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Dietary Patterns and Cancer: Risks and Survival Outcomes

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (15 November 2025) | Viewed by 13503

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Prof. Dr. Caixia Zhang

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School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
Interests: chronic diseases epidemiology; nutritional factors and incidence and prognosis of breast and colorectal cancer; cancer epidemiology; maternal and child nutrition
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Special Issue Information

Dear Colleagues,

This Special Issue, entitled “Dietary Patterns and Cancer: Risks and Survival Outcomes”, will examine how overall eating habits and food choices influence the likelihood of developing cancer. While past research often focused on individual nutrients, recent studies have emphasized the importance of examining broader dietary patterns to more accurately reflect how people eat in everyday life. Investigating the connection between dietary patterns and cancer is crucial in understanding how combinations of foods can influence cancer risk and progression. As opposed to analyzing single nutrients, assessing dietary patterns can provide a comprehensive view of how different foods work together to either lower or increase cancer risk. For example, the Mediterranean diet, which includes a high consumption of fruits, vegetables, whole grains, and healthy fats, has been linked to reduced risk for various cancers.

On the other hand, the Western diet, high in red and processed meats, refined sugars, and unhealthy fats, is associated with higher risk, particularly for colorectal cancer. Focusing on entire dietary patterns rather than isolated nutrients allows us to gain practical insights to inform cancer prevention and public health strategies. This approach highlights the importance of maintaining a balanced diet to reduce cancer risk.

Prof. Dr. Caixia Zhang
Guest Editor

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Keywords

dietary patterns
cancer risk
nutrition and cancer
diet and cancer prevention
oxidative balance score and cancer
dietary inflammatory index and cancer
plant-based diet and cancer
Western diet and cancer
Mediterranean diet and cancer

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Published Papers (7 papers)

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Research

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12 pages, 469 KB

Open AccessArticle

Mediterranean Diet Adherence and One-Year Metabolic Changes in Patients with Papillary Thyroid Cancer: An Observational Study

by Jinyoung Shin, Seok-Jae Heo, Yae-Ji Lee, Sang-Wook Kang, Yu-Jin Kwon and Ji-Won Lee

Nutrients 2025, 17(21), 3420; https://doi.org/10.3390/nu17213420 - 30 Oct 2025

Viewed by 610

Abstract

Background/Objectives: The Mediterranean diet (MD) has been associated with favorable metabolic outcomes in the general population. However, evidence of these associations among thyroid cancer survivors remains limited. This study examined whether higher MD adherence at diagnosis is associated with longitudinal changes in insulin resistance and lipid profiles in patients with papillary thyroid cancer (PTC). Methods: We analyzed 345 Korean patients aged ≥20 years with histologically confirmed PTC at a tertiary hospital between April 2023 and March 2024. MD adherence at baseline (diagnosis) was assessed using the Korean Mediterranean Diet Adherence Screener and categorized into tertiles. Changes in body mass index (BMI), hemoglobin A1c (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), metabolic score for insulin resistance (METS-IR), homeostasis model assessment of β-cell function (HOMA-β), and triglyceride-glucose (TyG) index were evaluated between baseline and one year post-diagnosis. A stratified analysis was conducted according to BMI (<25 vs. ≥25 kg/m²). Results: During the one-year follow-up, patients with PTC experienced significant reductions in BMI, HbA1c, METS-IR, HOMA-β, triglycerides, LDL-cholesterol, and the TyG index, whereas HDL-cholesterol levels increased. Patients in the high MD adherence group showed decreased HOMA-IR and increased HDL-cholesterol levels compared to those in the low adherence groups. In BMI-stratified analyses, reductions in insulin and HOMA-IR were observed only among patients with obesity in the high MD adherence group. Conclusions: Higher adherence to the MD at diagnosis was associated with decreases in insulin resistance markers and an increase in HDL-cholesterol levels among patients with PTC during the first year after diagnosis. Full article

(This article belongs to the Special Issue Dietary Patterns and Cancer: Risks and Survival Outcomes)

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20 pages, 2352 KB

Open AccessArticle

Lower Adherence to Lifestyle Recommendations of the World Cancer Research Fund/American Institute for Cancer Research (2018) Is Associated with Decreased Overall 10-Year Survival in Women with Breast Cancer

by Jaqueline Schroeder de Souza, Luiza Kuhnen Reitz, Cândice Laís Knöner Copetti, Yara Maria Franco Moreno, Francilene Gracieli Kunradi Vieira and Patricia Faria Di Pietro

Nutrients 2025, 17(6), 1001; https://doi.org/10.3390/nu17061001 - 12 Mar 2025

Viewed by 1799

Abstract

Background/Objectives: The 2018 lifestyle recommendations of the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) have been associated with lower incidence of breast cancer, but their impact on mortality, survival, and recurrence of the disease is not known. This study aimed to investigate the association between adherence to WCRF/AICR recommendations on mortality, overall 10-year survival, and recurrence in women diagnosed with breast cancer. Methods: This prospective study included 101 women diagnosed with breast cancer between 2006 and 2011. Food consumption, body weight, and physical activity data were collected at diagnosis to calculate the WCRF/AICR score. Mortality, survival, and recurrence data were collected in 2020–2021. Kaplan–Meier curves and Cox proportional hazards regression models were applied to verify the association between WCRF/AICR score and its components with outcomes. Results: Women with lower adherence to the WCRF/AICR score (1st tertile, which was the reference group for regression models) had lower chance of 10-year overall survival when compared to patients with higher scores (2nd and 3rd tertiles, n = 67) (p = 0.025). Consumption of sugary drinks increased the chance of all-cause mortality (p = 0.005) and daily fiber intake increased the chance of overall 10-year survival (p = 0.027). Conclusions: It is suggested that adherence to WCRF/AICR recommendations before breast cancer treatment may contribute to better life expectancy. Full article

(This article belongs to the Special Issue Dietary Patterns and Cancer: Risks and Survival Outcomes)

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17 pages, 1385 KB

Open AccessArticle

Oxidative Balance Score Calculated Using Different Methods and Its Associations with Colorectal Cancer Risk

by Fangting Lin, Ruolin Zhou, Qingjian Ou, Kexin Tu, Yujing Fang and Caixia Zhang

Nutrients 2025, 17(4), 679; https://doi.org/10.3390/nu17040679 - 14 Feb 2025

Cited by 2 | Viewed by 1887

Abstract

Background: The oxidative balance score (OBS) measures oxidative stress from diet and lifestyle, but research linking it to colorectal cancer (CRC) risk is scarce and varies in calculation methods. Methods: We conducted a case-control study in Guangzhou, China, involving 2799 CRC cases and an equal number of sex- and age-matched controls. We adopted and compared four different methods for calculating the OBSs. The odds ratio (OR) and 95% confidence interval (95%CI) for the relationship between OBS and CRC risk were determined using an unconditional logistic regression model. Restricted cubic splines were used to explore potential non-linear relationships. Additionally, stratified analyses were performed by sex, and subgroup analyses were performed based on the tumor site. Results: Among the four OBSs assessed, OBS-1 demonstrated superior performance. Higher adherence to four OBSs was associated with a lower risk of CRC. The adjusted ORs (95%CIs) for the highest quartile compared to the lowest quartile were as follows: 0.42 (0.35, 0.50) for OBS-1, 0.43 (0.36, 0.51) for OBS-2, 0.50 (0.42, 0.59) for OBS-3, and 0.43 (0.36, 0.51) for OBS-4. Linear relationships were observed between four OBSs and CRC risk (all p-Nonlinear > 0.05). Stratified analysis by sex revealed that all four OBSs were negatively associated with CRC risk in both male and female patients. Subgroup analysis by cancer site indicated that four OBSs were negatively associated with the risk of both colon and rectal cancer. Conclusions: All four OBSs were negatively associated with CRC risk, with OBS-1 showing the strongest association in our analysis. Full article

(This article belongs to the Special Issue Dietary Patterns and Cancer: Risks and Survival Outcomes)

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14 pages, 2250 KB

Open AccessArticle

Possible Prognostic Role of BMI Before Chemotherapy in the Outcomes of Women with Ovarian Cancer

by Stavroula A. Paschou, Angeliki Andrikopoulou, Nikoletta Mili, Anna Svarna, Maria Kaparelou, Katerina Stefanaki, Nikolaos Dedes, Efstathia Liatsou, Nikolaos Thomakos, Dimitrios Haidopoulos, Theodora Psaltopoulou, Efstathios Kastritis, Flora Zagouri, Meletios-Athanasios Dimopoulos and Michalis Liontos

Nutrients 2025, 17(3), 556; https://doi.org/10.3390/nu17030556 - 31 Jan 2025

Cited by 1 | Viewed by 1852

Abstract

Background/Objectives: Survival rates for ovarian cancer remain distressingly low. Despite established prognostic factors, the need to identify modifiable parameters to influence survival outcomes is imperative. Overweight and obesity, both prevalent conditions, have been implicated in cancer development and potentially poor survival. However, conflicting data on the associations of body mass index (BMI) with progression-free survival (PFS) and overall survival (OS) in ovarian cancer patients necessitate further exploration. This study aims to investigate the prognostic role of BMI before chemotherapy in women with ovarian cancer, specifically focusing on PFS and OS. Methods: A retrospective analysis encompassed 1,136 patients diagnosed with ovarian carcinomas between 1995 and 2018. Patients were categorized based on BMI at presentation, and a comprehensive examination of clinicopathological, treatment, and survival data was conducted. Results: In the patient population, normal weight patients (BMI < 25 kg/m²) demonstrated a median PFS of 12.8 months (95% CI 11.7–13.9 months), while overweight/obese patients (BMI ≥ 25 kg/m²) exhibited a significantly longer median PFS of 14.9 months (95% CI 13.6–16.4 months, P = 0.006). No statistically significant difference was noted in median OS between the two BMI groups. Subgroup analysis for different histological subtypes revealed a statistically significant benefit for overweight and obese patients with serous and endometrioid histology (mPFS 12.9 months, 95% CI 11.7–14.0 vs. 15.6 months, 95% CI 13.9–17.3, P = 0.012 and 14.6 months 95% CI 13.7–15.5 vs. 25.6 months, 95% CI 9.5–41.7, P = 0.031, respectively). Additionally, BMI ≥ 25 kg/m² demonstrated a significant advantage in advanced-stage disease. Conclusions: The study underscores the intricate association between BMI and ovarian cancer prognosis. While a statistically significant difference in progression-free survival was noted between normal weight and overweight/obese patients, with the latter group experiencing a survival benefit, no such difference was observed in overall survival. Full article

(This article belongs to the Special Issue Dietary Patterns and Cancer: Risks and Survival Outcomes)

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15 pages, 2051 KB

Open AccessArticle

The Impact of the Dietary Inflammatory Index, Fasting Blood Glucose, and Smoking Status on the Incidence and Survival of Pancreatic Cancer: A Retrospective Case–Control Study and a Prospective Study

by Ga Hyun Lee, Yeon Hee Kim, Sang Myung Woo, Woo Jin Lee, Sung-Sik Han, Sang-Jae Park, Sherry Price, Penias Tembo, James R. Hébert and Mi Kyung Kim

Nutrients 2024, 16(22), 3941; https://doi.org/10.3390/nu16223941 - 19 Nov 2024

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Abstract

Background: Pancreatic cancer (PC), a highly malignant cancer with a poor diagnosis, may be influenced by diet-related inflammation. This study examined the association between dietary inflammatory index (DII) scores and the incidence and prognosis of PC in Korea. Methods: A total of 55 patients with PC were matched with 280 healthy controls (HCs) by age and sex. We also analyzed the combined effects of DII scores and fasting blood glucose (FBG) levels or smoking status on the risk of PC and performed a survival analysis using the Cox proportional hazards method. Results: The DII scores were higher in the patients with PC than those in HCs (odds ratio [OR] = 3.36, confidence interval [CI] = 1.16–9.73, p = 0.03), and the effect was larger in women (OR = 6.13, CI = 1.11–33.82, p = 0.04). A high DII score was jointly associated with FBG ≥ 126 mg/dL in raising PC risk [OR = 32.5, relative excess risk due to interaction/synergy (RERI/S) index = 24.2/4.34, p-interaction = 0.04], indicating a multiplicative interaction. A high DII score combined with ex/current smoker status increased PC risk through an additive interaction (RERI/S = 1.01/1.54, p-interaction = 0.76). However, DII scores did not influence disease-free survival. Conclusions: The consumption of an anti-inflammatory diet, coupled with maintaining normal FBG levels and abstaining from smoking, may help reduce the risk of PC by mitigating pancreatic inflammation. Full article

(This article belongs to the Special Issue Dietary Patterns and Cancer: Risks and Survival Outcomes)

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Review

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16 pages, 265 KB

Open AccessReview

The Influence of Dietary Factors on Melanoma Development and Progression: A Comprehensive Review

by Abigail E. Watson and Nabiha Yusuf

Nutrients 2025, 17(11), 1891; https://doi.org/10.3390/nu17111891 - 31 May 2025

Cited by 1 | Viewed by 3645

Abstract

Melanoma is an aggressive cutaneous malignancy with increasing global incidence and high metastatic potential. While ultraviolet (UV) radiation remains the primary environmental risk factor, emerging evidence suggests that dietary factors may influence melanoma risk, progression, and treatment outcomes. This comprehensive review examines the impact of dietary components, including fats, vitamins, minerals, antioxidants, bioactive compounds, and the gut microbiome, on melanoma pathogenesis. The current literature indicates that diets rich in polyunsaturated fatty acids (PUFAs), antioxidants, and plant-based bioactive compounds may confer protective effects against melanoma by modulating oxidative stress, inflammation, and immune response. Additionally, the gut microbiome plays a critical role in melanoma progression and immunotherapy response, with dietary patterns influencing microbial composition and, consequently, host immunity. Despite these promising associations, research remains limited, and findings across studies are inconsistent, preventing the establishment of definitive dietary guidelines for melanoma prevention and management. Future research should focus on large-scale prospective studies to elucidate the mechanisms underlying the dietary influences on melanoma and determine evidence-based nutritional strategies. Understanding the interplay between diet, immune modulation, and gut microbiome composition represents a promising avenue for advancing melanoma prevention and treatment strategies. Full article

(This article belongs to the Special Issue Dietary Patterns and Cancer: Risks and Survival Outcomes)

Other

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17 pages, 971 KB

Open AccessSystematic Review

The Association of Dietary Diabetes Risk Reduction Score and the Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies

by Zahra Maghsoudi, Saleh A. Alsanie, Yohannes Adama Melaku, Aliakbar Sayyari, Mehran Nouri, Marzieh Shoja, Beheshteh Olang, Habib Yarizadeh and Behzad Zamani

Nutrients 2025, 17(23), 3802; https://doi.org/10.3390/nu17233802 - 4 Dec 2025

Viewed by 388

Abstract

Background/Objectives: Several studies have suggested a contrasting link between a diabetes risk reduction diet (DRRD) pattern and cancer risk; however, their findings have been inconsistent. This study aims to systematically review observational studies and, where possible, quantify the overall effect through a meta-analysis. Methods: Searches were conducted in PubMed, Scopus, and Web of Science through May 2025. Odds ratios (ORs), along with their confidence intervals, were extracted for meta-analysis. The random-effects model was used to combine the ORs. Results: Nineteen studies met the inclusion criteria for the systematic review and meta-analysis. Of these, six reports examined the relationship between the DRRD and breast cancer risk, three assessed liver cancer incidence, two analyzed pancreatic cancer risk, and two focused on endometrial cancer. Additionally, seven studies explored the association with other cancers, including ovarian, colorectal, renal, head and neck, bladder, and lung cancers. The meta-analysis revealed that high adherence to the DRRD is associated with a decreased cancer risk (OR = 0.77, 95% confidence interval [95% CI]: 0.71–0.84, p < 0.001). Conclusions: After stratifying by geographic region, gender, study design, and cancer site, the inverse relationship remained significant across all subgroups. DRRD can be viewed as a beneficial approach associated with a lower cancer risk. Full article

(This article belongs to the Special Issue Dietary Patterns and Cancer: Risks and Survival Outcomes)

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