Long-term supplementation of decaffeinated green tea extract does not modify body weight or abdominal obesity in a randomized trial of men at high risk for prostate cancer

Nagi B Kumar, Roshni Patel, Julio Pow-Sang, Philippe E Spiess, Raoul Salup, Christopher R Williams, Michael J Schell, Nagi B Kumar, Roshni Patel, Julio Pow-Sang, Philippe E Spiess, Raoul Salup, Christopher R Williams, Michael J Schell

Abstract

Background: Evidence continues to demonstrate the role of obesity in prostate carcinogenesis and prognosis, underscoring the need to identify and continue to evaluate the effective interventions to reduce obesity in populations at high risk. The aim of the study was to determine the effect of daily consumption of decaffeinated green tea catechins (GTC) formulation (Polyphenon E® (PolyE)) for 1 year on biomarkers of obesity in men who are at high risk for prostate cancer.

Materials and methods: A randomized, double-blinded trial was conducted targeting 97 men diagnosed with HGPIN or ASAP. Subjects were randomized to receive GTC (PolyE) (n = 49) or placebo (n = 48) for 1 year. Anthropometric data were collected at baseline, 6 and 12 months and data analyzed to observe change in weight, body mass index (indicator of obesity) and waist: hip ratio (indicator of abdominal obesity).

Results: Decaffeinated GTC containing 400 mgs of the bioactive catechin, EGCG administered for 1 year to men diagnosed with ASAP and HGPIN appears to be bioavailable, well tolerated but not effective in reducing biomarkers of obesity including body weight, body mass index and waist: hip ratio.

Conclusions: The results of our trial demonstrates that men who are obese and at high risk for prostate cancer should resort to effective weight management strategies to reduce obesity and not resort to ineffective measures such as taking supplements of green tea to reduce biomarkers of obesity. Changes in body mass index and abdominal obesity seen in other studies were potentially due to caffeine and not GTC.

Keywords: body mass index and abdominal obesity; green tea catechins; obesity; prostate cancer risk.

Conflict of interest statement

CONFLICTS OF INTEREST No authors listed in this manuscript have direct or indirect commercial financial incentives associated with publishing the article. To date, the results of this study have not been reported elsewhere.

References

    1. Centers for Disease Control
    1. Augustin H. Obesity and prostate cancer: an ambiguous relationship. Eur J Cancer. 2007;43:1114–16.
    1. Baillargeon J, Rose DP. Obesity, adipokines, and prostate cancer (review) Int J Oncol. 2006;28:737–45. review.
    1. Fowke JH, Motley S, Dai Q, Concepcion R, Barocas DA. Association between biomarkers of obesity and risk of high-grade prostatic intraepithelial neoplasia and prostate cancer—evidence of effect modification by prostate size. Cancer Lett. 2013;328:345–52.
    1. Kasper JS, Giovannucci E. A meta-analysis of diabetes mellitus and the risk of prostate cancer. Cancer Epidemiol Biomarkers Prev. 2006;15:2056–62.
    1. MacInnis RJ, English DR. Body size and composition and prostate cancer risk: systematic review and meta-regression analysis. Cancer Causes Control. 2006;17:989–1003.
    1. Meyerhardt JA, Ma J, Courneya KS. Energetics in colorectal and prostate cancer. J Clin Oncol. 2010;28:4066–73.
    1. Redman MW, Tangen CM, Goodman PJ, Lucia MS, Coltman CA, Jr, Thompson IM. Finasteride does not increase the risk of high-grade prostate cancer: a bias-adjusted modeling approach. Cancer Prev Res (Phila) 2008;1:174–81.
    1. Stewart SB, Freedland SJ. Influence of obesity on the incidence and treatment of genitourinary malignancies. Urol Oncol. 2011;29:476–86.
    1. Bai PD, Hu MB, Xu H, Zhu WH, Hu JM, Yang T, Jiang HW, Ding Q. Body mass index is associated with higher Gleason score and biochemical recurrence risk following radical prostatectomy in Chinese men: a retrospective cohort study and meta-analysis. World J Surg Oncol. 2015;13:311.
    1. Bhindi B, Locke J, Alibhai SM, Kulkarni GS, Margel DS, Hamilton RJ, Finelli A, Trachtenberg J, Zlotta AR, Toi A, Hersey KM, Evans A, van der Kwast TH, Fleshner NE. Dissecting the association between metabolic syndrome and prostate cancer risk: analysis of a large clinical cohort. Eur Urol. 2015;67:64–70.
    1. Boehm K, Sun M, Larcher A, Blanc-Lapierre A, Schiffmann J, Graefen M, Sosa J, Saad F, Parent ME, Karakiewicz PI. Waist circumference, waist-hip ratio, body mass index, and prostate cancer risk: results from the North-American case-control study Prostate Cancer & Environment Study. Urol Oncol. 2015;33:494 e491–497.
    1. De Nunzio C, Simone G, Brassetti A, Mastroianni R, Collura D, Muto G, Gallucci M, Tubaro A. Metabolic syndrome is associated with advanced prostate cancer in patients treated with radical retropubic prostatectomy: results from a multicentre prospective study. BMC Cancer. 2016;16:407.
    1. Gong Z, Neuhouser ML, Goodman PJ, Albanes D, Chi C, Hsing AW, Lippman SM, Platz EA, Pollak MN, Thompson IM, Kristal AR. Obesity, diabetes, and risk of prostate cancer: results from the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev. 2006;15:1977–83.
    1. Keto CJ, Aronson WJ, Terris MK, Presti JC, Kane CJ, Amling CL, Freedland SJ. Obesity is associated with castration-resistant disease and metastasis in men treated with androgen deprivation therapy after radical prostatectomy: results from the SEARCH database. BJU Int. 2012;110:492–98.
    1. King CR, Freedland SJ, Terris MK, Kane CJ, Amling CL, Aronson WJ, Presti JC., Jr Impact of obesity on the utility of preoperative prostate-specific antigen velocity to predict for relapse after prostatectomy: a report from the SEARCH database. Urology. 2007;69:921–26.
    1. Price MM, Hamilton RJ, Robertson CN, Butts MC, Freedland SJ. Body mass index, prostate-specific antigen, and digital rectal examination findings among participants in a prostate cancer screening clinic. Urology. 2008;71:787–91.
    1. Spangler E, Zeigler-Johnson CM, Coomes M, Malkowicz SB, Wein A, Rebbeck TR. Association of obesity with tumor characteristics and treatment failure of prostate cancer in African-American and European American men. J Urol. 2007;178:1939–1944.
    1. Wright ME, Chang SC, Schatzkin A, Albanes D, Kipnis V, Mouw T, Hurwitz P, Hollenbeck A, Leitzmann MF. Prospective study of adiposity and weight change in relation to prostate cancer incidence and mortality. Cancer. 2007;109:675–84.
    1. Xiang YZ, Xiong H, Cui ZL, Jiang SB, Xia QH, Zhao Y, Li GB, Jin XB. The association between metabolic syndrome and the risk of prostate cancer, high-grade prostate cancer, advanced prostate cancer, prostate cancer-specific mortality and biochemical recurrence. J Exp Clin Cancer Res. 2013;32:9.
    1. Yamoah K, Zeigler-Johnson CM, Jeffers A, Malkowicz B, Spangler E, Park JY, Whittemore A, Rebbeck TR. The impact of body mass index on treatment outcomes for patients with low-intermediate risk prostate cancer. BMC Cancer. 2016;16:557.
    1. Cicione A, De Nunzio C, Tubaro A, Cantiello F, Manno S, Oliveira C, Lima E, Damiano R. Metabolic syndrome diagnosis and widespread high grade prostatic intraepithelial neoplasia significantly increase prostate cancer risk: results from a multicenter biopsy study. BMC Cancer. 2016;16:59.
    1. Bostwick DG, Cheng L. Precursors of prostate cancer. Histopathology. 2012;60:4–27.
    1. Chornokur G, Han G, Tanner R, Lin HY, Green BL, Pow-Sang J, Phelan CM. High grade prostate intraepithelial neoplasia (PIN) is a PSA-independent risk factor for prostate cancer in African American men: results from a pilot study. Cancer Lett. 2013;331:154–57.
    1. Humphrey PA. High grade prostatic intraepithelial neoplasia in prostate needle biopsy. J Urol. 2013;189:315–16.
    1. Lee MC, Moussa AS, Yu C, Kattan MW, Magi-Galluzzi C, Jones JS. Multifocal high grade prostatic intraepithelial neoplasia is a risk factor for subsequent prostate cancer. J Urol. 2010;184:1958–62.
    1. Gacci M, Russo GI, De Nunzio C, Sebastianelli A, Salvi M, Vignozzi L, Tubaro A, Morgia G, Serni S. Meta-analysis of metabolic syndrome and prostate cancer. Prostate Cancer Prostatic Dis. 2017;20:146–55.
    1. Dorin RP, Wiener S, Harris CD, Wagner JR. Prostate atypia: does repeat biopsy detect clinically significant prostate cancer? Prostate. 2015;75:673–78.
    1. Kim TS, Ko KJ, Shin SJ, Ryoo HS, Song W, Sung HH, Han DH, Jeong BC, Seo SI, Jeon SS, Lee KS, Lee SW, Lee HM, et al. Multiple cores of high grade prostatic intraepithelial neoplasia and any core of atypia on first biopsy are significant predictor for cancer detection at a repeat biopsy. Korean J Urol. 2015;56:796–802.
    1. Leone A, Rotker K, Butler C, Mega A, Li J, Amin A, Schiff SF, Pareek G, Golijanin D, Renzulli JF., 2nd Atypical Small Acinar Proliferation: Repeat Biopsy and Detection of High Grade Prostate Cancer. Prostate Cancer. 2015;2015:810159.
    1. Moyer VA, U.S. Preventive Services Task Force Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157:120–34.
    1. Bailey RL, Gahche JJ, Miller PE, Thomas PR, Dwyer JT. Why US adults use dietary supplements. JAMA Intern Med. 2013;173:355–61.
    1. Blanck HM, Serdula MK, Gillespie C, Galuska DA, Sharpe PA, Conway JM, Khan LK, Ainsworth BE. Use of nonprescription dietary supplements for weight loss is common among Americans. J Am Diet Assoc. 2007;107:441–47.
    1. Connors SK, Chornokur G, Kumar NB. New insights into the mechanisms of green tea catechins in the chemoprevention of prostate cancer. Nutr Cancer. 2012;64:4–22.
    1. Goto T, Yuko Y, Masaaki K, Hitoshi N. Simultaneous analysis of individual catechins and caffeine in green tea. Journal of Chromatography. 1996;749:295–299.
    1. Phung OJ, Baker WL, Matthews LJ, Lanosa M, Thorne A, Coleman CI. Effect of green tea catechins with or without caffeine on anthropometric measures: a systematic review and meta-analysis. Am J Clin Nutr. 2010;91:73–81.
    1. Grove KA, Lambert JD. Laboratory, epidemiological, and human intervention studies show that tea (Camellia sinensis) may be useful in the prevention of obesity. J Nutr. 2010;140:446–53.
    1. Hursel R, Westerterp-Plantenga MS. Catechin- and caffeine-rich teas for control of body weight in humans. Am J Clin Nutr. 2013 (Suppl) 98:1682S–93S.
    1. Rains TM, Agarwal S, Maki KC. Antiobesity effects of green tea catechins: a mechanistic review. J Nutr Biochem. 2011;22:1–7.
    1. Lonac MC, Richards JC, Schweder MM, Johnson TK, Bell C. Influence of short-term consumption of the caffeine-free, epigallocatechin-3-gallate supplement, Teavigo, on resting metabolism and the thermic effect of feeding. Obesity (Silver Spring) 2011;19:298–304.
    1. Mielgo-Ayuso J, Barrenechea L, Alcorta P, Larrarte E, Margareto J, Labayen I. Effects of dietary supplementation with epigallocatechin-3-gallate on weight loss, energy homeostasis, cardiometabolic risk factors and liver function in obese women: randomised, double-blind, placebo-controlled clinical trial. Br J Nutr. 2014;111:1263–71.
    1. Dostal AM, Arikawa A, Espejo L, Kurzer MS. Long-Term Supplementation of Green Tea Extract Does Not Modify Adiposity or Bone Mineral Density in a Randomized Trial of Overweight and Obese Postmenopausal Women. J Nutr. 2016;146:256–64.
    1. Kumar NB, Pow-Sang J, Egan KM, Spiess PE, Dickinson S, Salup R, Helal M, McLarty J, Williams CR, Schreiber F, Parnes HL, Sebti S, Kazi A, et al. Randomized, Placebo-Controlled Trial of Green Tea Catechins for Prostate Cancer Prevention. Cancer Prev Res (Phila) 2015;8:879–87.
    1. Bettuzzi S, Brausi M, Rizzi F, Castagnetti G, Peracchia G, Corti A. Chemoprevention of human prostate cancer by oral administration of green tea catechins in volunteers with high-grade prostate intraepithelial neoplasia: a preliminary report from a one-year proof-of-principle study. Cancer Res. 2006;66:1234–40.
    1. Marberger M. Medical management of lower urinary tract symptoms in men with benign prostatic enlargement. Adv Ther. 2013;30:309–19.
    1. McHorney CA, Ware JE, Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993;31:247–63.
    1. Kumar NB, Cantor A, Allen K, Riccardi D, Besterman-Dahan K, Seigne J, Helal M, Salup R, Pow-Sang J. The specific role of isoflavones in reducing prostate cancer risk. Prostate. 2004;59:141–47.
    1. Schapira DV, Kumar NB, Lyman GH. Estimate of breast cancer risk reduction with weight loss. Cancer. 1991;67:2622–25.
    1. Schapira DV, Kumar NB, Lyman GH. Variation in body fat distribution and breast cancer risk in the families of patients with breast cancer and control families. Cancer. 1993;71:2764–68.
    1. Hung SF, Chung SD, Kuo HC. Increased serum C-reactive protein level is associated with increased storage lower urinary tract symptoms in men with benign prostatic hyperplasia. PLoS One. 2014;9:e85588.
    1. Nam S, Smith DM, Dou QP. Ester bond-containing tea polyphenols potently inhibit proteasome activity in vitro and in vivo. J Biol Chem. 2001;276:13322–30.
    1. Wu KM, Yao J, Boring D. Green tea extract-induced lethal toxicity in fasted but not in nonfasted dogs. Int J Toxicol. 2011;30:19–20.
    1. Jonnalagadda SS, Mitchell DC, Smiciklas-Wright H, Meaker KB, Van Heel N, Karmally W, Ershow AG, Kris-Etherton PM. Accuracy of energy intake data estimated by a multiple-pass, 24-hour dietary recall technique. J Am Diet Assoc. 2000;100:303–08.
    1. Mitchell DC, Shacklock F. Computers in nutrition: the Minnesota nutrition database. Nutr Today. 1991;25:52–53.
    1. Hursel R, Viechtbauer W, Westerterp-Plantenga MS. The effects of green tea on weight loss and weight maintenance: a meta-analysis. Int J Obes. 2009;33:956–61.
    1. Jurgens TM, Whelan AM, Killian L, Doucette S, Kirk S, Foy E. Green tea for weight loss and weight maintenance in overweight or obese adults. Cochrane Database Syst Rev. 2012;12:CD008650.
    1. Nádas J, Putz Z, Kolev G, Nagy S, Jermendy G. Intraobserver and interobserver variability of measuring waist circumference. Med Sci Monit. 2008;14:CR15–18.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit