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Review
. 2016 Dec;74(12):737-748.
doi: 10.1093/nutrit/nuw045.

Effect of diet on mortality and cancer recurrence among cancer survivors: a systematic review and meta-analysis of cohort studies

Carolina Schwedhelm  1 , Heiner Boeing  1 , Georg Hoffmann  1 , Krasimira Aleksandrova  1 , Lukas Schwingshackl  2
Affiliations
Review

Effect of diet on mortality and cancer recurrence among cancer survivors: a systematic review and meta-analysis of cohort studies

Carolina Schwedhelm et al. Nutr Rev. 2016 Dec.

Abstract

Context: Evidence of an association between dietary patterns and individual foods and the risk of overall mortality among cancer survivors has not been reviewed systematically.

Objective: The aim of this meta-analysis of cohort studies was to investigate the association between food intake and dietary patterns and overall mortality among cancer survivors.

Data sources: The PubMed and Embase databases were searched.

Study selection: A total of 117 studies enrolling 209 597 cancer survivors were included.

Data extraction: The following data were extracted: study location, types of outcome, population characteristics, dietary assessment method, risk estimates, and adjustment factors.

Results: Higher intakes of vegetables and fish were inversely associated with overall mortality, and higher alcohol consumption was positively associated with overall mortality (RR, 1.08; 95%CI, 1.02-1.16). Adherence to the highest category of diet quality was inversely associated with overall mortality (RR, 0.78; 95%CI, 0.72-0.85; postdiagnosis RR, 0.79; 95%CI, 0.71-0.89), as was adherence to the highest category of a prudent/healthy dietary pattern (RR, 0.81; 95%CI, 0.67-0.98; postdiagnosis RR, 0.77; 95%CI, 0.60-0.99). The Western dietary pattern was associated with increased risk of overall mortality (RR, 1.46; 95%CI, 1.27-1.68; postdiagnosis RR, 1.51; 95%CI, 1.24-1.85).

Conclusion: Adherence to a high-quality diet and a prudent/healthy dietary pattern is inversely associated with overall mortality among cancer survivors, whereas a Western dietary pattern is positively associated with overall mortality in this population.

Keywords: cancer recurrence; cancer survivors; dietary patterns; food intake; meta-analysis; overall mortality.

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Figures

Figure 1
Figure 1
Flow diagram of the literature search process. Number of records by dietary pattern/indices, foods/food groups, and beverages may not add up because some studies were listed for multiple exposures (dietary patterns, foods, beverages).
Figure 2
Figure 2
Forest plot showing pooled risk ratios (RRs) with 95%CIs for overall risk of mortality when comparing the highest vs the lowest category of adherence to diet-quality indices. Abbreviations: I2, inconsistency; SE, standard error; tau, estimate between study variance.
Figure 3
Figure 3
Forest plot showing pooled risk ratios (RRs) with 95%CIs for overall risk of mortality when comparing the highest vs the lowest category of adherence to a Western dietary pattern. Abbreviations: I2, inconsistency; SE, standard error; tau, estimate between study variance.
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