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      Higher baseline dietary fat and fatty acid intake is associated with increased risk of incident prostate cancer in the SABOR study

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          Abstract

          To study the association of nutrient intake measured by baseline food frequency questionnaire and risk of subsequent prostate cancer (PCa) in the SABOR (San Antonio Biomarkers of Risk) cohort study. After IRB approval, more than 1903 men enrolled in a prospective cohort from 2000 to 2010 as part of the SABOR clinical validation site for the National Cancer Institute Early Detection Research Network. Food and nutrient intakes were calculated using a Food Frequency Questionnaire. Cox proportional hazards modeling and covariate-balanced propensity scores were used to assess the associations between all nutrients and PCa. A total of 229 men were diagnosed with PCa by prostate biopsy. Among all nutrients, increased risk of PCa was associated with intake of dietary fat scaled by the total caloric intake, particularly saturated fatty acid (SFA) [HR 1.19; 95% CI, 1.07–1.32), P value <0.001, False discovery rate (FDR) 0.047] and trans fatty acid (TFA) [HR per quintile 1.21; (95% CI) (1.08–1.35), P < 0.001, FDR 0.039]. There was an increased risk of PCa with increasing intake of monounsaturated fatty acid (MUFA) (HR per quintile 1.14; 95% CI 1.03–1.27, P = 0.01, FDR 0.15) and cholesterol [HR per quintile 1.13; 95% confidence interval (95% CI) (1.02–1.26), P -value 0.02, FDR 0.19]. After examining a large, population-based cohort for PCa diagnosis, we identified dietary total fat and certain fatty acids as associated with increased risk of PCa. We found no factors that were protective from PCa. Dietary modification of fatty acid intake may reduce risk of PCa.

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          Most cited references29

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          Covariate balancing propensity score

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            Association of Specific Dietary Fats With Total and Cause-Specific Mortality.

            Previous studies have shown distinct associations between specific dietary fat and cardiovascular disease. However, evidence on specific dietary fat and mortality remains limited and inconsistent.
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              Prostate cancer in relation to diet, physical activity, and body size in blacks, whites, and Asians in the United States and Canada.

              International and interethnic differences in prostate cancer incidence suggest an environmental, potentially modifiable etiology for the disease. We conducted a population-based case-control study of prostate cancer among blacks (very high risk), whites (high risk), and Asian-Americans (low risk) in Los Angeles, San Francisco, Hawaii, Vancouver, and Toronto. Our aim was to evaluate the roles of diet, physical activity patterns, body size, and migration characteristics on risk in these ethnic groups and to assess how much of the interethnic differences in risk might be attributed to interethnic differences in such lifestyle characteristics. We used a common protocol and questionnaire to administer personal interviews to 1655 black, white, Chinese-American, and Japanese-American case patients diagnosed during 1987-1991 with histologically confirmed prostate carcinoma and to 1645 population-based control subjects matched to case patients by age, ethnicity, and region of residence. Sera collected from 1127 control subjects were analyzed for levels of prostate-specific antigen (PSA) to permit comparison of case patients with control subjects lacking serological evidence of prostate disease. Odds ratios were estimated using conditional logistic regression. We estimated the proportion of prostate cancer attributable to certain risk factors and the proportion of interethnic risk differences attributable to interethnic differences in risk-factor prevalence. A positive statistically significant association of prostate cancer risk and total fat intake was found for all ethnic groups combined. This association was attributable to energy from saturated fats; after adjusting for saturated fat, risk was associated only weakly with monounsaturated fat and was unrelated to protein, carbohydrate, polyunsaturated fat, and total food energy. Saturated fat intake was associated with higher risks for Asian-Americans than for blacks and whites. In all ethnic groups combined, the risk tended to be higher when only case patients with advanced disease were compared with control subjects with normal PSA levels. Among foreign-born Asian-Americans, risk increased independently with years of residence in North America and with saturated fat intake. Crude estimates suggest that differences in saturated fat intake account for about 10% of black-white differences and about 15% of white-Asian-American differences in prostate cancer incidence. Risk was not consistently associated with intake of any micronutrients, body mass, or physical activity patterns. These data support a causal role in prostate cancer for saturated fat intake but suggest that other factors are largely responsible for interethnic differences in risk.
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                Author and article information

                Journal
                Prostate Cancer and Prostatic Diseases
                Prostate Cancer Prostatic Dis
                Springer Nature America, Inc
                1365-7852
                1476-5608
                November 1 2018
                Article
                10.1038/s41391-018-0105-2
                6685438
                30385837
                368993d7-9863-440f-9979-5b087557fb0d
                © 2018

                http://www.springer.com/tdm

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