Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Can diet and exercise mitigate cardiovascular risk in prostate cancer survivors treated with androgen deprivation therapy? A systematic review (#560)

Hattie H Wright 1 2 , Meegan Walker 1 , Suzanne Broadbent 1 , Karina Rune 1 , Michelle Morris 3 , Cindy Davis 1 , Anao Zhang 4 , Rob Newton 5 6 , Skye Marshall 7 8 9
  1. University of the Sunshine Coast, Sippy Downs, QLD, Australia
  2. Sunshine Coast Health Institute, Britinya, Queensland, Australia
  3. Medical Oncology, Sunshine Coast University Private Hospital, Britinya, Qld, Australia
  4. School of Social Work, University of Michigan, Michigan, USA
  5. Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
  6. School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Qld, Australia
  7. Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Qld, Australia
  8. The Centre for Health Services Research, University of Queensland, Brisbane, Qld, Australia
  9. Nutrition and Dietetics Research Group, Bond University, Gold Coast, Qld, Australia

Introduction: Lifestyle medicine may mitigate the elevated risk of cardiovascular disease (CVD) experienced by prostate cancer (PCa) survivors treated with androgen deprivation therapy (ADT); however, evidence synthesis is lacking. The aim of this review was to synthesize the synergistic effect of diet and exercise on CVD risk in PCa survivors treated with ADT.

Methods: A systematic review was conducted, searching four databases in May 2023. Studies were eligible if they implemented an intervention which included both dietary and exercise components in adults who had previously received or were receiving ADT for treatment of PCa. Outcomes were CVD incidence, CVD events, and cardiometabolic biomarkers. Studies were appraised using the Quality Criteria Checklist and confidence in the body of evidence was appraised using GRADE.

Results: Seven studies (n=5 randomized controlled trials, n=2 pre-post trials) were included investigating a healthy Western dietary pattern alongside aerobic and resistance exercise (n=4 studies), a low carbohydrate diet alongside aerobic exercise (n=2 studies), and protein supplementation alongside resistance exercise (n=1 study). All studies had low risk of bias. A healthy Western dietary pattern alongside aerobic and resistance exercise improved blood pressure (GRADE: Moderate), HDL cholesterol (GRADE: Low), and flow mediated dilation (GRADE: N/A). A low carbohydrate diet alongside aerobic exercise improved HDL cholesterol, metabolic syndrome incidence, and Framingham CVD risk score (GRADE: N/A for all). Protein supplementation alongside resistance exercise had no effect.

Conclusion: Despite the substantial burden of CVD in PCa survivors with a history of ADT treatment, there was a scarcity of evidence investigating the mitigating effects of diet and exercise. A healthy Western dietary pattern combined with aerobic and resistance exercise may improve some risk factors; however, evidence was heterogenous and based on small samples. Well-designed lifestyle medicine interventions targeting CVD outcomes in this population are required.