MEAL Deal.

Top Line: Everyone knows that you should eat your vegetables.

The Study: In fact, there is an increasing amount of data that suggests that dietary habits are linked to the risk of developing multiple types of cancer. Despite this, randomized trials of diet and clinical outcomes in oncology are rare. Here, authors impressively randomized over 400 men with early-stage prostate cancer to active surveillance +/- vegetables. More specifically, the Men’s Eating and Living (MEAL) Study, aka CALGB 70807, was a prospective randomized at 91 US centers enrolling men ages 50-80 with prostate adenocarcinoma grade group 1 or 2, cT2a or less with a PSA <10 ng/mL. Patients were randomized to a counseling behavioral intervention by telephone that promoted consumption of seven or more daily vegetable servings (n=237) or a control group that received written information about diet and prostate cancer (n=241). The primary endpoint was time to progression defined as PSA ≥10, PSA doubling time <3 years, or upgrade in tumor size or grade on subsequent biopsy. All of that to say, there was no statistical difference in time to progression between groups (44% alive without progression after intervention compared to 41% otherwise). It's unclear if this all came down to men not following verbal cues.

TBL: A homegrown behavioral intervention to increase vegetable consumption unfortunately failed to reduce the risk of early-stage prostate cancer progression. | Parsons, JAMA 2020