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      Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta‐analysis of observational studies

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        1 , , 1
      Cancer Medicine
      John Wiley and Sons Inc.
      Cancer, Mediterranean diet, meta‐analysis

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          Abstract

          The aim of the present systematic review and meta‐analysis of observational studies was to gain further insight into the effects of adherence to Mediterranean Diet ( MD) on overall cancer mortality, incidence of different types of cancer, and cancer mortality risk in cancer survivors. Literature search was performed using the electronic databases PubMed, and EMBASE until 2 July 2015. We included either cohort (for specific tumors only incidence cases were used) or case–control studies. Study specific risk ratios, hazard ratios, and odds ratios ( RR/ HR/ OR) were pooled using a random effect model. The updated review process showed 23 observational studies that were not included in the previous meta‐analysis (total number of studies evaluated: 56 observational studies). An overall population of 1,784,404 subjects was included in the present update. The highest adherence score to an MD was significantly associated with a lower risk of all‐cause cancer mortality ( RR: 0.87, 95% CI 0.81–0.93, I 2 = 84%), colorectal cancer ( RR: 0.83, 95% CI 0.76–0.89, I 2 = 56%), breast cancer ( RR: 0.93, 95% CI 0.87–0.99, I 2=15%), gastric cancer ( RR: 0.73, 95% CI 0.55–0.97, I 2 = 66%), prostate cancer ( RR: 0.96, 95% CI 0.92–1.00, I 2 = 0%), liver cancer ( RR: 0.58, 95% CI 0.46–0.73, I 2 = 0%), head and neck cancer ( RR: 0.40, 95% CI 0.24–0.66, I 2 = 90%), pancreatic cancer ( RR: 0.48, 95% CI 0.35–0.66), and respiratory cancer ( RR: 0.10, 95% CI 0.01–0.70). No significant association could be observed for esophageal/ovarian/endometrial/and bladder cancer, respectively. Among cancer survivors, the association between the adherence to the highest MD category and risk of cancer mortality, and cancer recurrence was not statistically significant. The updated meta‐analyses confirm a prominent and consistent inverse association provided by adherence to an MD in relation to cancer mortality and risk of several cancer types.

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          Association of mediterranean diet with mild cognitive impairment and Alzheimer's disease: a systematic review and meta-analysis.

          To conduct a systematic review of all studies to determine whether there is an association between the Mediterranean diet (MeDi) and cognitive impairment. We conducted a comprehensive search of the major databases and hand-searched proceedings of major neurology, psychiatry, and dementia conferences through November 2012. Prospective cohort studies examining the MeDi with longitudinal follow-up of at least 1 year and reporting cognitive outcomes (mild cognitive impairment [MCI] or Alzheimer's disease [AD]) were included. The effect size was estimated as hazard-ratio (HR) with 95% confidence intervals (CIs) using the random-effects model. Heterogeneity was assessed using Cochran's Q-test and I2-statistic. Out of the 664 studies screened, five studies met eligibility criteria. Higher adherence to the MeDi was associated with reduced risk of MCI and AD. The subjects in the highest MeDi tertile had 33% less risk (adjusted HR = 0.67; 95% CI, 0.55-0.81; p < 0.0001) of cognitive impairment (MCI or AD) as compared to the lowest MeDi score tertile. Among cognitively normal individuals, higher adherence to the MeDi was associated with a reduced risk of MCI (HR = 0.73; 95% CI, 0.56-0.96; p = 0.02) and AD (HR = 0.64; 95% CI, 0.46-0.89; p = 0.007). There was no significant heterogeneity in the analyses. While the overall number of studies is small, pooled results suggest that a higher adherence to the MeDi is associated with a reduced risk of developing MCI and AD, and a reduced risk of progressing from MCI to AD. Further prospective-cohort studies with longer follow-up and randomized controlled trials are warranted to consolidate the evidence. Systematic review registration number: PROSPERO 2013: CRD42013003868.
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            Associations of key diet-quality indexes with mortality in the Multiethnic Cohort: the Dietary Patterns Methods Project.

            Healthy dietary patterns have been linked positively with health and longevity. However, prospective studies in diverse populations in the United States addressing dietary patterns and mortality are limited. We assessed the ability of the following 4 diet-quality indexes [the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010 (AHEI-2010), the alternate Mediterranean diet score (aMED), and the Dietary Approaches to Stop Hypertension (DASH)] to predict the reduction in risk of mortality from all causes, cardiovascular disease (CVD), and cancer. White, African American, Native Hawaiian, Japanese American, and Latino adults (n = 215,782) from the Multiethnic Cohort completed a quantitative food-frequency questionnaire. Scores for each dietary index were computed and divided into quintiles for men and women. Mortality was documented over 13-18 y of follow-up. HRs and 95% CIs were computed by using adjusted Cox models. High HEI-2010, AHEI-2010, aMED, and DASH scores were all inversely associated with risk of mortality from all causes, CVD, and cancer in both men and women (P-trend < 0.0001 for all models). For men, the HEI-2010 was consistently associated with a reduction in risk of mortality for all causes (HR: 0.75; 95% CI: 0.71, 0.79), CVD (HR: 0.74; 95% CI: 0.69, 0.81), and cancer (HR: 0.76; 95% CI: 0.70, 0.83) when lowest and highest quintiles were compared. In women, the AHEI and aMED showed large reductions for all-cause mortality (HR: 0.78; 95% CI: 0.74, 0.82), the AHEI showed large reductions for CVD (HR: 0.76; 95% CI: 0.69, 0.83), and the aMED showed large reductions for cancer (HR: 0.84; 95% CI: 0.76, 0. 92). These results, in a US multiethnic population, suggest that consuming a dietary pattern that achieves a high diet-quality index score is associated with lower risk of mortality from all causes, CVD, and cancer in adult men and women. © 2015 American Society for Nutrition.
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              Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis.

              Adherence to a Mediterranean diet is associated with significant improvements in health status. However, to date no systematic review and meta-analysis has summarized the effects of Mediterranean diet adherence on the risk of type 2 diabetes mellitus.
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                Author and article information

                Journal
                Cancer Med
                Cancer Med
                10.1002/(ISSN)2045-7634
                CAM4
                Cancer Medicine
                John Wiley and Sons Inc. (Hoboken )
                2045-7634
                16 October 2015
                December 2015
                : 4
                : 12 ( doiID: 10.1002/cam4.2015.4.issue-12 )
                : 1933-1947
                Affiliations
                [ 1 ] Department of Nutritional SciencesFaculty of Life Sciences University of Vienna Althanstraße 14 UZA II, A‐1090 ViennaAustria
                Author notes
                [*] [* ] Correspondence

                Lukas Schwingshackl, Department of Nutritional Sciences, University of Vienna, Faculty of Life Sciences, Althanstraße 14 UZA II, A‐1090 Vienna, Austria. Tel: +43‐1‐4277‐54956; Fax: +43 1 4277‐9549; E‐mail: lukas.schwingshackl@ 123456univie.ac.at German Institute of Human Nutrition Potsdam‐Rehbruecke (DIfE), Arthur‐Scheunert‐Allee 114‐116, 14558 Nuthetal Germany. Tel: 033200 88‐2714; E‐mail: lukas.schwingshackl@ 123456dife.de

                Author information
                http://orcid.org/0000-0003-3407-7594
                Article
                CAM4539
                10.1002/cam4.539
                5123783
                26471010
                d0a5a337-67e0-43e7-8efd-88e1789c36fc
                © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 April 2015
                : 14 August 2015
                : 17 August 2015
                Page count
                Pages: 15
                Categories
                Original Research
                Cancer Prevention
                Original Research
                Custom metadata
                2.0
                cam4539
                December 2015
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.9.8 mode:remove_FC converted:25.11.2016

                Oncology & Radiotherapy
                cancer,mediterranean diet,meta‐analysis
                Oncology & Radiotherapy
                cancer, mediterranean diet, meta‐analysis

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