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American Journal of Clinical Nutrition, Vol. 74, No. 4, 549-554, October 2001

Original Research Communication

Dairy products, calcium, and prostate cancer risk in the Physicians' Health Study1,2,3

June M Chan, Meir J Stampfer, Jing Ma, Peter H Gann, J Michael Gaziano and Edward L Giovannucci

1 From the Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston; the Channing Laboratory, the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; the Department of Preventive Medicine, Northwestern University Medical School, Chicago; the Division of Preventive Medicine, Brigham and Women's Hospital, Boston; and Massachusetts Veterans Epidemiology and Information Center, VA Boston Health Care System.

Background: A high calcium intake, mainly from dairy products, may increase prostate cancer risk by lowering concentrations of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], a hormone thought to protect against prostate cancer. The results of epidemiologic studies of this hypothesis are inconclusive.

Objective: We investigated the association between dairy product and calcium intakes and prostate cancer risk in the Physicians' Health Study, a cohort of male US physicians.

Design: At baseline, the men answered abbreviated dietary questionnaires. During 11 y of follow-up, we documented 1012 incident cases of prostate cancer among 20885 men. We estimated dairy calcium intake on the basis of consumption of 5 major dairy products and used logistic regression to estimate relative risk.

Results: At baseline, men who consumed >600 mg Ca/d from skim milk had lower plasma 1,25(OH)2D3 concentrations than did those consuming <=150 mg Ca/d [71 compared with 85 pmol/L (30.06 compared with 35.64 pg/mL); P = 0.005]. Compared with men consuming <=0.5 daily servings of dairy products, those consuming >2.5 servings had a multivariate relative risk of prostate cancer of 1.34 (95% CI: 1.04, 1.71) after adjustment for baseline age, body mass index, smoking, exercise, and randomized treatment assignment in the original placebo-controlled trial. Compared with men consuming <=150 mg Ca/d from dairy products, men consuming >600 mg/d had a 32% higher risk of prostate cancer (95% CI: 1.08, 1.63).

Conclusions: These results support the hypothesis that dairy products and calcium are associated with a greater risk of prostate cancer.

Key Words: Dairy products calcium prostate cancer vitamin D diet Physicians' Health Study 1 25-dihydroxyvitamin D3

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