo, Oviedo, Spain.
10
Urology Department, Hospital del Mar, Barcelona, Spain.
11
Laboratory and Department of Urology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain; Centre de Recerca Biomèdica CELLEX, Barcelona, Spain.

Abstract

PURPOSE:

We explored the association of the previously described Western, prudent and Mediterranean dietary patterns with prostate cancer risk by tumor aggressiveness and extension.

MATERIALS AND METHODS:

MCC-Spain (Multicase-Control Study on Common Tumors in Spain) is a population based, multicase-control study that was done in 7 Spanish provinces between September 2008 and December 2013. It collected anthropometric, epidemiological and dietary information on 754 histologically confirmed incident cases of prostate cancer and 1,277 controls 38 to 85 years old. Three previously identified dietary patterns, including Western, prudent and Mediterranean, were reconstructed using MCC-Spain data. The association of each pattern with prostate cancer risk was assessed by logistic regression models with random, province specific intercepts. Risk according to tumor aggressiveness (Gleason score 6 vs greater than 6) and extension (cT1-cT2a vs cT2b-cT4) was evaluated by multinomial regression models.

RESULTS:

High adherence to a Mediterranean dietary pattern rich not only in fruits and vegetables but also in fish, legumes and olive oil was specifically associated with a lower risk of Gleason score greater than 6 prostate cancer (quartile 3 vs 1 relative RR 0.66, 95% CI 0.46-0.96 and quartile 4 vs 1 relative RR 0.68, 95% CI 0.46-1.01, p-trend = 0.023) or with higher clinical stage (cT2b-T4 quartile 4 vs 1 relative RR 0.49, 95% CI 0.25-0.96, p-trend = 0.024). This association was not observed with the prudent pattern, which combines vegetables and fruits with low fat dairy products, whole grains and juices. The Western pattern did not show any association with prostate cancer risk.

CONCLUSIONS:

Nutritional recommendations for prostate cancer prevention should consider whole dietary patterns instead of individual foods. We found important differences between the Mediterranean dietary pattern, which was associated with a lower risk of aggressive prostate cancer, and Western and prudent dietary patterns, which had no relationship with prostate cancer risk.

KEYWORDS:

Mediterranean; diet; prevention & control; principal component analysis; prostatic neoplasms; risk

PMID:
28842246
DOI:
10.1016/j.juro.2017.08.087
[Indexed for MEDLINE]

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