title: Effect of diet on mortality and cancer recurrence among cancer survivors: a systematic review and meta-analysis of cohort studies.
abstract: Evidence of an association between dietary patterns and individual foods and the risk of overall mortality among cancer survivors has not been reviewed systematically.
  
  
  
  The aim of this meta-analysis of cohort studies was to investigate the association between food intake and dietary patterns and overall mortality among cancer survivors.
  
  
  
  The PubMed and Embase databases were searched.
  
  
  
  A total of 117 studies enrolling 209 597 cancer survivors were included.
  
  
  
  The following data were extracted: study location, types of outcome, population characteristics, dietary assessment method, risk estimates, and adjustment factors.
  
  
  
  Higher intakes of vegetables and fish were inversely associated with overall mortality, and higher alcohol consumption was positively associated with overall mortality (RR, 1.08; 95%CI, 1.02-1.16). Adherence to the highest category of diet quality was inversely associated with overall mortality (RR, 0.78; 95%CI, 0.72-0.85; postdiagnosis RR, 0.79; 95%CI, 0.71-0.89), as was adherence to the highest category of a prudent/healthy dietary pattern (RR, 0.81; 95%CI, 0.67-0.98; postdiagnosis RR, 0.77; 95%CI, 0.60-0.99). The Western dietary pattern was associated with increased risk of overall mortality (RR, 1.46; 95%CI, 1.27-1.68; postdiagnosis RR, 1.51; 95%CI, 1.24-1.85).
  
  
  
  Adherence to a high-quality diet and a prudent/healthy dietary pattern is inversely associated with overall mortality among cancer survivors, whereas a Western dietary pattern is positively associated with overall mortality in this population.
authors.affiliation: C. Schwedhelm, H. Boeing, and L. Schwingshackl are with the Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. G. Hoffmann is with the Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria. K. Aleksandrova is with the Nutrition, Immunity, and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany.
authors.forename: Carolina
authors.initials: C
authors.lastname: Schwedhelm
authors.affiliation: C. Schwedhelm, H. Boeing, and L. Schwingshackl are with the Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. G. Hoffmann is with the Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria. K. Aleksandrova is with the Nutrition, Immunity, and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany.
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.affiliation: C. Schwedhelm, H. Boeing, and L. Schwingshackl are with the Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. G. Hoffmann is with the Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria. K. Aleksandrova is with the Nutrition, Immunity, and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Hoffmann
authors.affiliation: C. Schwedhelm, H. Boeing, and L. Schwingshackl are with the Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. G. Hoffmann is with the Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria. K. Aleksandrova is with the Nutrition, Immunity, and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany.
authors.forename: Krasimira
authors.initials: K
authors.lastname: Aleksandrova
authors.affiliation: C. Schwedhelm, H. Boeing, and L. Schwingshackl are with the Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. G. Hoffmann is with the Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria. K. Aleksandrova is with the Nutrition, Immunity, and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. lukas.schwingshackl@dife.de.
authors.forename: Lukas
authors.initials: L
authors.lastname: Schwingshackl
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D000818:Animals; D015331:Cohort Studies; D004032:Diet; D000072001:Diet, Healthy; D066273:Diet, Western / Q000009:adverse effects; D005399:Fishes; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality*; D012306:Risk; D012307:Risk Factors; D017741:Survivors; D014675:Vegetables
keywords: cancer recurrence; cancer survivors; dietary patterns; food intake; meta-analysis; overall mortality