http://archinte.jamanetwork.com/ en-us Mon, 10 Jun 2013 00:00:00 GMT Mon, 10 Jun 2013 16:47:58 GMT Silverchair editor@archinte.jamanetwork.com webmaster@archinte.jamanetwork.com http://archinte.jamanetwork.com/article.aspx?articleID=1696179 Mon, 10 Jun 2013 00:00:00 GMT Richman EL, Kenfield SA, Chavarro JE, et al. <span class="paragraphSection"><div class="boxTitle">Importance</div>Nearly 2.5 million men currently live with prostate cancer in the United States, yet little is known about the association between diet after diagnosis and prostate cancer progression and overall mortality.<div class="boxTitle">Objective</div>To examine postdiagnostic fat intake in relation to lethal prostate cancer and all-cause mortality.<div class="boxTitle">Design, Setting, and Participants</div>Prospective study of 4577 men with nonmetastatic prostate cancer in the Health Professionals Follow-up Study (1986-2010).<div class="boxTitle">Exposures</div>Postdiagnostic intake of saturated, monounsaturated, polyunsaturated, trans, animal, and vegetable fat.<div class="boxTitle">Main Outcomes and Measures</div>Lethal prostate cancer (distant metastases or prostate cancer–specific death) and all-cause mortality.<div class="boxTitle">Results</div>We observed 315 events of lethal prostate cancer and 1064 deaths (median follow-up, 8.4 years). Crude rates per 1000 person-years for lethal prostate cancer were as follows (highest vs lowest quintile of fat intake): 7.6 vs 7.3 for saturated, 6.4 vs 7.2 for monounsaturated, 5.8 vs 8.2 for polyunsaturated, 8.7 vs 6.1 for trans, 8.3 vs 5.7 for animal, and 4.7 vs 8.7 for vegetable fat. For all-cause mortality, the rates were 28.4 vs 21.4 for saturated, 20.0 vs 23.7 for monounsaturated, 17.1 vs 29.4 for polyunsaturated, 32.4 vs 17.1 for trans, 32.0 vs 17.2 for animal, and 15.4 vs 32.7 for vegetable fat. Replacing 10% of energy intake from carbohydrate with vegetable fat was associated with a lower risk of lethal prostate cancer (hazard ratio [HR], 0.71; 95% CI, 0.51-0.98; P = .04) and all-cause mortality (HR, 0.74; 95% CI, 0.61-0.88; P = .001). No other fats were associated with lethal prostate cancer. Saturated and trans fats after diagnosis (replacing 5% and 1% of energy from carbohydrate, respectively) were associated with higher all-cause mortality (HR, 1.30 [95% CI, 1.05-1.60; P = .02] and 1.25 [95% CI, 1.05-1.49; P = .01], respectively).<div class="boxTitle">Conclusions and Relevance</div>Among men with nonmetastatic prostate cancer, replacing carbohydrates and animal fat with vegetable fat may reduce the risk of all-cause mortality. The potential benefit of vegetable fat for prostate cancer–specific outcomes merits further research.</span> 1 8 10.1001/jamainternmed.2013.6536 http://archinte.jamanetwork.com/article.aspx?articleID=1696179 http://archinte.jamanetwork.com/article.aspx?articleID=1696188 Mon, 10 Jun 2013 00:00:00 GMT Freedland SJ. <span class="paragraphSection">There are 3 well-established risk factors for prostate cancer: race (specifically, African American race), family history, and age. Unfortunately, we cannot change our race or our parents nor can we stop time. Given this reality, there is much interest in identifying modifiable risk factors for prostate cancer. In a landmark study, Calle and colleagues followed up more than 900 000 persons for more than 16 years and found that obesity was linked with death from 17 different cancer types. Although prostate cancer was one of the cancers identified, its association with obesity was modest, with mildly obese (body mass index [calculated as weight in kilograms divided by height in meters squared], 30-34.9) and moderately obese (body mass index, 35-39.9) men being 20% and 34% more likely, respectively, to die of prostate cancer. Even so, given the large number of men who die annually of prostate cancer (258 100 worldwide and 32 600 in North America in 2008) and the high prevalence of obesity (35% in the United States in 2012), the association means that tens of thousands of men die annually of obesity-related prostate cancer. While the exact links between obesity and prostate cancer are complex, diet and lifestyle invariably play a role.</span> 1 2 10.1001/jamainternmed.2013.7744 http://archinte.jamanetwork.com/article.aspx?articleID=1696188