Is lifestyle responsible for our epidemic of prostate cancer
(url not available at drmirkin.com, article taken
from mail.yahoo on 20150208)

Is Lifestyle Responsible for our Epidemic of Prostate Cancer?
 
By age 90, almost all North American men will develop
prostate cancer, and the incidence of prostate cancer
is rising in countries that eat the typical Western
diet. An excellent extensive review of the world's
scientific research concludes: "Heart healthy equals
prostate healthy . . . the best dietary advice for
prostate cancer prevention or management seems to
include: increasing fruits and vegetables, replacing
refined carbohydrates with whole grains, reducing
total and saturated fat, reducing overcooked meats and
consuming a moderate amount of calories and reducing
carbohydrates with a primary goal of obtaining and
maintaining a healthy body weight" (BMC Medicine,
January 8, 2015;13(3).

 Another extensive review shows that exercise is
associated with a lowered risk for prostate cancer and
its recurrence (Cancer Epidemiology, Biomarkers &
Prevention, January 28, 2015). The literature
overwhelmingly shows that to reduce your chances of
developing prostate cancer, avoid being overweight and
do not use tobacco or excessive alcohol.

Elevated Blood Sugar a Risk Factor for Prostate Cancer 
Prostate cancer is associated with everything that
raises blood sugar levels: metabolic syndrome (pre-
diabetes), diabetes, inflammation, obesity and weight
gain (Cancer Causes and Control, 05/14/2014), lack of
exercise (Cancer Epidemiology, Biomarkers &
Prevention, 04/02/2014), and lack of vitamin D.
Vitamin D deficiency blocks insulin receptors to raise
blood sugar levels and increase risk for diabetes.
Scientists have not shown that high blood sugar levels
cause prostate cancer, but they have shown that having
high blood sugar levels is associated with increased
prostate cancer risk.

 A high rise in blood sugar causes a marked increase
in insulin and IGF-1, hormones that cause cells to
multiply and grow to increase cancer risk. People who
take in a lot of refined carbohydrates have high
insulin and IGF-1 levels and are at increased risk for
prostate cancer (Prostate, 2008, 68:11-19). 

This year, the Annual Scientific Meeting of the
American Urological Association had several papers
associating prostate cancer with factors that raise
blood sugar levels:
 * Men who eat lots of high complex carbohydrate foods
(fiber, whole grains) that are associated with low
blood sugar levels are at reduced risk for prostate
cancer. Diets rich in sugar-added foods and drinks are
associated with increased prostate cancer risk (#PD31-11).
 * High milk intake is associated with increased risk
for rapidly progressive advanced prostate cancer.
Yogurt, ice cream and cheese consumption were not
associated with either advanced or localized cancer
(#PD31-06). 
* Having two or more metabolic syndrome components was
associated with an increased risk of high-grade
prostate cancer (obesity, high blood pressure,
elevated fasting blood sugar (>100), high fasting
insulin (>5), low HDL cholesterol (<40), high
triglycerides (>150), or fatty liver and storing fat
primarily in the belly (#PD31-01).

Metformin 
We do not know if metformin helps to prevent prostate
cancer. Metformin is a drug that is used to treat
diabetes because it lowers high blood sugar levels. In
some studies, it reduces prostate cancer risk and
death from prostate cancer in humans (J Clin Oncol.
2013, 31:3069-3075), while in other studies, it offers
no protection at all (Prostate Cancer Prostatic Dis,
2013, 16:391-397). 

Lack of Vitamin D 
Men who have low blood levels of vitamin D are at
increased risk for prostate cancer and specifically
for the type of prostate cancer that kills (Clinical
Cancer Research, May 1, 2014). Vitamin D plays several
critical roles in how cells develop and grow. Vitamin
D helps to regulate how stem cells change into
prostate cells and the rate that normal cells turn
into cancer cells. Adding vitamin D to prostate cells
in a petri dish slows their rate of growth. Perhaps
not having enough vitamin D can cause normal cells to
become cancerous. Researchers found that almost all of
667 men referred for prostate biopsies because of high
blood PSA tests or abnormal prostate exams had low
levels of vitamin D. Their levels of hydroxy vitamin D
were usually below 20ng/ml. Normal is 30 to 80.
Furthermore, 44 percent of the men with prostate
cancer had very low levels of vitamin D compared to 38
percent of those who tested negative. The lower the
level of vitamin D, the more likely the cancer was to
kill them.

Protein 
No good data determines whether the amount of protein
you eat affects prostate cancer risk. One recent study
reported that low protein intake is associated with
lower risk for prostate cancer in men 65 and younger,
while in men older than 65, low protein intake was
associated with a higher risk for cancer and death
(Cell Metab, 2014, 19:407-417).

 Red meat has been associated with increased advanced
prostate cancer risk (Am J Clin Nutr, 2010, 91:712-
721). Fish may be associated with reduced death from
prostate cancer. Cooking protein without water
(grilling, broiling, frying and so forth) increases
cancer risk because it causes carcinogens called
Advanced Glycation Endproducts (AGEs) to form. When
you cook with water, sugar binds to the water and is
harmless. When you cook without water, sugar binds to
protein and nucleic acids to form AGEs that are known
carcinogens (Cancer Causes Control, 2012, 23:405-420).

Fruits and Vegetables 
Eating a diet rich in fruits and vegetables is
associated with reduced risk for suffering prostate
cancer (Int J Urol, 2012, 19:134-141 and Asian Pac J
Cancer Prev, 2014, 15:5223-5227) and reduced risk for
recurrence in men already diagnosed with prostate
cancer (Int J Cancer, 2012, 131:201-210).

My Recommendations 
I think the data is strong enough to recommend that
you follow a prostate-healthy (and heart-healthy) diet
as much as you can:
 * Eat plenty of fruits and vegetables,
 * Restrict sugared drinks and sugar-added foods,
 * Replace refined carbohydrates with whole grains,
beans, nuts and other seeds,
 * Restrict red meat,
 * Restrict cooking meat at high temperatures,
 * Restrict fried foods