Evidence map›Paper›PMID 30664736›Full record

Trial reportProstate cancer and prostatic diseases2019

A lifestyle intervention of weight loss via a low-carbohydrate diet plus walking to reduce metabolic disturbances caused by androgen deprivation therapy among prostate cancer patients: carbohydrate and prostate study 1 (CAPS1) randomized controlled trial.

Stephen J Freedland, Lauren Howard, Jenifer Allen, Jordan Smith, Jennifer Stout, William Aronson, Brant A Inman, Andrew J Armstrong, Daniel George, Eric Westman and 1 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Prostate cancer and prostatic diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05590624 (Elucidating the Metabolic Impact of Isocaloric, Controlled, Mediterranean-Type Diets in Treatment-Naïve Men With Prostate Cancer on Active Surveillance), which is not on this map. Cited by 34 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 8 pooled it
4.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05590624 narecruitingnot on this mapstarted 2024, after this paper: background citation

Elucidating the Metabolic Impact of Isocaloric, Controlled, Mediterranean-Type Diets in Treatment-Naïve Men With Prostate Cancer on Active Surveillance (DINE Study)

TypeinterventionalSponsorCase Comprehensive Cancer CenterRan2024 to 2026Enrolled30ConditionsProstate CancerArmsLower-Carbohydrate Med-t-Diet, Low-Fat Med-t-Diet
3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 8 syntheses or guidelines pooled it, 60 citations in OpenAlex.

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  14. Tackling the Cardio-Kidney-Metabolic Burden in Cancer.Current atherosclerosis reports · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Stephen J FreedlandCenter for Integrated Research on Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute and Department of Surgery, Division of Urology Cedars-Sinai Medical Center, Section of Urology, Los Angeles, CA, USA. Stephen.freedland@cshs.org.
Lauren HowardDepartment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA.
Jenifer AllenTranslational Population Health Research, Duke Clinical and Translational Science Institute, Kannapolis, NC, USA.
Jordan SmithDepartment of Medicine, Nephrology Division, Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC, USA.
Jennifer StoutDivision of Urology, Duke University Medical Center, Durham, NC, USA.
William AronsonUrology Section, Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Brant A InmanDivision of Urology, Duke University Medical Center, Durham, NC, USA.ORCID http://orcid.org/0000-0002-6060-4485
Andrew J ArmstrongDepartment of Medicine, Division of Urology, Duke University Medical Center, Durham, NC, USA.ORCID http://orcid.org/0000-0001-7012-1754
Daniel GeorgeDivision of Urology, Duke University Medical Center, Durham, NC, USA.
Eric WestmanDepartment of Medicine, Duke University Medical Center, Durham, NC, USA.
Pao-Hwa LinDepartment of Medicine, Nephrology Division, Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC, USA.
Duke Medical Center · USDuke University · USCedars-Sinai Medical Center · USUniversity of California, Los Angeles · US

Funding

Midcareer Investigator AwardK24CA160653 · NCI · DUKE UNIVERSITY · PI FREEDLAND, STEPHEN JAY · 2012 to 2016
$877k
NCI NIH HHS K24 CA160653
6 · The paper itself

Abstract

purposeThe objective of this study was to test a low-carbohydrate diet (LCD) plus walking to reduce androgen deprivation therapy (ADT)-induced metabolic disturbances. MATERIALS AND

methodsThis randomized multi-center trial of prostate cancer (PCa) patients initiating ADT was designed to compare an LCD (≤20g carbohydrate/day) plus walking (≥30 min for ≥5 days/week) intervention vs. control advised to maintain usual diet and exercise patterns. Primary outcome was change in insulin resistance by homeostatic model assessment at 6 months. To detect 20% reduction in insulin resistance, 100 men were required. The study was stopped early after randomizing 42 men due to slow accrual. Secondary outcomes included weight, body composition, lipids, and prostate-specific antigen (PSA). Changes from baseline were compared between arms using rank-sum tests.

resultsAt 6 months, LCD/walking reduced insulin resistance by 4% vs. 36% increase in control (p = 0.13). At 3 months, vs. control, LCD/walking arm significantly lost weight (7.8kg; p<0.001), improved insulin resistance (↑36%; p = 0.015), hemoglobin A1c (↓3.3%; p = 0.01), high-density lipoprotein (HDL) (↑13%; p = 0.004), and triglyceride (↓37%; p = 0.036). At 6 months, weight loss (10.6kg; p<0.001) and HDL (↑27%; p = 0.003) remained significant. LCD/walking preserved total body bone mineral count (p = 0.025), reduced fat mass (p = 0.002), lean mass (p = 0.036), and percent body fat (p = 0.004). There were no differences in PSA. Limitations include the effect of LCD, weight loss vs. walking instruction are indistinguishable, and small sample size.

conclusionsIn an underpowered study, LCD/walking did not improve insulin sensitivity at 6 months. Given most secondary outcomes were improved at 3 months with some remaining improved at 6 months and a secondary analysis showed that LCD/walking reduced insulin resistance over the study, supporting future larger studies of LCD/walking intervention to reduce ADT-induced disturbances.

Indexed as

Diet, Carbohydrate-RestrictedAgedAndrogen AntagonistsBody CompositionBody WeightHealthy LifestyleHumansMaleMetabolic SyndromeMiddle AgedProstatic NeoplasmsTreatment OutcomeWalkingWeight LossAndrogen Antagonists

Identifiers

PMID30664736
OpenAlexW2911564708

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.