A nutrient-wide association study for risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition and the Netherlands Cohort Study

Research output: Contribution to journalArticle


Purpose: The evidence from the literature regarding the association of dietary factors and risk of prostate cancer is inconclusive. 

Methods: A nutrient-wide association study was conducted to systematically and comprehensively evaluate the associations between 92 foods or nutrients and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cox proportional hazard regression models adjusted for total energy intake, smoking status, body mass index, physical activity, diabetes and education were used to estimate hazard ratios and 95% confidence intervals for standardized dietary intakes. As in genome-wide association studies, correction for multiple comparisons was applied using the false discovery rate (FDR < 5%) method and suggested results were replicated in an independent cohort, the Netherlands Cohort Study (NLCS). 

Results: A total of 5916 and 3842 incident cases of prostate cancer were diagnosed during a mean follow-up of 14 and 20 years in EPIC and NLCS, respectively. None of the dietary factors was associated with the risk of total prostate cancer in EPIC (minimum FDR-corrected P, 0.37). Null associations were also observed by disease stage, grade and fatality, except for positive associations observed for intake of dry cakes/biscuits with low-grade and butter with aggressive prostate cancer, respectively, out of which the intake of dry cakes/biscuits was replicated in the NLCS. 

Conclusions: Our findings provide little support for an association for the majority of the 92 examined dietary factors and risk of prostate cancer. The association of dry cakes/biscuits with low-grade prostate cancer warrants further replication given the scarcity in the literature.


  • Nikos Papadimitriou
  • David Muller
  • Piet A. van den Brandt
  • Milan Geybels
  • Chirag J. Patel
  • Marc J. Gunter
  • David S. Lopez
  • Timothy J. Key
  • Aurora Perez-Cornago
  • Pietro Ferrari
  • Paolo Vineis
  • Elisabete Weiderpass
  • Heiner Boeing
  • Antonio Agudo
  • María José Sánchez
  • Kim Overvad
  • Tilman Kühn
  • Renee T. Fortner
  • Domenico Palli
  • Carmen Santiuste
  • Bas H. Bueno-de-Mesquita
  • Vittorio Krogh
  • Anne Tjønneland
  • Dorthe Furstrand Lauritzen
  • Aurelio Barricarte Gurrea
  • José Ramón Quirós
  • Pär Stattin
  • Antonia Trichopoulou
  • Georgia Martimianaki
  • Anna Karakatsani
  • Elin Thysell
  • Ingegerd Johansson
  • Fulvio Ricceri
  • Rosario Tumino
  • Nerea Larrañaga
  • Kay Tee Khaw
  • Elio Riboli
  • Ioanna Tzoulaki
  • Konstantinos K. Tsilidis
External organisations
  • University of Ioannina
  • International Agency for Research on Cancer, World Health Organization
  • Imperial College London
  • Maastricht University
  • Harvard Medical School
  • University of Texas Health Science Center at Houston
  • University of Oxford
  • German Institute of Human Nutrition
  • Catalan Institute of Oncology
  • Andalusian School of Public Health
  • University of Granada
  • CIBER Epidemiology and Public Health (CIBERESP)
  • Aarhus University
  • German Cancer Research Centre
  • Institute for Cancer Research, Prevention and Clinical Network (ISPRO)
  • Murcia Regional Health Council
  • National Institute for Public Health and the Environment (RIVM)
  • University Medical Center Utrecht
  • University of Malaya
  • Istituto Nazionale dei Tumori
  • Danish Cancer Society Research Center
  • University of Copenhagen
  • Health Research Institute of Navarra (IDISNA)
  • Public Health Directorate
  • Uppsala University
  • Hellenic Health Foundation, Athens
  • National and Kapodistrian University of Athens
  • Umeå University
  • University of Turin
  • Civic and M.P Arezzo Hospital
  • Public Health Division of Gipuzkoa
  • Addenbrooke's Hospital
  • University of Cambridge
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Nutrition and Dietetics


  • Cohort study, Diet, Epidemiology, Nutrition, Prostate cancer
Original languageEnglish
Pages (from-to)2929-2937
Number of pages9
JournalEuropean Journal of Nutrition
Issue number7
Early online date2019 Nov
Publication statusPublished - 2020 Oct
Publication categoryResearch