Key
Takeaways
-
In
a
cohort
study
of
men
with
nonmetastatic
prostate
cancer,
the
highest
level
of
post-diagnosis
saturated
fat
consumption
was
associated
with
greater
all-cause
mortality
compared
with
the
lowest
level. -
This
increased
risk
of
all-cause
mortality
was
likely
due
to
deaths
from
cardiovascular
disease. -
There
was
no
association
between
consumption
of
dietary
fats
and
prostate
cancer
mortality.
Regularly
eating
certain
dietary
fats,
including
animal
fats,
was
associated
with
greater
all-cause
mortality
in
men
with
nonmetastatic
prostate
cancer,
a
cohort
study
suggested.
Among
nearly
4,900
men,
the
highest
level
of
post-diagnosis
saturated
fat
consumption
was
associated
with
greater
all-cause
mortality
compared
with
the
lowest
level
(HR
1.24,
95%
CI
1.05-1.47),
reported
Lorelei
Mucci,
ScD,
MPH,
of
the
Harvard
T.H.
Chan
School
of
Public
Health
in
Boston,
and
colleagues.
As
might
be
expected,
death
from
cardiovascular
disease
was
a
likely
reason
for
the
increase
in
all-cause
mortality
(HR
1.42,
95%
CI
1.02-1.98),
they
noted
in
JAMA
Network
Open.
In
addition,
animal
fat,
a
major
source
of
saturated
fats,
was
positively
associated
with
deaths
from
other
cancers
(HR
1.49,
95%
CI
1.00-2.21).
Notably,
replacing
10%
of
calories
from
animal
fats
with
plant-based
fat
sources
(HR
0.84,
95%
CI
0.76-0.93)
and
replacing
5%
of
calories
from
saturated
fats
with
monounsaturated
fats
(HR
0.80,
95%
CI
0.70-0.91)
was
associated
with
a
decrease
in
all-cause
mortality.
There
was
no
association
between
consumption
of
dietary
fats
and
prostate
cancer
mortality.
“This
study
coupled
with
prior
epidemiologic
studies
provides
evidence-based
recommendations
for
patients
and
clinicians
around
dietary
fat
consumption
to
improve
survivorship
outcomes
in
the
clinical
setting
of
nonmetastatic
prostate
cancer,”
Mucci
and
colleagues
wrote.
In
an
accompanying
commentary,
David-Dan
Nguyen,
MDCM,
MPH,
of
the
University
of
Toronto,
and
colleagues
noted
that
many
patients
with
prostate
cancer
ask
what
they
can
do
to
improve
their
outcomes.
“This
question
is
particularly
relevant
for
men
with
nonmetastatic
prostate
cancer,
many
of
whom
will
live
for
years
or
decades
after
diagnosis
and
face
substantial
competing
risks
from
cardiovascular
disease
and
other
chronic
conditions,”
they
wrote.
However,
while
clinicians
want
to
offer
practical
guidance,
survivorship
guidelines
—
including
those
related
to
healthy
lifestyle
counseling
—
“are
often
supported
by
limited
evidence
and
remain
inconsistently
implemented,”
Nguyen
and
team
pointed
out.
“Clinicians
should
not
present
dietary
fat
modification
as
a
proven
prostate
cancer-directed
therapy,
but
neither
should
they
ignore
an
important
opportunity
to
promote
health
when
patients
are
motivated
to
act,”
they
noted.
“For
patients,
the
message
can
be
framed
simply:
a
healthier
diet
may
not
treat
prostate
cancer
directly,
but
it
remains
an
important
means
of
caring
for
the
whole
person
living
with
prostate
cancer,”
they
added.
“Among
individuals
with
nonmetastatic
prostate
cancer,
cardiovascular
disease
is
a
leading
and
often
more
common
cause
of
death
than
prostate
cancer
itself.
Therefore,
using
the
period
after
diagnosis
to
improve
diet,
physical
activity,
smoking
status,
and
cardiometabolic
risk
may
provide
substantial
benefits,
even
without
a
demonstrated
effect
on
prostate
cancer-specific
mortality.”
Mucci
and
colleagues
included
4,884
participants
in
the
Health
Professionals
Follow-Up
Study
—
a
cohort
of
more
than
50,000
male
health
professionals
from
across
50
states
ongoing
since
1986
—
with
confirmed
nonmetastatic
prostate
cancer
between
1986
and
January
2019.
They
were
followed
through
December
2022.
Mean
age
at
diagnosis
was
69.5,
97%
were
white,
62%
received
a
diagnosis
of
clinical
stage
T1
disease,
and
10%
had
tumors
with
a
Gleason
score
of
8
to
10.
Median
follow-up
was
12.8
years,
“which
is
key
given
the
long-term
natural
history
of
outcomes
in
nonmetastatic
prostate
cancer,”
the
authors
noted.
Data
on
diet
were
collected
using
validated
semiquantitative
food
frequency
questionnaires
every
4
years.
Participants
with
higher
saturated,
trans,
and
animal
fat
intakes
were
more
likely
to
be
current
smokers
and
have
a
higher
body
mass
index,
lower
physical
activity
levels,
and
diabetes.
During
follow-up,
3,040
patients
died
from
any
cause,
which
included
441
due
to
prostate
cancer,
499
due
to
other
cancers,
and
803
due
to
cardiovascular
disease.
Mucci
and
colleagues
acknowledged
that
their
study
had
limitations,
including
their
inability
to
examine
specific
fatty
acids.
“Given
that
certain
fatty
acids
may
be
more
beneficial
or
harmful,
classifying
them
together
in
groups
may
lead
to
conflicting
results
between
studies
depending
on
the
different
components
of
diets,”
they
wrote.
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