Adherence to the mediterranean diet and lymphoma risk in the european prospective investigation into cancer and nutrition.
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
There is a growing evidence of the protective role of the Mediterranean diet (MD) on cancer. However, no prospective study has yet investigated its influence on lymphoma. We evaluated the association between adherence to the MD and risk of lymphoma and its subtypes in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The analysis included 476,160 participants, recruited from 10 European countries between 1991 and 2001. Adherence to the MD was estimated through the adapted relative MD (arMED) score excluding alcohol. Cox proportional hazards regression models were used while adjusting for potential confounders. During an average follow-up of 13.9 years, 3,136 lymphomas (135 Hodgkin lymphoma [HL], 2,606 non-HL and 395 lymphoma not otherwise specified) were identified. Overall, a 1-unit increase in the arMED score was associated with a 2% lower risk of lymphoma (95% CI: 0.97; 1.00, p-trend = 0.03) while a statistically nonsignificant inverse association between a high versus low arMED score and risk of lymphoma was observed (hazard ratio [HR]: 0.91 [95% CI 0.80; 1.03], p-trend = 0.12). Analyses by lymphoma subtype did not reveal any statistically significant associations. Albeit with small numbers of cases (N = 135), a suggestive inverse association was found for HL (HR 1-unit increase = 0.93 [95% CI: 0.86; 1.01], p-trend = 0.07). However, the study may have lacked statistical power to detect small effect sizes for lymphoma subtype. Our findings suggest that an increasing arMED score was inversely related to the risk of overall lymphoma in EPIC but not by subtypes. Further large prospective studies are warranted to confirm these findings.
Date Issued
2019-07-01
Date Acceptance
2018-11-21
Citation
International Journal of Cancer, 2019, 145 (1), pp.122-131
ISSN
0020-7136
Publisher
Wiley
Start Page
122
End Page
131
Journal / Book Title
International Journal of Cancer
Volume
145
Issue
1
Copyright Statement
© 2018 UICC. This is the accepted version of the following article, which has been published in final form at https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.32091.
Sponsor
Imperial College Trust
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30588620
Grant Number
P47328
Subjects
Europe
Mediterranean diet
lymphoma
prospective studies
risk
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2018-12-26