Post-diagnosis serum insulin like growth factors in relation to dietary and lifestyle changes in the Prostate testing for cancer and Treatment (ProtecT) trial

Vanessa Er, Kalina Biernacka, Andrew Simpkin, Richard Martin, Mona Jeffreys, Pauline Emmett, Becky Gilbert, Kerry Avery, Eleanor Walsh, Michael Davis, Jenny Donovan, David Neal, Freddie C Hamdy, Jeff M. P. Holly, J. Athene Lane

Research output: Contribution to journalArticle (Academic Journal)peer-review

2 Citations (Scopus)
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The insulin-like growth factor (IGF) system is modifiable by diet and lifestyle, and has been linked to prostate cancer development and progression.

We conducted a prospective cohort study of 621 men diagnosed with localized prostate cancer to investigate the associations of dietary and lifestyle changes with post-diagnosis circulating levels of IGF-I and IGFBP-3. We used analysis of covariance to estimate the associations, controlling for baseline IGF-I or IGFBP-3, respectively.

Mean IGF-I levels were 6.5% (95% CI −12.8, −0.3%, p = 0.04) lower in men who decreased their protein intake after diagnosis compared to men who did not change. Men who changed their fruit and vegetable intake had lower IGF-I levels compared to non-changers [Decreased intake: −10.1%, 95% CI −18.4, −1.8%, p = 0.02; Increased intake: −12.0%, 95% CI −18.4, −1.8%, p = 0.002]. IGFBP-3 was 14.6% (95% CI −24.5, −4.8%, p = 0.004) lower in men who achieved a healthy body mass index after diagnosis. Men who became inactive had 9.5% higher average IGF-I levels (95% CI 0.1, 18.9%, p = 0.05).

Decreased protein intake and body mass index, and increased physical activity and fruit and vegetable intake, following a prostate cancer diagnosis were associated with reduced post-diagnosis serum IGF-I and IGFBP-3. Counterintuitively, reduced fruit and vegetable intake was also associated with reduced IGF-I, but with weak statistical support, possibly implicating chance. If confirmed in other studies, our findings may inform potential lifestyle interventions in prostate cancer. ProtecT was registered at International Standard Randomised Controlled Trial Registry, as ISRCTN20141297.
Original languageEnglish
Pages (from-to)877-888
Number of pages12
JournalCancer Causes and Control
Issue number18
Early online date23 Jun 2017
Publication statusPublished - Aug 2017

Structured keywords

  • ICEP
  • Centre for Surgical Research
  • BRTC
  • BTC (Bristol Trials Centre)


  • Prostatic neoplasms
  • Diet
  • Lifestyle
  • Insulin-like growth factors
  • Post-diagnosis


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  • NIHR BRC Surgical Innovation

    Blazeby, J.


    Project: Research, Parent

  • NIHR BRC Nutrition

    Ness, A. R.


    Project: Research, Parent

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