Abstract
Lung cancer in men and breast cancer in women are the most commonly diagnosed cancers in Poland and worldwide. Results of studies involving dietary patterns (DPs) and breast or lung cancer risk in European countries outside the Mediterranean Sea region are limited and inconclusive. This study aimed to develop a ‘Polish-adapted Mediterranean Diet’ (‘Polish-aMED’) score, and then study the associations between the ‘Polish-aMED’ score and a posteriori-derived dietary patterns with breast or lung cancer risk in adult Poles. This pooled analysis of two case-control studies involved 560 subjects (280 men, 280 women) aged 40–75 years from Northeastern Poland. Diagnoses of breast cancer in 140 women and lung cancer in 140 men were found. The food frequency consumption of 21 selected food groups was collected using a 62-item Food Frequency Questionnaire (FFQ)-6. The ‘Polish-adapted Mediterranean Diet’ score which included eight items—vegetables, fruit, whole grain, fish, legumes, nuts and seeds—as well as the ratio of vegetable oils to animal fat and red and processed meat was developed (range: 0–8 points). Three DPs were identified in a Principal Component Analysis: ‘Prudent’, ‘Non-healthy’, ‘Dressings and sweetened-low-fat dairy’. In a multiple logistic regression analysis, two models were created: crude, and adjusted for age, sex, type of cancer, Body Mass Index (BMI), socioeconomic status (SES) index, overall physical activity, smoking status and alcohol abuse. The risk of breast or lung cancer was lower in the average (3–5 points) and high (6–8 points) levels of the ‘Polish-aMED’ score compared to the low (0–2 points) level by 51% (odds ratio (OR): 0.49; 95% confidence interval (Cl): 0.30–0.80; p < 0.01; adjusted) and 63% (OR: 0.37; 95% Cl: 0.21–0.64; p < 0.001; adjusted), respectively. In the middle and upper tertiles compared to the bottom tertile of the ‘Prudent’ DP, the risk of cancer was lower by 38–43% (crude) but was not significant after adjustment for confounders. In the upper compared to the bottom tertile of the ‘Non-healthy’ DP, the risk of cancer was higher by 65% (OR: 1.65; 95% Cl: 1.05–2.59; p < 0.05; adjusted). In conclusion, the Polish adaptation of the Mediterranean diet could be considered for adults living in non-Mediterranean countries for the prevention of the breast or lung cancers. Future studies should explore the role of a traditional Mediterranean diet fitted to local dietary patterns of non-Mediterranean Europeans in cancer prevention.
Highlights
Based on statistics from the GLOBOCAN [1], the number of cancer cases is growing rapidly worldwide, and in 2012, the number of cases increased to 14 million, including 8 million deaths.Lung cancer in men and breast cancer in women are the most commonly diagnosed cancers, including in developed and developing countries [2]
In comparison with the controls, more cases of breast or lung cancer were identified in individuals who came from a village, had a lower education level or lower socioeconomic status, were less physically active, including physical activity at work and in leisure time, or were smokers, including former smokers (Table 4)
The present study provides interesting insight into the strong beneficial effects of high and average adherence to the ‘Polish-adapted Mediterranean Diet’, and the harmful effects of high adherence to a ‘Non-healthy’ dietary pattern on breast and lung cancer risk among adults from Northeastern Poland
Summary
Based on statistics from the GLOBOCAN [1], the number of cancer cases is growing rapidly worldwide, and in 2012, the number of cases increased to 14 million, including 8 million deaths.Lung cancer in men and breast cancer in women are the most commonly diagnosed cancers, including in developed and developing countries [2]. 17% of the total cancer cases and 24% of cancer deaths in males, and breast cancer accounted for about. According to the World Cancer Research Fund [6,7], convincing evidence has only been obtained for ethanol and beta-carotene supplements for smokers as factors increasing the risk of breast and lung cancers, respectively. The consumption of fruits and foods containing carotenoids probably decreases the risk of lung cancer [6]. There is limited evidence suggesting that non-starchy vegetables, foods containing selenium and quercetin decrease the risk of lung cancer [6] (but red and processed meat, total fat, butter and retinol supplements (for smokers only) increase the risk). The similar epigenetic mechanisms of breast and lung cancer indicate common dietary causes [8]
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