Systematic review highlights diet’s role in prostate cancer outcomes

In this interview, Stephen J. Freedland, MD, a professor of urology at Cedars-Sinai in Los Angeles, California, discussed findings from a recent systematic review examining the relationship between diet and prostate cancer risk and outcomes.¹ Given the abundance of conflicting studies—some emphasizing specific foods like tomatoes or nutrients such as lycopene—his team sought a broader, more clinically relevant approach by focusing on overall dietary patterns rather than isolated components.

The review included 63 studies, the majority of which (49) were observational cohort studies that tracked dietary habits and prostate cancer outcomes over time. Although informative, these studies carry inherent limitations, such as confounding lifestyle factors and the lack of randomized trial design. Only a small number of randomized clinical trials were identified, limiting the strength of the available evidence.

Among men without prostate cancer, the analysis suggested that plant-based, healthy dietary patterns were associated with a lower risk of developing the disease. Surprisingly, the Mediterranean diet—which has shown benefits in other areas of health—was not consistently linked to prostate cancer risk reduction.

For men already diagnosed with prostate cancer, dietary patterns emphasizing plant-based foods, Mediterranean-style eating, and particularly low-inflammatory diets were more consistently associated with reduced risk of progression and prostate cancer–specific mortality. These findings suggest that lowering systemic inflammation through diet may be a promising strategy for improving outcomes.

However, the evidence was not entirely uniform. One randomized study of low-carbohydrate diets demonstrated potential benefits, a finding that somewhat contradicts the plant-based emphasis and highlights the complexity of diet–cancer relationships.

Freedland emphasized that although current data point toward potential benefits of healthier dietary patterns, significant gaps remain—most notably the lack of high-quality randomized trials. Still, the overall takeaway is that adopting balanced, plant-forward, and anti-inflammatory diets may support better prostate cancer prevention and management.

REFERENCE

1. Lin P-H, Burwell AD, Giovannucci EL, et al. Dietary patterns in prostate cancer prevention and management: A systematic review of prospective cohort studies and randomized clinical trials. Eur Urol. 2025 Aug 19:S0302-2838(25)00433-6. doi:10.1016/j.eururo.2025.07.017