The toll of prostate cancer is immense. In the US, one out of every eight men will be diagnosed with this devastating disease.^[1] This contrasts sharply from men in other parts of the world, especially those in many Asian and African countries. The incidence in China, for example, was around one per 100,000 person years (PY) in 1990.^[2] Although rates have increased in the decades since (likely due to changing lifestyles plus earlier diagnoses), they remain far lower than rates in the US.

While we don’t know all the factors leading to this huge discrepancy, we do know that hormone levels, particularly those of testosterone, can be a factor in prostate cancer. We also know that hormone levels are affected considerably by our dietary patterns.

You may be surprised to know that, whether you are a man or a woman, you have a mix of male and female hormones. The various proportions of testosterone and estrogen account for not only the differences between men and women but also the differences, potentially, between life and death. Among the many advantages of a plant-based diet is the fact that vegetables contain phytoestrogens (plant estrogens) that help normalize the proportion of testosterone to estrogen in the body. Several studies have shown that men eating diets high in phytoestrogen-containing foods (soybeans and peas, for example) are less likely to develop cancer.^[3]

Even more impressive is the finding that dietary fat, especially animal fat, “is associated with an elevated risk of advanced prostate cancer.”^[4] A prospective study including more than fifty-one thousand US men found that men who ate the most fat had 79 percent more advanced prostate cancer than the men who kept to low-fat diets.

When the downside of an animal foods diet is compared with the full spectrum of advantages of a plant-based diet (including the addition of antioxidants, vitamins, and other helpful nutrients), the difference in prostate cancer rates between Chinese and American men is not so surprising.

References

1. American Cancer Society (ACS). Key statistics for prostate cancer. Web page accessed July 22, 2025. https://www.cancer.org/cancer/types/prostate-cancer/about/key-statistics.html
2. Zhang L, Wu S, Guo LR, Zhao XJ. Diagnostic strategies and the incidence of prostate cancer: reasons for the low reported incidence of prostate cancer in China. Asian J Androl. 2009;11(1):9-13. doi:10.1038/aja.2008.21
3. He J, Wang S, Zhou M, Yu W, Zhang Y, He X. Phytoestrogens and risk of prostate cancer: a meta-analysis of observational studies. World J Surg Oncol. 2015;13:231. Published 2015 Jul 31. doi:10.1186/s12957-015-0648-9
4. Giovannucci E, Rimm EB, Colditz GA, et al. A prospective study of dietary fat and risk of prostate cancer [published correction appears in J Natl Cancer Inst. 2013 Jul 3;105(13):944. Chute, C C [corrected to Chute, C G]. J Natl Cancer Inst. 1993;85(19):1571-1579. doi:10.1093/jnci/85.19.1571