Background: In studies from Italy and Greece, a Mediterranean dietary pattern was shown to favorably affect life expectancy in the elderly population. This pattern is thought to reduce the risk of cancer in addition to being cardioprotective. Objective: The objective of this study was to evaluate the interactive effects of the Mediterranean diet and age with respect to survival after controlling for several other variables that could be considered as confounders: age, sex, body mass index, albumin concentration, physical activity, self-assessment of health, and dieting in response to chronic conditions. Design: This was a cohort study involving 161 nonsmoking elderly subjects (74 subjects aged <80 y and 87 subjects aged ≥80 y) living in Spain. The subjects were followed up for ≥9 y. Diet was assessed with a semiquantitative food-frequency questionnaire. Results: A diet score based on 8 characteristics of the traditional diet in the Mediterranean region was associated with a significant reduction in overall mortality in elderly subjects aged <80 y but not in subjects aged ≥80 y. A unit increase in the diet score predicted a 31% reduction in mortality in subjects aged <80 y (95% CI: 7%, 57%). Conclusion: Efforts to promote adherence to the Mediterranean dietary pattern appear to be worthwhile in persons aged <80 y, in whom the diet predicts survival, but we do not have any available evidence that such a diet benefits subjects aged ≥80 y.

Background: Selenium status is suboptimal in many Europeans and may be a risk factor for the development of various cancers, including those of the l

Chronic inflammation plays a critical role in the pathogenesis of the 2 major types of gastric cancer. Several foods, nutrients, and nonnutrient food components seem to be involved in the regulation of chronic inflammation. We assessed the association between the inflammatory potential of the diet and the risk of gastric carcinoma, overall and for the 2 major subsites: cardia cancers and noncardia cancers. A total of 476,160 subjects (30% men, 70% women) from the European Investigation into Cancer and Nutrition (EPIC) study were followed for 14 y, during which 913 incident cases of gastric carcinoma were identified, including 236 located in the cardia, 341 in the distal part of the stomach (noncardia), and 336 with overlapping or unknown tumor site. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated with the use of 28 dietary components and their corresponding inflammatory scores. The association between the ISD and gastric cancer risk was estimated by HRs and 95% CIs calculated by multivariate Cox regression models adjusted for confounders. The inflammatory potential of the diet was associated with an increased risk of gastric cancer. The HR (95% CI) for each increase in 1 SD of the ISD were 1.25 (1.12, 1.39) for all gastric cancers, 1.30 (1.06, 1.59) for cardia cancers, and 1.07 (0.89, 1.28) for noncardia cancers. The corresponding values for the highest compared with the lowest quartiles of the ISD were 1.66 (1.26, 2.20), 1.94 (1.14, 3.30), and 1.07 (0.70, 1.70), respectively. Our results suggest that low-grade chronic inflammation induced by the diet may be associated with gastric cancer risk. This pattern seems to be more consistent for gastric carcinomas located in the cardia than for those located in the distal stomach. This study is listed on the ISRCTN registry as ISRCTN12136108.

Copper and zinc are essential micronutrients and cofactors of many enzymatic reactions that may be involved in liver-cancer development. We aimed to assess pre-diagnostic circulating levels of copper, zinc and their ratio (Cu/Zn) in relation to hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBD) and gall bladder and biliary tract (GBTC) cancers. A nested case–control study was conducted within the European Prospective Investigation into Cancer and Nutrition cohort. Serum zinc and copper levels were measured in baseline blood samples by total reflection X-ray fluorescence in cancer cases (HCC n=106, IHDB n=34, GBTC n=96) and their matched controls (1:1). The Cu/Zn ratio, an indicator of the balance between the micronutrients, was computed. Multivariable adjusted odds ratios and 95% confidence intervals (OR; 95% CI) were used to estimate cancer risk. For HCC, the highest vs lowest tertile showed a strong inverse association for zinc (OR=0.36; 95% CI: 0.13–0.98, P_trend=0.0123), but no association for copper (OR=1.06; 95% CI: 0.45–2.46, P_trend=0.8878) in multivariable models. The calculated Cu/Zn ratio showed a positive association for HCC (OR=4.63; 95% CI: 1.41–15.27, P_trend=0.0135). For IHBC and GBTC, no significant associations were observed. Zinc may have a role in preventing liver-cancer development, but this finding requires further investigation in other settings.

Polyphenols may play a chemopreventive role in colorectal cancer (CRC); however, epidemiological evidence supporting a role for intake of individual polyphenol classes, other than flavonoids is insufficient. We evaluated the association between dietary intakes of total and individual classes and subclasses of polyphenols and CRC risk and its main subsites, colon and rectum, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The cohort included 476,160 men and women from 10 European countries. During a mean follow-up of 14 years, there were 5991 incident CRC cases, of which 3897 were in the colon and 2094 were in the rectum. Polyphenol intake was estimated using validated centre/country specific dietary questionnaires and the Phenol-Explorer database. In multivariable-adjusted Cox regression models, a doubling in total dietary polyphenol intake was not associated with CRC risk in women (HR_log2 = 1.06, 95% CI 0.99–1.14) or in men (HR_log2 = 0.97, 95% CI 0.90–1.05), respectively. Phenolic acid intake, highly correlated with coffee consumption, was inversely associated with colon cancer in men (HR_log2 = 0.91, 95% CI 0.85–0.97) and positively associated with rectal cancer in women (HR_log2 = 1.10, 95% CI 1.02–1.19); although associations did not exceed the Bonferroni threshold for significance. Intake of other polyphenol classes was not related to colorectal, colon or rectal cancer risks. Our study suggests a possible inverse association between phenolic acid intake and colon cancer risk in men and positive with rectal cancer risk in women.