Clinical nutrition ESPEN · 2026
The role of nutrition in prostate cancer risk, progression, and mortality: A comprehensive review.
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Souroujon Torun Ariela A, Sundaresan Vinaik, Golos Aleksandra, Leapman Michael S, Gomez-Santamaría Olga A, Casilla-Lennon Marianne
Аннотация
BACKGROUND: Prostate cancer (PCa) is one of the most prevalent malignancies among men worldwide, yet evidence-based nutritional recommendations for its prevention and progression remain limited. Growing research indicates that diet may play a significant role in modulating PCa risk, tumor behavior, and mortality.
OBJECTIVE: This narrative review synthesizes current evidence on major dietary components, including carbohydrates, protein sources, fats, vegetables, vitamins, and minerals. It evaluates their associations with PCa incidence, progression, and disease-specific mortality.
METHODS: This narrative review synthesized evidence from PubMed/MEDLINE, Embase, and Web of Science (up to 2025), including randomized trials, observational studies, and meta-analyses, to evaluate associations between dietary factors and prostate cancer incidence, progression, and mortality.
FINDINGS: High intake of simple sugars and refined carbohydrates is associated with elevated PCa risk, whereas complex carbohydrates are associated with a more favorable metabolic profile. Evidence consistently supports increased fish consumption and suggests potential benefit from soy products. In contrast, high intake of red/processed meats and full-fat dairy may increase the risk of aggressive disease. Total and saturated fat intake is associated with poorer outcomes, although evidence on omega-3 fatty acids is mixed. Cruciferous vegetables show a strong protective factor, supported by epidemiologic data, whereas evidence for allium vegetables is emerging. Findings for micronutrients were highly heterogeneous: lycopene and physiologic vitamin E levels may confer benefit, whereas high-dose vitamin A derivatives, supplemental folic acid, selenium, and excessive dairy-derived calcium may increase PCa risk.
CONCLUSION: Although evidence is often inconsistent, several dietary patterns appear promising for PCa prevention and decreasing mortality. Emphasizing complex carbohydrates, fish, soy, plant-based fats, and cruciferous vegetables-while limiting simple sugars, red/processed meats, whole milk, saturated fats, and unnecessary supplementation-may support improved outcomes. High-quality randomized trials remain urgently needed to clarify causality and refine clinical nutrition guidance for PCa.
OBJECTIVE: This narrative review synthesizes current evidence on major dietary components, including carbohydrates, protein sources, fats, vegetables, vitamins, and minerals. It evaluates their associations with PCa incidence, progression, and disease-specific mortality.
METHODS: This narrative review synthesized evidence from PubMed/MEDLINE, Embase, and Web of Science (up to 2025), including randomized trials, observational studies, and meta-analyses, to evaluate associations between dietary factors and prostate cancer incidence, progression, and mortality.
FINDINGS: High intake of simple sugars and refined carbohydrates is associated with elevated PCa risk, whereas complex carbohydrates are associated with a more favorable metabolic profile. Evidence consistently supports increased fish consumption and suggests potential benefit from soy products. In contrast, high intake of red/processed meats and full-fat dairy may increase the risk of aggressive disease. Total and saturated fat intake is associated with poorer outcomes, although evidence on omega-3 fatty acids is mixed. Cruciferous vegetables show a strong protective factor, supported by epidemiologic data, whereas evidence for allium vegetables is emerging. Findings for micronutrients were highly heterogeneous: lycopene and physiologic vitamin E levels may confer benefit, whereas high-dose vitamin A derivatives, supplemental folic acid, selenium, and excessive dairy-derived calcium may increase PCa risk.
CONCLUSION: Although evidence is often inconsistent, several dietary patterns appear promising for PCa prevention and decreasing mortality. Emphasizing complex carbohydrates, fish, soy, plant-based fats, and cruciferous vegetables-while limiting simple sugars, red/processed meats, whole milk, saturated fats, and unnecessary supplementation-may support improved outcomes. High-quality randomized trials remain urgently needed to clarify causality and refine clinical nutrition guidance for PCa.