Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Am J Clin Nutr. 2022 Mar 4;115(3):662-670. doi: 10.1093/ajcn/nqab365.
Plant-based diets are associated with multiple health benefits and a favorable environmental impact. For prostate cancer, previous studies suggest a beneficial role of specific plant-based foods (e.g., tomatoes) and a potentially harmful role of specific animal-based foods (e.g., meat, dairy). However, less is known about plant-based dietary patterns.
We sought to examine the relation between plant-based diet indices and prostate cancer risk, including clinically relevant disease.
This was a prospective cohort study including 47,239 men in the Health Professionals Follow-Up Study (1986-2014). Overall and healthful plant-based diet indices were calculated from FFQs. Cox proportional hazards models were used to estimate HRs and 95% CIs to examine the risk of incident prostate cancer (total and by clinical category), among men ages <65 and ≥65 y.
Of the 47,239 men, 6655 men were diagnosed with prostate cancer over follow-up, including 515 with advanced-stage disease at diagnosis, 956 with lethal disease (metastasis or death), and 806 prostate cancer deaths. Greater overall plant-based consumption was associated with a significantly lower risk of fatal prostate cancer (HR: 0.81; 95% CI: 0.64, 1.01; P-trend = 0.04). In men aged <65, a higher plant-based diet index was associated with a lower risk of advanced, lethal, and fatal prostate cancer. Moreover, greater consumption of a healthful plant-based diet was associated with lower risks of total (HR: 0.84; 95% CI: 0.73, 0.98; P-trend = 0.046) and lethal prostate cancer (HR: 0.56; 95% CI: 0.34, 0.94; P-trend = 0.03) at age <65. There were no associations between overall or healthful plant-based diet indices with prostate cancer among men ≥65 y. Fewer than 1% of participants followed a strict vegetarian or vegan diet.
This prospective study provides supportive evidence that greater consumption of healthful plant-based foods is associated with a lower risk of aggressive forms of prostate cancer, with stronger benefit among men aged <65 y.
植物性饮食与多种健康益处和有利的环境影响有关。对于前列腺癌，先前的研究表明某些植物性食物（例如西红柿）具有有益作用，而某些动物性食物（例如肉类、奶制品）则具有潜在的有害作用。然而，对于植物性饮食模式的了解较少。
我们旨在研究植物性饮食指数与前列腺癌风险之间的关系，包括临床相关疾病。
这是一项前瞻性队列研究，包括参加健康专业人员随访研究（1986-2014 年）的 47239 名男性。通过 FFQ 计算总体和健康的植物性饮食指数。使用 Cox 比例风险模型来估计 HRs 和 95%CI，以检查年龄<65 岁和≥65 岁的男性中前列腺癌（总发病率和按临床分类）的发病风险。
在 47239 名男性中，随访期间有 6655 名男性被诊断为前列腺癌，其中 515 名在诊断时患有晚期疾病，956 名患有致命疾病（转移或死亡），806 名死于前列腺癌。较高的总体植物性食物摄入量与致命前列腺癌的风险显著降低相关（HR：0.81；95%CI：0.64，1.01；P 趋势=0.04）。在年龄<65 岁的男性中，较高的植物性饮食指数与较低的晚期、致命和致命前列腺癌风险相关。此外，较高的健康植物性饮食摄入量与总前列腺癌（HR：0.84；95%CI：0.73，0.98；P 趋势=0.046）和致命前列腺癌（HR：0.56；95%CI：0.34，0.94；P 趋势=0.03）的风险降低相关。在年龄≥65 岁的男性中，总体或健康的植物性饮食指数与前列腺癌之间没有关联。少于 1%的参与者遵循严格的素食或纯素饮食。
这项前瞻性研究提供了支持性证据，表明更多地食用健康的植物性食物与侵袭性前列腺癌的风险降低有关，在年龄<65 岁的男性中受益更强。
