Men with prostate cancer make positive dietary changes following diagnosis and treatment
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Few studies have measured dietary changes made among men diagnosed with prostate cancer (PC) without formal dietary interventions, yet they may offer insight into the needs of PC survivors. This study examined dietary changes in men before and after treatment for PC within the prostate testing for cancer and treatment randomized trial.
This was a prospective cohort study in community-based men aged 50–69 tested for PC in nine UK areas. 3,935 men completed food frequency questionnaires before diagnosis and 678 with localized PC repeated the questionnaire 1 year later (response 82.7 %).
Men subsequently diagnosed with or without PC all consumed similar diets before diagnosis. Diagnosis of PC led to dietary changes, with 234 (34.7 %) men eating more fresh tomatoes (p < 0.0001) and 156 (23.5 %) more tomato products (p = 0.01). 271 (40.0 %) men consumed more protein (p < 0.0001) and 193 (28.6 %) more fruit/vegetable juice (p < 0.0001). Fewer macronutrients were obtained from dairy products (p < 0.01). Men undergoing active monitoring increased their fruit/vegetable juice intake after diagnosis (p = 0.0023) more than men who had surgery or radiotherapy.
Around one-third of men spontaneously adopted a healthier diet and also consumed more ‘prostate-healthy’ foods following a diagnosis of PC. Dietary choices also differed by radical or monitoring treatments, indicating that men undergoing active surveillance may be more likely to pursue dietary changes as an adjunct therapy. PC survivors can adopt healthier diets, thus providing clinicians with opportunities to support PC survivorship by providing targeted advice beneficial to general and potentially prostate-specific health.
KeywordsActive monitoring Diet Health behavior Prostatic neoplasms Randomized controlled trial
Food frequency questionnaire
High-grade prostatic intraepithelial neoplasia
Prostate cancer: mechanisms of progression and treatment study
Prostate testing for cancer and treatment trial (International Standard Randomized Controlled Trial Number 20141297)
This work was supported by the UK National Institute for Health Research (NIHR). This work is produced by Kerry Avery under the terms of a Post-doctoral Award research training fellowship issued by the NIHR. The views expressed in this publication are those of the author(s) and not necessarily those of the UK NHS, the NIHR, or the Department of Health. The ProtecT trial is funded by the UK NIHR, Health Technology Assessment Programme (HTA 96/20/99). Funding for additional research has been received from the World Cancer Research Fund, the University of Bristol Cancer Research Fund, and the National Cancer Research Institute (NCRI—formed by the Department of Health, Medical Research Council and Cancer Research UK). The Prostate Cancer: Mechanisms of Progression and Treatment (ProMPT) study is funded by the UK NCRI (formed by the Department of Health, Medical Research Council and Cancer Research UK). This work was conducted in collaboration with the National Institute for Health Research Biomedical Research Unit (NIHR BRU) in Nutrition, Diet and Lifestyle at University Hospitals Bristol NHS Trust and the University of Bristol. The study sponsors (University of Bristol for the primary study, University of Oxford for the ProtecT study) took no involvement in the study design, collection, analysis, and interpretation of data, in writing the manuscript and in the decision to submit the manuscript for publication. The authors acknowledge the tremendous contributions of: Nurses: Lead: Sue Bonnington, Lynne Bradshaw, Debbie Cooper, Emma Elliott, Pippa Herbert, Peter Holding, Joanne Howson, Mandy Jones, Teresa Lennon, Norma Lyons, Hilary Moody, Claire Plumb, Tricia O’Sullivan, Liz Salter, Sarah Tidball, Pauline Thompson; others: Tonia Adam, Sarah Askew, Sharon Atkinson, Tim Baynes, Jan Blaikie, Viv Breen, Sean Bryne, Jo Bythem, Jenny Clarke, Jenny Cloete, Susan Dark, Gill Davis, Rachael De La Rue, Elspeth Dewhurst, Anna Dimes, Nicola Dixon, Penny Ebbs, Ingrid Emmerson, Jill Ferguson, Ali Gadd, Lisa Geoghegan, Alison Grant, Collette Grant, Catherine Gray, Rosemary Godfrey, Louise Goodwin, Susie Hall, Liz Hart, Andrew Harvey, Chloe Hoult, Sarah Hawkins, Sharon Holling, Alastair Innes, Sue Kilner, Fiona Marshall, Louise Mellen, Andrea Moore, Sally Napier, Julie Needham, Kevin Pearse, Anna Pisa, Mark Rees, Elliw Richards, Lindsay Robson, Janet Roxburgh, Nikki Samuel, Irene Sharkey, Michael Slater, Donna Smith, Pippa Taggart, Helen Taylor, Ayesha Thomas, Nicola Trewick, Claire Ward, Christy Walker, Ayesha Williams, Colin Woodhouse, Elizabeth Wyber and others. Urologists: Prasad Bollina, Jim Catto, Andrew Doble, Alan Doherty, Garett Durkan, David Gillatt, Owen Hughes, Roger Kocklebergh, Howard Kynaston, Hing Leung, Edgar Paez, Alan Paul, Raj Persad, Philip Powell, Stephen Prescott, Derek Rosario, Hartwig Schwaibold, David Tulloch, Mike Wallace. Clinical oncologists: Amit Bahl, Richard Benson, Mark Beresford, Catherine Ferguson, John Graham, Grahame Howard, Nick James, Carmel Loughrey, Malcolm Mason, Duncan McClaren, Helen Patterson, Ian Pedley, Angus Robinson, Simon Russell, John Staffurth, Paul Symonds, Subramaniam Vasanthan, Paula Wilson. Pathologists: Selina Bhattarai, Neeta Deshmukh, John Dormer, John Goepel, David Griffiths, Ken Grigor, Pat Harnden, Nick Mayer, Jon Oxley, Mary Robinson, Murali Varma, Anne Warren. Radiotherapy and medical physics: Helen Appleby, Dominic Ash, Dean Aston, Steven Bolton, Graham Chalmers, John Conway, Nick Early, Tony Geater, Lynda Goddall, Claire Heymann, Deborah Hicks, Liza Jones, Susan Lamb, Geoff Lambert, Gill Lawrence, Geraint Lewis, John Lilley, Aileen MacLeod, Pauline Massey, Alison McQueen, Rollo Moore, Lynda Penketh, Janet Potterton, Neil Roberts, Helen Showler, Stephen Slade, Alasdair Steele, James Swinscoe, Marie Tiffany, John Townley, Jo Treeby, Joyce Wilkinson, Lorraine Williams, Lucy Wills, Owain Woodley, Sue Yarrow. Research and data management: Leila Ayandi, Lucy Brindle, Dan Dedman, Chris Metcalfe, Sian Noble, Tim Peters, Julia Wade, Eleanor Walsh. Administrative support: Susan Baker, Elizabeth Bellis-Sheldon, Chantal Bougard, Joanne Bowtell, Catherine Brewer, Jennie Charlton, Nicholas Christoforou, Rebecca Clark, Susan Coull, Christine Croker, Rosemary Currer, Claire Daisey, Gill Delaney, Rose Donohue, Susan Fry, Jean Haddow, Susan Halpin, Belle Harris, Barbara Hattrick, Sharon Holmes, Helen Hunt, Vicky Jackson, Mandy Le Butt, Jo Leworthy, Tanya Liddiatt, Alex Martin, Jainee Mauree, Susan Moore, Gill Moulam, Jackie Mutch, Kathleen Parker, Christopher Pawsey, Michelle Purdie, Teresa Robson, Lynne Smith, Carole Stenton, Tom Steuart-Feilding, Chris Sully, Caroline Sutton, Carol Torrington, Zoe Wilkins, Sharon Williams, Andrea Wilson, and others.
Conflict of interest
The authors declare that they have no conflict of interest.
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