Sarah L Ullevig1, Dean J Bacich2, Jose M Gutierrez2, Ashton Balarin1, C Austin Lobitz1, Denise S O'Keefe2, Michael A Liss3. 1. College for Health, Community and Policy, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, United States. 2. Department of Urology, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78249, United States. 3. Department of Urology, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78249, United States; College of Pharmacy, University of Texas at Austin, 110 Inner Campus Drive, Austin, TX 78705, United States. Electronic address: liss@uthscsa.edu.
Abstract
BACKGROUND & AIMS: Fortification of the US food supply has increased folic acid intake and resulted in a concomitant decrease in neural tube defects in women. However, a body evidence supports the hypothesis that increased circulating folate levels due to excessive dietary or supplemental folic acid may be harmful for men with prostate cancer. Therefore, this pilot study aimed to investigate the feasibility of a reduced folic acid dietary intervention in men on an active surveillance monitoring program for prostate cancer. METHODS: Men with low-grade prostate cancer enrolled into a 12-week dietary folic acid reduction diet. Primary outcome was red blood cell (RBC) folate reduction at 12 weeks. Other outcomes include serum folate, homocysteine, and vitamin B12 levels. The number of patients who complete the trial and reasons for disenrollment or dropout were also assessed. RESULTS: Twenty-eight participants were enrolled into the dietary intervention study. Six participants withdrew from the study and a total of 21 participants completed all baseline and week 12 biochemical assessments. Only 18 participants completed all dietary questionnaires. Participants withdrew from the study due to difficulty with the diet or personal reasons. A substantial reduction was noted in serum folate (p < 0.007), RBC folate (p < 0.001) and dietary consumption of folic acid from foods (p = 0.003) and supplements (p = 0.003) without reduction in serum homocysteine or vitamin B12. Although an overall decrease in PSA from baseline to twelve weeks was found, the reduction was not significant (-3.55 ng/mL, p = 0.197). CONCLUSIONS: This phase 1 feasibility study reduced dietary folic acid intake from food and supplements and successfully lowered serum and RBC folate without resulting harmful effects. Data from this study supports future intervention trials with a larger prostate cancer active surveillance population and has the potential to reduce prostate cancer progression. There are no interventions to reduce progression of prostate cancer in man on active surveillance.
BACKGROUND & AIMS: Fortification of the US food supply has increased folic acid intake and resulted in a concomitant decrease in neural tube defects in women. However, a body evidence supports the hypothesis that increased circulating folate levels due to excessive dietary or supplemental folic acid may be harmful for men with prostate cancer. Therefore, this pilot study aimed to investigate the feasibility of a reduced folic acid dietary intervention in men on an active surveillance monitoring program for prostate cancer. METHODS: Men with low-grade prostate cancer enrolled into a 12-week dietary folic acid reduction diet. Primary outcome was red blood cell (RBC) folate reduction at 12 weeks. Other outcomes include serum folate, homocysteine, and vitamin B12 levels. The number of patients who complete the trial and reasons for disenrollment or dropout were also assessed. RESULTS: Twenty-eight participants were enrolled into the dietary intervention study. Six participants withdrew from the study and a total of 21 participants completed all baseline and week 12 biochemical assessments. Only 18 participants completed all dietary questionnaires. Participants withdrew from the study due to difficulty with the diet or personal reasons. A substantial reduction was noted in serum folate (p < 0.007), RBC folate (p < 0.001) and dietary consumption of folic acid from foods (p = 0.003) and supplements (p = 0.003) without reduction in serum homocysteine or vitamin B12. Although an overall decrease in PSA from baseline to twelve weeks was found, the reduction was not significant (-3.55 ng/mL, p = 0.197). CONCLUSIONS: This phase 1 feasibility study reduced dietary folic acid intake from food and supplements and successfully lowered serum and RBC folate without resulting harmful effects. Data from this study supports future intervention trials with a larger prostate cancer active surveillance population and has the potential to reduce prostate cancer progression. There are no interventions to reduce progression of prostate cancer in man on active surveillance.
Authors: Frederik B Thomsen; Klaus Brasso; Laurence H Klotz; M Andreas Røder; Kasper D Berg; Peter Iversen Journal: J Surg Oncol Date: 2014-03-07 Impact factor: 3.454
Authors: Jeffrey J Tomaszewski; Jessica L Cummings; Anil V Parwani; Rajiv Dhir; Joel B Mason; Joel B Nelson; Dean J Bacich; Denise S O'Keefe Journal: Prostate Date: 2011-02-09 Impact factor: 4.104
Authors: Silvina F Choumenkovitch; Jacob Selhub; Peter W F Wilson; Jeanne I Rader; Irwin H Rosenberg; Paul F Jacques Journal: J Nutr Date: 2002-09 Impact factor: 4.798
Authors: Jan-Erik Johansson; Ove Andrén; Swen-Olof Andersson; Paul W Dickman; Lars Holmberg; Anders Magnuson; Hans-Olov Adami Journal: JAMA Date: 2004-06-09 Impact factor: 56.272
Authors: Montserrat Bacardí-Gascón; Silvia Ley y de Góngora; Brenda Yuniba Castro-Vázquez; Arturo Jiménez-Cruz Journal: Arch Med Res Date: 2003 Jul-Aug Impact factor: 2.235
Authors: Jennifer Williams; Cara T Mai; Joe Mulinare; Jennifer Isenburg; Timothy J Flood; Mary Ethen; Barbara Frohnert; Russell S Kirby Journal: MMWR Morb Mortal Wkly Rep Date: 2015-01-16 Impact factor: 17.586