Abstract
Background and Objectives: Advancements in treatment and care, as well as early detection, have contributed to an increase in cancer survival rates. However, limited evidence exists on the optimal diet that should be followed by people after receiving a cancer diagnosis and how it may affect their survival outcomes. Recently, the EAT-Lancet Commission on Food, Planet, Health proposed the “planetary health diet” as a diet within the planetary boundaries. We aimed to investigate, for the first time, the association between adherence to the EAT-Lancet reference diet and mortality in cancer survivors. Methods: Using data from the UK Biobank cohort, we created a sub-population of cancer survivors, based on cancer-registry diagnoses. Data from the UK Biobank’s Touchscreen questionnaire were used to develop a score reflecting adherence to the EAT-Lancet reference diet. Cox proportional hazards regression models were fitted to assess the association of the EAT-Lancet reference diet score with all-cause, cancer, and cardiovascular mortality in cancer survivors. Results: Better adherence to the EAT-Lancet reference diet was inversely associated with all-cause and cancer mortality, while mostly null associations were seen for cardiovascular mortality. Stratified analyses using potential effect modifiers led to largely similar results. Discussion: Our findings support the notion that the adoption of the EAT-Lancet reference diet has the potential to be beneficial for cancer survivors. Additional studies are needed in this specific population to further assess their post-diagnostic needs as well as the perceived barriers to the adoption of healthy lifestyle habits.
Author Contributions
Conception and design: N.K., G.P., A.K., K.P., A.C., T.K. and S.R. Data acquisition: N.K. and S.R. Analyzing the data: N.K., T.K. and S.R. Interpretation of the data: N.K., G.P., T.K. and S.R. Drafting the manuscript: N.K. Critically revising the manuscript: N.K, G.P., A.K., K.P., A.C., T.K. and S.R. All authors have read and agreed to the published version of the manuscript.
Funding
Funding for grant IIG_FULL_2021_012 was obtained from World Cancer Research Fund (WCRF UK), as part of the World Cancer Research Fund International grant programme. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Institutional Review Board Statement
The UK Biobank has ethical approval from the North West Multi-centre Research Ethics Committee.
Informed Consent Statement
All participants provided informed consent.
Data Availability Statement
The UK Biobank is an open access resource and bona fide researchers can apply to use the UK Biobank dataset by registering and applying at http://ukbiobank.ac.uk/register-apply/.
Acknowledgments
We would like to thank Alysha S. Thompson and Flurina Suter for their contributions to this project.
Conflicts of Interest
Currently, Karavasiloglou is an EFSA staff member. At the time of preparation of this work, Karavasiloglou was affiliated with the University of Zurich and the University Hospital Zurich. Where authors are identified as personnel of the European Food Safety Authority, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy, or views of the European Food Safety Authority.
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