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

Marta Solans, Yolanda Benavente, Marc Saez, Antonio Agudo, Sabine Naudin, Fatemeh Saberi Hosnijeh, Hwayoung Noh, Heinz Freisling, Pietro Ferrari, Caroline Besson, Yahya Mahamat-Saleh, Marie Christine Boutron-Ruault, Tilman Kühn, Rudolf Kaaks, Heiner Boeing, Cristina Lasheras, Miguel Rodríguez-Barranco, Pilar Amiano, Jose Maria Huerta, Aurelio BarricarteJulie A. Schmidt, Paolo Vineis, Elio Riboli, Antonia Trichopoulou, Christina Bamia, Eleni Peppa, Giovanna Masala, Claudia Agnoli, Rosario Tumino, Carlotta Sacerdote, Salvatore Panico, Guri Skeie, Elisabete Weiderpass, Mats Jerkeman, Ulrika Ericson, Florentin Späth, Lena Maria Nilsson, Christina C. Dahm, Kim Overvad, Anne Katrine Bolvig, Anne Tjønneland, Silvia de Sanjose, Genevieve Buckland, Roel Vermeulen, Alexandra Nieters, Delphine Casabonne

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)122-131
Number of pages10
JournalInternational Journal of Cancer
Volume145
Issue number1
DOIs
Publication statusPublished - Jul 1 2019

Fingerprint

Immunoproliferative Small Intestinal Disease
Mediterranean Diet
Lymphoma
Neoplasms
Hodgkin Disease
Prospective Studies
Proportional Hazards Models
Non-Hodgkin's Lymphoma
Alcohols

Keywords

  • Europe
  • lymphoma
  • Mediterranean diet
  • prospective studies
  • risk

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Solans, M., Benavente, Y., Saez, M., Agudo, A., Naudin, S., Hosnijeh, F. S., ... Casabonne, D. (2019). Adherence to the mediterranean diet and lymphoma risk in the european prospective investigation into cancer and nutrition. International Journal of Cancer, 145(1), 122-131. https://doi.org/10.1002/ijc.32091

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; Besson, Caroline; Mahamat-Saleh, Yahya; Boutron-Ruault, Marie Christine; Kühn, Tilman; Kaaks, Rudolf; Boeing, Heiner; Lasheras, Cristina; Rodríguez-Barranco, Miguel; Amiano, Pilar; Huerta, Jose Maria; Barricarte, Aurelio; Schmidt, Julie A.; Vineis, Paolo; Riboli, Elio; Trichopoulou, Antonia; Bamia, Christina; Peppa, Eleni; Masala, Giovanna; Agnoli, Claudia; Tumino, Rosario; Sacerdote, Carlotta; Panico, Salvatore; Skeie, Guri; Weiderpass, Elisabete; Jerkeman, Mats; Ericson, Ulrika; Späth, Florentin; Nilsson, Lena Maria; Dahm, Christina C.; Overvad, Kim; Bolvig, Anne Katrine; Tjønneland, Anne; de Sanjose, Silvia; Buckland, Genevieve; Vermeulen, Roel; Nieters, Alexandra; Casabonne, Delphine.

In: International Journal of Cancer, Vol. 145, No. 1, 01.07.2019, p. 122-131.

Research output: Contribution to journalArticle

Solans, M, Benavente, Y, Saez, M, Agudo, A, Naudin, S, Hosnijeh, FS, Noh, H, Freisling, H, Ferrari, P, Besson, C, Mahamat-Saleh, Y, Boutron-Ruault, MC, Kühn, T, Kaaks, R, Boeing, H, Lasheras, C, Rodríguez-Barranco, M, Amiano, P, Huerta, JM, Barricarte, A, Schmidt, JA, Vineis, P, Riboli, E, Trichopoulou, A, Bamia, C, Peppa, E, Masala, G, Agnoli, C, Tumino, R, Sacerdote, C, Panico, S, Skeie, G, Weiderpass, E, Jerkeman, M, Ericson, U, Späth, F, Nilsson, LM, Dahm, CC, Overvad, K, Bolvig, AK, Tjønneland, A, de Sanjose, S, Buckland, G, Vermeulen, R, Nieters, A & Casabonne, D 2019, 'Adherence to the mediterranean diet and lymphoma risk in the european prospective investigation into cancer and nutrition', International Journal of Cancer, vol. 145, no. 1, pp. 122-131. https://doi.org/10.1002/ijc.32091
Solans, Marta ; Benavente, Yolanda ; Saez, Marc ; Agudo, Antonio ; Naudin, Sabine ; Hosnijeh, Fatemeh Saberi ; Noh, Hwayoung ; Freisling, Heinz ; Ferrari, Pietro ; Besson, Caroline ; Mahamat-Saleh, Yahya ; Boutron-Ruault, Marie Christine ; Kühn, Tilman ; Kaaks, Rudolf ; Boeing, Heiner ; Lasheras, Cristina ; Rodríguez-Barranco, Miguel ; Amiano, Pilar ; Huerta, Jose Maria ; Barricarte, Aurelio ; Schmidt, Julie A. ; Vineis, Paolo ; Riboli, Elio ; Trichopoulou, Antonia ; Bamia, Christina ; Peppa, Eleni ; Masala, Giovanna ; Agnoli, Claudia ; Tumino, Rosario ; Sacerdote, Carlotta ; Panico, Salvatore ; Skeie, Guri ; Weiderpass, Elisabete ; Jerkeman, Mats ; Ericson, Ulrika ; Späth, Florentin ; Nilsson, Lena Maria ; Dahm, Christina C. ; Overvad, Kim ; Bolvig, Anne Katrine ; Tjønneland, Anne ; de Sanjose, Silvia ; Buckland, Genevieve ; Vermeulen, Roel ; Nieters, Alexandra ; Casabonne, Delphine. / Adherence to the mediterranean diet and lymphoma risk in the european prospective investigation into cancer and nutrition. In: International Journal of Cancer. 2019 ; Vol. 145, No. 1. pp. 122-131.
@article{0897d18b9b0c4e09a62bb64e5cf9ece0,
title = "Adherence to the mediterranean diet and lymphoma risk in the european prospective investigation into cancer and nutrition",
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.",
keywords = "Europe, lymphoma, Mediterranean diet, prospective studies, risk",
author = "Marta Solans and Yolanda Benavente and Marc Saez and Antonio Agudo and Sabine Naudin and Hosnijeh, {Fatemeh Saberi} and Hwayoung Noh and Heinz Freisling and Pietro Ferrari and Caroline Besson and Yahya Mahamat-Saleh and Boutron-Ruault, {Marie Christine} and Tilman K{\"u}hn and Rudolf Kaaks and Heiner Boeing and Cristina Lasheras and Miguel Rodr{\'i}guez-Barranco and Pilar Amiano and Huerta, {Jose Maria} and Aurelio Barricarte and Schmidt, {Julie A.} and Paolo Vineis and Elio Riboli and Antonia Trichopoulou and Christina Bamia and Eleni Peppa and Giovanna Masala and Claudia Agnoli and Rosario Tumino and Carlotta Sacerdote and Salvatore Panico and Guri Skeie and Elisabete Weiderpass and Mats Jerkeman and Ulrika Ericson and Florentin Sp{\"a}th and Nilsson, {Lena Maria} and Dahm, {Christina C.} and Kim Overvad and Bolvig, {Anne Katrine} and Anne Tj{\o}nneland and {de Sanjose}, Silvia and Genevieve Buckland and Roel Vermeulen and Alexandra Nieters and Delphine Casabonne",
year = "2019",
month = "7",
day = "1",
doi = "10.1002/ijc.32091",
language = "English",
volume = "145",
pages = "122--131",
journal = "International Journal of Cancer",
issn = "0020-7136",
publisher = "Wiley-Liss Inc.",
number = "1",

}

TY - JOUR

T1 - Adherence to the mediterranean diet and lymphoma risk in the european prospective investigation into cancer and nutrition

AU - Solans, Marta

AU - Benavente, Yolanda

AU - Saez, Marc

AU - Agudo, Antonio

AU - Naudin, Sabine

AU - Hosnijeh, Fatemeh Saberi

AU - Noh, Hwayoung

AU - Freisling, Heinz

AU - Ferrari, Pietro

AU - Besson, Caroline

AU - Mahamat-Saleh, Yahya

AU - Boutron-Ruault, Marie Christine

AU - Kühn, Tilman

AU - Kaaks, Rudolf

AU - Boeing, Heiner

AU - Lasheras, Cristina

AU - Rodríguez-Barranco, Miguel

AU - Amiano, Pilar

AU - Huerta, Jose Maria

AU - Barricarte, Aurelio

AU - Schmidt, Julie A.

AU - Vineis, Paolo

AU - Riboli, Elio

AU - Trichopoulou, Antonia

AU - Bamia, Christina

AU - Peppa, Eleni

AU - Masala, Giovanna

AU - Agnoli, Claudia

AU - Tumino, Rosario

AU - Sacerdote, Carlotta

AU - Panico, Salvatore

AU - Skeie, Guri

AU - Weiderpass, Elisabete

AU - Jerkeman, Mats

AU - Ericson, Ulrika

AU - Späth, Florentin

AU - Nilsson, Lena Maria

AU - Dahm, Christina C.

AU - Overvad, Kim

AU - Bolvig, Anne Katrine

AU - Tjønneland, Anne

AU - de Sanjose, Silvia

AU - Buckland, Genevieve

AU - Vermeulen, Roel

AU - Nieters, Alexandra

AU - Casabonne, Delphine

PY - 2019/7/1

Y1 - 2019/7/1

N2 - 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.

AB - 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.

KW - Europe

KW - lymphoma

KW - Mediterranean diet

KW - prospective studies

KW - risk

UR - http://www.scopus.com/inward/record.url?scp=85061195385&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061195385&partnerID=8YFLogxK

U2 - 10.1002/ijc.32091

DO - 10.1002/ijc.32091

M3 - Article

C2 - 30588620

AN - SCOPUS:85061195385

VL - 145

SP - 122

EP - 131

JO - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

IS - 1

ER -