Whole Food Interventions and Nutrient Displacement: Tomato Sauce Entrees for Prostate Cancer Patients

This study sought to determine changes in self-selected diets in response to a high energy tomato pasta entree. Thirty men, mostly African-American, who were diagnosed with prostate cancer and also scheduled for prostatectomy were enrolled in the study. Dietary intakes were obtained by 24 hr diet recall for 3 days before the intervention and 3 days in week 2 during the intervention. Tomato pasta entrees were formulated to contain 30 mg of lycopene with roughly the same macronutrient composition and averaged 771 kcal/entree. Mean adherence to lycopene dose was 82% and, days when the entree was consumed, the mean adherence to lycopen was 90%. Lycopene intake in their self-selected diet decreased from 5 to 1 mg/day which lowered the exposure to lycopene, planned during the intervention. The men were able to decompensate for most of the added energy to their diet, but there was still a mean increase in total intake of 242 kcal/day (p=0.04), which did not result in weight gain over the short period of the study. There were no significant changes in the percent of energy from protein, fat or carbohydrates, but dietary cholesterol increased from 341 to 472 mg/day (p=0.0002). Mean intakes of vitamins A and C, and folate were not significantly different and were above the EAR. Vitamin E intake decreased, but, because of the variance in intake, the decrease was not statistically significant. Possible deterioration of diet quality should be a consideration when recommending whole food interventions for the prevention of chronic disease or the amelioration of physiological dysfunction.