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An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer

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Morze, Jakub, Danielewicz, Anna, Przybyłowicz, Katarzyna, Zeng, Hongmei, Hoffmann, Georg, Schwingshackl, Lukas·2021·European Journal of Nutrition
DOI 10.1007/s00394-020-02346-6
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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 (RR cohort: 0.87, 95% CI 0.82, 0.92; N = 18 studies), all-cause mortality among cancer survivors (RR cohort: 0.75, 95% CI 0.66, 0.86; N = 8), breast (RR observational: 0.94, 95% CI 0.90, 0.97; N = 23), colorectal (RR observational: 0.83, 95% CI 0.76, 0.90; N = 17), head and neck (RR observational: 0.56, 95% CI 0.44, 0.72; N = 9), respiratory (RR cohort: 0.84, 95% CI 0.76, 0.94; N = 5), gastric (RR observational: 0.70, 95% CI 0.61, 0.80; N = 7), bladder (RR observational: 0.87, 95% CI 0.76, 0.98; N = 4), and liver cancer (RR observational: 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.

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Cited by

See all 352

Metadata

Authors
Morze, J., Danielewicz, A., Przybyłowicz, K., Zeng, H., Hoffmann, G., & Schwingshackl, L.
Venue
European Journal of Nutrition
Publisher
Springer Science and Business Media LLC
Published
2020-08-08
Volume
60
Issue
3
Pages
1561-1586
ISSN
  • 1436-6207 (ISSN-L)
  • 1436-6215
DOI
10.1007/s00394-020-02346-6
OpenAlex
W3047947891
Cited by
352
References
18
FWCI
8.76
Type
journal article
Language
en
Open access
hybrid
Licence
Funders
Ministerstwo Nauki i Szkolnictwa Wyższego (010/RID/2018/19)

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.