Prostate Cancer Coverage from Every Angle

Could a Low-Carb Diet Improve PSA Levels in Prostate Cancer?

By: Lauren Harrison, MS
Posted: Monday, April 6, 2020

Patients who have been diagnosed with prostate cancer and have biochemical recurrence may reap metabolic benefits and weight loss when eating a low-carbohydrate diet. Exploratory findings from a randomized controlled trial suggest that the low-carbohydrate diet may lead to longer prostate-specific antigen (PSA) doubling time. Stephen J. Freedland, MD, of the Cedars-Sinai Medical Center in Los Angeles, and colleagues published their work in Clinical Cancer Research.

This 6-month trial enrolled 45 patients with prostate cancer who have had a biochemical recurrence after local treatment. Patients had a body mass index above 24 kg/m2 and a PSA doubling time between 3 and 36 months. There were 27 patients within the low-carbohydrate diet group, who were instructed to eat less than 20 g of carbohydrates per day, and 18 control patients, who were told to avoid any changes in their diet.

At the 6-month follow-up, the carbohydrate intake in the low-carbohydrate group decreased by 117 g/day, whereas the control group increased carbohydrate intake by 8 g/day (P < .001). The low-carbohydrate group also lost more weight compared with the control group, with a 12.1-kg loss compared with a 0.5-kg loss on average (P < .001). The low-carbohydrate diet reduced the levels of high-density lipoprotein, triglycerides, and hemoglobin A1C in patients with no difference in total cholesterol or glucose.

The mean PSA doubling time was similar between the low-carbohydrate and control groups (21 months and 15 months, respectively; P = .316). Researchers performed a post hoc analysis of PSA doubling time accounting for prestudy PSA doubling time, baseline PSA levels, primary treatment, and hemoconcentration. The multivariate adjusted PSA doubling time was significantly longer in the low-carbohydrate arm than in the control arm (35 months vs. 16 months; P = .04). Adverse events among enrolled patients were reported to be few and mild.

Disclosure: The authors reported no conflicts of interest.

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