Low Carbohydrate Diets Reduce Metabolic Syndrome Risk in Prostate Cancer
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Metabolic syndrome is a common medical comorbidity, which may be associated with both prostate cancer and worse prostate cancer outcomes. The authors of this retrospective study pooled data from two randomized trials which evaluated the utility of a low carbohydrate diet (LCD) versus usual care on prostate cancer care in men who have started hormone therapy or have failed primary treatment. One of the trials also included a physical activity component. An LCD significantly reduced metabolic syndrome. Estimated cardiovascular risk was significantly reduced based on BMI, but this risk reduction failed to meet statistical significance when based on lipid profiles.
- These data support the use of an LCD as a component of prostate cancer care. The sample size was small (79 total patients), and the outcomes did not specifically address prostate cancer outcomes. Nevertheless, reduction in metabolic syndrome may be an important endpoint in men undergoing advanced prostate care, given the known cardiovascular risks of androgen deprivation.
abstract
This abstract is available on the publisher's site.
Access this abstract nowPURPOSE
A low carbohydrate diet (LCD) was shown to suggestively slow prostate cancer (PC) growth. In noncancer patients, LCDs improve metabolic syndrome (MetS) without weight loss. However, concerns about negative impact on cardiovascular disease (CVD) risk remain. The objective of this secondary analysis is to determine the impact of an LCD on risk of MetS and estimated CVD risk in patients with PC.
MATERIALS AND METHODS
Pooled data were analyzed from 2 randomized trials testing LCD vs control on 1) preventing insulin resistance after starting hormone therapy (CAPS1) and 2) slowing PC growth in recurrent PC after failed primary treatment (CAPS2). Both trials included a usual care control vs LCD intervention in which patients were instructed to limit carbohydrate intake to ≤20 gm/day, and in CAPS1 only, to walk for ≥30 minutes/day for ≥5 days/week. MetS components (hypertension, high triglycerides, low high-density lipoprotein cholesterol, central obesity and diabetes), 10-year CVD risk estimated using the Framingham Score with either body mass index (BMI) or lipids, and remnant cholesterol were compared between arms using mixed models adjusting for trial.
RESULTS
LCD resulted in a significantly reduced risk of MetS (p=0.004) and remnant cholesterol (p <0.001). Moreover, LCD resulted in significantly lower estimated CVD risk using BMI (p=0.002) over the study with no difference in estimated CVD risk using lipids (p=0.14).
CONCLUSIONS
LCD resulted in a significantly reduced risk of MetS and remnant cholesterol, and a significantly lower estimated CVD risk using BMI. By comparison, there was no difference in estimated CVD risk using lipids. Study limitations include small sample size, short followup, and inability to distinguish effects of carbohydrate restriction and weight loss. Long-term studies are needed to confirm this finding.
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Additional Info
Disclosure statements are available on the authors' profiles:
Low Carbohydrate Diets and Estimated Cardiovascular and Metabolic Syndrome Risk in Prostate Cancer
J Urol 2021 Dec 01;206(6)1411-1419, SJ Freedland, LE Howard, A Ngo, A Ramirez-Torres, I Csizmadi, S Cheng, A Mack, PH LinFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
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