Mediterranean diet and quality of life in women treated for breast cancer: A baseline analysis of DEDiCa multicentre trial

G. Porciello, C. Montagnese, A. Crispo, M. Grimaldi, M. Libra, S. Vitale, E. Palumbo, R. Pica, I. Calabrese, S. Cubisino, L. Falzone, L. Poletto, V. Martinuzzo, M. Prete, N. Esindi, G. Thomas, D. Cianniello, M. Pinto, M. de Laurentiis, C. PacilioM. Rinaldo, M. D’Aiuto, D. Serraino, S. Massarut, C. Evangelista, A. Steffan, F. Catalano, G.L. Banna, G. Scandurra, F. Ferraù, R. Rossello, G. Antonelli, G. Guerra, A. Farina, F. Messina, G. Riccardi, D. Gatti, D.J.A. Jenkins, A. Minopoli, B. Grilli, E. Cavalcanti, E. Celentano, G. Botti, M. Montella, L.S.A. Augustin

Research output: Contribution to journalArticlepeer-review


Evidence suggests a beneficial role of the Mediterranean Diet (MedDiet) on health-related quality of life (HRQoL) in healthy subjects. HRQoL is relevant in cancer therapy and disease outcomes, therefore we investigated the association between adherence to the MedDiet and HRQoL in breast cancer survivors participating in the multicentre trial DEDiCa. Diet and HRQoL were assessed at baseline in a subgroup of 309 women enrolled within 12 months of breast cancer diagnosis without metastasis (stages I-III, mean age 52±1 yrs, BMI 27±7 kg/m2). The 14-item PREDIMED questionnaire was used to analyse adherence to the MedDiet. HRQoL was assessed with three validated questionnaires measuring physical, mental, emotional and social factors: EQ-5D-3L, EORTC QLQ-C30 and EORTC QLQ-BR23. Analysis of variance (ANOVA) and multivariate analyses were performed to assess the possible role of the MedDiet on HRQoL. Patients with higher adherence to MedDiet (PREDIMED score >7) showed significantly higher scores for physical functioning (p = 0.02) and lower scores on the symptomatic pain scale (p = 0.04) assessed by the EORTC QLQ-C30 questionnaire compared to patients with a lower adherence to MedDiet (PREDIMED score ≤7). Higher scores from the EQ-5D-3L indicating higher well-being were observed mainly in participants with higher MedDiet adherence (p = 0.05). In adjusted multivariate analyses significant positive associations were found between MedDiet, physical functioning (p = 0.001) and EQ 5D-3L score (p = 0.003) while inverse associations were found with pain and insomnia symptoms (p = 0.005 and p = 0.029, respectively). These results suggest that higher adherence to the MedDiet in breast cancer survivors is associated with better aspects of quality of life, specifically higher physical functioning, better sleep, lower pain and generally higher well-being confirming findings in healthy subjects. Copyright: © 2020 Porciello et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Original languageEnglish
Article numbere0239803
Number of pages16
JournalPLoS ONE
Issue number10 October
Publication statusPublished - 2020


  • adult
  • Article
  • body mass
  • breast cancer
  • cancer staging
  • cancer survivor
  • controlled study
  • European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer 23
  • European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30
  • European Quality of Life 5 Dimensions 3 Level questionnaire
  • female
  • human
  • insomnia
  • Italy
  • major clinical study
  • Mediterranean diet
  • middle aged
  • multicenter study
  • pain assessment
  • quality of life
  • quality of life assessment
  • sleep quality
  • wellbeing
  • aged
  • breast tumor
  • clinical trial
  • epidemiology
  • pain
  • patient compliance
  • questionnaire
  • Adult
  • Aged
  • Breast Neoplasms
  • Cancer Survivors
  • Diet, Mediterranean
  • Female
  • Humans
  • Middle Aged
  • Pain
  • Patient Compliance
  • Quality of Life
  • Sleep Initiation and Maintenance Disorders
  • Surveys and Questionnaires


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