Canada: Reduction of serum cholesterol through dietary interventions significantly lowers serum prostate-specific antigen (PSA) and the risk of prostate cancer, claims a recent study in Canadian Urological Association Journal.
Previous studies have shown that statins may lower serum PSA and improve the outcomes of prostate cancer through cholesterol-dependent and independent mechanisms. Dietary modifications also have been said to have an established role in the reduction of serum cholesterol but it is not clear if diet-driven cholesterol reductions yield similar PCa benefits to that observed with statins.

Against the above background, Viranda H. Jayalath, Division of Surgery-Urology, Faculty of Medicine, University of Toronto, Toronto, Canada, and colleagues aimed to investigate the effect of diet-driven cholesterol reduction on serum PSA and estimated-PCa risk.
For this purpose, the researchers included a total of 291 men from six published randomized controlled trials of dietary interventions. Men were aged ≥40 years, free of PCa, and had baseline PSA <10.0 ng/mL. For 8-24 weeks, participants received one of four diets (low-glycemic index, high-fiber, low-glycemic load, or cholesterol-lowering).
The primary outcomes evaluated the association between change from baseline low-density lipoprotein cholesterol (LDL-C) and PSA. The Prostate Cancer Prevention Trial (PCPT) risk calculator (limited to age ≥55 years, baseline PSA ≥1.0 ng/mL) was used to estimate how cholesterol reduction modified PCa risk.
The researchers reported the following findings:
Baseline PSA was 0.90 ng/mL (interquartile range [IQR] 0.55-1.60) and LDL-C was 90 mg/dL (IQR 69-125).
In multivariate regression, PSA decreased 1.9% per 10% reduction in LDL-C.
This regression was greater in men with baseline PSA ≥2.0 ng/mL (-5.4% per 10% LDL-C reduction).
In men with estimable PCPT risk, statin-comparable LDL-C reductions (≥15%) reduced PSA by 12% and estimated PCa risk by 6.5%.
"This is the first study to show that serum cholesterol reduction through dietary interventions significantly lowered serum PSA and estimated PCa risk," the researchers wrote. "However, an investigation is warranted on whether cholesterol-lowering diets improve PCa outcomes."
Reference:
Jayalath , V. H. ., Lajkosz , K. ., Fleshner , N. E. ., Hamilton, R. J., & Jenkins , D. J. . (2022). The effect of lowering cholesterol through diet on serum prostate-specific antigen levels: A secondary analysis of clinical trials. Canadian Urological Association Journal, 16(8), 279–82. https://doi.org/10.5489/cuaj.7975