Adherence to mediterranean diet, physical activity and survival after prostate cancer diagnosis

Matteo Di Maso, Livia S.A. Augustin, Federica Toffolutti, Carmen Stocco, Luigino Dal Maso, David J.A. Jenkins, Neil E. Fleshner, Diego Serraino, Jerry Polesel

Research output: Contribution to journalArticlepeer-review


Despite the considerable number of studies investigating the Mediterranean diet in prostate cancer (PCa) etiology, very few focused on cancer survival. We assessed the pre-diagnostic diet and physical activity in a cohort of 777 men with PCa diagnosed between 1995 and 2002 in north-eastern Italy; adherence to the Mediterranean diet was evaluated through the Mediterranean Diet Score (MDS). Hazard ratios (HR) of death with confidence intervals (CI) were estimated using the Cox model, adjusting for potential confounders. During 10 years of follow-up, 208 patients (26.8%) died, 75 (9.7%) due to PCa. Patients reporting MDS ≥ 5 showed a higher overall survival than those with MDS < 5 (HR = 0.74; 95% CI: 0.56–0.99). Although high physical activity was not significantly associated with overall survival (HR = 0.79; 95% CI: 0.59–1.07), the HR for all-cause death was the lowest (HR = 0.58; 95% CI: 0.38–0.90) for men reporting MDS ≥ 5 and high physical activity compared to those reporting MDS < 5 and low/moderate physical activity. No association emerged for PCa specific survival. Study findings support the beneficial impact of pre-diagnostic adherence to the Mediterranean diet and physical activity on overall survival; they are mainly driven by risk reduction in non-prostate cancer mortality, which however accounts for about 80% of death in men with PCa.

Original languageEnglish
Article number243
Pages (from-to)1-11
Number of pages11
Issue number1
Publication statusPublished - Jan 2021


  • Mediterranean diet
  • Physical activity
  • Prostate cancer
  • Survival

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics


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