Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

How does the Mediterranean diet decrease the risk of a variety of cancers?

European Journal of Clinical Nutrition volume 69, page 1372 (2015)Cite this article

Subjects

A number of studies have demonstrated that adherence to a Mediterranean diet (MD) is associated with a significantly reduced risk of various cancers,1 and the association between nutrition and the maintenance of the state of health in the prevention of numerous diseases, mainly cancer, is increasingly evident among the scientific community. In a recent article Filomeno et al.2 analyzed the association between endometrial cancer risk and MD, based on a statistical analysis of pooling data from three case–control studies carried out between 1983 and 2006 in various Italian areas and in the Swiss Canton of Vaud. This study clearly shows that the risk of endometrial cancer is reduced up to 50% when adopting a diet fully adherent to the MD. The authors also emphasize how the MD as a whole is a stronger protective factor compared with individual dietary components, which probably act synergistically against cancer development.

Several epidemiological studies suggest that MD decreases the risk of a variety of cancers, but the underlying mechanisms are still unclear. The main reason is probably its ability to reduce inflammation: inflammation is one of the major risk factors for cancer;3 therefore, it is a very plausible hypothesis that reducing inflammation may protect against cancer. The inflammation, in fact, was also included among biological processes able to transform normal cells into cancer cells, described by the framework developed by Hanahan and Weinberg,4 together with self-renewal, ability to evade programmed cell death (apoptosis), the ability to sustain angiogenesis, the ability to invade tissues and dysregulated metabolism. The EPIC study (European Prospective Investigation into Cancer and Nutrition) is providing many evidences of the link between MD and mortality reduction, demonstrating its protective role in prevention of cancer and cardiovascular diseases.5 One of the recommendations of the MD is to prefer the consumption of unrefined whole-grain carbohydrates, because of their low glycemic index, thus preventing increases in blood glucose, limiting the secretion of insulin and, therefore, inflammation.6 The MD modulates multiple interconnected processes involved in carcinogenesis and inflammatory response, such as nuclear factor-κB activation and expression of inflammatory mediators. Thus, special attention is paid to the ability of MD to affect the maintenance of gut microbiota (GM) homeostasis,7 and according to us the MD can be the missing link between GM and inflammatory diseases.8 A dysbiotic condition of GM can induce the carcinogenic processes in the intestinal mucosa, and it has been demonstrated that mice with a compromised microbiota homeostasis show an increased susceptibility to an inflammatory state of intestinal mucosa, which, in turn, predisposes to cancer development.9 Therefore, the adoption of a diet adhering to the MD, for its ability to influence intestinal microbiota, could represent an interesting opportunity by reducing inflammation to protect against cancer.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Schwingshackl L, Hoffmann G . Adherence to Mediterranean diet and risk of cancer: a systematic review and meta-analysis of observational studies. Int J Cancer 2014; 135: 1884–1897.

    Article  CAS  Google Scholar 

  2. Filomeno M, Bosetti C, Bidoli E, Levi F, Serraino D, Montella M et al. Mediterranean diet and risk of endometrial cancer: a pooled analysis of three Italian case-control studies. Br J Cancer 2015; 112: 1816–1821.

    Article  CAS  Google Scholar 

  3. Mantovani A, Allavena P, Sica A, Balkwill F . Cancer-related inflammation. Nature 2008; 454: 436–444.

    Article  CAS  Google Scholar 

  4. Hanahan D, Weinberg RA . Hallmarks of cancer: the next generation. Cell 2011; 144: 646–674.

    Article  CAS  Google Scholar 

  5. Benetou V, Trichopoulou A, Orfanos P, Naska A, Lagiou P, Boffetta P et al. Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort. Br J Cancer 2008; 99: 191–195.

    Article  CAS  Google Scholar 

  6. Brand-Miller J, Dickinson S, Barclay A, Celermajer D . The glycemic index and cardiovascular disease risk. Curr Atheroscler Rep 2007; 9: 479–485.

    Article  Google Scholar 

  7. Ostan R, Lanzarini C, Pini E, Scurti M, Vianello D, Bertarelli C et al. Inflammaging and cancer: a challenge for the Mediterranean diet. Nutrients 2015; 7: 2589–2621.

    Article  Google Scholar 

  8. Bifulco M . Mediterranean diet: the missing link between gut microbiota and inflammatory diseases. Eur J Clin Nutr 2015, e-pub ahead of print 27 May 2015; doi: 10.1038/ejcn.2015.81.

  9. Mladenova D, Kohonen-Corish MR . Mouse models of inflammatory bowel disease: insights into the mechanisms of inflammation-associated colorectal cancer. In Vivo 2012; 26: 627–646.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine and Surgery, Faculty of Pharmacy and Medicine, University of Salerno, Baronissi (Salerno), Italy

    M Bifulco

Authors
  1. M Bifulco
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M Bifulco.

Ethics declarations

Competing interests

The author declares no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bifulco, M. How does the Mediterranean diet decrease the risk of a variety of cancers?. Eur J Clin Nutr 69, 1372 (2015). https://doi.org/10.1038/ejcn.2015.142

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2015.142

This article is cited by

Search

Advanced search

Quick links