We recently reviewed evidence relating diet and prostate cancer, suggesting that a traditional Cretan Mediterranean style diet based on a variety of plant foods (fruits, vegetables, wholegrain cereals, nuts and legumes), olive oil as the main source of fat, low intake of red meat, moderate to low intake of dairy foods, moderate to high intake of fish and moderate intake of wine, mostly consumed with meals, may be helpful in reducing prostate cancer risk.

Importantly, the Mediterranean diet has other health benefits that further support its widespread adoption. A recent meta-analysis of prospective cohort studies using an a priori score to assess adherence to a Mediterranean diet found that stronger adherence was associated with reduced all cause, cardiovascular and cancer mortality, as well as decreased incidence of Parkinson’s and Alzheimer’s diseases (1).

Two intervention studies have supported the benefits of a Mediterranean style diet on metabolic risk factors (2) (3). In a Spanish study, men and women with elevated levels of cardiovascular risk factors were randomized to either of two “Mediterranean” diets and provided with either olive oil or nuts, or to a control low fat diet. After 3 months the Mediterranean diet groups had lower mean plasma glucose, systolic blood pressure and total/HDL cholesterol ratio than the control group (2).

Italian adults with the Metabolic Syndrome were randomized to a “Mediterranean” diet or a “prudent” diet, both with similar macronutrient composition. The “Mediterranean” diet was associated with greater improvements in markers of vascular risk and endothelial function than the control group (3). It should be noted however that in both studies the “Mediterranean” diet groups received more nutrition education than the control groups.

The Lyon Heart Study demonstrated that a modified Cretan diet low in butter and meats, and high in fish, fruits and enriched with α-linolenic acid from canola oil was more effective than a ‘prudent’ diet in the secondary prevention of coronary events and overall mortality (4). We have also shown that a Cretan style diet reduced HbA1c from a mean of 7.1% (95% CI: 6.5-7.7) to 6.8% (95% CI: 6.3-7.3) (p=0.012), in people with type 2 diabetes (unpublished data).

Simopoulos (5) notes that the traditional Greek diet resembles the Paleolithic diet in terms of fibre, antioxidants, saturated and monounsaturated fat, thus is consistent with human evolution. While traditional diets must reflect the regionally available foods, the characteristics of the traditional Greek diet can be applied in many countries, notwithstanding the likely effect of environment and growing methods on the nutrient composition of plant and animal foods. The evidence suggests that a traditional Greek or Cretan style diet is consistent with what humans have evolved to consume and may protect against common chronic diseases, including prostate cancer.

References:
1. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. Bmj 2008;337:a1344.
2. Estruch R, Martinez-Gonzalez MA, Corella D, et al. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med 2006;145:1-11.
3. Esposito K, Marfella R, Ciotola M, et al. Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. J Am Med Assoc 2004;292:1440-6.
4. de Lorgeril M, Salen P. Modified Cretan Mediterranean diet in the prevention of coronary heart disease and cancer. In: Simopoulos AP, Visioli F, eds. Mediterranean Diets. World Review Nutr Diet. Basel: Karger, 2000:1-23.
5. Simopoulos AP. The traditional diet of Greece and cancer. Eur J Cancer Prev 2004;13:219-30.

Written by:
Allison Hodge, MD, and Catherine Itsiopoulos, MD, as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc… of their research by referencing the published abstract.

Source: UroToday