The role of nutrition in prostate cancer risk, progression, and mortality: A comprehensive review.

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.