Do Benefits of the Mediterranean Diet Go Beyond Cardioprotection?

September 14, 2015

Do Benefits of the Mediterranean Diet Go Beyond Cardioprotection?

  1. Andrew M. Kaunitz, MD

A randomized trial suggests this diet can lower risk for breast cancer.

  1. Andrew M. Kaunitz, MD

The Mediterranean diet (MeD), with its emphasis on plant-based foods, fish, and olive oil, has cardiovascular benefits; limited evidence also suggests the MeD can lower incidence of cancer. To examine the effect of the MeD on breast cancer incidence, researchers in Spain conducted a secondary analysis of a large randomized trial originally designed to assess cardiovascular effects of the MeD (supplemented either with extra-virgin olive oil [EVOO] or nuts) versus a conventional reduced-fat diet in persons at high cardiovascular risk (NEJM JW Gen Med Apr 1 2013 and N Engl J Med 2013; 368:1279). Participants included 4282 white women (mean baseline age, 68). The trial was stopped after a median of 4.8 years because of cardiovascular benefit.

The estimated 5-year incidence of breast cancer was significantly lower in the MeD-plus-EVOO group than in the control group (approximately 0.5% vs. 1.3%) — roughly one case fewer per 100 women on the EVOO diet. A smaller reduction in breast cancer incidence in the MeD-plus-nuts group was not statistically significant.

Comment

This is the first randomized trial assessing the effects of the Mediterranean diet on risk for breast cancer, although this disease was not the trial's primary outcome. Breast cancer prophylaxis afforded by EVOO has several potential biological mechanisms (e.g., reduction in DNA oxidative damage). Given the cardiovascular benefits of the MeD, it's reasonable to suggest to our menopausal patients that this diet — plus extra EVOO — may also reduce risk for breast cancer.

Editor Disclosures at Time of Publication

  • Disclosures for Andrew M. Kaunitz, MD at time of publication Consultant / Advisory board Actavis plc; Bayer AG; Merck Royalties UpToDate Grant / Research support Therapeutics MD; Bayer; Agile; NIH Editorial boards Contraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health Leadership positions in professional societies North American Menopause Society (Treasurer)

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