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00925njm 22002777a 4500 dc Castelló Pastor, Adela author Boldo, Elena author Amiano, Pilar author Castaño-Vinyals, Gemma author Aragones, Nuria author Gómez-Acebo, Inés author Peiró, Rosana author Jimenez-Moleon, Jose J. author Alguacil, Juan author Tardón, Adonina author Cecchini, Lluís author Lope Carvajal, Virginia author Dierssen-Sotos, Trinidad author Mengual, Lourdes author Kogevinas, Manolis author Pollan-Santamaria, Marina author Perez-Gomez, Beatriz author MCC-Spain Researchers author 2018 PURPOSE: We explored the association of the previously described Western, prudent and Mediterranean dietary patterns with prostate cancer risk by tumor aggressiveness and extension. MATERIALS AND METHODS: MCC-Spain (Multicase-Control Study on Common Tumors in Spain) is a population based, multicase-control study that was done in 7 Spanish provinces between September 2008 and December 2013. It collected anthropometric, epidemiological and dietary information on 754 histologically confirmed incident cases of prostate cancer and 1,277 controls 38 to 85 years old. Three previously identified dietary patterns, including Western, prudent and Mediterranean, were reconstructed using MCC-Spain data. The association of each pattern with prostate cancer risk was assessed by logistic regression models with random, province specific intercepts. Risk according to tumor aggressiveness (Gleason score 6 vs greater than 6) and extension (cT1-cT2a vs cT2b-cT4) was evaluated by multinomial regression models. RESULTS: High adherence to a Mediterranean dietary pattern rich not only in fruits and vegetables but also in fish, legumes and olive oil was specifically associated with a lower risk of Gleason score greater than 6 prostate cancer (quartile 3 vs 1 relative RR 0.66, 95% CI 0.46-0.96 and quartile 4 vs 1 relative RR 0.68, 95% CI 0.46-1.01, p-trend = 0.023) or with higher clinical stage (cT2b-T4 quartile 4 vs 1 relative RR 0.49, 95% CI 0.25-0.96, p-trend = 0.024). This association was not observed with the prudent pattern, which combines vegetables and fruits with low fat dairy products, whole grains and juices. The Western pattern did not show any association with prostate cancer risk. CONCLUSIONS: Nutritional recommendations for prostate cancer prevention should consider whole dietary patterns instead of individual foods. We found important differences between the Mediterranean dietary pattern, which was associated with a lower risk of aggressive prostate cancer, and Western and prudent dietary patterns, which had no relationship with prostate cancer risk. J Urol. 2018 Feb;199(2):430-437. 10.1016/j.juro.2017.08.087 1527-3792 0022-5347 The Journal of urology 28842246 http://hdl.handle.net/20.500.12105/8553 Mediterranean Diet Prevention & control Principal component analysis Prostatic neoplasms Risk Mediterranean Dietary Pattern is Associated with Low Risk of Aggressive Prostate Cancer: MCC-Spain Study