Table 4.
Evidence synthesis of the association between diet and prostate cancer in the EPIC study.
| Wholegrains, Vegetables, and Fruit | |||
|---|---|---|---|
| No. of Cases (Non-Cases) |
Mean Follow-Up (Years) | Results, Relative Risk (95% Confidence Interval (CI)) | Reference |
| 1104 (129,440) | 4.8 | No significant associations between fruit and vegetable consumption and prostate cancer risk were observed (highest vs. lowest quintile): Total fruits: RR 1.06 (0.84–1.34) Total vegetables: RR 1.00 (0.81–1.22) Total fruits and vegetables combined: RR 1.00 (0.79–1.26) |
Key 2004 [111] |
| 2747 (139,843) | 8.7 | Overall, no association between dietary fiber intake (total, cereal, fruit or vegetable fiber) and prostate cancer risk, although calibrated intakes of total fiber and fruit fiber were associated with non-statistically significant reductions in risk (per 10 g/day): IRR 0.91 (0.81–1.02) P trend = 0.12 and IRR 0.95 (0.89–1.00) P trend = 0.06, respectively. | Suzuki 2009 [113] |
| 7036 (135,200) | 13.9 | Total fruit intake (highest vs. lowest quintile): HR 0.91 (0.83–0.99) P trend = 0.01 Citrus fruits intake (highest vs. lowest quintile): HR 0.94 (0.86–1.02) P trend = 0.01 |
Perez-Cornago 2017 [112] |
| Meat, Fish, Dairy Products, and Preservation/Processing of Foods | |||
|
No. of Cases
(Non-Cases) |
Mean Follow-Up (Years) | Results, Relative Risk (95% Confidence Interval (CI)) | Reference |
| 2727 (139,793) | 8.7 | Yoghurt intake was associated with an increased risk (highest vs. lowest quintile): HR 1.17 (1.04–1.31) P trend = 0.02, but there was no evidence of an association with intakes of milk and milk beverages or cheese. Total protein intake was not positively associated with increased risk (highest vs. lowest quintile): HR 1.17 (0.96–1.44) P trend = 0.07. Protein from dairy foods was significantly associated with an increased risk (highest vs. lowest quintile): HR 1.22 (1.07–1.41) P trend = 0.02. Total dietary calcium intake and calcium intake from dairy foods were also associated with an increased risk (highest vs. lowest quintile): HR 1.17 (1.00–1.35) P trend = 0.01 for total dietary calcium, and HR 1.18 (1.03–1.36) P trend = 0.02 for dairy calcium. Calcium intake from nondairy foods was not associated with risk. An increment of 35 g day−1 dairy protein was associated with an HR of 1.32 (1.01–1.72) P trend = 0.04, and increments of 0.3 g day−1 of total calcium and dairy calcium were associated with HR of 1.09 (1.01–1.16) P trend = 0.02, and HR 1.07 (1.00–1.14) P trend = 0.04, respectively. |
Allen, Key 2008 [115] |
| 2727 (139,793) | 8.7 | There were no significant associations between prostate cancer risk and fat from red meat, dairy products, and fish. There was a significant inverse relation between fat from dairy products and risk of localized prostate cancer (each 5% increase in energy from dairy fat): HR 0.92 (0.86–0.99) and HR 0.90 (0.82–0.99), for the observed and calibrated intakes, respectively. There was no significant association between dietary fat (total, saturated, monounsaturated, and polyunsaturated fat and the ratio of polyunsaturated to saturated fat) and risk of prostate cancer: Total fat intake (highest vs. lowest quintile): HR 0.96 (0.84–1.09) P trend = 0.155. There was a significant inverse association between the observed and calibrated intakes of total, monounsaturated, and polyunsaturated fats and the risk of high-grade prostate cancer: For each 10% increase in the observed intake of total fat, the risk of high-grade prostate cancer decreased: HR 0.83 (0.72–0.95). Each 5% increase in monounsaturated and polyunsaturated fat intake was associated with a lower risk of high-grade prostate cancer: HR 0.82 (0.70–0.97) and HR 0.77 (0.62–0.97), respectively. |
Crowe, Key 2008 [114] |
| 861 (25,639) | NR | There was no significant joint effect of red and processed meat intake and genotype polymorphism on the risks for prostate cancer. | Loh 2010 [53] |
| Dietary Patterns | |||
|
No. of Cases
(Non-Cases) |
Mean Follow-Up (Years) | Results, Relative Risk (95% Confidence Interval (CI)) | Reference |
| 6745 (421,701) | 15.3 | A higher FSAm-NPS DI score (lower nutritional quality diet) score was associated with a borderline significant higher risk of prostate cancer (highest vs. lowest quintile): HR 1.07 (0.98–1.17) P trend = 0.04 | Deschasaux 2018 [36] |
| Alcoholic and Non-Alcoholic Drinks | |||
|
No. of Cases
(Non-Cases) |
Mean Follow-Up (Years) | Results, Relative Risk (95% Confidence Interval (CI)) | Reference |
| 630 (NR) | 3.4 | Insulin-like growth factor I serum concentration (highest vs. lowest third): OR 1.39 (1.02–0.89) | Allen 2007 [122] |
| 2655 (139,952) | 8.7 | Neither alcohol consumption at baseline nor average lifetime alcohol consumption was significantly associated with risk for prostate cancer: Alcohol intake: RR 0.88 (0.72–1.08) highest intake (≥60 g per day) vs. lowest (0.1–4.9 g/d) Average lifetime alcohol intake: RR 1.09 (0.86–1.39) |
Rohrmann 2008 [116] |
| 861 (25,639) | NR | A higher prostate cancer risk was seen with higher alcohol intake among the MGMTIle143Val polymorphism with the variant genotype compared to the MGMTIle143Val polymorphism with the common genotype with lower alcohol intake: OR 2.08 (1.21–3.57) P interaction = 0.0009 | Loh 2010 [53] |
| NR (521,330) | 16.4 | Total, sugar-sweetened, and artificially sweetened soft drink consumption was not associated with risk of death from prostate cancer. | Mullee 2019 [44] |
| 7036 (135,160) | 14.0 | No evidence of association for consumption of total, caffeinated or decaffeinated coffee or tea and risk of total prostate cancer or cancer by stage, grade or fatality (highest vs. lowest consumers): Coffee intake for total prostate cancer: HR 1.02 (0.94–1.09) Tea intake for total prostate cancer: HR 0.98 (0.90–1.07) Coffee intake for total fatal prostate cancer: HR 0.97 (0.79–1.21) Tea intake for total fatal prostate cancer: HR 0.89 (0.70–1.13) |
Sen 2019 [117] |
| Other Dietary Exposures | |||
|
No. of Cases
(Non-Cases) |
Mean Follow-Up (Years) | Results, Relative Risk (95% Confidence Interval (CI)) | Reference |
| 966 (136,035) | 6.0 | None of the micronutrients examined were significantly associated with prostate cancer risk. The risk of advanced disease (highest vs. lowest quintile of plasma concentrations): IRR 0.40 (0.19–0.88) for lycopene and IRR 0.35 (0.17–0.78) for the sum of carotenoids. | Key 2007 [123] |
| 959 (149,041) | 11.0 | Plasma selenium concentration was not associated with prostate cancer risk (highest vs. lowest quintile): RR 0.96 (0.70–1.31) P trend = 0.25 | Allen, Naomi 2008 [124] |
| 962 (152,495) | 4.2 | An inverse association between palmitic acid and the risk of total, localized, and low-grade prostate cancer (highest vs. lowest quintile): RR 1.47 (0.97–2.23) P trend = 0.032, RR 1.90 (1.03–3.49) P trend = 0.013, and RR 1.93 (1.02–3.64) P trend = 0.045, respectively. An inverse association between stearic acid and the risk of total and localized prostate cancer (highest vs. lowest quintile): RR 0.77 (0.56–1.06) P trend = 0.03, and RR 0.60 (0.38–0.94) P trend = 0.014, respectively. Significant positive associations between myristic, α-linolenic and eicosapentaenoic acids and risk of high-grade prostate cancer: RR 1.79 (0.80–3.98), 1.79 (0.91–3.53), and 2.00 (1.07–3.76), respectively. |
Crowe, Allen 2008 [125] |
| 268 (11,660) | 8.6 | Total menaquinone intake (highest vs. lowest quartile): HR 0.65 (0.39–1.06) Total menaquinone intake for advanced prostate cancer: HR 0.37 (0.16–0.88) P trend = 0.03 Phylloquinone intake (highest vs. lowest quartile): HR 1.02 (0.70–1.48) |
Nimptsch 2008 [118] |
| 250 (11,678) | 8.0 | Serum ucOC/iOC ratio in advanced-stage prostate cancer (per 0.1 increment): OR 1.38 (1.03–1.86) Serum ucOC/iOC ratio in high-grade prostate cancer (per 0.1 increment): OR 1.21 (1.00–1.46) |
Nimptsch 2009 [119] |
| 652 (152,805) | 4.1 | No significant association between 25-hydroxyvitamin D and risk of prostate cancer (highest vs. lowest quintile): OR 1.28 (0.88–1.88) P trend = 0.188 | Travis, Crowe 2009 [126] |
| 950 (136,050) | 4.2 | Plasma concentrations of phyto-oestrogen genistein (highest vs. lowest quintile): RR 0.74 (0.54–1.00) P trend = 0.05 | Travis, Spencer 2009 [127] |
| 180 (22,585) | 10.2 | Dietary intake of menaquinone (highest vs. lowest quintile): HR 0.65 (0.44–0.97) P trend = 0.03 | Nimptsch 2010 [108] |
| 566 (152,834) | 4.8 | Plasma phytanic acid concentration: OR 1.27 (1.01–1.60) P trend = 0.04 | Price 2010 [121] |
| 248 (11,680) | NR | Glucosinolate intake (per 10 mg/d increment): OR 0.72 (0.53–0.96) | Steinbrecher 2010 [128] |
| 204 (812) | 9 | Total enterolignans intake: OR 1.19 (0.77–1.82) P trend = 0.44 | Ward 2010 [59] |
| 962 (152,495) | NR | A high score on a factor reflecting a long-chain n23 PUFA pattern (fatty acids) was associated with greater risk of prostate cancer (highest vs. lowest quintile): OR 1.36 (0.99–1.86) P trend = 0.041 | Dahm 2012 [129] |
| 4606 (134,399) | 10.0 | Prostate cancer risk was not associated with intake of nitrosamines (highest vs. lowest quintile): HR 0.91 (0.81- 1.03) for endogenous Nitrosocompounds, and HR 1.04 (0.95–1.18) for N-Nitrosodimethlyamine. There was also no association with heme iron (highest vs. lowest quintile): HR 1.00 (0.88–1.39). | Jakszyn 2012 [130] |
| 5916 (117,082) | 14.0 | Dry cakes/biscuits and butter intakes for low-grade prostate cancer: HR 1.07 (1.03–1.11) P = 0.01 Dry cakes/biscuits and butter intakes for aggressive prostate cancer: HR 1.08 (1.04–1.13) P = 0.02 |
Papadimitriou 2020 [131] |
|
7036 (135,203) |
13.9 | Butyric acid intake calibrated for advanced stage prostate cancer (for 1 SD increase): HR 1.08 (1.01–1.15) P trend = 0.026 Eicosenoic acid intake calibrated for fatal prostate cancer (for 1 SD increase): HR 1.05 (1.00–1.11) P trend = 0.048 Eicosapentaenoic acid intake calibrated for fatal prostate cancer (for 1 SD increase): HR 1.07 (1.00–1.14) P trend = 0.045 |
Perez-Cornago 2020 [120] |
HR: hazard ratio; IRR: incidence rate ratio; NR: not reported; OR: odds ratio; RR: risk ratio.