Data_Sheet_1_Adherence to mediterranean diet and the risk of differentiated thyroid cancer in a European cohort: The EPIC study.docx

BackgroundThe Mediterranean diet (MD) has been proposed as a healthy diet with a potential to lower the incidence of several types of cancer, but there is no data regarding thyroid cancer (TC). We investigated the association between MD adherence, and its components, and the differentiated TC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.MethodsOver 450,000 men and women from nine European countries were followed up for a mean of 14.1 years, during which 712 differentiated TC cases were identified. Adherence to MD was estimated using the relative MD (rMED) score, an 18-point scale including alcohol, and the adapted rMED (arMED) score, a 16-point scale excluding alcohol. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models adjusted for potential confounding factors.ResultsAdherence to the arMED score was not associated with the risk of differentiated TC (HRhigh vs. low adherence = 0.94, 95% CI: 0.70–1.25; p-trend 0.27), while a suggestive, but non-statistically significant inverse relationship was observed with rMED (HRhigh vs. low adherence = 0.88, 95% CI: 0.68–1.14; p-trend 0.17). Low meat (HRlow vs. high meat intake = 0.81, 95% CI: 0.67–0.99; p-trend = 0.04) and moderate alcohol (HRmoderate vs. non−moderate intake = 0.88, 95% CI: 0.75–1.03) intake were related with lower differentiated TC risk.ConclusionsOur study shows that a high adherence to MD is not strongly related to differentiated TC risk, although further research is required to confirm the impact of MD and, especially, meat intake in TC risk.

背景：地中海饮食（MD）被提出作为一种健康饮食，具有降低多种类型癌症发病率的潜在能力，但对于甲状腺癌（TC）尚无相关数据。本研究旨在探讨地中海饮食依从性及其组成部分与欧洲癌症与营养前瞻性调查（EPIC）队列中分化型TC风险之间的关系。方法：对来自九个欧洲国家的45万余名男性和女性进行了平均14.1年的随访，期间共识别出712例分化型TC病例。采用相对地中海饮食（rMED）评分（包含酒精的18点量表）和调整酒精的相对地中海饮食（arMED）评分（16点量表）来估算地中海饮食的依从性。使用Cox回归模型调整潜在混杂因素后，估计了风险比（HRs）和95%置信区间（CIs）。结果：根据arMED评分的依从性与分化型TC风险无显著关联（高依从性比低依从性HR = 0.94，95% CI: 0.70–1.25；趋势p值为0.27），而与rMED存在一种暗示性的、但非统计学上显著的负相关关系（高依从性比低依从性HR = 0.88，95% CI: 0.68–1.14；趋势p值为0.17）。低肉类摄入（低肉类摄入比高肉类摄入HR = 0.81，95% CI: 0.67–0.99；趋势p值为0.04）和适量饮酒（适量饮酒比非适量饮酒摄入HR = 0.88，95% CI: 0.75–1.03）与较低的分化型TC风险相关。结论：本研究表明，高依从性地遵循地中海饮食与分化型TC风险关系不强，尽管需要进一步的研究来确认地中海饮食以及特别是肉类摄入对TC风险的影响。