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More and more, the Mediterranean diet is explored in the context of both cancer prevention and adjuvant enhancement of cancer treatments. Bolte et al reported in their study that high adherence to the Mediterranean diet improved the response rate to immune checkpoint treatments among melanoma patients. Higher response rates also came with a higher probability of progression-free survival at 12 months. An ancillary analysis revealed that several individual components of the Mediterranean diet, including monounsaturated and polyunsaturated fatty acids, whole-grain bread, vegetables, legumes, and potatoes, were also positively associated with treatment response, much like the overall Mediterrenean Diet Score (aMED). At the same time, intake of red meat was associated with a higher rate of adverse effects indicating that it may lower treatment acceptability. In sum, the study emphasizes the importance of a healthy diet beyond primary prevention. It raises the question about whether current treatment guidelines sufficiently consider diet as an integral part of health and as an important modifier of treatment success in oncology.
Besides its potential to improve therapy outcomes, olive oil, which is an essential part of the Mediterranean diet, can be used in palliative care for cancer patients. In a clinical trial, olive oil and honey were tested against placebo to assess their potential to alleviate the symptoms of oral mucositis and pain in children with leukemia receiving intensive chemotherapy. Olive oil and honey proved to be a viable and cost-effective option.
Aiming to identify risk factors for the development of gastric cancer, researchers using the Multiethnic Cohort found mixed results regarding a protective effect of diet quality against the risk of gastric cancer. There was no risk reduction for the entire cohort, however, the authors underlined a reduced risk among never smokers and former aspirin users that displayed higher adherence to the Mediterranean diet. The results spur researchers to replicate these findings in other cohorts and identify subgroups which would particularly benefit from a healthy dietary pattern for prevention of gastric cancer.
Most certainly, we are still far from fully understanding the role of diet in cancer prevention and treatment. Soon, the BRIDGE-CRC trial will be launched to investigate the effects of the Mediterranean diet, weight loss, or both, on the gut-microbiome and on the risk of colorectal cancer. Future results may be a major contribution to further understand protective mechanisms, disentangling the effects of diet quality from those of weight loss.
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