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An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer.
Eur J Nutr. 2021 Apr; 60(3):1561-1586.EJ

Abstract

PURPOSE

The aim of current systematic review was to update the body of evidence on associations between adherence to the Mediterranean diet (MedDiet) and risk of cancer mortality, site-specific cancer in the general population; all-cause, and cancer mortality as well as cancer reoccurrence among cancer survivors.

METHODS

A literature search for randomized controlled trials (RCTs), case-control and cohort studies published up to April 2020 was performed using PubMed and Scopus. Study-specific risk estimates for the highest versus lowest adherence to the MedDiet category were pooled using random-effects meta-analyses. Certainty of evidence from cohort studies and RCTs was evaluated using the NutriGrade scoring system.

RESULTS

The updated search revealed 44 studies not identified in the previous review. Altogether, 117 studies including 3,202,496 participants were enclosed for meta-analysis. The highest adherence to MedDiet was inversely associated with cancer mortality (RRcohort: 0.87, 95% CI 0.82, 0.92; N = 18 studies), all-cause mortality among cancer survivors (RRcohort: 0.75, 95% CI 0.66, 0.86; N = 8), breast (RRobservational: 0.94, 95% CI 0.90, 0.97; N = 23), colorectal (RRobservational: 0.83, 95% CI 0.76, 0.90; N = 17), head and neck (RRobservational: 0.56, 95% CI 0.44, 0.72; N = 9), respiratory (RRcohort: 0.84, 95% CI 0.76, 0.94; N = 5), gastric (RRobservational: 0.70, 95% CI 0.61, 0.80; N = 7), bladder (RRobservational: 0.87, 95% CI 0.76, 0.98; N = 4), and liver cancer (RRobservational: 0.64, 95% CI 0.54, 0.75; N = 4). Adhering to MedDiet did not modify risk of blood, esophageal, pancreatic and prostate cancer risk.

CONCLUSION

In conclusion, our results suggest that highest adherence to the MedDiet was related to lower risk of cancer mortality in the general population, and all-cause mortality among cancer survivors as well as colorectal, head and neck, respiratory, gastric, liver and bladder cancer risks. Moderate certainty of evidence from cohort studies suggest an inverse association for cancer mortality and colorectal cancer, but most of the comparisons were rated as low or very low certainty of evidence.

Links

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Authors+Show Affiliations

Morze J
Department of Cardiology and Internal Diseases, University of Warmia and Mazury, al. Warszawska 30, 10-082, Olsztyn, Poland. jakub.morze@uwm.edu.pl. Department of Human Nutrition, University of Warmia and Mazury, ul. Sloneczna 45f, 10-718, Olsztyn, Poland. jakub.morze@uwm.edu.pl.
Danielewicz A
Department of Human Nutrition, University of Warmia and Mazury, ul. Sloneczna 45f, 10-718, Olsztyn, Poland.
Przybyłowicz K
Department of Human Nutrition, University of Warmia and Mazury, ul. Sloneczna 45f, 10-718, Olsztyn, Poland.
Zeng H
National Cancer Registry Office, National Cancer Center, 17 South Lane, Beijing, 100021, China. Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Building 2, Boston, MA, 02551, USA.
Hoffmann G
Department of Nutritional Sciences, University of Vienna, Althanstraβe 14, UZA II, 1090, Vienna, Austria.
Schwingshackl L
Institute for Evidence in Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straβe 153, 79110, Freiburg, Germany.

MeSH

Case-Control StudiesCohort StudiesDiet, MediterraneanHumansMaleNeoplasmsRisk

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32770356

Citation

Morze, Jakub, et al. "An Updated Systematic Review and Meta-analysis On Adherence to Mediterranean Diet and Risk of Cancer." European Journal of Nutrition, vol. 60, no. 3, 2021, pp. 1561-1586.
Morze J, Danielewicz A, Przybyłowicz K, et al. An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer. Eur J Nutr. 2021;60(3):1561-1586.
Morze, J., Danielewicz, A., Przybyłowicz, K., Zeng, H., Hoffmann, G., & Schwingshackl, L. (2021). An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer. European Journal of Nutrition, 60(3), 1561-1586. https://doi.org/10.1007/s00394-020-02346-6
Morze J, et al. An Updated Systematic Review and Meta-analysis On Adherence to Mediterranean Diet and Risk of Cancer. Eur J Nutr. 2021;60(3):1561-1586. PubMed PMID: 32770356.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer. AU - Morze,Jakub, AU - Danielewicz,Anna, AU - Przybyłowicz,Katarzyna, AU - Zeng,Hongmei, AU - Hoffmann,Georg, AU - Schwingshackl,Lukas, Y1 - 2020/08/08/ PY - 2020/02/28/received PY - 2020/07/21/accepted PY - 2020/8/10/pubmed PY - 2021/6/24/medline PY - 2020/8/10/entrez KW - Cancer KW - Certainty of evidence KW - Mediterranean diet KW - Meta-analysis SP - 1561 EP - 1586 JF - European journal of nutrition JO - Eur J Nutr VL - 60 IS - 3 N2 - PURPOSE: The aim of current systematic review was to update the body of evidence on associations between adherence to the Mediterranean diet (MedDiet) and risk of cancer mortality, site-specific cancer in the general population; all-cause, and cancer mortality as well as cancer reoccurrence among cancer survivors. METHODS: A literature search for randomized controlled trials (RCTs), case-control and cohort studies published up to April 2020 was performed using PubMed and Scopus. Study-specific risk estimates for the highest versus lowest adherence to the MedDiet category were pooled using random-effects meta-analyses. Certainty of evidence from cohort studies and RCTs was evaluated using the NutriGrade scoring system. RESULTS: The updated search revealed 44 studies not identified in the previous review. Altogether, 117 studies including 3,202,496 participants were enclosed for meta-analysis. The highest adherence to MedDiet was inversely associated with cancer mortality (RRcohort: 0.87, 95% CI 0.82, 0.92; N = 18 studies), all-cause mortality among cancer survivors (RRcohort: 0.75, 95% CI 0.66, 0.86; N = 8), breast (RRobservational: 0.94, 95% CI 0.90, 0.97; N = 23), colorectal (RRobservational: 0.83, 95% CI 0.76, 0.90; N = 17), head and neck (RRobservational: 0.56, 95% CI 0.44, 0.72; N = 9), respiratory (RRcohort: 0.84, 95% CI 0.76, 0.94; N = 5), gastric (RRobservational: 0.70, 95% CI 0.61, 0.80; N = 7), bladder (RRobservational: 0.87, 95% CI 0.76, 0.98; N = 4), and liver cancer (RRobservational: 0.64, 95% CI 0.54, 0.75; N = 4). Adhering to MedDiet did not modify risk of blood, esophageal, pancreatic and prostate cancer risk. CONCLUSION: In conclusion, our results suggest that highest adherence to the MedDiet was related to lower risk of cancer mortality in the general population, and all-cause mortality among cancer survivors as well as colorectal, head and neck, respiratory, gastric, liver and bladder cancer risks. Moderate certainty of evidence from cohort studies suggest an inverse association for cancer mortality and colorectal cancer, but most of the comparisons were rated as low or very low certainty of evidence. SN - 1436-6215 UR - https://www.unboundmedicine.com/medline/citation/32770356/An_updated_systematic_review_and_meta_analysis_on_adherence_to_mediterranean_diet_and_risk_of_cancer_ DB - PRIME DP - Unbound Medicine ER -