The Men's Eating and Living (MEAL) Study: A Cancer and Leukemia Group B pilot trial of dietary intervention for the treatment of prostate cancer
ABSTRACT To evaluate the feasibility of implementing a diet-based intervention in men with prostate cancer.
Seventy-four men aged 50 to 80 years with biopsy-proven adenocarcinoma of the prostate were randomized to receive either telephone-based dietary counseling or standardized, written nutritional information. Telephone dietary counseling targets included increased intakes of vegetables (particularly cruciferous vegetables and tomato products), whole grains, and beans/legumes. Dietary intakes and plasma carotenoid levels were assessed at baseline and at 6 months' follow-up.
In the intervention arm, mean daily intakes of total vegetables, crucifers, tomato products, and beans/legumes increased by 76%, 143%, 292%, and 95%, respectively, whereas fat intake decreased by 12% (P = 0.02). In the control arm, there were no significant changes in mean intakes of total vegetables, tomato products, crucifers, beans/legumes, or fat. Similarly, in the intervention arm, mean plasma levels of alpha-carotene, beta-carotene, lutein, lycopene, and total carotenoids increased by 33%, 36%, 19%, 30%, and 26%, respectively (P <0.05). In the control arm, there were no significant changes in plasma levels of alpha- or beta-carotene, lutein, lycopene, or total carotenoids.
Telephone-based dietary counseling increases vegetable intake, decreases fat intake, and significantly increases plasma levels of potentially anticarcinogenic carotenoids in men with prostate cancer. These data support the feasibility of implementing clinical trials of dietary intervention in men with prostate cancer.
SourceAvailable from: J. Kellogg Parsons[Show abstract] [Hide abstract]
ABSTRACT: Epidemiological data suggest robust associations of high vegetable intake with decreased risks of bladder cancer incidence and mortality, but translational prevention studies have yet to be performed. We designed and tested a novel intervention to increase vegetable intake in patients with non-invasive bladder cancer. We randomized 48 patients aged 50 to 80 years with biopsy-proven non-invasive (Ta, T1, or carcinoma in situ) urothelial cell carcinoma to telephone- and Skype-based dietary counseling or a control condition that provided print materials only. The intervention behavioral goals promoted 7 daily vegetable servings, with at least 2 of these as cruciferous vegetables. Outcome variables were self-reported diet and plasma carotenoid and 24-hour urinary isothiocyanate (ITC) concentrations. We used 2-sample t-tests to assess between-group differences at 6-month follow-up. After 6 months, intervention patients had higher daily intakes of vegetable juice (p=0.02), total vegetables (p=0.02), and cruciferous vegetables (p=0.07); lower daily intakes of energy (p=0.007), (p=0.002) and energy from fat (p=0.06); and higher plasma alpha-carotene concentrations (p=0.03). Self-reported cruciferous vegetable intake correlated with urinary ITC concentrations at baseline (p<0.001) and at 6 months (p=0.03). Although urinary ITC concentrations increased in the intervention group and decreased in the control group, these changes did not attain between-group significance (p=0.32). In patients with non-invasive bladder cancer, our novel intervention induced diet changes associated with protective effects against bladder cancer. These data demonstrate the feasibility of implementing therapeutic dietary modifications to prevent recurrent and progressive bladder cancer.Cancer Prevention Research 07/2013; 6(9). DOI:10.1158/1940-6207.CAPR-13-0050 · 5.27 Impact Factor
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ABSTRACT: Adverse changes in nutrition-related outcomes including quality of life (QoL) occur after PBSC transplantation. This randomised controlled trial aims to evaluate the impact of nutrition and exercise counselling provided at hospital discharge on nutritional status, body composition and QoL post transplantation. Usual care (UC) (n=19) received no intervention after discharge; extended care (EC) (n=18) received fortnightly telephone counselling from a dietitian and exercise physiologist up to 100 days post transplantation. Nutritional status (patient-generated subjective global assessment, and diet history), QoL (EORTC QLQ-C30 version 3) and body composition (air displacement plethysmography) were assessed at pre-admission, discharge and 100 days post transplantation. Intervention groups were compared using two-sample t-tests of changes in the outcomes; results were adjusted using analysis of covariance. EC exhibited clinically important but not statistically significant increases in protein intake (14.7 g; confidence interval (CI) 95% -6.5, 35.9, P=0.165), cognitive functioning (7.2; CI 95% -7.9, 22.2, P=0.337) and social functioning (16.5; CI 95% -7.3, 40.3, P=0.165) compared with UC. Relative to pre-admission, EC experienced less weight loss than UC (-3.3 kg; CI 95% -6.7, 0.2, P=0.062). Physical activity was not significantly different between the groups. Ongoing nutrition and exercise counselling may prevent further weight loss and improve dietary intake and certain QoL components in autologous PBSC transplantation patients following hospitalisation.Bone Marrow Transplantation advance online publication, 7 April 2014; doi:10.1038/bmt.2014.52.Bone marrow transplantation 04/2014; DOI:10.1038/bmt.2014.52 · 3.47 Impact Factor
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ABSTRACT: Diet may substantially alter prostate cancer initiation and progression. However, large-scale clinical trials of diet modification have yet to be performed for prostate cancer. The Men's Eating and Living (MEAL) Study (CALGB 70807 [Alliance]) is investigating the effect of increased vegetable consumption on clinical progression in men with localized prostate cancer.Contemporary Clinical Trials 05/2014; 38(2). DOI:10.1016/j.cct.2014.05.002 · 1.99 Impact Factor