Summer is the time of year associated with sunshine and barbeques and, where there are sausages, burgers, flammable liquids, flames and smoke, there will likely be a man adorned with an apron and holding a beer. Whether men actually prefer red meat or if they subconsciously (or otherwise) adhere to the image of the red-blooded male demolishing steaks and burgers rather than salads with salmon is a long-debated subject. It’s worth noting, however, that there may be some significant health benefits for those men who do choose fish over meat, especially when it comes to specific areas of men’s health.
For example, epidemiological studies have shown that men with a higher intake of fish may have a slower spread of prostate cancer and a lower risk of death compared to those who don’t eat as much fish. With individuals suffering from prostate cancer, there is a reduced risk of cancer spreading to other parts of the body and increased longevity if fish is a regular part of the diet.
One potentially protective factor is a diet high in omega-3 polyunsaturated fatty acids (PUFAs). Fish are abundant sources of these PUFAs; the epidemiological evidence on fish and prostate cancer risk is mixed, however, with some studies reporting inverse associations (protective effect), others reporting positive associations (undesired effect) and some reporting no associations.
So why are there these discrepancies? Many studies look at total fish consumption but do not analyse the effect of different varieties of fish, e.g. fish full of good fats including salmon, tuna and anchovies, or those lower in omega-3 fatty acids like cod and haddock. Furthermore, many studies do not take into account different fish preparation methods, e.g. deep or pan-frying that might add unhealthy fat to the diet and thereby be associated with prostate cancer. To shed some light on this, let’s look at both the choice of fish and type of cooking method,in terms of the association between fish intake and prostate cancer risk.
Recently published results from a US population based case-control study (the California Prostate Cancer Study) published in the journal Cancer Causes and Control suggest that avoiding high-temperature cooking methods for white fish may lower prostate cancer risk.  The group report that their results support the hypothesis that mutagenic compounds (products capable of making DNA changes that could lead to cancer) formed during the frying process were key contributors to the risk of developing prostate cancer. For example, heterocyclic amines (HCAs) are formed in cooked fish when their precursors (creatine and amino acids) react with high temperatures achieved during frying and the amount formed increases as temperature and cooking time increases. Therefore, frying white fish leads to higher levels of HCA, compared with baking or roasting. White fish is also more likely than oily fish to absorb undesired fat during the frying process because the rate of absorption is inversely proportional to the fish fat content. Oily fish is not only rich in long-chain omega-3 fatty acids but is also rich in powerful antioxidants (i.e. squalene and astaxanthin), which can protect from and repair DNA damage caused by mutagens.
Eicosapentaenoic acid is a long-chain omega-3 found in high levels in oily fish and has been shown to reduce the growth rate of prostate cancer cells in cultured cells (in vitro studies), which gives us some insight into the mechanisms by which omega-3 fatty acids slow the spread of prostate cancer in humans. For example, hydroxyeicosatetraenoic acid (HETE) is one of the many by-products of EPA metabolism and acts to inhibit the proliferation (cell division) of prostate cancer cells. In contrast, by-products of the omega-6 fatty acid arachidonic acid (found in high levels in non-organic dairy products and red meat!) are known to increase proliferation, supporting the link between diets low in fish but high in red meat on prostate cancer risk. 
For those men who can’t stretch to swapping their BBQ ribs for salmon, or burgers for tuna, try substituting instead for chicken, turkey or pork as a positive step in reducing prostate cancer risk (or, where possible, opt for grass-fed organic meat). In addition, it may be wise to supplement with a good quality EPA supplement such as E-EPA 90 or Vegepa E-EPA-70. Offering a myriad of health benefits, concentrated EPA also acts to reduce risk further by displacing arachidonic acid offering a two-pronged attack against prostate cancer risk.
 Joshi AD, John EM, Koo J, Ingles SA & Stern MC. (2012) Fish intake, cooking practices, and risk of prostate cancer: results from a multi-ethnic case-control study. Cancer Causes Control. 23:405-20.
 Sinha R, Park Y, Graubard B, Leitzmann MF, Hollenbeck A, Schatzkin A & Cross AJ. (2009) Meat and meat-related compounds and risk of prostate cancer in a large prospective cohort study in the United States. American Journal of Epidemiology. 170:1165–77.