Non-adherence to Mediterranean diet and synergy with lifestyle habits in the occurrence of breast cancer: a case-control study in Italy

G. La Torre, I. De Carlo, C. Sestili, R.A. Cocchiara, L. Lia, O. Di Bella, S. Cianfanelli, V. D’Egidio, M. Mancino, V. Palmeri, A. De Luca, F. Frusone, V. Aceti, M.I. Amabile, M. Cardi, I. Backhaus, A. Mannocci, M. Monti

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy. giuseppe.latorre@uniroma1.it

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• Pharmacology

OBJECTIVE: The aim of this study was to assess the synergistic effect of non-adherence to the Mediterranean Diet (MD) and lifestyle habits on the occurrence of breast cancer (BC).

PATIENTS AND METHODS: A case-control study was carried out from September 2018 to February 2019 at the Teaching Hospital “Umberto I” in Rome. A Food Frequency Questionnaire was used for assessing the level of adherence to MD, the IPAQ Questionnaire to measure physical activity, and AUDIT-C to estimate alcohol consumption. The possible interaction between risk factors was tested using the synergism index.

RESULTS: A total of 94 cases and 88 controls were enrolled (median age 55.8 for cases and 57.9 for controls). The MD Score over 6 was associated with low odds of having breast cancer (OR = 0.29; 95% CI: 0.12-0.69). There is a clear indication for the additivity and synergism between non-adherence to MD and many risk factors on the occurrence of BC: current smoker (S = 2.02; 95% CI 0.62-8.07), physical inactivity (S = 2.14; 95% CI 0.71 2-8.28) and alcohol consumption (S = 3.02; 95% CI 0.91-12.95).

CONCLUSIONS: Primary prevention of BC can benefit from intervention targeting nutritional and lifestyle factors that act synergistically.

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