BJC Open article

British Journal of Cancer (2008) 99, 191–195. doi:10.1038/sj.bjc.6604418 www.bjcancer.com
Published online 1 July 2008

Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort

V Benetou1, A Trichopoulou1, P Orfanos1, A Naska1, P Lagiou1, P Boffetta2 and D Trichopoulos3,4

  1. 1Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75 Mikras Asias street, Athens 115 27, Greece
  2. 2Genetics and Epidemiology Cluster, International Agency for Research on Cancer (IARC), 150 Cours Albert-Thomas, Lyon 69008, France
  3. 3Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
  4. 4Hellenic Health Foundation, 10–12 Tetrapoleos street, Athens 115 27, Greece

Correspondence: Dr D Trichopoulos, Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. E-mail: dtrichop@hsph.harvard.edu

Received 29 February 2008; Revised 18 April 2008; Accepted 18 April 2008



Adherence to traditional Mediterranean diet (MD) has been reported to be inversely associated with total, as well as cardiovascular, mortality. We have examined the relation between degree of such adherence and incidence of cancer overall in a general population sample of 25623 participants (10582 men, 15041 women) of the Greek segment of the European Prospective Investigation into Cancer and nutrition (EPIC). All subjects completed a validated, interviewer-administered, semi-quantitative food-frequency questionnaire at enrolment. Degree of adherence to the traditional MD was assessed through a 10-point scale (0 minimal; 9 maximal) that incorporated key dietary characteristics. During a median follow-up of 7.9 years and 188042 total person-years, 851 medically confirmed incident cancer cases (421 men, 430 women) were recorded. Using proportional hazards regression with adjustment for potential confounders, we found that a higher degree of MD adherence was associated with lower overall cancer incidence. A two-point increase in the score corresponded to a 12% reduction in cancer incidence (adjusted hazard ratio, 0.88 (95% confidence interval 0.80, 0.95)). The association was exposure-dependent and stronger among women. This inverse association with MD adherence was considerably stronger than that predicted on the basis of the associations of the individual components of this diet and points to the value of analysing dietary patterns in cancer studies.


Mediterranean diet; cancer incidence; dietary patterns; Greece; EPIC Study; cohort study



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