Mediterranean dietary pattern and cancer risk in the EPIC cohort.
Couto E., Boffetta P., Lagiou P., Ferrari P., Buckland G., Overvad K., Dahm CC., Tjønneland A., Olsen A., Clavel-Chapelon F., Boutron-Ruault MC., Cottet V., Trichopoulos D., Naska A., Benetou V., Kaaks R., Rohrmann S., Boeing H., von Ruesten A., Panico S., Pala V., Vineis P., Palli D., Tumino R., May A., Peeters PH., Bueno-de-Mesquita HB., Büchner FL., Lund E., Skeie G., Engeset D., Gonzalez CA., Navarro C., Rodríguez L., Sánchez MJ., Amiano P., Barricarte A., Hallmans G., Johansson I., Manjer J., Wirfärt E., Allen NE., Crowe F., Khaw KT., Wareham N., Moskal A., Slimani N., Jenab M., Romaguera D., Mouw T., Norat T., Riboli E., Trichopoulou A.
BACKGROUND: Although several studies have investigated the association of the Mediterranean diet with overall mortality or risk of specific cancers, data on overall cancer risk are sparse. METHODS: We examined the association between adherence to Mediterranean dietary pattern and overall cancer risk using data from the European Prospective Investigation Into Cancer and nutrition, a multi-centre prospective cohort study including 142,605 men and 335,873. Adherence to Mediterranean diet was examined using a score (range: 0-9) considering the combined intake of fruits and nuts, vegetables, legumes, cereals, lipids, fish, dairy products, meat products, and alcohol. Association with cancer incidence was assessed through Cox regression modelling, controlling for potential confounders. RESULTS: In all, 9669 incident cancers in men and 21,062 in women were identified. A lower overall cancer risk was found among individuals with greater adherence to Mediterranean diet (hazard ratio=0.96, 95% CI 0.95-0.98) for a two-point increment of the Mediterranean diet score. The apparent inverse association was stronger for smoking-related cancers than for cancers not known to be related to tobacco (P (heterogeneity)=0.008). In all, 4.7% of cancers among men and 2.4% in women would be avoided in this population if study subjects had a greater adherence to Mediterranean dietary pattern. CONCLUSION: Greater adherence to a Mediterranean dietary pattern could reduce overall cancer risk.