1. In a cohort of men with prostate cancer, disease progression was lower in men who had a higher intake of plant-based foods.

Evidence Rating Level: 2 (Good)

Plant-based diets have been increasing in popularity and have shown benefits among individuals living with chronic diseases such as prostate cancer, one of the most prevalent cancers among men in the United States. As there is not much known about the associations between a plant-based diet and prostate cancer, this cohort study focused on the relation between clinical outcomes in patients with prostate cancer and plant-based food intake postdiagnosis. The focus was on two plant-based diet indices, those being the overall plant-based diet index (PDI) and the healthful plant-based index (hPDI). A total of 18 groups were created to compute food intake to plant-based diets based on nutritional commonalities. These groups were then split into 3 larger groups which consisted of 7 healthy foods, 5 unhealthy foods, and 6 animal foods. The primary outcome assessed was the progression of prostate cancer, which took into account bone metastases, recurrence, and secondary treatment. Death from prostate cancer was assessed as the secondary outcome. To understand the correlation between the PDI and hPDI, the Pearson correlation coefficient was used. Multiple surveys were administered over the years, with 2891 participants completing at least 1, and 2062 of them (mean [IQR] age at diagnosis, 65.0 [59.0-70.0] years) met the inclusion criteria. PDI scores were between 27 and 76, while hPDI scores were between 29 and 84, with the two indices being moderately positively correlated (r=0.34; P<.001). When compared to the lowest quintile, those in the highest quintile had a 47% decreased risk of prostate cancer progression (HR, 0.53; 95% CI, 0.37-0.74; P for trend=.003). There was a 55% decrease in risk of cancer progression in the highest quintile compared to the lowest quintile (HR 0.45; 95% CI, 0.25-0.81; P for trend=.01) for 680 participants with a Gleason grade of 7 or higher at diagnosis. Overall, of the men with prostate cancer, those who had a higher intake of plant-based foods postdiagnosis were associated with a lower cancer progression risk. 

Click to read the study in JAMA Network Open

Image: PD

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