Association of Mediterranean diet with survival after breast cancer diagnosis in women from nine European countries: results from the EPIC cohort study

  1. Castro Espin, Carlota ORCID logo
  2. Bonet, Catalina
  3. Crous-Bou, Marta
  4. Nadal-Zaragoza, Núria
  5. Tjønneland, Anne
  6. Mellemkjær, Lene
  7. Hajji-Louati, Mariem
  8. Truong, Thérèse
  9. Katzke, Verena
  10. Le Cornet, Charlotte
  11. Schulze, Matthias B.
  12. Jannasch, Franziska
  13. Masala, Giovanna
  14. Sieri, Sabina
  15. Panico, Salvatore
  16. Di Girolamo, Chiara
  17. Skeie, Guri
  18. Borch, Kristin Benjaminsen
  19. Olsen, Karina Standahl
  20. Sánchez, Maria-Jose
  21. Amiano, Pilar
  22. Chirlaque, María-Dolores
  23. Guevara, Marcela
  24. Sund, Malin
  25. Bodén, Stina
  26. Gunter, Marc J.
  27. Gonzalez-Gil, Esther M.
  28. Weiderpass, Elisabete
  29. Aguilera-Buenosvinos, Inmaculada
  30. Tsilidis, Kostas K.
  31. Heath, Alicia K.
  32. Aune, Dagfinn
  33. Dossus, Laure
  34. Agudo, Antonio

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1000 Titel
  • Association of Mediterranean diet with survival after breast cancer diagnosis in women from nine European countries: results from the EPIC cohort study
1000 Autor/in
  1. Castro Espin, Carlota |
  2. Bonet, Catalina |
  3. Crous-Bou, Marta |
  4. Nadal-Zaragoza, Núria |
  5. Tjønneland, Anne |
  6. Mellemkjær, Lene |
  7. Hajji-Louati, Mariem |
  8. Truong, Thérèse |
  9. Katzke, Verena |
  10. Le Cornet, Charlotte |
  11. Schulze, Matthias B. |
  12. Jannasch, Franziska |
  13. Masala, Giovanna |
  14. Sieri, Sabina |
  15. Panico, Salvatore |
  16. Di Girolamo, Chiara |
  17. Skeie, Guri |
  18. Borch, Kristin Benjaminsen |
  19. Olsen, Karina Standahl |
  20. Sánchez, Maria-Jose |
  21. Amiano, Pilar |
  22. Chirlaque, María-Dolores |
  23. Guevara, Marcela |
  24. Sund, Malin |
  25. Bodén, Stina |
  26. Gunter, Marc J. |
  27. Gonzalez-Gil, Esther M. |
  28. Weiderpass, Elisabete |
  29. Aguilera-Buenosvinos, Inmaculada |
  30. Tsilidis, Kostas K. |
  31. Heath, Alicia K. |
  32. Aune, Dagfinn |
  33. Dossus, Laure |
  34. Agudo, Antonio |
1000 Erscheinungsjahr 2023
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2023-06-26
1000 Erschienen in
1000 Quellenangabe
  • 21(1):225
1000 Copyrightjahr
  • 2023
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s12916-023-02934-3 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294413/ |
1000 Ergänzendes Material
  • https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02934-3#Sec13 |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • BACKGROUND: The Mediterranean diet has been associated with lower risk of breast cancer (BC) but evidence from prospective studies on the role of Mediterranean diet on BC survival remains sparse and conflicting. We aimed to investigate whether adherence to Mediterranean diet prior to diagnosis is associated with overall and BC-specific mortality. METHODS: A total of 13,270 incident breast cancer cases were identified from an initial sample of 318,686 women in 9 countries from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Adherence to Mediterranean diet was estimated through the adapted relative Mediterranean diet (arMED), a 16-point score that includes 8 key components of the Mediterranean diet and excludes alcohol. The degree of adherence to arMED was classified as low (score 0–5), medium (score 6–8), and high (score 9–16). Multivariable Cox proportional hazards models were used to analyze the association between the arMED score and overall mortality, and Fine-Gray competing risks models were applied for BC-specific mortality. RESULTS: After a mean follow-up of 8.6 years from diagnosis, 2340 women died, including 1475 from breast cancer. Among all BC survivors, low compared to medium adherence to arMED score was associated with a 13% higher risk of all-cause mortality (HR 1.13, 95%CI 1.01–1.26). High compared to medium adherence to arMED showed a non-statistically significant association (HR 0.94; 95% CI 0.84–1.05). With no statistically significant departures from linearity, on a continuous scale, a 3-unit increase in the arMED score was associated with an 8% reduced risk of overall mortality (HR3-unit 0.92, 95% CI: 0.87–0.97). This result sustained when restricted to postmenopausal women and was stronger among metastatic BC cases (HR3-unit 0.81, 95% CI: 0.72–0.91). CONCLUSIONS: Consuming a Mediterranean diet before BC diagnosis may improve long-term prognosis, particularly after menopause and in cases of metastatic breast cancer. Well-designed dietary interventions are needed to confirm these findings and define specific dietary recommendations.
1000 Sacherschließung
lokal Breast cancer
lokal Mediterranean diet
lokal Dietary patterns
lokal Cancer survivors
lokal Propsective studies
1000 Fächerklassifikation (DDC)
1000 Liste der Beteiligten
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1000 Label
1000 Förderer
  1. Instituto de Salud Carlos III |
  2. European Social Fund |
  3. Fundación Científica Asociación Española Contra el Cáncer |
  4. Centre International de Recherche sur le Cancer |
  5. Department of Epidemiology, Biostatistics and Occupational Health, McGill University |
  6. NIHR Imperial Biomedical Research Centre |
  7. Kræftens Bekæmpelse |
  8. Institut National de la Santé et de la Recherche Médicale |
  9. Deutsches Krebsforschungszentrum |
  10. German Institute of Human Nutrition |
  11. Bundesministerium für Bildung und Forschung |
  12. Compagnia di San Paolo |
  13. Ministerie van Volksgezondheid, Welzijn en Sport |
  14. Netherlands Cancer Registry |
  15. World Cancer Research Fund |
  16. Regional Governments of Andalucia |
  17. Catalan Institute of Oncology |
  18. Cancerfonden |
  19. Swedish Research Council and County Councils of Skåne and Västerbotten |
  20. Cancer Research UK |
  21. Medical Research Council |
1000 Fördernummer
  1. FI19/00197
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  20. 14136 to EPIC-Norfolk;C8221/A29017 to EPIC-Oxford
  21. 1000143 to EPIC-Norfolk;MR/M012190/1 to EPIC-Oxford
1000 Förderprogramm
  1. -
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  3. PRYES211366AGUD
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1000 Dateien
1000 Förderung
  1. 1000 joinedFunding-child
    1000 Förderer Instituto de Salud Carlos III |
    1000 Förderprogramm -
    1000 Fördernummer FI19/00197
  2. 1000 joinedFunding-child
    1000 Förderer European Social Fund |
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    1000 Fördernummer -
  3. 1000 joinedFunding-child
    1000 Förderer Fundación Científica Asociación Española Contra el Cáncer |
    1000 Förderprogramm PRYES211366AGUD
    1000 Fördernummer -
  4. 1000 joinedFunding-child
    1000 Förderer Centre International de Recherche sur le Cancer |
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  5. 1000 joinedFunding-child
    1000 Förderer Department of Epidemiology, Biostatistics and Occupational Health, McGill University |
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  6. 1000 joinedFunding-child
    1000 Förderer NIHR Imperial Biomedical Research Centre |
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    1000 Förderer Kræftens Bekæmpelse |
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  8. 1000 joinedFunding-child
    1000 Förderer Institut National de la Santé et de la Recherche Médicale |
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    1000 Förderer Deutsches Krebsforschungszentrum |
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    1000 Förderer German Institute of Human Nutrition |
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    1000 Förderer Bundesministerium für Bildung und Forschung |
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  12. 1000 joinedFunding-child
    1000 Förderer Compagnia di San Paolo |
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  13. 1000 joinedFunding-child
    1000 Förderer Ministerie van Volksgezondheid, Welzijn en Sport |
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  14. 1000 joinedFunding-child
    1000 Förderer Netherlands Cancer Registry |
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  15. 1000 joinedFunding-child
    1000 Förderer World Cancer Research Fund |
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  16. 1000 joinedFunding-child
    1000 Förderer Regional Governments of Andalucia |
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  17. 1000 joinedFunding-child
    1000 Förderer Catalan Institute of Oncology |
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  18. 1000 joinedFunding-child
    1000 Förderer Cancerfonden |
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  19. 1000 joinedFunding-child
    1000 Förderer Swedish Research Council and County Councils of Skåne and Västerbotten |
    1000 Förderprogramm -
    1000 Fördernummer -
  20. 1000 joinedFunding-child
    1000 Förderer Cancer Research UK |
    1000 Förderprogramm -
    1000 Fördernummer 14136 to EPIC-Norfolk;C8221/A29017 to EPIC-Oxford
  21. 1000 joinedFunding-child
    1000 Förderer Medical Research Council |
    1000 Förderprogramm -
    1000 Fördernummer 1000143 to EPIC-Norfolk;MR/M012190/1 to EPIC-Oxford
1000 Objektart article
1000 Beschrieben durch
1000 @id frl:6453502.rdf
1000 Erstellt am 2023-08-10T10:24:54.788+0200
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