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Background: Advanced prostate cancer etiology is poorly understood. Few studies have examined associations of anthropometric factors (e.g. early adulthood obesity) with advanced prostate cancer risk.Patients and methods: We carried out pooled analyses to examine associations between body fatness, height, and prostate cancer risk. Among 830 772 men, 51 734 incident prostate cancer cases were identified, including 4762 advanced (T4/N1/M1 or prostate cancer deaths) cases, 2915 advanced restricted (same as advanced, but excluding localized cancers that resulted in death) cases, 9489 high-grade cases, and 3027 prostate cancer deaths. Cox proportional hazards models were used to calculate study-specific hazard ratios (HR) and 95% confidence intervals (CI); results were pooled using random effects models.Results: No statistically significant associations were observed for body mass index (BMI) in early adulthood for advanced, advanced restricted, and high-grade prostate cancer, and prostate cancer mortality. Positive associations were shown for BMI at baseline with advanced prostate cancer (HR = 1.30, 95% CI = 0.95-1.78) and prostate cancer mortality (HR = 1.52, 95% CI = 1.12-2.07) comparing BMI >= 35.0 kg/m(2) with 21-22.9 kg/m(2). When considering early adulthood and baseline BMI together, a 27% higher prostate cancer mortality risk (95% CI = 9% to 49%) was observed for men with BMI = 30.0 kg/m(2) at baseline compared with BMI = 110 cm with = 1.00 with = 1.90 m withConclusion: Our findings suggest that height and total and central adiposity in mid-to-later adulthood, but not early adulthood adiposity, are associated with risk of advanced forms of prostate cancer. Thus, maintenance of healthy weight may help prevent advanced prostate cancer.

Active surveillance (AS) is increasingly used to monitor patients with low-risk prostate cancer; however, approximately 50% of AS patients experience disease reclassification requiring definitive treatment and little is known about patient characteristics that modify the risk of reclassification. Obesity may be one of the major contributing factors. The Prostate Cancer Active Lifestyle Study (PALS) is a clinical trial evaluating the impact of weight loss among overweight/obese (Body Mass Index (BMI) ≥ 25 kg/m2) men with clinically localized prostate cancer on AS. Two hundred participants will be randomized to either the PALS intervention, a 6-month structured diet and exercise program adapted from the Diabetes Prevention Program followed by 6 months of maintenance, or control (general diet and physical activity guidelines delivered in a single session). The PALS intervention involves one-on-one instruction with a registered dietitian and exercise physiologist to achieve the study goal of loss of 7% of baseline weight. Participation is coordinated so that the 6-month time point coincides with the participants' standard-of-care AS prostate biopsy. Primary outcomes will evaluate the intervention effects on circulating and tissue markers of glucose and insulin regulation, health-related quality of life and pathologic upgrading on follow-up prostate biopsies. Additional analyses will determine whether changes in weight and glucose regulation can be sustained for 6 months after the end of instruction. Findings from this trial may have wide reaching implications for men diagnosed with clinically-localized prostate cancer by providing an active lifestyle-based approach to improve prostate cancer patient outcomes.

"Mindful eating" describes a nonjudgmental awareness of physical and emotional sensations associated with eating. This article reports the development of a mindful eating questionnaire (MEQ) to support rigorous scientific inquiry into this concept. An item pool was developed based on hypothesized domains of mindful eating. A cross-sectional survey examined associations of MEQ scores with demographic and health-related characteristics. The MEQ was distributed to seven convenience samples between January and May 2007, with an overall response rate of 62% (n=303). Participants were mostly women (81%) and white (90%), and had a mean age of 42+/-14.4 years (range 18 to 80 years). Exploratory factor analysis was used to identify factors, which were defined as the mean of items scored one to four, where four indicated higher mindfulness; the mean of all factors was the summary MEQ score. Multiple regression analysis was used to measure associations of demographic characteristics, obesity, yoga practice, and physical activity with MEQ scores. Domains of the final 28-item questionnaire were: disinhibition, awareness, external cues, emotional response, and distraction. The mean MEQ score was 2.92+/-0.37, with a reliability (Chronbach's alpha) of .64. The covariate-adjusted MEQ score was inversely associated with body mass index (3.02 for body mass index25 vs 2.54 for body mass index30, P0.001). Yoga practice, but neither walking nor moderate/intense physical activity, was associated with higher MEQ score. In this study sample, the MEQ had good measurement characteristics. Its negative association with body mass index and positive association with yoga provide evidence of construct validity. Further evaluation in more diverse populations is warranted.