Lung Cancer and Diet: Exploring the Mediterranean Diet’s Impact

Overview of Lung Cancer

Lung cancer ranks among the most commonly diagnosed cancers globally and is associated with a dismal prognosis, with five-year survival rates below 20%. While tobacco smoking is a primary risk factor, emerging evidence suggests that dietary choices may also influence lung cancer risk.

The Mediterranean Diet Defined

The Mediterranean diet is characterized by a plant-based approach that emphasizes the consumption of substantial quantities of fish, vegetables, legumes, fruits, whole grains, and nuts. It restricts red and processed meats, refined grains, high-fat dairy products, and sweets, while allowing moderate consumption of red wine.

Previous Research on Diet and Lung Cancer Risk

Earlier studies indicated a potential reduction in lung cancer risk associated with higher adherence to the Mediterranean diet. However, these studies often focused on a limited number of lung cancer cases and did not explore sex-specific or lung cancer subtype associations.

The Netherlands Cohort Study

Study Design and Methodology

A cohort study published in the British Journal of Nutrition examined the relationship between adherence to the Mediterranean diet and lung cancer risk in the Netherlands. This study analyzed data from participants aged 55 to 69 years, utilizing the Netherlands Cohort Study (NLCS), a prospective population-based cohort study. Researchers assessed participants’ dietary habits and cancer risk factors through a self-administered questionnaire, which was used to calculate diet scores reflecting adherence to the Mediterranean diet.

Findings on Lung Cancer Risk and Diet

The study identified a statistically significant association between higher adherence to the Mediterranean diet and reduced lung cancer risk across both sexes. The inverse correlation was slightly more pronounced in females than males, although the difference was not statistically significant. In men, adherence to the Mediterranean diet was inversely associated with the risk of small cell carcinoma, squamous cell carcinoma, and large cell carcinoma, but not adenocarcinoma.

Limitations Related to Body Mass Index

In women, a higher adherence to the Mediterranean diet was associated with a non-significant reduction in the risk of adenocarcinoma, squamous cell carcinoma, and small cell carcinoma. However, the differences among the four major lung cancer subtypes were not statistically significant. Notably, the findings appear to be confined to individuals with a normal body mass index (BMI) and those consuming at least 15 grams of alcohol daily.

Potential Measurement Errors in Dietary Assessments

The substantial number of lung cancer cases in the study allowed for adjustment of potential confounders, and the high follow-up completion rate minimized the risk of information and selection bias. However, relying on a single dietary assessment at baseline may have led to weaker associations and potential measurement errors.

Conclusion and Future Research

Overall, the study’s results align with previous research indicating that adherence to the Mediterranean diet may lower lung cancer risk. Despite observing potential differences in associations between sexes and lung cancer subtypes, further investigation is necessary to draw definitive conclusions on these topics.

Reference

Schulpen, M., & Brandt, P. A. (2018). Adherence to the Mediterranean diet and risk of lung cancer in the Netherlands Cohort Study. British Journal of Nutrition, 119(6), 674-684. doi:10.1017/s0007114517003737