Is There a Link Between Macronutrient Intake and Prostate Cancer?

Michael F Leitzmann


Nat Clin Pract Oncol. 2005;2(4):184-185. 

In This Article


It has been suggested that there is a link between dietary intake of certain macronutrients and the risk of prostate cancer. Until now, the majority of studies in this area have focused on the relationship between fat consumption and the disease, with variable results, and very little is known about the effects of carbohydrates, cholesterol and proteins on prostate cancer risk.

To examine the association between the risk of prostate cancer and dietary intake of six macronutrients: proteins, sugars, starch, cholesterol, monounsaturated and polyunsaturated fatty acids; in a sample of Italian men.

This large, case-control study recruited cases and control patients that had been admitted to hospitals in five Italian provinces between 1991 and 2002. All cases were admitted with incident, histologically confirmed prostate cancer and the controls presented with a variety of other conditions unrelated to malignancy, digestive disease or any illness linked to diet. Clinical staff used a food frequency questionnaire to obtain information on the participants' dietary intake of 78 food categories for which macronutrient levels had been defined. Demographic data were also obtained. Unconditional multiple logistic regression models were used to determine odds ratios (OR) and 95% confidence intervals (CI) for quintiles of increasing nutrient levels compared with the lowest quintile.

Primary endpoints were effects of macronutrients, sources and types of dietary fat and specific fatty acids on prostate cancer risk. Age, BMI and family history were also assessed.

Case and control groups comprised 1,294 men (46−74 years old, median 66) and 1,451 men (46−74 years old, median 63), respectively. Less than 5% of participants declined to be interviewed. The risk of prostate cancer was significantly greater in those with a high starch intake (OR = 1.4; 95% CI 1.1−1.8), and polyunsaturated fats were associated with low prostate cancer risk (OR = 0.8; 95% CI 0.6−1.0), although this result was not significant. Of the fatty acids measured, only linolenic acid was significantly related to a decreased risk of prostate cancer (OR = 0.7; 95% CI 0.6−0.9). Prostate cancer risk was not affected by cholesterol intake. The significant correlation between high levels of starch and increased prostate cancer risk persisted when all six nutrients were analysed in the same model (OR = 1.07; 95% CI 1.02−1.13), and a significant inverse relationship was detected for polyunsaturated fatty acids (OR = 0.84; 95% CI 0.72−0.98). In addition, this model indicated that monounsaturated fatty acid intake was significantly associated with increased risk (OR = 1.11; 95% CI 1.03−1.20). No relationship was found for proteins, sugars, saturated fats or cholesterol.

In this sample of Italian men, intake of monounsaturated fatty acids and starch was directly related to an increased risk of prostate cancer. Polyunsaturated fatty acid consumption was associated with a significantly lower risk of the disease.


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