Author: Haley Adams

Affiliation: Dietetics Student, University of Kentucky, Lexington, Kentucky

Date: April 19th, 2019.

Title: Animal Products In The Diet and Their Effect on Hormone-

Sensitive Cancer Development

INTRODUCTION:

Hormone-sensitive cancers are prevalent and may be linked to certain diets,

particularly those high in animal products, which include meat, fish, eggs and dairy.

The hormone-sensitive cancers targeted in this review are breast cancer and

prostate cancer. According to the American Cancer Society, in 2019 there will be an

estimated 1.7 million cancer cases in the U.S. alone, including hormone-sensitive

cancers (1). A diet high in animal products is linked to a higher hormone-sensitive

cancer incidence (2,4-9). A vegetarian or vegan diet may be protective against

hormone-sensitive cancer development (2, 6,7,8). Men following a vegan diet had

the lowest prostate cancer incidence, (HR: 0.65; 95% CI: 0.49, 0.85). When

observing breast cancer incidence in a population of women, breast cancer rates

decreased on a vegan diet (fully excludes animal products) from the group following

a non-vegetarian diet (high in animal fat and animal protein), (25.9 ± 25.6 mg vs.

18.1 ± 15.6 mg, P < 0.001). It is beneficial to examine the amount of certain cancers

developing at a higher rate with an omnivorous, non-vegetarian diet, as it is rare to

have diet guidelines as a protective measure against hormone-sensitive cancers.

PURPOSE OF CURRENT REVIEW:

 The purpose of this review is to examine the relationship of diet and

hormone-sensitive cancer development. The hormone-sensitive cancers analyzed

for this review include: breast cancer, prostate cancer, hematopoietic cancer, and

cancer of the lymph tissue. A diet low or void of animal products has shown

protective against breast cancer, prostate cancer and other various cancer

development; while diets high in meat and processed meats were associated with an

increase in hormone-sensitive and other various cancer development (6,7,8,9).

Evidence supports the theory of plant foods being the protective factor against

hormone-sensitive cancer development (6,8,9). Some evidence supports the

elimination or strict limitation of meat from the diet in order to be protective

against hormone-sensitive cancers (4,6).

METHODS:

Selecting relevant studies can be tedious, as study choices that include

hormone-sensitive cancer development rates within the necessary diet groups are

few. 15 studies were selected. Selection criteria included whether the study was

peer-reviewed, was published within the last 5 years, and contained only human

subjects. PubMed and Google Scholar were the databases used for locating these

studies. Table 1 shows the key words searched to find breast cancer studies,

prostate cancer studies, and all cancer studies.

Table 1: Key Words Searched to Find Studies.

Key words searched to find studies:
 Breast Cancer Studies Breast cancer diet, vegan diet breast cancer, breast
cancer vegetarian, vegan breast cancer, meat and
breast cancer.
Prostate Cancer Studies Vegan prostate cancer, prostate cancer, vegetarian
prostate cancer, prostate cancer diet.

All Cancer Studies Cancer and diet, vegan diet cancer, vegetarian
cancer, plant based cancer, meat and cancer,
cancer lifestyle, meat intake cancer, animal
products cancer.

Once the studies were found and organized within the respective categories,

a table was created to organize all of the data. Table 2, shown in the results section,

organizes and combines the data from studies 2, 3, 4 and 7. Once the data is

combined a formula was used to create Table 3, which shows the percent of cancer

based on a specific diet. The formula used to calculate each percentage is shown in

Equation 1, below.

number of cancer patients

Equation 1 : ∗100 %
total number of patients

RESULTS:

The synthesized results from studies 2, 3, 4 and 7 are shown in Table 1.

Studies were selected for Table 1 if the study provided a total number of

participants and had at least two diet groups (non-vegetarian, vegetarian) and

included breast cancer, prostate cancer or various cancer incidences. Figure 2

shows the percentages from averaging the data of studies 2, 3, 4, and 7.

Table 2

Total
Total
Total particip
Brea Prost Particip
Various/ Particip ants in
st ate ants In
Cancer Type All ants in Prostat
Canc Cance All
Cancers Breast e
er r Cancer
Cancer Cancer
Studies
Studies Studies
Total Cancer
Population in
892 1,079 9,866 50404 27,188 199,549
all studies
reviewed
Non-
vegetarian,
414 503 7,296 24211 13105 118,405
omnivorous
diet
Vegetarian
(including 478 576 2,574 26193 14,072 81,133
vegan)

Table 3

Breast Prostate Various/All

Cancer Type
Cancer Cancer Cancers
Non-
vegetarian,
2% 4% 6%
omnivorous
diet

Vegetarian
(including 2% 4% 3%
vegan)

Total cancer percentages were doubled when averaging the numbers from

the four studies, revealing a 6% cancer development in non-vegetarians and only a

3% risk in vegetarians, with vegan participants included in the 3%. The total cancer

population was higher than the populations for breast and prostate cancer (199,549
total cancer subjects, 50,404 breast cancer subjects, 27,188 prostate cancer

subjects), which may have created more accurate data.

DISCUSSION:

The averaged statistics in table 2 and table 3, from studies 2, 3, 4, and 7, show

that there were not any changes in cancer development in a non-vegetarian

population versus a vegetarian population for breast or prostate cancer. One

possible error in this data is that it is general; instead of offering a vegetarian and

vegan group, along with a non-vegetarian group, 3 out of the 4 studies only offered

population data for a non-vegetarian group and a vegetarian group. Since a

vegetarian group still consumes animal products, this could be misleading data.

When determining if a plant-based, vegan diet is more protective than an

omnivorous, non-vegetarian diet, this table would not represent that information, as

it only shows the relationship of a diet with a lower consumption of a limited variety

of animal products (vegetarian) and a diet with higher consumption of a full range

of animal products (non-vegetarian).

Breast Cancer

A vegetarian and non-vegetarian group revealed similar rates of breast

cancer development; however, the fully plant-based, vegan participants were not

separated from the vegetarian group (3,10). Not separating vegan participants from

vegetarian participants could be an issue when trying to determine if animal

products in the diet have a positive correlation to breast cancer development, since

a vegetarian diet still includes animal products such as eggs and dairy. A diet high in
fruits and vegetables was protective against developing breast cancer (3). In a study

on Taiwanese women, the vegetarian group, which included vegan participants,

showed protective against developing breast cancer (8). Women with a high meat

intake, including processed meat, were associated with a significantly higher breast

cancer incidence, (OR 2.25, 95% CI: 1.69–2.98, P < 0.001; OR 1.56, 95% CI: 1.14–

2.13, P = 0.006) (8).

When reviewing studies specific to diet and breast cancer, one review

explained that blood samples had been taken from women before switching to a diet

high in plant-based foods and practicing daily exercise, in this case, walking (11).

After 2 weeks of consuming only plant-based foods and walking every day, cancer

cells were placed in the new samples of blood, in vitro. Their new blood samples

killed 20-30% more malignant cancer cells than the original blood samples tested 2

weeks prior to following the new diet and exercise regimen (11). This shows that a

vegan diet, when paired with exercise, offers protective qualities against breast

cancer, as well as qualities that could reverse the progression of breast cancer cells.

In a case-controlled study, 469 women were observed. The control group (236

participants) did not have breast cancer, and the test group (233 participants) were current

breast cancer patients at the time of the study (8). It was determined that there were not

any significant differences between age, education, family history, or regular exercise in

the two groups of women. From this study, it was determined that certain food items

were shown to have a strong association with breast cancer development (8). Women in

the study that consumed meat, processed meat and fat were more likely to develop breast

cancer, (Odds ratio (OR): 2.22, 95% CI 1.67–2.94, P < 0.001) (8). Meanwhile, a
vegetarian dietary pattern and high soy isoflavone intake was associated with a decrease

in risk of developing breast cancer, (25.9 ± 25.6 mg vs. 18.1 ± 15.6 mg, P < 0.001) (8).

In this study, a vegetarian diet, particularly one high in soy, was significantly shown to be

a protective measure against developing breast cancer (8). It would be beneficial to see

this study performed on a larger population, to improve accuracy.

Prostate Cancer

It is estimated that 1 in 9 men will develop prostate cancer within his lifetime

(1). In a national population of men, a diet with high meat intake was strongly and

significantly related to an increased rate of developing prostate cancer (6)

Consuming an increase of plant-based sources of food had a negative correlation to

the development of prostate cancer; the more plant foods eaten, the less likely men

were to develop prostate cancer (6). It is difficult to pinpoint the reasoning for the

decrease in prostate cancer; it could have been the abundance of plant foods

consumed in a vegetarian diet, or it could be the limiting or the complete

elimination of animal products. Vegetarians experience a combination of both

limiting animal products from the diet and increasing plant based sources; a

combination of both factors should not be ruled out when considering the

association between a vegetarian diet and a decreased risk of developing prostate

cancer.

In one study, neither a vegetarian nor a non-vegetarian diet offered

protection against developing prostate cancer. However, when the vegetarian and

non-vegetarian groups were compared to a vegan diet group, the vegan group did
offer a significant reduced rate of developing prostate cancer, (HR: 0.65; 95% CI:

0.49, 0.85) (7). It was theorized that one important difference in the

vegetarian group that showed higher rates of prostate cancer and the

vegan group that showed low rates of prostate cancer, was dairy

consumption (7). The vegan group did not consume dairy, while the

vegetarian group could have dairy, without any specified limitations

(7). It was determined that eliminating dairy may have been the

helping factor in the vegan group, as the high saturated fat content

and high animal protein content may be a component in developing

prostate cancer (7).

Other Cancers

It may be beneficial to note other various cancer incidences in the diet

groups observed, as the general formation of cancer cells remains the same,

regardless of where the cancer is located within the body (1). There has been a

significant decrease in various cancer risk in a vegetarian and vegan group when

compared to a non-vegetarian group, including stomach cancer, colorectal cancer,

lymphatic and hematopoietic cancers, and multiple myeloma (2). When examining a

sample of 61,647 men and women living in the United Kingdom, the vegetarian group

had a significantly lower risk than non-vegetarians for total cancer development. After an

average follow up of 14.9 years, there were 4,998 total cancer incidences; 3,275 in meat

eaters (10.1%) and 1,203 in vegetarians (5.9%) (2). A review and meta-analysis studying

overall health outcomes of vegans and vegetarians did not find a significant decrease in
breast cancer in the vegetarian group, but did find a decrease in total cancer incidence in

the vegan population (p=0.002) (12).

Consuming Plants For Cancer Protection

While studies can find it difficult to pinpoint one diet for cancer prevention,

all studies that examined beneficial plant foods for cancer protection were in

consensus that an increase in plant-based foods in the diet leads to an increase in

overall health. When compared to a diet low in fruits and vegetables, whole grains,

nuts, seeds, beans and legumes, a diet high in these foods showed protection against

various cancers (4,5,7,14,15,16). In Argentina, a low consumption of fruits and

vegetables was found in men suffering from prostate cancer (9).

Plants contain inulin, which may be responsible for increasing gut bacterium

such as F. prausnitzii, which may protect vegetarians and vegans (populations that

consume mostly or fully plant-based foods) against various cancers (13). Another

discovery has been the link of a diet high in cruciferous vegetables and soy foods

and a decreased risk of developing certain cancers, including prostate cancer (14).

It could be that the elimination of animal products allows more calories to be

spent on fruits, vegetables, soy and other legumes; however, this was not the case

for the vegetarian group (which was consuming more fruits, vegetables and soy

than the non-vegetarian group) when cancer rates were compared. (3) In this

particular study, the vegetarian group had similar cancer incidence rates as the non-

vegetarian, control group, which could mean that, on it’s own, adding plants to the

diet is not an effective method for cancer protection.

Eliminating Animal Products For Cancer Protection

The elimination of animal products from the diet may be a protective

measure against developing certain cancers. When changing only the amount of

meat in the diet, a decrease in meat was associated with a decrease in prostate

cancer incidence (7). IGF-1 is a hormone related to animal protein consumption; the

more animal protein consumed, the more IGF-1 in the body (12). Reduced IGF-1

presence in the body is associated with reduced prostate cancer incidence (12).

Certain compounds, such as nitrates, found in red and processed meats may

be associated with the increased cancer rates in non-vegetarians (12). However,

naturally occurring nitrates in plant foods have not been shown to increase the risk

of developing various cancers (12). A review and meta-analysis found a positive

correlation to increased dairy intake and an increased risk of developing prostate

cancer (14,17). Increased dairy consumption being associated with an increase in

prostate cancer development could further explain why some vegetarian

populations did not see protection against hormone-sensitive cancers, since a

vegetarian diet does not eliminate dairy.

CONCLUSIONS:

An increase in animal products is associated with an increase in certain

cancers, including hormone-sensitive cancers such as breast cancer and prostate

cancer. A vegan diet was shown to offer more protection when considering all

various cancer developments, whereas a non-vegetarian diet did not offer

protection for hormone-sensitive cancers nor for total various cancer risks. A

vegetarian diet, which still contains animal products, was also shown to have little

effect on hormone-sensitive cancer prevention. A plant-based or vegan diet, which

excludes all animal products, had the most success in reducing risk of developing

hormone-sensitive cancer.
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