Cancer Causes & Control

, Volume 25, Issue 4, pp 525–532 | Cite as

Nutrient-based dietary patterns and prostate cancer risk: a case–control study from Italy

  • Valentina Rosato
  • Valeria Edefonti
  • Francesca Bravi
  • Cristina Bosetti
  • Paola Bertuccio
  • Renato Talamini
  • Luigino Dal Maso
  • Maurizio Montella
  • Monica Ferraroni
  • Carlo La VecchiaEmail author
  • Adriano Decarli
Original paper



The role of various foods and nutrients, and their combinations, on prostate cancer risk remains largely undefined. We addressed therefore the issue of complex dietary patterns.


We analyzed data from an Italian case–control study, including 1,294 men with prostate cancer and 1,451 hospital controls. We carried out an exploratory principal component factor analysis on 28 selected nutrients in order to identify dietary patterns. We estimated odds ratios (ORs) and corresponding confidence intervals (CIs) using logistic regression models on quintiles of factor scores, adjusting for major confounding variables.


We identified five dietary patterns, labeled “Animal Products,” “Vitamins and Fiber,” “Starch-rich,” “Vegetable Unsaturated Fatty Acids (VUFA),” and “Animal Unsaturated Fatty Acids (AUFA).” We found positive associations between prostate cancer and “Animal Products” (OR for the highest vs. the lowest score quintile: 1.51, 95 % CI 1.16–1.96), “Starch-rich” (OR 1.50, 95 % CI 1.16 1.93), and “AUFA” (OR 1.32, 95 % CI 1.02–1.70) patterns. No significant associations emerged with “Vitamins and Fiber” (OR 0.93) and “VUFA” (OR 1.16) patterns.


Our findings suggest that a diet rich in animal products, including several types of meat and dairy products, as well as of (refined) cereals and sugars has an unfavorable role on prostate cancer.


Case–control study Dietary patterns Factor analysis Nutrients Prostate cancer Risk factor 



This work was supported by the Italian Association for Cancer Research (AIRC Grant Numbers 10068 and 10415) and by the Italian Ministry of University, Education and Research (PRIN 2009 X8YCBN). F.B. was supported by a fellowship of the “Fondazione Umberto Veronesi.”

Conflict of interest

The opinions expressed in this manuscript are those of the authors and do not necessarily reflect the opinions of the organization that they work for. The authors declare that they have no conflict of interest.


  1. 1.
    Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90PubMedCrossRefGoogle Scholar
  2. 2.
    Platz EA, Giovannucci E (2006) Prostate cancer. In: Schottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 1128–1150CrossRefGoogle Scholar
  3. 3.
    World Cancer Research Fund and American Institute for Cancer Research (2007) Food, nutrition, physical activity and the prevention of cancer: a global perspective. AICR, WashingtonGoogle Scholar
  4. 4.
    Niclis C, Diaz Mdel P, Eynard AR, Roman MD, La Vecchia C (2012) Dietary habits and prostate cancer prevention: a review of observational studies by focusing on South America. Nutr Cancer 64:23–33PubMedCrossRefGoogle Scholar
  5. 5.
    Hu FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13:3–9PubMedCrossRefGoogle Scholar
  6. 6.
    Edefonti V, Randi G, La Vecchia C, Ferraroni M, Decarli A (2009) Dietary patterns and breast cancer: a review with focus on methodological issues. Nutr Rev 67:297–314PubMedCrossRefGoogle Scholar
  7. 7.
    Ambrosini GL, Fritschi L, de Klerk NH, Mackerras D, Leavy J (2008) Dietary patterns identified using factor analysis and prostate cancer risk: a case control study in Western Australia. Ann Epidemiol 18:364–370PubMedCrossRefGoogle Scholar
  8. 8.
    De Stefani E, Ronco AL, Deneo-Pellegrini H, Boffetta P, Aune D, Acosta G, Brennan P, Ferro G, Mendilaharsu M (2010) Dietary patterns and risk of advanced prostate cancer: a principal component analysis in Uruguay. Cancer Causes Control 21:1009–1016PubMedCrossRefGoogle Scholar
  9. 9.
    Jackson M, Walker S, Simpson C, McFarlane-Anderson N, Bennett F (2009) Are food patterns associated with prostate cancer in Jamaican men: a preliminary report. Infect Agent Cancer 4(Suppl 1):S5PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Walker M, Aronson KJ, King W, Wilson JW, Fan W, Heaton JP, MacNeily A, Nickel JC, Morales A (2005) Dietary patterns and risk of prostate cancer in Ontario, Canada. Int J Cancer 116:592–598PubMedCrossRefGoogle Scholar
  11. 11.
    Muller DC, Severi G, Baglietto L, Krishnan K, English DR, Hopper JL, Giles GG (2009) Dietary patterns and prostate cancer risk. Cancer Epidemiol Biomarkers Prev 18:3126–3129PubMedCrossRefGoogle Scholar
  12. 12.
    Tseng M, Breslow RA, DeVellis RF, Ziegler RG (2004) Dietary patterns and prostate cancer risk in the National Health and Nutrition Examination Survey Epidemiological Follow-up Study cohort. Cancer Epidemiol Biomarkers Prev 13:71–77PubMedCrossRefGoogle Scholar
  13. 13.
    Wu K, Hu FB, Willett WC, Giovannucci E (2006) Dietary patterns and risk of prostate cancer in U.S. men. Cancer Epidemiol Biomarkers Prev 15:167–171PubMedCrossRefGoogle Scholar
  14. 14.
    Bosire C, Stampfer MJ, Subar AF, Park Y, Kirkpatrick SI, Chiuve SE, Hollenbeck AR, Reedy J (2013) Index-based Dietary Patterns and the Risk of Prostate Cancer in the NIH-AARP Diet and Health Study. Am J Epidemiol 177:504–513PubMedCrossRefGoogle Scholar
  15. 15.
    Bosetti C, Micelotta S, Dal Maso L, Talamini R, Montella M, Negri E, Conti E, Franceschi S, La Vecchia C (2004) Food groups and risk of prostate cancer in Italy. Int J Cancer 110:424–428PubMedCrossRefGoogle Scholar
  16. 16.
    Bidoli E, Talamini R, Zucchetto A, Bosetti C, Negri E, Lenardon O, Dal Maso L, Polesel J, Montella M, Franceschi S, Serraino D, La Vecchia C (2009) Dietary vitamins E and C and prostate cancer risk. Acta Oncol 48:890–894Google Scholar
  17. 17.
    Pelucchi C, Galeone C, Talamini R, Negri E, Parpinel M, Franceschi S, Montella M, La Vecchia C (2005) Dietary folate and risk of prostate cancer in Italy. Cancer Epidemiol Biomarkers Prev 14:944–948PubMedCrossRefGoogle Scholar
  18. 18.
    Bidoli E, Talamini R, Bosetti C, Negri E, Maruzzi D, Montella M, Franceschi S, La Vecchia C (2005) Macronutrients, fatty acids, cholesterol and prostate cancer risk. Ann Oncol 16:152–157PubMedCrossRefGoogle Scholar
  19. 19.
    Franceschi S, Barbone F, Negri E, Decarli A, Ferraroni M, Filiberti R, Giacosa A, Gnagnarella P, Nanni O, Salvini S et al (1995) Reproducibility of an Italian food frequency questionnaire for cancer studies. Results for specific nutrients. Ann Epidemiol 5:69–75CrossRefGoogle Scholar
  20. 20.
    Franceschi S, Negri E, Salvini S, Decarli A, Ferraroni M, Filiberti R, Giacosa A, Talamini R, Nanni O, Panarello G et al (1993) Reproducibility of an Italian food frequency questionnaire for cancer studies: results for specific food items. Eur J Cancer 29A:2298–2305PubMedCrossRefGoogle Scholar
  21. 21.
    Decarli A, Franceschi S, Ferraroni M, Gnagnarella P, Parpinel MT, La Vecchia C, Negri E, Salvini S, Falcini F, Giacosa A (1996) Validation of a food-frequency questionnaire to assess dietary intakes in cancer studies in Italy. Results for specific nutrients. Ann Epidemiol 6:110–118CrossRefGoogle Scholar
  22. 22.
    Salvini S (1998) Banca dati di composizione degli alimenti per studi epidemiologici in Italia. Istituito Europeo di Oncologia, ItaliaGoogle Scholar
  23. 23.
    Gnagnarella P, Parpinel M, Salvini S, Franceschi S, Palli D, Boyle P (2004) The update of the Italian food composition database. J Food Comp Analysis 17:509–522CrossRefGoogle Scholar
  24. 24.
    Pett MA, Lackey NR, Sullivan JJ (2003) Making sense of factor analysis: the use of factor analysis for instrument development in health care research. Sage, Thousand OaksGoogle Scholar
  25. 25.
    Johnson RA, Wichern DW (2002) Applied multivariate statistical analysis, 5th edn. Prentice Hall, Upper Saddler RiverGoogle Scholar
  26. 26.
    Comrey A, Lee HB (1992) A first course in factor analysis, 2nd edn. Lawrence Erlbaum Associates, HillsdaleGoogle Scholar
  27. 27.
    Edefonti V, Bravi F, Garavello W, La Vecchia C, Parpinel M, Franceschi S, Dal Maso L, Bosetti C, Boffetta P, Ferraroni M, Decarli A (2010) Nutrient-based dietary patterns and laryngeal cancer: evidence from an exploratory factor analysis. Cancer Epidemiol Biomarkers Prev 19:18–27PubMedCrossRefGoogle Scholar
  28. 28.
    Edefonti V, Hashibe M, Ambrogi F, Parpinel M, Bravi F, Talamini R, Levi F, Yu G, Morgenstern H, Kelsey K, McClean M, Schantz S, Zhang Z, Chuang S, Boffetta P, La Vecchia C, Decarli A (2012) Nutrient-based dietary patterns and the risk of head and neck cancer: a pooled analysis in the International Head and Neck Cancer Epidemiology consortium. Ann Oncol 23:1869–1880PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Edefonti V, Bravi F, La Vecchia C, Randi G, Ferraroni M, Garavello W, Franceschi S, Talamini R, Boffetta P, Decarli A (2010) Nutrient-based dietary patterns and the risk of oral and pharyngeal cancer. Oral Oncol 46:343–348PubMedCrossRefGoogle Scholar
  30. 30.
    Breslow NE, Day NE (1980) Statistical methods in cancer research, vol I. The analysis of case–control studies. IARC Sci Publ No. 32. IARC, LyonGoogle Scholar
  31. 31.
    Edefonti V, Decarli A, La Vecchia C, Bosetti C, Randi G, Franceschi S, Dal Maso L, Ferraroni M (2008) Nutrient dietary patterns and the risk of breast and ovarian cancers. Int J Cancer 122:609–613PubMedCrossRefGoogle Scholar
  32. 32.
    Bravi F, Edefonti V, Randi G, Garavello W, La Vecchia C, Ferraroni M, Talamini R, Franceschi S, Decarli A (2012) Dietary patterns and the risk of esophageal cancer. Ann Oncol 23:765–770PubMedCrossRefGoogle Scholar
  33. 33.
    Pelucchi C, Bosetti C, Negri E, Lipworth L, La Vecchia C (2011) Olive oil and cancer risk: an update of epidemiological findings through 2010. Curr Pharm Des 17:805–812PubMedCrossRefGoogle Scholar
  34. 34.
    Sala-Vila A, Calder PC (2011) Update on the relationship of fish intake with prostate, breast, and colorectal cancers. Crit Rev Food Sci Nutr 51:855–871PubMedCrossRefGoogle Scholar
  35. 35.
    Chung M, Lee J, Terasawa T, Lau J, Trikalinos TA (2011) Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med 155:827–838PubMedCrossRefGoogle Scholar
  36. 36.
    D’Avanzo B, La Vecchia C, Katsouyanni K, Negri E, Trichopoulos D (1997) An assessment, and reproducibility of food frequency data provided by hospital controls. Eur J Cancer Prev 6:288–293PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Valentina Rosato
    • 1
  • Valeria Edefonti
    • 2
  • Francesca Bravi
    • 1
    • 2
  • Cristina Bosetti
    • 1
  • Paola Bertuccio
    • 1
  • Renato Talamini
    • 3
  • Luigino Dal Maso
    • 3
  • Maurizio Montella
    • 4
  • Monica Ferraroni
    • 2
  • Carlo La Vecchia
    • 1
    • 2
    Email author
  • Adriano Decarli
    • 2
    • 5
  1. 1.Department of EpidemiologyIRCCS-Istituto di Ricerche Farmacologiche “Mario Negri”MilanItaly
  2. 2.Department of Clinical Sciences and Community HealthUniversità degli Studi di MilanoMilanItaly
  3. 3.Unit of Epidemiology and Biostatistics, Centro di Riferimento OncologicoIRCCSAvianoItaly
  4. 4.Unit of EpidemiologyIstituto Tumori “Fondazione Pascale”NaplesItaly
  5. 5.Unity of Medical Statistics, Biometry and BioinformaticsFondazione IRCCS Istituto Nazionale TumoriMilanItaly

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