Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

Race and BMI modify associations of calcium and vitamin D intake with prostate cancer

Authors: Ken Batai, Adam B. Murphy, Maria Ruden, Jennifer Newsome, Ebony Shah, Michael A. Dixon, Elizabeth T. Jacobs, Courtney M. P. Hollowell, Chiledum Ahaghotu, Rick A. Kittles

Published in: BMC Cancer | Issue 1/2017

Login to get access

Abstract

Background

African Americans have disproportionately higher burden of prostate cancer compared to European Americans. However, the cause of prostate cancer disparities is still unclear. Several roles have been proposed for calcium and vitamin D in prostate cancer pathogenesis and progression, but epidemiologic studies have been conducted mainly in European descent populations. Here we investigated the association of calcium and vitamin D intake with prostate cancer in multiethnic samples.

Methods

A total of 1,657 prostate cancer patients who underwent screening and healthy controls (888 African Americans, 620 European Americans, 111 Hispanic Americans, and 38 others) from Chicago, IL and Washington, D.C. were included in this study. Calcium and vitamin D intake were evaluated using food frequency questionnaire. We performed unconditional logistic regression analyses adjusting for relevant variables.

Results

In the pooled data set, high calcium intake was significantly associated with higher odds for aggressive prostate cancer (ORQuartile 1 vs. Quartile 4 = 1.98, 95% C.I.: 1.01–3.91), while high vitamin D intake was associated with lower odds of aggressive prostate cancer (ORQuartile 1 vs. Quartile 4 = 0.38, 95% C.I.: 0.18–0.79). In African Americans, the association between high calcium intake and aggressive prostate cancer was statistically significant (ORQuartile 1 vs. Quartile 4 = 4.28, 95% C.I.: 1.70–10.80). We also observed a strong inverse association between total vitamin D intake and prostate cancer in African Americans (ORQuartile 1 vs. Quartile 4 = 0.06, 95% C.I.: 0.02–0.54). In European Americas, we did not observe any significant associations between either calcium or vitamin D intake and prostate cancer. In analyses stratifying participants based on Body Mass Index (BMI), we observed a strong positive association between calcium and aggressive prostate cancer and a strong inverse association between vitamin D intake and aggressive prostate cancer among men with low BMI (<27.8 kg/m2), but not among men with high BMI (≥27.8 kg/m2). Interactions of race and BMI with vitamin D intake were significant (P Interaction < 0.05).

Conclusion

Calcium intake was positively associated with aggressive prostate cancer, while vitamin D intake exhibited an inverse relationship. However, these associations varied by race/ethnicity and BMI. The findings from this study may help develop better prostate cancer prevention and management strategies.
Appendix
Available only for authorised users
Literature
1.
2.
Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T, et al. American Cancer Society guidelines on nutrition and physical activity for cancer prevention. CA Cancer J Clin. 2012;62(1):30–67.CrossRefPubMed
3.
Chan JM, Stampfer MJ, Ma J, Gann PH, Gaziano JM, Giovannucci EL. Dairy products, calcium, and prostate cancer risk in the Physicians’ Health Study. Am J Clin Nutr. 2001;74(4):549–54.PubMed
4.
Feldman D, Krishnan AV, Swami S, Giovannucci E, Feldman BJ. The role of vitamin D in reducing cancer risk and progression. Nat Rev Cancer. 2014;14(5):342–57.CrossRefPubMed
5.
Ahn J, Albanes D, Peters U, Schatzkin A, Lim U, Freedman M, Chatterjee N, Andriole GL, Leitzmann MF, Hayes RB. Dairy products, calcium intake, and risk of prostate cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Cancer Epidemiol Biomarkers Prev. 2007;16(12):2623–30.CrossRefPubMed
6.
Aune D, Navarro Rosenblatt DA, Chan DS, Vieira AR, Vieira R, Greenwood DC, Vatten LJ, Norat T. Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. Am J Clin Nutr. 2015;101(1):87–117.CrossRefPubMed
7.
Park S-Y, Murphy SP, Wilkens LR, Stram DO, Henderson BE, Kolonel LN. Calcium, vitamin D, and dairy product intake and prostate cancer risk: the Multiethnic Cohort Study. Am J Epidemiol. 2007;166(11):1259–69.CrossRefPubMed
8.
Park Y, Mitrou PN, Kipnis V, Hollenbeck A, Schatzkin A, Leitzmann MF. Calcium, dairy foods, and risk of incident and fatal prostate cancer: the NIH-AARP diet and health study. Am J Epidemiol. 2007;166(11):1270–9.CrossRefPubMed
9.
Song Y, Chavarro JE, Cao Y, Qiu W, Mucci L, Sesso HD, Stampfer MJ, Giovannucci E, Pollak M, Liu S, et al. Whole milk intake ss associated with prostate cancer-specific mortality among U.S. male physicians. J Nutr. 2013;143(2):189–96.CrossRefPubMed
10.
11.
Rodriguez C, McCullough ML, Mondul AM, Jacobs EJ, Fakhrabadi-Shokoohi D, Giovannucci EL, Thun MJ, Calle EE. Calcium, dairy products, and risk of prostate cancer in a prospective cohort of United States men. Cancer Epidemiol Biomarkers Prev. 2003;12(7):597–603.PubMed
12.
Giovannucci E, Liu Y, Stampfer MJ, Willett WC. A prospective study of calcium intake and incident and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev. 2006;15(2):203–10.CrossRefPubMed
13.
Rowland GW, Schwartz GG, John EM, Ingles SA. Protective effects of low calcium intake and low calcium absorption vitamin D receptor genotype in the California Collaborative Prostate Cancer Study. Cancer Epidemiol Biomarkers Prev. 2013;22(1):16–24.CrossRefPubMed
14.
Batai K, Murphy A, Shah E, Ruden M, Newsome J, Agate S, Dixon M, Chen H, Deane L, Hollowell CP, et al. Common vitamin D pathway gene variants reveal contrasting effects on serum vitamin D levels in African Americans and European Americans. Hum Genet. 2014;133(11):1395–405.CrossRefPubMedPubMedCentral
15.
Murphy AB, Kelley B, Nyame YA, Martin IK, Smith DJ, Castaneda L, Zagaja GJ, Hollowell CMP, Kittles RA. Predictors of serum vitamin D levels in African American and European American men in Chicago. Am J Mens Health. 2012;6:420–6.CrossRefPubMedPubMedCentral
16.
Jacobs ET, Alberts DS, Foote JA, Green SB, Hollis BW, Yu Z, Martínez ME. Vitamin D insufficiency in southern Arizona. Am J Clin Nutr. 2008;87(3):608–13.PubMedPubMedCentral
17.
Shea MK, Houston DK, Tooze JA, Davis CC, Johnson MA, Hausman DB, Cauley JA, Bauer DC, Tylavsky F, Harris TB, et al. Correlates and prevalence of insufficient 25-hydroxyvitamin D status in black and white older adults: the health, aging and body composition study. J Am Geriatr Soc. 2011;59(7):1165–74.CrossRefPubMedPubMedCentral
18.
Nyame YA, Murphy AB, Bowen DK, Jordan G, Batai K, Dixon M, Hollowell CMP, Kielb S, Meeks JJ, Gann PH, et al. Associations between serum vitamin D and adverse pathology in men undergoing radical prostatectomy. J Clin Oncol. 2016;34(12):1345–9.CrossRefPubMed
19.
20.
Mohler JL, Kantoff PW, Armstrong AJ, Bahnson RR, Cohen M, D’Amico AV, Eastham JA, Enke CA, Farrington TA, Higano CS, et al. Prostate cancer, version 2.2014. J Natl Compr Canc Netw. 2014;12(5):686–718.PubMed
21.
Coates RJ, William Eley J, Block G, Gunter EW, Sowell AL, Grossman C, Greenberg RS. An evaluation of a food frequency questionnaire for assessing dietary intake of specific carotenoids and vitamin E among low-income Black women. Am J of Epidemiol. 1991;134(6):658–71.
22.
Institute of Medicine. Dietary reference intakes for calcium and vitamin D. Washington, DC: National Academy Press; 2011.
23.
World Cancer Research Fund International/American Institute for Cancer Research. Continuous update project report: diet, nutrition, physical acitivity, and prostate cancer. London: WCRF International; 2014.
24.
Brändstedt J, Almquist M, Manjer J, Malm J. Vitamin D, PTH, and calcium and the risk of prostate cancer: a prospective nested case–control study. Cancer Causes Control. 2012;23(8):1377–85.CrossRefPubMed
25.
Schwartz GG, Skinner HG. A prospective study of total and ionized serum calcium and time to fatal prostate cancer. Cancer Epidemiol Biomarkers Prev. 2012;21(10):1768–73.CrossRefPubMed
26.
Albanes D, Mondul AM, Yu K, Parisi D, Horst RL, Virtamo J, Weinstein SJ. Serum 25-hydroxy vitamin D and prostate cancer risk in a large nested case–control study. Cancer Epidemiol Biomarkers Prev. 2011;20(9):1850–60.CrossRefPubMedPubMedCentral
27.
Gilbert R, Metcalfe C, Fraser WD, Donovan J, Hamdy F, Neal DE, Lane JA, Martin RM. Associations of circulating 25-hydroxyvitamin D with prostate cancer diagnosis, stage and grade. Int J Cancer. 2012;131(5):1187–96.CrossRefPubMed
28.
Shui IM, Mondul AM, Lindström S, Tsilidis KK, Travis RC, Gerke T, Albanes D, Mucci LA, Giovannucci E, Kraft P, et al. Circulating vitamin D, vitamin D–related genetic variation, and risk of fatal prostate cancer in the National Cancer Institute Breast and Prostate Cancer Cohort Consortium. Cancer. 2015;121(12):1949–56.CrossRefPubMedPubMedCentral
29.
Murphy AB, Nyame Y, Martin IK, Catalona WJ, Hollowell CMP, Nadler RB, Kozlowski JM, Perry KT, Kajdacsy-Balla A, Kittles R. Vitamin D deficiency predicts prostate biopsy outcomes. Clin Cancer Res. 2014;20:2289–99.CrossRefPubMedPubMedCentral
30.
31.
Barreto AM, Schwartz GG, Woodruff R, Cramer SD. 25-Hydroxyvitamin D3, the prohormone of 1,25-dihydroxyvitamin D3, inhibits the proliferation of primary prostatic epithelial cells. Cancer Epidemiol Biomarkers Prev. 2000;9(3):265–70.PubMed
32.
Qin L-Q, He K, Xu J-Y. Milk consumption and circulating insulin-like growth factor-I level: a systematic literature review. Int J Food Sci Nutr. 2009;60(s7):330–40.CrossRefPubMed
33.
Roddam AW, Allen NE, Appleby P, Key TJ, Ferrucci L, Carter HB, Metter EJ, Chen C, Weiss NS, Fitzpatrick A, et al. Insulin-like growth factors, their binding proteins, and prostate cancer risk: analysis of individual patient data from 12 prospective studies. Ann Intern Med. 2008;149(7):461–71.CrossRefPubMedPubMedCentral
34.
Egan K, Signorello L, Munro H, Hargreaves M, Hollis B, Blot W. Vitamin D insufficiency among African-Americans in the southeastern United States: implications for cancer disparities (United States). Cancer Causes Control. 2008;19(5):527–35.CrossRefPubMed
35.
Benjamin A, Moriakova A, Akhter N, Rao D, Xie H, Kukreja S, Barengolts E. Determinants of 25-hydroxyvitamin D levels in African-American and Caucasian male veterans. Osteoporos Int. 2009;20(10):1795–803.CrossRefPubMed
36.
Kristal AR, Cohen JH, Qu P, Stanford JL. Associations of energy, fat, calcium, and vitamin D with prostate cancer risk. Cancer Epidemiol Biomarkers Prev. 2002;11(8):719–25.PubMed
37.
Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr. 2005;81(5):1147–54.PubMed
38.
Kirkpatrick SI, Dodd KW, Reedy J, Krebs-Smith SM. Income and race/ethnicity are associated with adherence to food-based dietary guidance among US adults and children. J Acad Nutr Diet. 2012;112(5):624–35. e626.CrossRefPubMedPubMedCentral
39.
Bovell-Benjamin A, Dawkins N, Pace R, Shikany JM. Dietary consumption practice and cancer risk in African Americans in the rural South. J Health Care Poor Underserved. 2010;21:57–75.CrossRefPubMed
40.
Hiza HAB, Casavale KO, Guenther PM, Davis CA. Diet quality of Americans differs by age, sex, race/ethnicity, income, and education level. J Acad Nutr Diet. 2013;113(2):297–306.CrossRefPubMed
41.
Savoca MR, Arcury TA, Leng X, Bell RA, Chen H, Anderson A, Kohrman T, Quandt SA. The diet quality of rural older adults in the South as measured by healthy eating index-2005 varies by ethnicity. J Am Diet Assoc. 2009;109(12):2063–7.CrossRefPubMedPubMedCentral
42.
Yanoff LB, Parikh SJ, Spitalnik A, Denkinger B, Sebring NG, Slaughter P, McHugh T, Remaley AT, Yanovski JA. The prevalence of hypovitaminosis D and secondary hyperparathyroidism in obese Black Americans. Clin Endocrinol. 2006;64(5):523–9.CrossRef
43.
Butler LM, Wong AS, Koh W-P, Wang R, Yuan J-M, Yu MC. Calcium intake increases risk of prostate cancer among Singapore Chinese. Cancer Res. 2010;70(12):4941–8.CrossRefPubMedPubMedCentral
44.
Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000;72(3):690–3.PubMed
45.
Byers T. Food frequency dietary assessment: how bad is good enough? Am J Epidemiol. 2001;154(12):1087–8.CrossRefPubMed
46.
Rejnmark L, Avenell A, Masud T, Anderson F, Meyer HE, Sanders KM, Salovaara K, Cooper C, Smith HE, Jacobs ET, et al. Vitamin D with calcium reduces mortality: patient level pooled analysis of 70,528 patients from eight major vitamin D trials. J Clin Endocrinol Metab. 2012;97(8):2670–81.CrossRefPubMedPubMedCentral
47.
Vogiatzi MG, Jacobson-Dickman E, DeBoer MD. Vitamin D supplementation and risk of toxicity in pediatrics: a review of current literature. J Clin Endocrinol Metab. 2014;99(4):1132–41.CrossRefPubMed
48.
Xiao Q, Murphy RA, Houston DK, Harris TB, Chow W, Park Y. Dietary and supplemental calcium intake and cardiovascular disease mortality: the National Institutes of Health–AARP diet and health study. JAMA Intern Med. 2013;173(8):639–46.CrossRefPubMedPubMedCentral
49.
Wallace RB, Wactawski-Wende J, O’Sullivan MJ, Larson JC, Cochrane B, Gass M, Masaki K. Urinary tract stone occurrence in the Women’s Health Initiative (WHI) randomized clinical trial of calcium and vitamin D supplements. Am J Clin Nutr. 2011;94(1):270–7.CrossRefPubMedPubMedCentral
50.
Moyer VA. Vitamin, mineral, and multivitamin supplements for the primary prevention of cardiovascular disease and cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;8(160):558–64.CrossRef
51.
NIH State-of-the Science Panel. National Institutes of Health State-of-the-Science Conference Statement: Multivitamin/Mineral Supplements and Chronic Disease Prevention. Am J Clin Nutr. 2007;85(1):257S–64.
52.
Marshall DT, Savage SJ, Garrett-Mayer E, Keane TE, Hollis BW, Horst RL, Ambrose LH, Kindy MS, Gattoni-Celli S. Vitamin D3 supplementation at 4000 international units per day for one year results in a decrease of positive cores at repeat biopsy in subjects with low-risk prostate cancer under active surveillance. J Clin Endocrinol Metab. 2012;97(7):2315–24.CrossRefPubMedPubMedCentral
53.
Wagner D, Trudel D, Van der Kwast T, Nonn L, Giangreco AA, Li D, Dias A, Cardoza M, Laszlo S, Hersey K, et al. Randomized clinical trial of vitamin D3 doses on prostatic vitamin D metabolite levels and ki67 labeling in prostate cancer patients. J Clin Endocrinol Metab. 2013;98(4):1498–507.CrossRefPubMed
Metadata
Title
Race and BMI modify associations of calcium and vitamin D intake with prostate cancer
Authors
Ken Batai
Adam B. Murphy
Maria Ruden
Jennifer Newsome
Ebony Shah
Michael A. Dixon
Elizabeth T. Jacobs
Courtney M. P. Hollowell
Chiledum Ahaghotu
Rick A. Kittles
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3060-8

Other articles of this Issue 1/2017

BMC Cancer 1/2017 Go to the issue

Research article

Evaluation of pancreatic cancer cell migration with multiple parameters in vitro by using an optical real-time cell mobility assay device

Research article

The C-reactive protein/albumin ratio, a validated prognostic score, predicts outcome of surgical renal cell carcinoma patients

Research article

XLF-mediated NHEJ activity in hepatocellular carcinoma therapy resistance

Study protocol

Implementing exercise in cancer care: study protocol to evaluate a community-based exercise program for people with cancer

Research article

Differential expression of estrogen receptor subtypes and variants in ovarian cancer: effects on cell invasion, proliferation and prognosis

Research article

An orthotopic xenograft model for high-risk non-muscle invasive bladder cancer in mice: influence of mouse strain, tumor cell count, dwell time and bladder pretreatment
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits