Low Carbohydrate Diets and Estimated Cardiovascular and Metabolic Syndrome Risk in Prostate Cancer.

A low carbohydrate diet (LCD) was shown to suggestively slow prostate cancer (PC) growth. In non-cancer 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 PC patients.

Pooled data were analyzed from two 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 ≤20gram/day, and in CAPS1 only, to walk for ≥30 minutes/day for ≥5 days/week. MetS components (hypertension, high triglycerides, low HDL, central obesity and diabetes), ten-year CVD risk estimated using the Framingham Score with either BMI or lipids, and remnant cholesterol were compared between arms using mixed models adjusting for trial.

and Conclusions: 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). Limitations include small sample size, short follow-up, and inability to distinguish effects of carbohydrate restriction and weight loss. Long-term studies are needed to confirm this finding.

NCT00932672 (CAPS1); NCT01763944 (CAPS2).

The Journal of urology. 2021 Jul 14 [Epub ahead of print]

Stephen J Freedland, Lauren E Howard, Alexis Ngo, Adela Ramirez-Torres, Ilona Csizmadi, Susan Cheng, Alexandra Mack, Pao-Hwa Lin

Center for Integrated Research on Cancer and Lifestyle, Department of Surgery, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California., Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina., Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California., Department of Medicine, Nephrology Division, Duke University Medical Center, Durham, North Carolina.

email news signup