Mediterranean diet associated with lower risk for death in cancer survivors
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Key takeaways:
- Researchers reported associations between higher Mediterranean diet scores and lower risk for all-cause, cardiovascular-related morality.
- No association observed between diet and cancer-related mortality.
Adopting the Mediterranean diet after receiving a cancer diagnosis improved survival outcomes, according to observational study results published in JACC: CardioOncology.
Researchers reported an association between high adherence to a traditional Mediterranean diet and significant reduction in all-cause and cardiovascular-related mortality rates among cancer survivors.
“Our findings suggest maintaining or adopting a traditional [Mediterranean diet] even after a cancer diagnosis may be beneficial and, importantly, motivate additional science regarding the development of dietary recommendations specifically targeted for cancer survivors,” Marialaura Bonaccio, PhD, of the department of epidemiology and prevention at IRCCS Instituto Neurologico Mediterraneo Neuromed, Italy, and researchers wrote.
Investigators conducted the study using prospectively collected data from a population-based cohort, which included men and women aged at least 35 years who live in the southern Italian region of Molise.
Eligible patients included those who reported any type of cancer diagnosis at their baseline visit and provided relevant medical records and information regarding cancer treatment.
A total of 802 patients (476 women, 326 men; mean age, 63 ± 12 years) made up the study population.
Bonaccio and colleagues analyzed participants’ dietary intake during the preceding 12 months using an interviewer-administered semiquantitative food frequency questionnaire, with adherence to a traditional Mediterranean diet being measured using a Mediterranean diet score.
They assessed all-cause mortality and cardiovascular disease-related mortality for the study and determined patients’ Mediterranean diet score as both categorical (poor, 0-3; average, 4 or 5; and high, 6-9) and continuous (per 2-point increment) based on based on previous studies.
Patients with a higher Mediterranean diet score tended to have a higher socioeconomic status and appeared more physically active than those with lower scores.
After 12.7 years of follow-up, researchers reported 248 all-cause deaths, including 59 cardiovascular-related deaths (25.4% ischemic heart disease, 23.7% cerebrovascular disease) and 140 from cancer.
Multivariate analysis showed a 16% (HR = 0.84; 95% CI, 0.71-0.99) decrease in all-cause mortality rate for every 2-point increase in a patient’s Mediterranean diet score. A adjusted multivariate analysis revealed a significant association between 2-point increase in Mediterranean diet score and a 31% reduction (adjusted HR = 0.69; 95% CI, 0.49-0.97) for cardiovascular disease-related mortality. However, the association between changes in diet score and cancer-related death lacked statistical significance (adjusted HR = 0.91; 95% CI, 0.73-1.12).
High adherence to a traditional Mediterranean diet substantially reduced all-cause mortality among cancer survivors, most specifically cardiovascular-related mortality.
Study limitations acknowledged by the researchers included an inability to infer causality due to the study’s observational design, the self-reported nature of dietary intake, and a risk for survival bias because patients had already survived, on average, 9 years at baseline.
Additional research could further analyze the impact of the Mediterranean diet in patients with specific cancer types, according to study investigators.
“Lack of a significant association with cancer mortality could be due to the different types of cancers included and the multifaceted nature of cancer progression and recurrence, which is strongly influenced by non-nutritional factors (eg, diagnostic and prevention strategies) varying substantially across socioeconomic strata of the population,” researchers wrote.
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Bonaccio M, et al. JACC CardioOncology. 2024;doi:10.1016/j.jaccao.2024.05.012.
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