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Adherence to the mediterranean diet and lymphoma risk in the european prospective investigation into cancer and nutrition

Solans, Marta ; Benavente, Yolanda ; Saez, Marc ; Agudo, Antonio ; Naudin, Sabine ; Hosnijeh, Fatemeh Saberi ; Noh, Hwayoung ; Freisling, Heinz ; Ferrari, Pietro and Besson, Caroline , et al. (2019) In International Journal of Cancer 145(1). p.122-131
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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Europe, lymphoma, Mediterranean diet, prospective studies, risk
in
International Journal of Cancer
volume
145
issue
1
pages
122 - 131
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:30588620
  • scopus:85061195385
ISSN
0020-7136
DOI
10.1002/ijc.32091
language
English
LU publication?
yes
id
22ae0174-fd81-4ae6-a0d8-f5ae6f6346b4
date added to LUP
2019-02-25 10:36:54
date last changed
2023-12-03 02:55:17
@article{22ae0174-fd81-4ae6-a0d8-f5ae6f6346b4,
  abstract     = {{<p>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.</p>}},
  author       = {{Solans, Marta and Benavente, Yolanda and Saez, Marc and Agudo, Antonio and Naudin, Sabine and Hosnijeh, Fatemeh Saberi and Noh, Hwayoung and Freisling, Heinz and Ferrari, Pietro and Besson, Caroline and Mahamat-Saleh, Yahya and Boutron-Ruault, Marie Christine and Kühn, Tilman and Kaaks, Rudolf and Boeing, Heiner and Lasheras, Cristina and Rodríguez-Barranco, Miguel and Amiano, Pilar and Huerta, Jose Maria and Barricarte, Aurelio and Schmidt, Julie A. and Vineis, Paolo and Riboli, Elio and Trichopoulou, Antonia and Bamia, Christina and Peppa, Eleni and Masala, Giovanna and Agnoli, Claudia and Tumino, Rosario and Sacerdote, Carlotta and Panico, Salvatore and Skeie, Guri and Weiderpass, Elisabete and Jerkeman, Mats and Ericson, Ulrika and Späth, Florentin and Nilsson, Lena Maria and Dahm, Christina C. and Overvad, Kim and Bolvig, Anne Katrine and Tjønneland, Anne and de Sanjose, Silvia and Buckland, Genevieve and Vermeulen, Roel and Nieters, Alexandra and Casabonne, Delphine}},
  issn         = {{0020-7136}},
  keywords     = {{Europe; lymphoma; Mediterranean diet; prospective studies; risk}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{122--131}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{International Journal of Cancer}},
  title        = {{Adherence to the mediterranean diet and lymphoma risk in the european prospective investigation into cancer and nutrition}},
  url          = {{http://dx.doi.org/10.1002/ijc.32091}},
  doi          = {{10.1002/ijc.32091}},
  volume       = {{145}},
  year         = {{2019}},
}