medwireNews: High adherence to the Mediterranean diet is associated with a slight but significant reduction in the risk for some obesity-related cancers, report researchers in JAMA Network Open.
“In addition, we observed that even a medium adherence was associated with a small reduction in the risk of these specific cancers,” they continue.
Outlining the background to the study, the investigators explain: “Adherence to the Mediterranean Diet has been associated with a lower incidence of cancer and reduced weight gain. These associations suggest a potential role for the [Mediterranean Diet] in lowering the risk of obesity-related cancers.”
They analyzed data from the European Prospective Investigation Into Cancer and Nutrition (EPIC) study, which enrolled individuals aged 35–70 years during 1992–2000 from 23 centers in 10 countries, focusing on 450,111 participants (mean age 51.1 years, 70.8% women) who were cancer-free at the time of enrolment.
“Dietary intake before baseline was evaluated using country-specific, validated questionnaires administered at recruitment,” explain Inmaculada Aguilera-Buenosvinos (University of Navarra, Pamplona, Spain) and colleagues. They add that adherence to the Mediterranean diet was measured using the Mediterranean Diet score (MDS), and categorized as low (0–3 points), medium (4–6 points), or high (7–9 points) according to the ratio of unsaturated to saturated fats consumed, and the consumption of fruit, vegetables, nuts, cereals, and fish.
Over a median follow-up of 14.9 years, 4.9% of the participants developed an obesity-related cancer, with rates per person–year of 0.053, 0.049, and 0.043 in people with low, medium, and high adherence, respectively.
Multivariable analysis accounting for a host of factors such as age at recruitment, sex, education level, smoking status, and alcohol intake, showed that the risk for obesity-related cancers was a significant 6% lower for people with a high versus low MDS.
The risk was similarly reduced, by 4%, for participants with a medium MDS relative to those with a low MDS.
Analysis by type of cancer revealed an inverse association between high adherence to the Mediterranean diet and the risk for hepatocellular carcinoma, kidney cancer, and colorectal cancer, with significant hazard ratios (HRs) versus low adherence of 0.52, 0.67, and 0.92, respectively.
There was also an inverse relationship between medium MDS and the risk for esophageal cancer, with a significant HR of 0.66.
“For hormone-related cancers in women, specifically postmenopausal breast cancer, endometrial cancer, and ovarian cancer, no associations were observed,” write Aguilera-Buenosvinos and associates.
Furthermore, “mediation analyses did not show associations of waist to hip ratio or body mass index between [Mediterranean diet] adherence and [obesity-related cancer] risk,” which the team speculates could be “due to the low prevalence of obesity in our cohort and the distinct contribution of general vs abdominal obesity to metabolic disruptions.”
The researchers summarize that “[t]hese findings indicate that higher adherence to the [Mediterranean diet] is associated with a modest reduction in the risk of [obesity-related cancers], independent of adiposity measures.”
And they conclude: “[M]ore studies are needed to better understand the mechanisms through which higher adherence to the [Mediterranean diet] might potentially reduce cancer risk.”
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