{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:11:49Z","timestamp":1788909109963,"version":"build-2803163510"},"reference-count":73,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018071","name":"OHSU Knight Cancer Institute","doi-asserted-by":"crossref","award":["CCSG CPCP-2023-002"],"award-info":[{"award-number":["CCSG CPCP-2023-002"]}],"id":[{"id":"10.13039\/100018071","id-type":"DOI","asserted-by":"crossref"}]},{"name":"NCI","award":["5P30CA069533-27"],"award-info":[{"award-number":["5P30CA069533-27"]}]},{"name":"NIA","award":["T32 AG055378"],"award-info":[{"award-number":["T32 AG055378"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>The gut microbiome is a modifiable factor in cancer survivorship. Diet represents the most practical intervention for modulating the gut microbiome. However, diet\u2013microbiome relationships in prostate-cancer survivors remain poorly characterized. We conducted a comprehensive analysis of diet\u2013microbiome associations in 79 prostate-cancer survivors (ages 62\u201381) enrolled in a randomized exercise intervention trial, 59.5% of whom still have active metastatic disease. Dietary intake was assessed using the Diet History Questionnaire (201 variables) and analyzed using three validated dietary pattern scores: Mediterranean Diet Adherence Score (MEDAS), Healthy Eating Index-2015 (HEI-2015), and the Mediterranean-Dash Intervention for Neurodegenerative Delay (MIND) diet score. Gut microbiome composition was characterized via 16S rRNA sequencing. Dimensionality reduction strategies, including theory-driven diet scores and data-driven machine learning (Random Forest, and Least Absolute Shrinkage and Selection Operator (LASSO)), were used. Statistical analyses included beta regression for alpha diversity, Permutational Multivariate Analysis of Variance (PERMANOVA) for beta diversity (both Bray\u2013Curtis and S\u00f8rensen metrics), and Microbiome Multivariable Associations with Linear Models (MaAsLin2) with negative binomial regression for taxa-level associations. All models tested interactions with exercise intervention, APOLIPOPROTEIN E (APOE) genotype, and testosterone levels. There was an interaction between MEDAS and exercise type on gut alpha diversity (Shannon: p = 0.0022), with stronger diet\u2013diversity associations in strength training and Tai Chi groups than flexibility controls. All three diet-quality scores predicted beta diversity (HEI p = 0.002; MIND p = 0.025; MEDAS p = 0.034) but not Bray\u2013Curtis (abundance-weighted) distance, suggesting diet shapes community membership rather than relative abundances. Taxa-level analysis revealed 129 genera with diet associations or diet \u00d7 host factor interactions. Among 297 dietary variables tested for cognitive outcomes, only caffeine significantly predicted Montreal Cognitive Assessment (MoCA) scores after False Discovery Rate (FDR) correction (p = 0.0009, q = 0.014) through direct pathways beneficial to cognitive performance without notable gut microbiome modulation. In cancer survivors, dietary recommendations should be tailored to exercise habits, genetic background, and hormonal status.<\/jats:p>","DOI":"10.3390\/microorganisms14010251","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T11:11:17Z","timestamp":1768993877000},"page":"251","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diet\u2013Microbiome Relationships in Prostate-Cancer Survivors with Prior Androgen Deprivation-Therapy Exposure and Previous Exercise Intervention Enrollment"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9861-9893","authenticated-orcid":false,"given":"Jacob","family":"Raber","sequence":"first","affiliation":[{"name":"Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, USA"},{"name":"Departments of Neurology and Radiation Medicine, Division of Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR 97239, USA"},{"name":"Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7815-6242","authenticated-orcid":false,"given":"Abigail","family":"O\u2019Niel","sequence":"additional","affiliation":[{"name":"Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin D.","family":"Kasschau","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Oregon State University, Corvallis, OR 97331, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Pederson","sequence":"additional","affiliation":[{"name":"Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7587-3426","authenticated-orcid":false,"given":"Carolyn","family":"Guidarelli","sequence":"additional","affiliation":[{"name":"Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA"},{"name":"Division of Oncological Sciences, School of Medicine, Oregon Health and Science University, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Chalmers","sequence":"additional","affiliation":[{"name":"Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA"},{"name":"Division of Oncological Sciences, School of Medicine, Oregon Health and Science University, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1706-8020","authenticated-orcid":false,"given":"Kerri","family":"Winters-Stone","sequence":"additional","affiliation":[{"name":"Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA"},{"name":"Division of Oncological Sciences, School of Medicine, Oregon Health and Science University, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Sharpton","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Oregon State University, Corvallis, OR 97331, USA"},{"name":"Department of Statistics, Oregon State University, Corvallis, OR 97331, USA"},{"name":"Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5534","DOI":"10.1158\/1078-0432.CCR-08-2584","article-title":"Inflammatory biomarkers and fatigue during radiation therapy for breast and prostate cancer","volume":"15","author":"Bower","year":"2009","journal-title":"Clin. 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