Ilka Ratjen1, Clemens Schafmayer2, Romina di Giuseppe1, Sabina Waniek1, Sandra Plachta-Danielzik1, Manja Koch1,3, Ute Nöthlings4, Jochen Hampe5, Sabrina Schlesinger1,6, Wolfgang Lieb7. 1. Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany. 2. Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Kiel, Germany. 3. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA. 4. Nutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany. 5. Medical Department 1, University Hospital Dresden, Technical University Dresden, Dresden, Germany; and. 6. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. 7. Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany; wolfgang.lieb@epi.uni-kiel.de.
Abstract
Background: Dietary factors are known to affect the risk of new-onset colorectal cancer (CRC), but information on the extent to which postdiagnostic diet affects mortality in long-term CRC survivors is scarce.Objective: We investigated the association of 2 a priori-defined postdiagnostic dietary patterns [Modified Mediterranean Diet Score (MMDS) and healthy Nordic Food Index (HNFI)] with all-cause mortality in long-term CRC survivors. Methods: Diet was assessed at a median time of 6 y after cancer diagnosis in 1404 CRC survivors (median age: 69 y; 56% men) in a prospective cohort study in Northern Germany by using a semiquantitative food-frequency questionnaire. Cox proportional hazard models, adjusting for clinical and sociodemographic characteristics, were used to assess associations of the MMDS and the HNFI with all-cause mortality. Results: A total of 204 patients died during a median follow-up time of 7 y after diet assessment. In multivariable-adjusted models, higher adherence to the modified Mediterranean diet was significantly associated with lower all-cause mortality (HR: 0.48; 95% CI: 0.32, 0.74 for highest compared with lowest score quartile and HR: 0.88; 95% CI: 0.81, 0.96 per 1-point increment in pattern score). Similarly, the HNFI was inversely associated with all-cause mortality when the highest was compared with the lowest index quartile (HR: 0.63; 95% CI: 0.39, 1.04) and when modeled as a continuous trait (HR: 0.90; 95% CI: 0.82, 0.99 per 1-point increment in the score).Conclusions: Our results suggest that higher adherences to the Mediterranean diet and to the healthy Nordic diet after CRC diagnosis are associated with better overall survival in long-term CRC survivors.
Background: Dietary factors are known to affect the risk of new-onset colorectal cancer (CRC), but information on the extent to which postdiagnostic diet affects mortality in long-term CRC survivors is scarce.Objective: We investigated the association of 2 a priori-defined postdiagnostic dietary patterns [Modified Mediterranean Diet Score (MMDS) and healthy Nordic Food Index (HNFI)] with all-cause mortality in long-term CRC survivors. Methods: Diet was assessed at a median time of 6 y after cancer diagnosis in 1404 CRC survivors (median age: 69 y; 56% men) in a prospective cohort study in Northern Germany by using a semiquantitative food-frequency questionnaire. Cox proportional hazard models, adjusting for clinical and sociodemographic characteristics, were used to assess associations of the MMDS and the HNFI with all-cause mortality. Results: A total of 204 patients died during a median follow-up time of 7 y after diet assessment. In multivariable-adjusted models, higher adherence to the modified Mediterranean diet was significantly associated with lower all-cause mortality (HR: 0.48; 95% CI: 0.32, 0.74 for highest compared with lowest score quartile and HR: 0.88; 95% CI: 0.81, 0.96 per 1-point increment in pattern score). Similarly, the HNFI was inversely associated with all-cause mortality when the highest was compared with the lowest index quartile (HR: 0.63; 95% CI: 0.39, 1.04) and when modeled as a continuous trait (HR: 0.90; 95% CI: 0.82, 0.99 per 1-point increment in the score).Conclusions: Our results suggest that higher adherences to the Mediterranean diet and to the healthy Nordic diet after CRC diagnosis are associated with better overall survival in long-term CRC survivors.
Authors: Jiali Zheng; Fred K Tabung; Jiajia Zhang; E Angela Murphy; Nitin Shivappa; Judith K Ockene; Bette Caan; Candyce H Kroenke; James R Hébert; Susan E Steck Journal: Eur J Nutr Date: 2019-04-06 Impact factor: 5.614
Authors: Sylvia H J Jochems; Frits H M Van Osch; Richard T Bryan; Anke Wesselius; Frederik J van Schooten; Kar Keung Cheng; Maurice P Zeegers Journal: BMJ Open Date: 2018-02-19 Impact factor: 2.692