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Dietary Fat and Androgens

Division of Endocrinology, Diabetes, and Metabolism, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104

Address correspondence to:. Prakash Seshadri, Division of Endocrinology, Diabetes, and Metabolism, University of Pennsylvania School of Medicine, 4 Penn Tower, 3400 Spruce Street, Philadelphia, Pennsylvania 19104. E-mail: p.seshadri{at}att.net.

To the editor:

Wang et al. (1) have performed a well-controlled dietary study demonstrating that an isocaloric low-fat diet decreases urine and serum androgens, and possibly by doing so lowering prostate cancer risk. The authors suggest that lower testosterone concentrations may be primarily due to lower cholesterol concentrations. Decreased testosterone production also may have been due to the decreases in LH and FSH that were observed by the authors. LH pulsatility was not accounted for in this study and may have contributed to lower testosterone concentrations. The effect of macronutrient variation on the regulation of pituitary hormones suggests a role of peripheral hormones that regulate energy homeostasis, such as leptin (2). When healthy men were fasted for 3 d, serum testosterone and pulsatile LH decreased in association with a decrease in pulsatile leptin (3). Essentially though, leptin concentration should not change if total energy intake remains constant, as occurred in this study (3). Interestingly, in healthy women, it has been shown that a high-carbohydrate/low-fat diet over 24 h increases diurnal leptin concentrations relative to a high-fat/low-carbohydrate diet (4). The diet used by Wang et al. (1) could theoretically cause leptin levels to rise, and thus there should be no effect on LH pulsatility. The hypothesis that a low-fat diet reduces androgens and thus potentially decreases the risk of prostrate cancer may also be tempered by the fact that leptin is elevated with low-fat/high-carbohydrate feeding. Increased leptin has been associated in vivo with increased prostate cancer risk (5) and in vitro with prostate cancer cell growth (6). Also, a high-fat/low-carbohydrate (high energy dense) diet may potentially increase prostate cancer risk as it is associated with obesity, a state in which elevated leptin concentrations are found. Analysis of leptin pulsatility in normal weight individuals on a low-fat diet may elucidate more clearly the link between diet and prostate cancer risk.

Received March 21, 2005.

References

1. Wang C, Catlin DH, Starcevic B, Heber D, Ambler C, Berman N, Lucas G, Leung A, Schramm K, Lee PWN, Hull L, Swerdloff RS 2005 Low-fat high-fiber diet decreased serum and urine androgens in men. J Clin Endocrinol Metab 90:3550–3559[Abstract/Free Full Text]
2. Ahima RS, Flier JS 2000 Adipose tissue as an endocrine organ. Trends Endocrinol Metab 11:327–332[CrossRef][Medline]
3. Chan JL, Heist K, DePaoli AM, Veldhuis JD, Mantzoros CS 2003 The role of falling leptin levels in the neuroendocrine and metabolic adaptation to short-term starvation in healthy men. J Clin Invest 111:1409–1421[CrossRef][Medline]
4. Havel PJ, Townsend R, Chaump L, Teff K 1999 High-fat meals reduce 24-h circulating leptin concentrations in women. Diabetes 48:334–341[Abstract]
5. Kaaks R, Lukanova A, Rinaldi S, Biessy C, Soderberg S, Olsson T, Stenman U-H, Riboli E, Hallmans G, Stattin P 2003 Interrelationships between plasma testosterone, SHBG, IGF-I, insulin and leptin in prostate cancer cases and controls. Eur J Cancer Prev 12:309–315[CrossRef][Medline]
6. Saglam K, Aydur E, Yilmaz I, Goktas S 2003 Leptin influences cellular differentiation and progression in prostate cancer. J Urol 169:1308–1311[CrossRef][Medline]
7. Guthrie N, Carroll KK 1999 Specific versus non-specific effects of dietary fat on carcinogenesis. Prog Lipid Res 38:261–271[CrossRef][Medline]

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