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Weight loss improved intestinal permeability in prostate cancer patients who followed a low-carbohydrate diet.

Evidence indicates that gut microbiota may influence urologic health, including prostate cancer (PC), possibly via influencing intestinal permeability (IP). According to several studies, diet changes and weight loss may improve IP. The Carbohydrate and Prostate Study 2 (CAPS2) clinical trial demonstrated that a low-carbohydrate diet (LCD) significantly reduced weight in men with PC and slowed the progression of PC disease.

This study was published in the Annals of Medicine and investigated the effects of LCD on an IP marker, zonulin, and an inflammation marker, high-sensitivity C-reactive protein (hsCRP).

Using prostate-specific antigen doubling time (PSADT) as the marker, the 6-month randomized controlled trial compared the effects of an LCD intervention to placebo on PC progression. All 45 participants had a history of PC therapy, PSADT >3 and <36 months, and a BMI of  ≥ 24 kg/m2.

At six months, zonulin decreased in the LCD group while it grew slightly in the control group (p= 0.014). There were no changes found in hsCRP. A significant relationship between weight change and log (PSADT) was also revealed, such that the higher the weight loss, the longer the PSADT (p= 0.003). Similar inverse trends were seen between the change in zonulin and log (PSADT) (p=0.050). Nonetheless, the analysis of mediation revealed that zonulin was not a significant mediator of the effect of weight change on PSADT (p= 0.3).

This research demonstrated that weight loss is directly beneficial to PSADT and that an improvement in IP, as demonstrated by a decrease in zonulin, may also be beneficial to PSADT.

It is suggested that future research should investigate the potential relationship between IP and inflammation and determine whether an improvement in IP is connected with a reduction in PC development. Future studies should investigate this hypothesis in greater depth, given the positive connections. [1]

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Lin, P. H., Howard, L., & Freedland, S. J. (2022). Weight loss via a low-carbohydrate diet improved the intestinal permeability marker, zonulin, in prostate cancer patients. Annals of Medicine, 54(1), 1221-1225. https://doi.org/10.1080/07853890.2022.2069853