SAN DIEGO—Carbohydrate restriction may be effective in ameliorating adverse effects associated with androgen-deprivation therapy (ADT) for prostate cancer, according to study findings presented at the American Urological Association annual meeting.
The study, Stephen J. Freedland, MD, of Cedars-Sinai Medical Center in Los Angeles, randomized 42 men starting ADT to follow a low-carbohydrate diet (20 total grams per day) or a standard diet (controls). Of these, 11 in the low-carbohydrate group and 18 in the control arm completed the 6-month study. The primary outcome was the difference between 6-month and baseline (pre-ADT) insulin sensitivity as measured by homeostasis model assessment (HOMA) between study arms.
From baseline to 3 months after ADT initiation, the low-carbohydrate group experienced a mean 19% decrease in HOMA, whereas the control arm had a mean 7% increase, a significant between-group difference. At the 6-month mark, the low-carbohydrate group had a mean 4% decrease in HOMA and the controls had a 36% increased, but the difference was not significant.
In addition, the low-carbohydrate group experienced a mean 9.3 kg weight loss at 6 months, whereas those in the control group had a mean 1.3 kg weight gain. During the 6-month period, bone mineral content, as measured by DXA scans, increased 0.1% in the low-carbohydrate arm and declined 2.3% in the control group. Fat body mass decreased 16.2% in the low-carbohydrate arm and increased 11% in the control arm. These between-group differences were statistically significant.
The study found no significant difference between the study arms with respect to PSA changes. In both groups, PSA levels declined 99% by 6 months.