Dietary Patterns Identified Using Factor Analysis and Prostate Cancer Risk: A Case Control Study in Western Australia

doi:10.1016/j.annepidem.2007.11.010

Annals of Epidemiology

Volume 18, Issue 5, May 2008, Pages 364-370

https://doi.org/10.1016/j.annepidem.2007.11.010 Get rights and content

Purpose

Dietary patterns offer an alternative method for analyzing dietary intakes that take into account the whole diet. We investigated empirical dietary patterns and prostate cancer risk in Western Australia (WA) using a population-based case-control study.

Methods

Incident prostate cancer cases were identified via the WA Cancer Registry. Controls were sourced from the WA electoral roll, frequency matched on age. A food frequency questionnaire (FFQ) estimated usual dietary intake from 10 years earlier. Factor analysis identified dietary patterns in FFQ data. Effects of independent dietary patterns on prostate cancer risk were examined using unconditional logistic regression, adjusting for potential confounders.

Results

A total of 546 cases and 447 controls provided data. Three distinct dietary patterns were identified, which we labeled vegetable, Western, and health-conscious. An increased risk for prostate cancer was observed with the Western pattern, which consisted of high intakes of red and processed meats, fried fish, hamburgers, chips, high-fat milk, and white bread. Men in the highest quartile for Western pattern score had an odds ratio of 1.82 (95% confidence interval 1.15–2.87, trend p = 0.02). Results were similar for aggressive cases and attenuated for non-aggressive cancers.

Conclusions

A western style diet may lead to increased risks for prostate cancer, especially aggressive prostate cancer.

Introduction

Prostate cancer is the second most commonly diagnosed cancer among men globally (1). Among Australian men, prostate cancer is the most common cancer diagnosed (excluding nonmelanoma skin cancer) and is the second most common cause of cancer death (2). Geographical differences in prostate cancer rates have stimulated research into possible lifestyle and environmental factors involved in the development of prostate cancer, including diet (3). Growing evidence exists of a role for diet in prostate cancer development. Dietary factors consistently associated with prostate cancer include tomatoes and tomato products, selenium and soy products as protective factors (4) and meat and dairy products as risk factors (3).

Almost all of the research on diet and prostate cancer to date has focused on individual nutrients or foods. Examining dietary patterns rather than isolated nutrients or foods offers the advantage of studying the effect of the whole diet (5). To date, only 3 published studies have examined dietary patterns (identified using cluster or factor-analytic methods) and prostate cancer risk 6, 7, 8. Two of these studies have indicated that diets characterized by high intakes of red meat, processed meat, and refined grains may be important in the development of prostate cancer (7) and advanced prostate cancer in older men (8). Most studies of dietary intake and prostate cancer have relied upon estimates of recent diet, whereas prostate cancer takes many years to develop, so that remote dietary intake may be more important when predicting risk. This study aims to examine the risk of prostate cancer according to dietary patterns from 10 years before disease diagnosis.

Section snippets

Materials and Methods

This study was conducted in Western Australia during 2001 and 2002 and was approved by the University of Western Australia's Human Research Ethics Committee and the Confidentiality of Health Information Committee, Department of Health, Western Australia.

Results

After consenting to the study, 79 cases and 85 controls did not return questionnaires even after multiple attempts at follow-up. An additional 9 cases and 9 controls did not complete a FFQ and 43 cases and 15 controls had missing covariate data in the questionnaires. Eight cases were excluded because of implausible energy intakes, which left 546 eligible cases and 447 eligible controls who had data available for this analysis. There were no differences in age or area of residence between men

Discussion

We identified 3distinct dietary patterns in men participating in this study that were subjectively labeled vegetable, Western, and health-conscious, although different labels could be applied. Neither the vegetable nor the health-conscious pattern was associated with prostate cancer risk. The Western pattern conferred an increased risk for prostate cancer, which increased significantly with increasing Western pattern score (p = 0.02). The Western dietary pattern identified in this study

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Dietary Patterns Identified Using Factor Analysis and Prostate Cancer Risk: A Case Control Study in Western Australia

Purpose

Methods

Results

Conclusions

Introduction

Section snippets

Materials and Methods

Results

Discussion

Am J Clin Nutr

J Nutr

J Urol

Am J Clin Nutr

Ann Oncol

Cancer in Australia 2001

Diet, Lifestyle and Risk of Prostate Cancer

Acta Oncol

Role of diet in prostate cancer development and progression

J Clin Oncol

Dietary patterns and prostate cancer risk in the national health and nutrition examination survey epidemiological follow up study cohort

Cancer Epidemiol Biomarkers Prev

Dietary patterns and risk of prostate cancer in Ontario, Canada

Int J Cancer

Dietary patterns and risk of prostate cancer in US men

Cancer Epidemiol Biomarkers Prev

Prognostic criteria in patients with prostate cancer: Gleason score versus volume-weighted mean nuclear volume

Clin Cancer Res

Development of the Melbourne Ffq: A food frequency questionnaire for use in an australian prospective study involving an ethnically diverse cohort

Asia Pac J Clin Nutr