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The relation of -linolenic acid to the risk of prostate cancer: a systematic review and meta-analysis^1,2,3

¹ From the General Internal Medicine Section, Medical Service, Veterans Affairs Medical Center, San Francisco, CA (JAS and SB), and the Department of Epidemiology and Biostatistics (JAS and SB) and the Osher Center for Integrative Medicine (Y-HC), School of Medicine, University of California, San Francisco, CA.

² Presented at the symposium, "Fifth International Congress on Vegetarian Nutrition," held in Loma Linda, CA, March 4–6, 2008.

³ Reprints not available. Address correspondence to JA Simon, General Internal Medicine Section (111A1), San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA, 94121. E-mail: joel.simon{at}ucsf.edu.

Background: -Linolenic acid (ALA; 18:3n–3) has been associated inconsistently with an increased risk of prostate cancer. Additional studies have become available since the publication of 2 previous meta-analyses.

Objective: The objective was to review the published data on the relation between ALA and prostate cancer.

Design: We conducted a systematic review to identify studies that included data on ALA and risk of prostate cancer. Data were pooled from studies that compared the highest ALA quantile with the lowest ALA quantile, and risk estimates were combined by using a random-effects model.

Results: The relation between ALA and prostate cancer is inconsistent across studies. We pooled data from 8 case-control and 8 prospective studies. The summary estimate revealed that high ALA dietary intakes or tissue concentrations are weakly associated with prostate cancer risk (relative risk [RR]: 1.20; 95% CI: 1.01, 1.43). When examined by study type (ie, retrospective compared with prospective or dietary ALA compared with tissue concentration) or by decade of publication, only the 6 studies examining blood or tissue ALA concentrations revealed a statistically significant association. With the exception of these studies, there was significant heterogeneity and evidence of publication bias. After adjustment for publication bias, there was no association between ALA and prostate cancer (RR: 0.96; 95% CI: 0.79, 1.17).

Conclusions: Studies examining the relation between ALA and prostate cancer have produced inconsistent findings. High ALA intakes or high blood and adipose tissue concentrations of ALA may be associated with a small increased risk of prostate cancer. However, these conclusions are qualified because of the heterogeneity across studies and the likelihood of publication bias.

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