Table 2.
Prospective cohort studies (n = 23) published between 2015 and November 2021 that investigated the associations between plant-based diets and their selected key components and cancer prognosis according to cancer sites
| Reference, region, cohort | Population | Time since cancer diagnosis | FU | Dietary assessment | N of cases | Adjustments | Exposure(s) | HR (95% CI) for each outcome (highest vs lowest or dose response) | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Breast cancer (n = 11) | |||||||||||||||||||||||||||
|
Andersen et al. [23] Denmark, The Danish Diet, Cancer and Health (DCH) cohort |
977 post-menopausal women, mean age at diagnosis: 66 y | n.a | 7 y | Semi-quantitative FFQ | 175 deaths, 121 due to BC, 152 recs | Pre-diagnostic intake of the variable of interest, Age and year at diagnosis, time since diagnosis, alcohol intake, smoking, physical activity, BMI, educational level, tumor size, nodal status, ER status, post-diagnostic diet | Intake of WG per serving/d | Rec | BC-M | AC-M | |||||||||||||||||
| Rye bread/50 g |
1.16 (0.84–1.56) |
1.25 (0.96–1.62) |
1.15 (0.92–1.43) |
||||||||||||||||||||||||
| WG bread/40 g |
0.82 (0.65–1.05) |
1.02 (0.84–1.24) |
0.95 (0.80–1.12) |
||||||||||||||||||||||||
| Oatmeal/muesli/50 g |
0.94 (0.68–1.42) |
0.88 (0.60–1.30) |
0.88 (0.63–1.22) |
||||||||||||||||||||||||
| Total WG (∑)/50 g |
0.94 (0.79–1.13) |
1.06 (0.91–1.23) |
1.00 (0.88–1.14) |
||||||||||||||||||||||||
|
Anyene et al. [11••] USA, the Pathways Study |
3646 women with BC (stages 1–4), 71% post-menopausal mean age at diagnosis: 60 y | 2.3 m | 9.5 y for death, 9.2 y for rec | Semi-quantitative FFQ (at 6-, 24-, and 72-m FU) | 461 recs, 653 deaths, 323 due to BC, 330 non-BC deaths | Age at diagnosis, total energy intake, physical activity, race/ethnicity, education, menopausal status, smoking status | 3 plant-based indices | Rec | AC-M | BC-M | Non-BC-M | ||||||||||||||||
|
PDI (per 10-point increase) |
1.17 (0.98–1.39) |
0.96 (0.82–1.11) |
0.98 (0.79–1.22) |
0.90 (0.73–1.11) |
|||||||||||||||||||||||
|
hPDI (per 10-point increase) |
1.11 (0.97–1.26) |
0.93 (0.83–1.05) |
1.07 (0.91–1.25) |
0.83 (0.71–0.98) |
|||||||||||||||||||||||
|
uPDI (per 10-point increase) |
0.90 (0.79–1.03) |
1.07 (0.96–1.20) |
0.94 (0.80–1.10) |
1.20 (1.02–1.41) | |||||||||||||||||||||||
|
Farvid et al. [24] USA, Nurses’ Health Study (NHS) and NHS II |
8932 women with invasive BC, stages I–III, 99% post-menopausal | At least 12 m | 11.5 y | Validated, semi-quantitative FFQ, every 4 y after diagnosis | 2532 deaths, 1017 due to BC | Age and calendar year at diagnosis, time between diagnosis and first FFQ, pre-diagnostic BMI, BMI change after diagnosis, smoking, physical activity, oral contraceptive use, alcohol consumption, total energy intake, pre-diagnostic menopausal status, age at menopause, post-menopausal hormone use, aspirin use, race, stage of disease, ER-, PR-status, radiotherapy, chemotherapy |
Carbohydrate intake from… (Q5 vs. Q1) |
BC-M | AC-M | ||||||||||||||||||
| Fruit | 1.02 (0.83–1.25) | 0.97 (0.85–1.11) | |||||||||||||||||||||||||
| Fruit juice | 1.24 (1.02–1.50) | 1.15 (1.01–1.30) | |||||||||||||||||||||||||
| Vegetables | 0.84 (0.69–1.02) | 0.86 (0.75–0.97) | |||||||||||||||||||||||||
| Whole grains | 1.12 (0.91–1.37) | 0.92 (0.80–1.05) | |||||||||||||||||||||||||
| Refined grains | 0.96 (0.79–1.18) | 1.16 (1.02–1.32) | |||||||||||||||||||||||||
| Legumes | 1.12 (0.92–1.36) | 0.99 (0.88–1.13) | |||||||||||||||||||||||||
| Potatoes | 1.25 (1.02–1.52) | 1.13 (0.99–1.28) | |||||||||||||||||||||||||
|
Farvid et al. [13•] USA, Nurses’ Health Study (NHS) and NHS II |
8927 women with invasive BC, stages I–III, 99% post-menopausal | At least 12 m | 11.5 y | Validated, semi-quantitative FFQ, every 4 y after diagnosis | 2521 deaths, 1070 due to BC | Age and calendar year at diagnosis, time between diagnosis and first FFQ, pre-diagnostic BMI, BMI change after diagnosis, smoking, physical activity, oral contraceptive use, alcohol consumption, total energy intake, pre-diagnostic menopausal status, age at menopause, post-menopausal hormone use, aspirin use, race, stage of disease, ER-, PR- status, radiotherapy, chemotherapy, | Fruit and vegetable intake | BC-M | AC-M | ||||||||||||||||||
|
Total fruits + vegetables Q5 vs. Q1 Per 2 servings/d |
0.88 (0.71–1.09) 0.98 (0.90–1.06) |
0.82 (0.71–0.94) 0.93 (0.88–0.98) |
|||||||||||||||||||||||||
|
Total fruits Q5 vs. Q1 Per 2 servings/d |
1.03 (0.83–1.26) 1.01 (0.85–1.19) |
0.93 (0.81–1.07) 0.93 (0.83–1.03) |
|||||||||||||||||||||||||
|
Total vegetables Q5 vs. Q1 Per 2 servings/d |
0.87 (0.70–1.08) 0.94 (0.84–1.05) |
0.84 (0.72–0.97) 0.89 (0.82–0.95) |
|||||||||||||||||||||||||
|
Fruit juices Q5 vs. Q1 |
1.33 (1.09–1.63) | 1.19 (1.04–1.36) | |||||||||||||||||||||||||
|
Cruciferous vegetables Q5 vs. Q1 |
1.02 (0.83–1.24) | 0.87 (0.76–0.99) | |||||||||||||||||||||||||
|
Vegetables high in β-carotene Q5 vs. Q1 |
0.90 (0.73–1.10) | 0.80 (0.70–0.91) | |||||||||||||||||||||||||
|
Vegetables high in α-carotene Q5 vs. Q1 |
1.14 (0.93–1.40) | 1.01 (0.89–1.16) | |||||||||||||||||||||||||
|
Ho et al.[ [25•] China, The Hong Kong Breast Cancer Survival Study (HKBCSS) |
1460 women with invasive BC, stages I–III, mean age at diagnosis: 52 y, 48% post-menopausal | 3 m and 21 m | 71 m | Validated semi-quantitative FFQ with a validated 29-item soy FFQ at baseline and at 18-month FU | 71 deaths, 64 due to BC, 137 recs |
Age, educational level, menopausal status, cancer stage, comorbidity, ER-status, PR-status, hormonal therapy, radio therapy * + HER2 status ** age, educational level, menopausal status, cancer stage, ER status, PR status, hormonal therapy |
Soy isoflavone intakea (mg/1000 kcal) |
AC-M | BC-M* | Rec** | |||||||||||||||||
|
Q2 vs. Q1 Q3 vs. Q1 Q4 vs. Q1 |
0.49 (0.25–0.97) 0.44 (0.22–0.89) 1.15 (0.63–2.10) |
0.45 (0.21–0.93) 0.49 (0.23–1.01) 1.24 (0.66–2.32) |
0.60 (0.36–0.99) 0.78 (0.48–1.26) 1.21 (0.76–1.93) |
||||||||||||||||||||||||
|
Holmes et al. [26] USA, Nurses’ Health Study |
6348 women with invasive BC, stages I–III, 99% post-menopausal | At least 12 m | n.a | Validated semi-quantitative FFQ, every 4 y | 1046 distant recs, 1847 deaths, 919 due to BC | Age and calendar year at diagnosis, time since diagnosis, energy intake, BMI, weight change, age at first birth, parity, oral contraceptive use, menopausal status, hormone therapy use, aspirin use, alcohol, smoking, physical activity, tumor stage, treatment, animal protein intake | Vegetable protein intake | Distant Rec | BC-M | AC-M | |||||||||||||||||
| Q5 vs. Q1 |
1.20 (0.97–1.49) |
1.09 (0.87–1.37) |
0.97 (0.83–1.14) |
||||||||||||||||||||||||
|
Jaskulski et al. [27•] Germany, Mamma Carcinoma Risk factor Investigation (MARIE) study |
1686 post-menopausal women with invasive BC (non-metastatic) or in situ carcinoma, median age at diagnosis: 63 y, mean age at dietary assessment: 69 y | 6.4 y | 5.5 y | Blood draw, phyto-estrogen metabolite conc. measured UPLC-MS/MS according to a validated method | 142 deaths, 73 due to BC, 93 recs | Age at diagnosis, time between blood draw at baseline and at FU1, study centre, tumor size, affected lymph nodes, grade, ER- and PR-status, mode of detection, recs between diagnosis and blood draw | 8 circulating phytoestrogen metabolites (Cont. b) | AC-M | BC-M | Rec | |||||||||||||||||
| Enterolactone |
0.98 (0.86–1.11) |
1.05 (0.87–1.26) |
1.14 (0.98–1.33) |
||||||||||||||||||||||||
| Genistein |
0.94 (0.83–1.08) |
0.93 (0.77–1.13) |
1.17 (1.01–1.36) |
||||||||||||||||||||||||
| Daidzein |
1.00 (0.90–1.12) |
1.00 (0.85–1.18) |
1.02 (0.88–1.17) |
||||||||||||||||||||||||
| Formonetin |
1.09 (0.90–1.32) |
1.17 (0.90–1.51) |
0.86 (0.64–1.15) |
||||||||||||||||||||||||
| Naringenin |
0.99 (0.87–1.13) |
0.99 (0.81–1.22) |
1.08 (0.94–1.25) |
||||||||||||||||||||||||
| Resveratrol |
1.10 (0.96–1.27) |
1.09 (0.89–1.33) |
1.19 (1.02–1.40) |
||||||||||||||||||||||||
| Kaempferol |
0.91 (0.68–1.21) |
0.78 (0.51–1.19) |
0.77 (0.55–1.09) |
||||||||||||||||||||||||
| Luteolin |
1.18 (0.77–1.80) |
1.96 (1.07–3.58) |
1.20 (0.68–2.12) |
||||||||||||||||||||||||
|
Mc Cullough et al. [28] USA, Cancer Prevention Study II (CPS II) Nutrition Cohort |
2152 women with BC (stages I–III), mean age at diagnosis: 71 y | 3.3 y | 9.9 y | 152-item Harvard FFQ, post-diagnostic diet was evaluated based on the first FFQ at least 1 y after diagnosis | 640 deaths, 192 due to BC, 129 due to CVD, 319 due to other causes | Age at diagnosis, diagnosis year, tumor stage and grade, ER and PR status, treatment, BMI, smoking status, physical activity, energy intake, other dietary factors | Adherence to dietary ACS recommends for cancer prevention | BC-M | CVD-M | OC-M | AC-M | ||||||||||||||||
| Fruit and vegetable intake score (Q4 vs. Q1) | 1.31 (0.83–2.06) |
0.80 (0.45–1.44) |
0.93 (0.65–1.34) |
1.03 (0.80–1.33) |
|||||||||||||||||||||||
| % WG from total grains (Q4 vs. Q1) |
1.24 (0.81–1.88) |
1.43 (0.82–2.50) |
0.91 (0.64–1.29) |
1.09 (0.86–1.38) |
|||||||||||||||||||||||
|
McEligot et al. [29] USA, Cancer Surveillance Program of Orange Country (CSPOC) |
471 post-menopausal women with primary BC (stages 0–IV) 15% in situ, 1% metastatic, mean age at diagnosis: 64 y | 1.2 y | 6.7 y | Blood draw, folate conc. measured by isotope-dilution LC–MS/MS | 85 deaths | Cancer stage, age at diagnosis, BMI, parity, HRT use, treatment, alcohol intake, folic acid supplement use, energy intake | Plasma total folate conc | OS | |||||||||||||||||||
| Q4 vs. Q1 | 0.41 (0.19–0.90) | ||||||||||||||||||||||||||
|
Wang et al. [30•] China, Shanghai Breast Cancer Survival Study (SBCSS) |
3449 long-term BC survivors, stages I–IV, mean age at diagnosis: 55 y |
5 y | 8.3 y | Validated, semi-quantitative FFQ | 374 deaths, 209 DFS events | Age at diagnosis, total energy intake, income, education, TNM stage, ER and PR status, menopause age, physical activity, Chinese Food Pagoda 2007 score, soy food intake, BMI and weight change during first 5-year FU | Nut intake | OS | DFS | ||||||||||||||||||
|
< Median ≥ Median (vs. non-consumer) |
1.00 (0.73–1.38) 0.74 (0.52–1.05) |
0.55 (0.37–0.81) 0.48 (0.31–0.73) |
|||||||||||||||||||||||||
|
Peanuts Walnuts Other nuts |
0.85 (0.63–1.20) 0.82 (0.59–1.13) 0.82 (0.59–1.14) |
0.50 (0.34–0.74) 0.46 (0.31–0.69) 0.51 (0.34–0.76) |
|||||||||||||||||||||||||
|
Zhang et al. [31] North America, The Breast Cancer Family Registry (BCFR) |
1466 women with invasive BC, 51% postmenopausal at enrolment, mean age 52 y | Within 5 y post-diagnosis | 9.4 y | Validated, semi-quantitative FFQ | 261 deaths | Age, study site, total caloric intake, race/ethnicity, education, total fiber intake, Healthy Eating Index, treatment, recreational physical activity, BMI, alcohol intake, smoking status | Total isoflavone intake (mg/d) | AC-M | |||||||||||||||||||
| Q4 vs. Q1 | 0.65 (0.41–1.00) | ||||||||||||||||||||||||||
| Colorectal cancer (n = 8) | |||||||||||||||||||||||||||
|
Brown et al. [12•] North America, Cancer and Leukemia Group B (CALGB) now Alliance for Clinical Trials in Oncology 89803 |
1024 patients with colon cancer stage III enrolled in a RCT of post-operative chemo-therapy, 56% male, median age: 60 y | 4 m (midway through adjuvant treatment) and 14 m after surgery (6 m after treatment end) | 7.3 y | Validated, semi-quantitative FFQ | 394 DFS events, 350 RFS events, 311 OS events | Age, sex, race, performance status, T stage, positive lymph nodes, location of primary tumor, treatment arm, time-varying body mass index, physical activity, total energy, and mutual adjustment for whole grain and refined grain intake | Grain intake (servings/day) | DFS | RFS | OS | |||||||||||||||||
| Refined grain (≥ 3 vs. < 1) |
1.56 (1.09–2.24) |
1.57 (1.08–2.30) |
1.88 (1.25–2.85) |
||||||||||||||||||||||||
| Whole grain (≥ 3 vs. < 1) |
0.89 (0.66–1.20) |
0.97 (0.71–1.33) |
0.86 (0.62–1.20) |
||||||||||||||||||||||||
| Subst.c |
0.87 (0.79–0.96) |
0.86 (0.77–0.96) |
0.87 (0.78–0.97) |
||||||||||||||||||||||||
|
Fadelu et al. [32] North America, CALGB 89803 (Alliance) |
826 patients with colon cancer stage III enrolled in a RCT of post-operative chemo-therapy, 62% male, median age: 66 y | 14 m after surgery (6 m after treatment end) | 6.5 y | Validated, semi-quantitative FFQ | 238 DFS events, 199 RFS events, 177 OS events | Energy intake, age, sex, depth of invasion through bowel wall, number of positive lymph nodes, baseline performance status, treatment group, BMI, physical activity, aspirin use, glycemic load | Nut intake | DFS | RFS | OS | |||||||||||||||||
|
Total nut intake (≥ 2/week vs. never) |
0.58 (0.37–0.92) |
0.70 (0.42–1.16) |
0.43 (0.25–0.74) |
||||||||||||||||||||||||
|
Tree nuts (≥ 1/week vs. never) |
0.54 (0.34–0.85) |
0.56 (0.33–0.94) |
0.47 (0.27–0.82) |
||||||||||||||||||||||||
|
Peanuts (≥ 1/week vs. never) |
0.81 (0.53–1.23) |
0.97 (0.61–1.53) |
0.60 (0.37–0.98) |
||||||||||||||||||||||||
|
Jiang et al. [33] Germany, Darmkrebs: Chancen der Verhütung durch Screening (DACHS) |
2051 participants with invasive CRC, stages I–III, 59% colon cancer cases, 60% male, mean age: 68 y |
79 d (93% after surgery) | 5.2 y | Blood draw; Serum flavonoid metabolite levels quantified by UPLC/MS method | 475 deaths, 254 due to CRC, 400 recs | Age, sex, stage, cancer site, BMI, education, physical activity, screening detected tumor, chemotherapy, diabetes, CVD, constipation, interval between surgery and blood draw, interval Between surgery and blood draw | Serum flavonoid conc | OM | CRC-M | Rec | |||||||||||||||||
|
Genistein Q4 vs. Q1 linear |
1.00 (0.77–1.30) 1.03 (0.90–1.19) |
0.83 (0.58–1.19) 0.96 (0.80–1.15) |
0.98 (0.72–1.34) 1.05 (0.89–1.25) |
||||||||||||||||||||||||
|
Luteolin Q4 vs. Q1 linear |
1.19 (0.92–1.53) 1.12 (0.89–1.40) |
1.05 (0.74–1.47) 0.96 (0.70–1.32) |
1.02 (0.76–1.36) 0.99 (0.75–1.30) |
||||||||||||||||||||||||
|
Lochhead et al. [34] USA, Nurses’ Health Study (NHS) and Health Professionals Follow-up Study (HPFS) |
1550 participants with CRC, 69% women, 31% men, stage I-III, 64% with colon cancer, 20% with rectal cancer, 16% unknown location, mean age: 66 y | 29.5 m | 14.9 y | Validated, semi-quantitative FFQ (returned between 1 and 4 y after diagnosis) | 641 deaths, 176 due to CRC | one-carbon nutrient intakes, pre-diagnostic folate intake, age and year, BMI, family history of CRC, aspirin use, multivitamin use, smoking status, alcohol consumption, physical activity, tumor location and differentiation, time from diagnosis to questionnaire return |
Folate intake (Q5 vs. Q1) |
OM | CRC-M | ||||||||||||||||||
| Total folate | 1.04 (0.60–1.82) | 0.87 (0.65–1.16) | |||||||||||||||||||||||||
| Food folate | 0.99 (0.63–1.54) | 1.08 (0.84–1.38) | |||||||||||||||||||||||||
|
Ratjen et al. [14••] Germany, biobank popgen |
1404 long-term CRC survivors (stages I–IV), 56% male, 47% with colon cancer, 42% with rectal cancer, 6% with unknown location, 17% with metastases, median age at diagnosis: 62 y | 6 y | 7 y | Validated, semi-quantitative FFQ | 204 deaths | Sex, age at diet assessment, BMI, physical activity, survival time from CRC diagnosis until diet assessment, tumor location, metastases, other cancer, type of therapy, smoking status, alcohol intake, total energy intake, time x age, time x BMI, time x metastases | 3 plant-based indices (PDI) | AC-M | |||||||||||||||||||
| PDI Q4 vs. Q1 per 10-point increase |
0.46 (0.29–0.75) 0.72 (0.57–0.91) |
||||||||||||||||||||||||||
| hPDI Q4 vs. Q1 per 10-point increase |
0.76 (0.51–1.14) 0.82 (0.67–1.01) |
||||||||||||||||||||||||||
| uPDI Q4 vs. Q1 per 10-point increase |
1.29 (0.84–1.98) 1.19 (0.96–1.48) |
||||||||||||||||||||||||||
| Healthy plant food groups (Q5 vs. Q1) | AC-M | ||||||||||||||||||||||||||
| Whole grains | 0.68 (0.44–1.06) | ||||||||||||||||||||||||||
| Fruits | 1.12 (0.70–1.81) | ||||||||||||||||||||||||||
| Vegetables | 0.78 (0.49–1.24) | ||||||||||||||||||||||||||
| Nuts | 0.48 (0.31–0.75) | ||||||||||||||||||||||||||
| Legumes | 0.88 (0.53–1.48) | ||||||||||||||||||||||||||
| Vegetable oils | 0.78 (0.50–1.22) | ||||||||||||||||||||||||||
| Less healthy plant food groups (Q5 vs. Q1) | AC-M | ||||||||||||||||||||||||||
| Fruit juices | 0.74 (0.49–1.13) | ||||||||||||||||||||||||||
| Refined grains | 1.24 (0.78–1.97) | ||||||||||||||||||||||||||
| Potatoes | 0.99 (0.63–1.55) | ||||||||||||||||||||||||||
| Sweets and desserts | 0.64 (0.38–1.06) | ||||||||||||||||||||||||||
|
Song et al. [15•] USA, Nurses’ Health Study (NHS) and Health Professionals Follow-up Study (HPFS) |
1575 participants with CRC, stages I–III, 61% women, 39% men, 72% with colon cancer, 22% with rectal cancer, 6% un-specified, median age: 69 y | 2.2 y | 8 y | Validated semi-quantitative FFQ, every 4 y, first FFQ collected at least 6 m but no more than 4 y after diagnosis | 773 deaths, 174 due to CRC |
Age at diagnosis, year of diagnosis, tumor grade, subsite, pre-diagnostic fibre intake, alcohol consumption, pack-years of smoking, BMI, physical activity, regular use of aspirin, glycemic load, consumption of total fat, folate, calcium and vitamin D * mutually adjusted ** + adjusted for fibre intake |
Fibre intake (from different sources*), whole grain intake | CRC-M | AC-M | ||||||||||||||||||
|
Total fibre Q4 vs. Q1 Per 5 g/d |
0.54 (0.35–0.85) 0.78 (0.65–0.93) |
0.64 (0.51–0.80) 0.86 (0.79–0.93) |
|||||||||||||||||||||||||
|
Cereal fibre Q4 vs. Q1 Per 5 g/d |
0.57 (0.38–0.86) 0.67 (0.50–0.90) |
0.69 (0.57–0.84) 0.78 (0.68–0.90) |
|||||||||||||||||||||||||
|
Vegetable fibre Q4 vs. Q1 Per 5 g/d |
0.65 (0.44–0.98) 0.82 (0.60–1.13) |
0.74 (0.61–0.91) 0.83 (0.72–0.96) |
|||||||||||||||||||||||||
|
Fruit fibre Q4 vs. Q1 Per 5 g/d |
0.95 (0.61–1.46) 0.91 (0.64–1.28) |
0.93 (0.76–1.13) 0.92 (0.78–1.08) |
|||||||||||||||||||||||||
|
WG Q4 vs. Q1 Per 5 g/d |
0.50 (0.32–0.77) 0.72 (0.59–0.88) |
0.75 (0.61–0.92) 0.88 (0.80–0.97) |
|||||||||||||||||||||||||
|
WG** Q4 vs. Q1 Per 5 g/d |
0.57 (0.35–0.92) 0.77 (0.62–0.96) |
0.81 (0.65–1.01) 0.91 (0.83–1.01) |
|||||||||||||||||||||||||
|
Van Blarigan et al. [35] North America, CALGB 89803 (Alliance) |
992 patients with colon cancer stage III enrolled in a RCT of post-operative chemo-therapy, 43% female, mean age 60 y | 3 and 15 m (during and 6 m after chemo-therapy) | 7 y | Validated, semi-quantitative FFQ | 299 deaths | Age, sex, energy intake, T-stage, number of positive lymph nodes, baseline performance status, treatment arm, smoking, aspirin use, and other ACS components (BMI, physical activity), other dietary factors, alcohol consumption | ACS dietary guidelines | OS | |||||||||||||||||||
| Fruit and vegetable intake (servings/d) ≥ 5 vs. < 5 | 0.60 (0.38–0.94) | ||||||||||||||||||||||||||
| % WG from total grains (Q4 vs. Q1) | 0.65 (0.45–0.94) | ||||||||||||||||||||||||||
|
Van Blarigan et al. [36] North America, CALGB 89803 (Alliance) |
1011 patients with colon cancer stage III enrolled in a RCT of post-operative chemo-therapy | 3 and 15 m (during and 6 m after chemo-therapy) | 7 y | Validated, semi-quantitative FFQ | 386 DFS events (305 deaths, 81 recs) | Age, sex, energy, T-stage, number of positive lymph nodes, baseline performance status, treatment arm, BMI, physical activity, smoking, aspirin use, intake of protein, alcohol, fats other than the fat of interest |
Vegetable fat intake (g/d) Q4 vs. Q1 |
DFS 1.17 (0.84–1.62) |
|||||||||||||||||||
| Urinary track cancer (n = 4); bladder cancer (n = 1), prostate cancer (n = 3) | |||||||||||||||||||||||||||
|
Jochems et al. [39] England, Bladder Cancer Prognosis Programme (BCPP) |
728 patients (80% male) with NMIBC (stages pTa, pT1, pTis), tumor grade I-III, mean age at diagnosis: 69 y, n = 389 with post-diagnosis dietary intake data | 1 y | 3.7 y | Semi-quantitative FFQ | 144 recs; 221 multiple recs | Age at diagnosis, sex, smoking status, tumor stage, grade, size, and multiplicity; *additionally adjusted for re-resection of a bladder tumor | Fruit and vegetable consumption | Time to first rec | Time to multiple rec* | ||||||||||||||||||
| Total fruit intake (> 1.5 vs. < 1 port./d) |
0.65 (0.44–1.00) |
1.02 (0.82–1.20) |
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| Total vegetable intake (> 2.5 vs. < 1.5 port./d) |
0.77 (0.50–1.18) |
0.96 (0.74–1.09) |
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| Total fruit + vegetable intake (> 4 vs. < 2.5 port./d) |
0.65 (0.42–1.01) |
1.00 (0.85–1.18) |
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|
Van Blarigan et al. [37] USA, Physicians’ Health Study (PHS) |
926 men with non-metastatic PC (stage T1-T3); mean age at diagnosis: 69 y | 5 y | 10 y | Validated FFQ | 333 total deaths, 56 due to PC | Age at diagnosis, energy, time since diagnosis, treatment, modified D’Amico risk category, BMI, smoking status, alcohol intake, protein intake, animal fat and trans-fat intake | Vegetable fat intake (en%) | AC-M | PC-M | ||||||||||||||||||
|
Q4 vs. Q1 Cont.d: CHO Subst.e: animal fat |
0.65 (0.45–0.93) 0.67 (0.47–0.96) 0.56 (0.38–0.80) |
0.93 (0.41–2.14) 0.81 (0.35–1.91) |
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|
Wang et al. [16] USA, Health Professionals Follow-up Study (HPFS) |
4,346 men with non-metastatic PC | n.a | 7.8 y for lethal PC, 10.3 y for fatal PC |
Validated, semiquantitative FFQ, at baseline and every 4 y thereafter |
1285 deaths, 359 lethal3 PC cases, 264 fatal4 PC cases | Age at diagnosis, time period, time since diagnosis to FFQ, energy, BMI, physical activity, smoking status, Gleason score, stage, treatment, * + PSA screening history, family history of PC, Ethnicity, height, history of diabetes, intake of multivitamin and supplements, tomato sauce and coffee intake, MED score; ** + + family history of diabetes, myocardial infarction, cancer, history of high blood pressure and elevated cholesterol | Nut intake | Lethal PCf* | Fatal PCg* | AC-M** | |||||||||||||||||
|
Total nuts (≥ 5 times/ week vs. < once/month) |
0.88 (0.57–1.35) |
0.62 (0.36–1.07) |
0.66 (0.52–0.83) |
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|
Other nuts (≥ 5 times/ week vs. < once/month) |
0.70 (0.5–0.95) |
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|
Peanuts (≥ 5 times/week vs. < once/month) |
0.79 (0.59–1.06) |
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|
Wang et al. [38] USA, Cancer Prevention Study II (CPS-II) Nutrition Cohort |
5643 men with non-metastatic PC, mean age at diagnosis: 72 y |
2.9 y | 9.6 y | Modified Willet FFQ | 363 | Age and calendar year at diagnosis, race, tumor extent, nodal involvement, Gleason score, history of pre-diagnosis PSA-testing, education, treatment, history of CVD, physical activity, smoking status, total dairy intake |
Lycopene and tomato intake (Q4 vs. Q1 |
PC-M (All PC) |
PC-M (Lower risk PC) |
PC-M (High-risk PCh) |
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| Dietary lycopene (mg/d) |
1.22 (0.91–1.64) |
1.22 (0.82–1.83) |
0.96 (0.56–1.65) |
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|
Tomato (serving/week) |
0.98 (0.69–1.40) |
0.71 (0.41–1.23) |
1.15 (0.65–2.03) |
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|
Total tomato products (serving/d) |
1.03 (0.76–1.41) |
0.93 (0.59–1.46) |
1.00 (0.60–1.66) |
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aAll quartiles reported, because results suggest a non-linear (U-shaped) association
bCont.: Per doubling of biomarker concentration (ng/ml)
cSubst.: Substitutional—1 daily serving of refined grain with whole grain
dCont.: Continuous—10% more daily calories from vegetable fat and 10% less from carbohydrate (CHO)
eSubst.: Substitutional—10% more daily calories from vegetable fat and 10% less from animal fat (nutrient density model), en%: Energy %
fLethal PC: cases that metastasised to distant organs at diagnosis or follow-up or that caused PC-death
gFatal PC: cases that caused PC-death
hhigh-risk PC: T3–T4 or Gleason score 8–10, or nodal involvement; according to the National Comprehensive Cancer Network guidelines
FU mean/median follow-up, t time since cancer diagnosis, N number, HR (95% CI) hazard ratio (95% confidence Interval), FFQ food frequency questionnaire, RCT randomized controlled trial, BC breast cancer, CRC colorectal cancer, NMIBC non-muscle invasive bladder cancer, PC prostate cancer, AC-M all-cause mortality, BC-M breast cancer specific mortality, OS overall survival, DFS disease-free survival, CVD cardiovascular disease, CVD-M mortality due to cardiovascular disease, OC-M mortality due to other causes, Rec recurrence, CRC-M CRC-specific mortality, RFS recurrence-free survival, PC-M prostate cancer-specific mortality. y year, d day, m month, port. portion, WG whole grain, PDI overall plant-based diet index, uPDI unhealthy plant-based diet index, hPDI healthy plant-based diet index, UPLC-MS/MS ultra-performance liquid chromatography-tandem mass spectrometry, UPLC/MS ultra-performance liquid chromatography-tandem mass spectrometry, conc. concentration, CH carbohydrates