Abstract 2210: Healthy dietary patterns and survival among men with prostate cancer
Authors: Liu Binkai , Vaselkiv Jane B. , Himbert Caroline , McGrath Colleen B. , Lucas LeeAnn , Giovannucci Edward , Stampfer Meir J. , Stopsack Konrad H. , Sun Qi , Mucci Lorelei A. 
Published: March 2024

Abstract
Background: While prostate cancer is the second leading cause of cancer death in U.S. males, most men with prostate cancer die from other causes. We prospectively examined the potential benefits of adhering to established healthy dietary patterns on overall and cause-specific mortality among men living with prostate cancer.
Methods: We studied men with incident prostate cancer in the Health Professionals Follow-up Study from 1986-2022. Five dietary indices-Alternative Healthy Eating Index (AHEI), the Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH), anti-insulinemic, and anti-inflammatory diet scores-were derived from validated food frequency questionnaires administered every 4 years. Post-diagnosis scores were cumulatively averaged, and time-varying changes in scores from pre- to post-diagnosis were calculated. We used multivariable-adjusted Cox models to estimate hazard ratios (HRs, 95% CI) for associations between adherence to dietary patterns with overall and cause-specific survival adjusting for demographics, dietary and lifestyle factors.
Results: Among 6,086 prostate cancer patients with 71,783 person-years of follow-up, 3,406 deaths occurred: 578 from prostate cancer, 918 from cardiovascular disease (CVD), and 1910 from other causes. When comparing extreme quintiles of post-diagnosis diet scores, a healthy diet was associated with lower overall mortality for AHEI (0.76, 0.66-0.88) and the Mediterranean diet (0.84, 0.73-0.97). Moreover, comparing extreme quintiles of score change, patients who increased their adherence to these diets after diagnosis had better overall survival with HRs (95% CI) that ranged from 0.79 (0.70-0.89) for AHEI to 0.89 (0.79- &lt;1.00) for the anti-inflammatory diet. No significant associations were observed for DASH. Regarding cause-specific survival, increased adherence to anti-insulinemic diet was associated with better CVD-specific survival (0.78, 0.61-0.99). No significant associations were found between these diet scores and prostate cancer survival. Stronger associations of post-diagnosis diet scores with overall survival were seen in men diagnosed before age 70, those classified as obese at diagnosis (BMI≥30 kg/m2), consuming less alcohol (&lt;7.8 g/d), and with lower grade (Gleason Score ≤7) or stage (T1/T2) tumors.
Conclusions: For men diagnosed with prostate cancer, adhering to a healthy dietary pattern after cancer diagnosis, such as the AHEI and Mediterranean Diet, was associated with better overall survival. Increasing adherence to these diets after cancer diagnosis was also associated with improved overall and CVD-specific survival.
Citation Format: Binkai Liu, Jane B. Vaselkiv, Caroline Himbert, Colleen B. McGrath, LeeAnn Lucas, Edward Giovannucci, Meir J. Stampfer, Konrad H. Stopsack, Qi Sun, Lorelei A. Mucci. Healthy dietary patterns and survival among men with prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2210.