Archive for month: December, 2024

A new study led by UCLA Health Jonsson Comprehensive Cancer Center investigators offers new evidence that dietary changes may help reduce cancer cell growth in patients undergoing active surveillance, a treatment approach that involves regular monitoring of the cancer without immediate intervention.

The findings, published in the Journal of Clinical Oncology, show that a diet low in omega-6 and high in omega-3 fatty acids, combined with fish oil supplements, significantly reduced the growth rate of prostate cancer cells in men with early-stage disease.

“This is an important step toward understanding how diet can potentially influence prostate cancer outcomes,” said Dr. William Aronson, Professor of Urology at the David Geffen School of Medicine at UCLA and first author of the study. “Many men are interested in lifestyle changes, including diet, to help manage their cancer and prevent the progression of their disease. Our findings suggest that something as simple as adjusting your diet could potentially slow cancer growth and extend the time before more aggressive interventions are needed.”

Many men with low-risk prostate cancer choose active surveillance over immediate treatment, however, within five years, about 50% of these men eventually need to undergo therapy with either surgery or radiation. Because of this, patients are eager to find ways to delay the need for treatment, including through dietary changes or supplements. However, specific dietary guidelines in this area have yet to be established. While other clinical trials have looked at increasing vegetable intake and healthy diet patterns, none have found a significant impact on slowing cancer progression.

To determine whether diet or supplements can play a role in managing prostate cancer, the UCLA-led team conducted a prospective clinical trial, called CAPFISH-3, that included 100 men with low risk or favorable intermediate risk prostate cancer who chose active surveillance. Participants were randomly assigned to either continue their normal diet or follow a low omega-6, high omega-3 diet, supplemented with fish oil, for one year.

Participants in the intervention arm received dietary personalized counseling by a registered dietician nutritionist, either in-person, through telehealth or by phone. Patients were guided on healthier, lower fat alternatives for high fat/high calorie foods (such as using olive oil or lemon and vinegar for salad dressing), and on reducing consumption of foods with higher omega-6 content (such as, chips, cookies, mayonnaise and other fried or processed foods). The goal was to create a favorable balance of their intake of omega-6 and omega-3 fats and make participants feel empowered to control how they change their behavior. They were also given fish oil capsules for extra omega-3s. The control group did not get any dietary counseling or take fish oil capsules.

The researchers tracked changes in a biomarker called the Ki-67 index, which indicates how fast cancer cells are multiplying-a key predictor of cancer progression, metastasis and survival.

Same site biopsies were obtained at the start of the study and again after the one-year mark, using an image fusion device that helps track and locate the cancer sites.

Results showed that the low omega-6, omega-3 rich diet and fish oil group had a 15% decrease in the Ki-67 index, while the control group saw a 24% increase.

“This significant difference suggests that the dietary changes may help slow cancer growth, potentially delaying or even preventing the need for more aggressive treatments,” said Aronson, who is also the Chief of urologic oncology at the West Los Angeles Veterans Affairs Medical Center and member of the UCLA Health Jonsson Comprehensive Cancer Center.

While the results are promising, researchers did not find any differences in other cancer growth markers, such as Gleason grade, which are commonly used to track prostate cancer progression.

The investigators caution that further research is necessary to confirm the long-term benefits of omega-3 fatty acids and lowering omega-6 in managing prostate cancer. The findings support further, larger trials to explore the long-term impact of dietary changes on cancer progression, treatment outcomes and survival rates in men on active surveillance.

Reference:

William J. Aronson, Tristan Grogan, Pei Liang, Patricia Jardack, Amana R. Liddell, Claudia Perez, David Elashoff, Jonathan Said, Pinchas Cohen, Leonard S. Marks, Susanne M. Henning. High Omega-3, Low Omega-6 Diet With Fish Oil for Men With Prostate Cancer on Active Surveillance: The CAPFISH-3 Randomized Clinical Trial. Journal of Clinical Oncology, 2024; DOI: 10.1200/JCO.24.00608

China: A recent cross-sectional study conducted at a university hospital has revealed a significant link between gluteal muscle size and density and the risk of trochanteric fractures (TRFs) in older women. The findings, published in BMJ Open, suggest that these muscle parameters are associated with TRFs independently of bone mineral density (BMD), highlighting their role in fracture risk among this population.

A new study published in the journal of Diabetes Care showed that people chosen based on their metabolic syndrome can effectively avoid diabetes by taking 1,700 mg of MET daily. Nearly 90% of fatalities in Europe are caused by noncommunicable diseases (NCDs). Metabolic syndrome (MetS), characterized by a clustering of metabolic risk factors such as abdominal obesity, dyslipidemia, high blood pressure, and high fasting glycemia, is a significant risk factor for the development of NCDs.

A 1.5-fold increase in the risk of all-cause mortality, a 2.5-fold increase in cardiovascular mortality, a two-fold increase in the risk of coronary and cerebrovascular illnesses, and a 5-fold increase in the risk of type 2 diabetes are all caused by the MetS. This Metformin and Dietary Restriction to Prevent Age-Related Morbid Events in People With Metabolic Syndrome (MeMeMe) study examined whether 1,700 mg of metformin (MET) per day, with or without a Mediterranean diet intervention (MedDiet), could lower the cumulative incidence of major noncommunicable diseases in individuals with metabolic syndrome.

1 of 4 interventions was randomly allocated to 1,442 individuals which where MET (1,700 mg/day) plus MedDiet intervention (MET+MedDiet), placebo plus MedDiet intervention, MET (1,700 mg/day) alone, or placebo alone. On average, the participants were monitored for 3 years. The cumulative incidence of major non-communicable illnesses, such as cancer, type 2 diabetes, and cardiovascular diseases, was the main outcome. Type 2 diabetes incidence and the shifting frequency of metabolic syndrome were secondary outcomes.

The MET+MedDiet group had a crude incidence of 6.7 cases per 100 person-years, while the MET alone group had a crude incidence of 6.9, whereas the placebo plus MedDiet group had a crude incidence of 13.3, and the group receiving placebo had an incidence of 11.3. The reduction in type 2 diabetes was 80% and 92% lower in the MET and MET+MedDiet groups, respectively, when compared to a placebo, entirely explained the differences.

Overall, this study clearly shows that among individuals chosen for the existence of MetS, 1,700 mg/day of MET is an excellent way to avoid diabetes. After being randomly assigned, only 22 people stopped taking MET which indicated the recommended dosage was safe. Despite the MedDiet intervention by itself did not appear to be effective in lowering diabetes and MetS, it was helpful when combined with MET intake, which enhanced the effects of medication.

Reference:

Pasanisi, P., Oliverio, A., Baldassari, I., Bruno, E., Venturelli, E., Bellegotti, M., Gargano, G., Morelli, D., Bognanni, A., Rigoni, M., Muti, P., & Berrino, F. (2024). Metformin Treatment With or Without Mediterranean Diet for the Prevention of Age-Related Diseases in People With Metabolic Syndrome: The MeMeMe Randomized Trial. In Diabetes Care. American Diabetes Association. https://doi.org/10.2337/dc24-1597