title: Postdiagnostic Mediterranean and Healthy Nordic Dietary Patterns Are Inversely Associated with All-Cause Mortality in Long-Term Colorectal Cancer Survivors.
abstract: Background:Dietary factors are known to affect the risk of new-onset colorectal cancer (CRC), but information on the extent to which postdiagnostic diet affects mortality in long-term CRC survivors is scarce.Objective:We investigated the association of 2 a priori-defined postdiagnostic dietary patterns [Modified Mediterranean Diet Score (MMDS) and healthy Nordic Food Index (HNFI)] with all-cause mortality in long-term CRC survivors.Methods:Diet was assessed at a median time of 6 y after cancer diagnosis in 1404 CRC survivors (median age: 69 y; 56% men) in a prospective cohort study in Northern Germany by using a semiquantitative food-frequency questionnaire. Cox proportional hazard models, adjusting for clinical and sociodemographic characteristics, were used to assess associations of the MMDS and the HNFI with all-cause mortality.Results:A total of 204 patients died during a median follow-up time of 7 y after diet assessment. In multivariable-adjusted models, higher adherence to the modified Mediterranean diet was significantly associated with lower all-cause mortality (HR: 0.48; 95% CI: 0.32, 0.74 for highest compared with lowest score quartile and HR: 0.88; 95% CI: 0.81, 0.96 per 1-point increment in pattern score). Similarly, the HNFI was inversely associated with all-cause mortality when the highest was compared with the lowest index quartile (HR: 0.63; 95% CI: 0.39, 1.04) and when modeled as a continuous trait (HR: 0.90; 95% CI: 0.82, 0.99 per 1-point increment in the score).Conclusions:Our results suggest that higher adherences to the Mediterranean diet and to the healthy Nordic diet after CRC diagnosis are associated with better overall survival in long-term CRC survivors.
authors.affiliation: Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany.
authors.forename: Ilka
authors.initials: I
authors.lastname: Ratjen
authors.affiliation: Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Schafmayer
authors.affiliation: Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany.
authors.forename: Romina
authors.initials: R
authors.lastname: di Giuseppe
authors.affiliation: Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany.
authors.forename: Sabina
authors.initials: S
authors.lastname: Waniek
authors.affiliation: Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Plachta-Danielzik
authors.affiliation: Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany.|Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
authors.forename: Manja
authors.initials: M
authors.lastname: Koch
authors.affiliation: Nutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Nöthlings
authors.affiliation: Medical Department 1, University Hospital Dresden, Technical University Dresden, Dresden, Germany; and.
authors.forename: Jochen
authors.initials: J
authors.lastname: Hampe
authors.affiliation: Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany.|Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Schlesinger
authors.affiliation: Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany; wolfgang.lieb@epi.uni-kiel.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lieb
mesh_terms: D015179:Colorectal Neoplasms / Q000401:mortality*; D004034:Diet Surveys; D038441:Diet, Mediterranean; D005260:Female; D005858:Germany; D006801:Humans; D008136:Longevity; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D044465:White People
keywords: Modified Mediterranean Diet Score; colorectal cancer; dietary patterns; healthy Nordic Food Index; mortality; survivors