Put down that hot dog!

While I admit to eating some lovely shish kabob steak this weekend, I am always interested in the ongoing data that supports changing our diets to improve our odds of dying from prostate cancer. Most studies support lowering fat overall and also decreasing carbohydrates. The carbs story makes some sense because we know that insulin (and IGF1) are probably growth factors for prostate cancer. For fat, the story is not quite so clear. We have been studying the intake of certain fatty acids by prostate cancer cells in culture and have noted that they tend to use fat as a source of energy more than do some other kinds of cancers like breast cancer. This might explain to some extent why FDG (glucose) PET scans don’t work so well in prostate cancer. On the other hand, for all the patients who ask, “doesn’t cancer feed on sugar”, the answer is yes, but so does your brain. And your body (especially the liver) can make glucose from other substrates like fat and amino acids through a process called gluconeogenesis. If it wasn’t for this process, your blood sugar would drop and your brain would seize (literally a seizure) and you would die. Unfortunately, the amount of sugar needed to keep your brain functioning is probably sufficient to keep most cancer cells alive too.

But back to the hot dog and fat. Not all fats are alike. The Mediterranean diet is high in unsaturated plant fats especially olive oil. In a recent analysis of 4577 men in the Health Professions Follow-up Study, “Replacing 10% of energy intake from carbohydrate with vegetable fat was associated with a lower risk of lethal prostate cancer (hazard ratio [HR], 0.71; 95% CI, 0.51-0.98; P = .04) and all-cause mortality (HR, 0.74; 95% CI, 0.61-0.88; P = .001).” This isn’t the first study to demonstrate benefits of this diet, and suggests a healthy way to replace your hot dog. Get out the olive oil and sauté some veggies – and stay away from the ice cream for desert!

Happy 4th of July America. Is this a great country or what?