Diet

A number of epidemiologic studies support an association between high-fat intake and risk of prostate cancer. A strong correlation between national per capita fat consumption and national prostate cancer mortality has been reported, and prospective case-control studies suggest that a high-fat diet doubles the risk of prostate cancer.5,8 This relationship between high-fat intake and prostate cancer may explain differences in insulin-like growth factor-1 (IGF-1). High-calorie and high-fat diets stimulate production of IGF-1 by the liver. This factor is involved in the regulation of proliferation of cancer cells and may also prevent them from undergoing apoptosis.5,8 High levels of IGF-1 are associated with an increased risk for prostate cancer.5

Other dietary factors implicated inprostate cancer include retinol, carotenoids, ly-copene, and vitamin D consumption. ,7,9 Retinol, or vitamin A, intake, especially in men older than 70, is correlated with an increased risk of prostate cancer, whereas intake of its precursor, ^-carotene, has a protective or neutral effect. Lycopene, obtained primarily from tomatoes, decreases the risk of prostate cancer in small cohort studies. Men who developed prostate cancer in one cohort study had lower levels of 1,25(OH)2-vitamin D than matched controls, although a prospective study did not support this. Clearly, dietary risk factors require further evaluation, but because fat and vitamins are modifiable risk factors, dietary intervention may be promising in prostate cancer prevention. Investigations of selenium and vitamin E supplementation are discussed further in the chemoprevention section.

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