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Higher adherence to American dietary guideline recommendations may be associated with a lower risk for grade reclassification in men with grade group 1 (GG1) prostate cancer, according to a study in JAMA Oncology. The prospective cohort study involved 886 men diagnosed with GG1 prostate cancer from January 2005 to February 2017. The authors found that 21% of the men had grade reclassification to GG2 or greater after a median follow-up of 6.5 years. The cumulative incidence of grade reclassification was 7%, 15%, and 33% at 3, 5, and 10 years; the corresponding values for extreme grade reclassification were 2%, 4%, and 10%. Higher baseline Healthy Eating Index 1999 to 2000 (HEI) and energy-adjusted HEI per one-standard-deviation increase in the score were associated with a lower risk for grade reclassification (sub hazard ratio, 0.85; 95% CI, 0.73-0.98; and 0.86; 95% CI, 0.74-1.00, respectively) and extreme grade reclassification (0.72; 95% CI, 0.57-0.93; and 0.73; 95% CI, 0.57 to 0.94, respectively).