title: Diet Quality and Risk of Melanoma in an Italian Population.
abstract: BACKGROUND
  Some results from laboratory and epidemiologic studies suggest that diet may influence the risk of melanoma, but convincing evidence for a role of single nutrients or food items is lacking. Diet quality, which considers the combined effect of multiple food items, may be superior for examining this relation.
  
  
  OBJECTIVE
  We sought to assess whether diet quality, evaluated with the use of 4 different dietary indexes, is associated with melanoma risk.
  
  
  METHODS
  In this population-based case-control study, we analyzed the relation between 4 diet quality indexes, the Healthy Eating Index 2010 (HEI-2010), Dietary Approaches to Stop Hypertension (DASH) index, Greek Mediterranean Index (GMI), and Italian Mediterranean Index (IMI), and melanoma risk in a northern Italian community, with the use of data from 380 cases and 719 matched controls who completed a semiquantitative food frequency questionnaire.
  
  
  RESULTS
  In the overall sample, we found an inverse association between disease risk and the HEI-2010 and DASH index, but not the Mediterranean indexes, adjusting for potential confounders (skin phototype, body mass index, energy intake, sunburn history, skin sun reaction, and education). However, in sex stratified analyses, the association appeared only in women (P-trend: 0.10 and 0.04 for the HEI-2010 and DASH index, respectively). The inverse relations were stronger in women younger than age 50 y than in older women, for whom the GMI and IMI scores also showed an inverse association with disease risk (P-trend: 0.05 and 0.02, respectively).
  
  
  CONCLUSIONS
  These results suggest that diet quality may play a role in cutaneous melanoma etiology among women.
authors.affiliation: Center for Environmental, Genetic, and Nutritional Epidemiology, Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy;
authors.forename: Carlotta
authors.initials: C
authors.lastname: Malagoli
authors.affiliation: Center for Environmental, Genetic, and Nutritional Epidemiology, Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy;
authors.forename: Marcella
authors.initials: M
authors.lastname: Malavolti
authors.affiliation: Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;
authors.forename: Claudia
authors.initials: C
authors.lastname: Agnoli
authors.affiliation: Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA;
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Crespi
authors.affiliation: Dermatologic Unit, University of Modena and Reggio Emilia, Modena, Italy;
authors.forename: Chiara
authors.initials: C
authors.lastname: Fiorentini
authors.affiliation: Dermatologic Unit, University of Modena and Reggio Emilia, Modena, Italy;
authors.forename: Francesca
authors.initials: F
authors.lastname: Farnetani
authors.affiliation: Dermatologic Unit, University of Modena and Reggio Emilia, Modena, Italy;
authors.forename: Caterina
authors.initials: C
authors.lastname: Longo
authors.affiliation: Dermatologic Unit, Santa Maria Nuova Hospital, Reggio Emilia, Italy;
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ricci
authors.affiliation: Dermatologic Unit, Santa Maria Nuova Hospital, Reggio Emilia, Italy;
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Albertini
authors.affiliation: Dermatologic Unit, Bellaria Hospital, Bologna, Italy;
authors.forename: Anna
authors.initials: A
authors.lastname: Lanzoni
authors.affiliation: Dermatologic Unit, Bellaria Hospital, Bologna, Italy;
authors.forename: Leonardo
authors.initials: L
authors.lastname: Veneziano
authors.affiliation: Dermatologic Unit, University of Ferrara, Ferrara, Italy;
authors.forename: Annarosa
authors.initials: A
authors.lastname: Virgili
authors.affiliation: Dermatologic Unit, University of Parma, Parma, Italy; and.
authors.forename: Calogero
authors.initials: C
authors.lastname: Pagliarello
authors.affiliation: Dermatologic Unit, University of Parma, Parma, Italy; and.
authors.forename: Marcello
authors.initials: M
authors.lastname: Santini
authors.affiliation: Dermatologic Unit, University of Bologna, Bologna, Italy.
authors.forename: Pier Alessandro
authors.initials: PA
authors.lastname: Fanti
authors.affiliation: Dermatologic Unit, University of Bologna, Bologna, Italy.
authors.forename: Emi
authors.initials: E
authors.lastname: Dika
authors.affiliation: Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;
authors.forename: Sabina
authors.initials: S
authors.lastname: Sieri
authors.affiliation: Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;
authors.forename: Vittorio
authors.initials: V
authors.lastname: Krogh
authors.affiliation: Dermatologic Unit, University of Modena and Reggio Emilia, Modena, Italy;
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pellacani
authors.affiliation: Center for Environmental, Genetic, and Nutritional Epidemiology, Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy; marco.vinceti@unimore.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Vinceti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003625:Data Collection; D004032:Diet / Q000592:standards*; D004034:Diet Surveys; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: case-control study; diet; diet quality; dietary patterns; epidemiology; melanoma