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TOPLINE
Among patients with nonmetastatic prostate cancer, those in the highest quintile of saturated fat intake after diagnosis had a 24% greater risk for all-cause mortality over the next 13 years. Replacing a small amount of saturated fat with monounsaturated fat would reduce mortality by a similar degree, researchers estimated.
METHODOLOGY
- Men with nonmetastatic prostate cancer most often die from cardiovascular disease or other cancers. In the general population, high saturated fat intake is associated with increased all-cause and cardiovascular mortality. But few studies have looked at postdiagnosis dietary fat consumption and long-term mortality trends among men with prostate cancer.
- Researchers used data from the Health Professionals Follow-Up Study to identify 4884 US men diagnosed with nonmetastatic prostate cancer between 1986 and 2019. Dietary information was collected every 4 years via a food frequency questionnaire and used to estimate postdiagnosis intake of saturated, unsaturated, trans, animal, and plant fats.
- Main outcomes included all-cause mortality and death from prostate cancer, other cancers, cardiovascular disease, and other causes.
- Statistical analysis adjusted for age at diagnosis, tumor stage, Gleason score, treatment type, BMI, smoking status, physical activity, diabetes, cholesterol levels, and comorbid conditions.
TAKEAWAY
- Over a median follow-up of 12.8 years, 3040 study participants died. Those in the highest quintile of saturated fat consumption after diagnosis had higher all-cause mortality than those in the lowest quintile (hazard ratio [HR], 1.24; 95% CI, 1.05-1.47) — primarily owing to increased cardiovascular disease mortality (HR, 1.42; 95% CI, 1.02-1.98) and other cancer mortality (HR, 1.42; 95% CI, 0.93-2.17).
- Replacing 5% of calories from carbohydrates with saturated fat was associated with higher all-cause mortality (HR, 1.15; 95% CI, 1.03-1.28) and cardiovascular disease mortality (HR, 1.37; 95% CI, 1.11-1.71). In contrast, replacing 5% of calories from saturated fat with monounsaturated fat reduced all-cause mortality by 20% (HR, 0.80; 95% CI, 0.70-0.91).
- Similarly, high intake of animal fat was positively associated with all-cause mortality (HR, 1.14; 95% CI, 0.97-1.33) and death from other cancers (HR, 1.49; 95% CI, 1.00-2.21). Replacing 10% of calories from animal fat with plant-based fat (such as vegetable oils, nuts, and seeds) would reduce all-cause mortality by 16% (HR, 0.84; 95% CI, 0.76-0.93).
- No associations were observed between any type of dietary fat and prostate cancer mortality itself.
IN PRACTICE
“This study suggests that replacing intake of animal fats with plant-based fats or saturated with monounsaturated sources of fats may improve survival among patients with nonmetastatic prostate cancer,” the study authors wrote. An accompanying editorial agreed, saying, “For patients, the message can be framed simply: A healthier diet may not treat prostate cancer directly, but it remains an important means of caring for the whole person living with prostate cancer.”
SOURCE
The study, led by Yiwen Zhang, PhD, of Harvard T.H. Chan School of Public Health in Boston, was published online in JAMA Network Open.
LIMITATIONS
Limitations include the potential for measurement error with food frequency questionnaires and residual confounding. Postdiagnosis dietary fat intake was based on the first eligible questionnaire after diagnosis and was not updated. The cohort were health professionals and were predominantly White, which may limit generalizability.
DISCLOSURES
The Health Professionals Follow-Up Study was supported by the National Institutes of Health. Several co-authors reported financial relationships with companies including Convergent Therapeutics; Endo USA, Inc.; and Pfizer outside of the submitted work. Full disclosures are noted in the original article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
