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Little information exists on diet and prostate cancer progression. We examined the association between intakes of total red meat, processed and unprocessed red meat, poultry, fish, and eggs and prostate cancer recurrence. We conducted a prospective study of 971 men treated with radical prostatectomy for prostate cancer between 2003 and 2010. Men completed a food frequency questionnaire at diagnosis. We used logistic regression to study the association between diet and high-grade or advanced-stage disease. We used Cox models to study the risk of progression [N = 94 events, mainly prostate-specific antigen (PSA) recurrence]. Total red meat intake was marginally associated with risk of high-grade disease [Gleason ≥ 4+3; adjusted OR top vs. bottom quartile: 1.66; 95% confidence interval (CI), 0.93-2.97; P trend = 0.05], as was very high intake of eggs (OR top decile vs. bottom quartile: 1.98; 95% CI, 1.08-3.63, P trend = 0.08). Well-done red meat was associated with advanced disease (≥pT3; OR top vs. bottom quartile: 1.74, 95% CI, 1.05-2.90; P trend = 0.01). Intakes of red meat, fish, and eggs were not associated with progression. Very high poultry intake was inversely associated with progression (HR top decile vs. bottom quartile: 0.19; 95% CI, 0.06-0.63; P trend = 0.02). Substituting 30 g/d of poultry or fish for total or unprocessed red meat was associated with significantly lower risk of recurrence. Lower intakes of red meat and well-done red meat and higher intakes of poultry and fish are associated with lower risk of high grade and advanced prostate cancer and reduced recurrence risk, independent of stage and grade. Cancer Prev Res; 9(12); 933-41. ©2016 AACR.

Meat, Fish, Poultry, and Egg Intake at Diagnosis and Risk of Prostate Cancer Progression