Prostate cancer is the second leading cause of cancer death in U.S. men, yet most patients die from other causes. We examined whether adherence to healthy dietary patterns after diagnosis is associated with overall and cause-specific survival.
We analyzed 6,085 men with prostate cancer (1986 to 2016) in the Health Professionals Follow-up Study. Five dietary patterns-Alternative Healthy Eating Index (AHEI), Mediterranean diet (AMED), DASH, anti-insulinemic, and anti-inflammatory diets-were derived from validated food frequency questionnaires every 4 years. Post-diagnosis scores were cumulatively averaged, and changes from pre- to post-diagnosis were calculated. Multivariable Cox models estimated hazard ratios (HR) and 95% CIs for mortality through 2024.
Over 71,760 person-years, 3,710 deaths occurred (592 prostate cancer, 971 cardiovascular disease [CVD], 2,147 other). Greater post-diagnosis adherence to AHEI (Q5 vs Q1, HR 0.75, 95% CI 0.66 to 0.86) and AMED (HR 0.80, 95% CI 0.70 to 0.92) was associated with lower all-cause mortality. Increased adherence after diagnosis also predicted better survival, particularly for AHEI. Survival benefits were stronger among men with less aggressive disease. Increased AHEI adherence was associated with lower CVD mortality (HR 0.82, 95% CI 0.66 to 1.03), but no associations were observed for prostate cancer-specific survival. Limitations include the observational design and potential residual confounding.
Adherence to healthy dietary patterns, especially AHEI and AMED, after prostate cancer diagnosis was associated with improved survival, particularly in less aggressive disease. These findings support dietary improvement as a part of survivorship care.
Journal of the National Cancer Institute. 2026 Mar 15 [Epub ahead of print]
Binkai Liu, Caroline Himbert, Jane B Vaselkiv, Colleen B Mcgrath, Leeann Lucas, Yiwen Zhang, Chaoran Ma, Mingyang Song, Rebecca E Graff, Edward L Giovannucci, Meir J Stampfer, Konrad H Stopsack, Qi Sun, Lorelei A Mucci
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Department of Nutrition, University of Massachusetts Amherst, Amherst, MA, USA.