TY - JOUR
T1 - Dietary Fiber Intake and Risk of Advanced and Aggressive Forms of Prostate Cancer
T2 - A Pooled Analysis of 15 Prospective Cohort Studies
AU - Sidahmed, Elkhansa
AU - Freedland, Stephen J
AU - Wang, Molin
AU - Wu, Kana
AU - Albanes, Demetrius
AU - Barnett, Matt
AU - van den Brandt, Piet A
AU - Cook, Michael B
AU - Giles, Graham G
AU - Giovannucci, Edward
AU - Haiman, Christopher A
AU - Larsson, Susanna C
AU - Key, Timothy J
AU - Loftfield, Erikka
AU - Männistö, Satu
AU - McCullough, Marjorie L
AU - Milne, Roger L
AU - Neuhouser, Marian L
AU - Platz, Elizabeth A
AU - Perez-Cornago, Aurora
AU - Sawada, Norie
AU - Schenk, Jeannette M
AU - Sinha, Rashmi
AU - Tsugane, Shoichiro
AU - Visvanathan, Kala
AU - Wang, Ying
AU - White, Kami K
AU - Willett, Walter C
AU - Wolk, Alicja
AU - Ziegler, Regina G
AU - Genkinger, Jeanine M
AU - Smith-Warner, Stephanie A
PY - 2025/1
Y1 - 2025/1
N2 - Background: Evidence of an association between dietary fiber intake and risk of advanced and aggressive forms of prostate cancer (PC) and PC mortality is limited. Objective: The aim of this study was to examine associations between intakes of dietary fiber overall and by food source and risk of advanced and aggressive forms of PC. Design: The study design was a pooled analysis of the primary data from 15 cohorts in 3 continents. Baseline dietary fiber intake was assessed using a validated food frequency questionnaire or diet history in each study. Participants/setting: There were 842 149 men followed for up to 9 to 22 years between 1985 and 2009 across studies. Main outcome measures: The primary outcome measures were advanced (stage T4, N1, or M1 or PC mortality), advanced restricted (excluded men with missing stage and those with localized PC who died of PC), and high-grade PC (Gleason score ≥8 or poorly differentiated/undifferentiated) and PC mortality. Statistical analysis performed: Study-specific multivariable hazard ratios (MVHR) were calculated using Cox proportional hazards regression and pooled using random effects models. Results: Intake of dietary fiber overall, from fruits, and from vegetables was not associated with risk of advanced (n = 4863), advanced restricted (n = 2978), or high-grade PC (n = 9673) or PC mortality (n = 3097). Dietary fiber intake from grains was inversely associated with advanced PC (comparing the highest vs lowest quintile, MVHR 0.84; 95% CI 0.76-0.93), advanced restricted PC (MVHR 0.85; 95% CI 0.74-0.97), and PC mortality (MVHR 0.78; 95% CI 0.68-0.89); statistically significant trends were noted for each of these associations (P ≤ .03), and a null association was observed for high-grade PC for the same comparison (MVHR 1.00; 95% CI 0.93-1.07). The comparable results were 1.06 (95% CI 1.01-1.10; P value, test for trend = .002) for localized PC (n = 35,199) and 1.05 (95% CI 0.99-1.11; P value, test for trend = .04) for low/intermediate grade PC (n = 34 366). Conclusions: Weak nonsignificant associations were observed between total dietary fiber intake and risk of advanced forms of PC, high-grade PC, and PC mortality. High dietary fiber intake from grains was associated with a modestly lower risk of advanced forms of PC and PC mortality.
AB - Background: Evidence of an association between dietary fiber intake and risk of advanced and aggressive forms of prostate cancer (PC) and PC mortality is limited. Objective: The aim of this study was to examine associations between intakes of dietary fiber overall and by food source and risk of advanced and aggressive forms of PC. Design: The study design was a pooled analysis of the primary data from 15 cohorts in 3 continents. Baseline dietary fiber intake was assessed using a validated food frequency questionnaire or diet history in each study. Participants/setting: There were 842 149 men followed for up to 9 to 22 years between 1985 and 2009 across studies. Main outcome measures: The primary outcome measures were advanced (stage T4, N1, or M1 or PC mortality), advanced restricted (excluded men with missing stage and those with localized PC who died of PC), and high-grade PC (Gleason score ≥8 or poorly differentiated/undifferentiated) and PC mortality. Statistical analysis performed: Study-specific multivariable hazard ratios (MVHR) were calculated using Cox proportional hazards regression and pooled using random effects models. Results: Intake of dietary fiber overall, from fruits, and from vegetables was not associated with risk of advanced (n = 4863), advanced restricted (n = 2978), or high-grade PC (n = 9673) or PC mortality (n = 3097). Dietary fiber intake from grains was inversely associated with advanced PC (comparing the highest vs lowest quintile, MVHR 0.84; 95% CI 0.76-0.93), advanced restricted PC (MVHR 0.85; 95% CI 0.74-0.97), and PC mortality (MVHR 0.78; 95% CI 0.68-0.89); statistically significant trends were noted for each of these associations (P ≤ .03), and a null association was observed for high-grade PC for the same comparison (MVHR 1.00; 95% CI 0.93-1.07). The comparable results were 1.06 (95% CI 1.01-1.10; P value, test for trend = .002) for localized PC (n = 35,199) and 1.05 (95% CI 0.99-1.11; P value, test for trend = .04) for low/intermediate grade PC (n = 34 366). Conclusions: Weak nonsignificant associations were observed between total dietary fiber intake and risk of advanced forms of PC, high-grade PC, and PC mortality. High dietary fiber intake from grains was associated with a modestly lower risk of advanced forms of PC and PC mortality.
KW - cohort studies
KW - dietary fiber
KW - grains
KW - pooled analysis
KW - prostate cancer
U2 - 10.1016/j.jand.2024.04.006
DO - 10.1016/j.jand.2024.04.006
M3 - Article
SN - 2212-2672
VL - 125
SP - 11-23.e22
JO - Journal of the Academy of Nutrition and Dietetics
JF - Journal of the Academy of Nutrition and Dietetics
IS - 1
ER -