African American men see biggest survival gain from healthier lifestyles post prostate cancer diagnosis

Research conducted across multiple institutions, including the University of Southern California, University of Hawaii, and Harvard T.H. Chan School of Public Health reported that healthier lifestyle and dietary behaviors after prostate cancer (PCa) diagnosis were linked to improved survival.

A significant association was found for African American men in reducing prostate cancer–specific deaths. African American men with higher lifestyle scores had a 54% lower risk of dying from prostate cancer compared to those with lower lifestyle scores.

Prostate cancer remains a leading cause of cancer-related death among men in the United States, prompting inquiries into modifiable behaviors that might improve outcomes. African American men face the highest risk of PCa-specific death, making it essential to explore how lifestyle factors influence survival outcomes. Prior research suggests that modifiable behaviors, such as diet and exercise, could play a role in improving prognosis.

Evidence suggests post-diagnosis smoking, eating processed foods, and high-fat dairy consumption can raise mortality risks. Exercise has also been associated with reduced prostate cancer mortality and improved physical functioning.

In the study, “Race and Ethnicity, Lifestyle, Diet, and Survival in Patients With Prostate Cancer,” published in JAMA Network Open, researchers applied a prospective cohort approach to investigate the influence of healthy lifestyle and dietary patterns on survival outcomes.

Study participants were men aged 45 to 75 recruited between 1993 and 1996 in the Multiethnic Cohort. Those with nonmetastatic prostate cancer completed a follow-up questionnaire between 2003 and 2008. Data on diet, physical activity, body mass index, and smoking were captured alongside clinical information from state cancer registries.

Researchers measured lifestyle and dietary quality via multiple indices, including the 2021 Prostate Cancer Behavior Score and the Healthy Eating Index–2015. Cox proportional hazards models were used to assess associations with all-cause, cardiovascular disease–related, and prostate cancer–specific mortality.

Findings showed that healthier post-diagnostic habits corresponded to lower all-cause mortality, driven primarily by fewer cardiovascular disease deaths. African American participants exhibited a notable benefit in prostate cancer–specific outcomes with higher lifestyle scores, while no strong associations emerged for other groups.

Researchers noted that African American men in the study had lower initial lifestyle scores, indicating a greater opportunity for improvement. Compared to other groups, they had the highest rates of proinflammatory and pro-insulinemic diets, factors linked to increased mortality.

The strong survival benefit observed in this group suggests that adopting healthier behaviors, such as improved diet and increased physical activity, may be particularly impactful in reducing their PCa-specific mortality risk.

Healthy eating choices were associated with a reduced risk of all-cause mortality. No diet or lifestyle indices showed consistent reductions in prostate cancer–specific deaths across the entire cohort.

Conclusions indicated that men with nonmetastatic prostate cancer may benefit from behavioral counseling to address comorbid conditions, thereby improving overall survival. Researchers emphasized the necessity for continued investigation in larger and more diverse populations.

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