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Adherence to Mediterranean Diet and Breast Cancer Risk: A Meta-Analysis of Prospective Observational Studies Publisher



Karimi M1, 2 ; Asbaghi O2 ; Hooshmand F3 ; Aghayan AH4 ; Shariati AA5 ; Kazemi K6 ; Amirpour M7 ; Davoodi SH8 ; Larijani B9
Authors
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Authors Affiliations
  1. 1. Faculty of Medicine, Bogomolets National Medical University (NMU), Kyiv, Ukraine
  2. 2. Cancer Research Center, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran
  3. 3. Faculty of Medicine, Golestan University of Medical Science, Gorgan, Iran
  4. 4. Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
  5. 5. Department of Nutrition Sciences, School of Health, Arak University of Medical Sciences, Arak, Iran
  6. 6. Department of Food Science and Technology, Islamic Azad University, Ayatollah Amoli Branch, Amol, Iran
  7. 7. Department of Clinical Nutrition & Dietetics, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran
  8. 8. National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran
  9. 9. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: Health Science Reports Published:2025


Abstract

Background and Aim: The Mediterranean diet (MD) is widely recognized for its health benefits and potential protective effects against various chronic diseases such as cardiovascular conditions and cancer. This meta-analysis evaluates the association between MD adherence and breast cancer risk in women. Methods: A comprehensive search of major databases was conducted until November 2024 to identify cohort or case-control studies. The meta-analysis employed a random-effects model to pool multivariable-adjusted effect sizes, reporting them as hazard ratios (HR) while evaluating heterogeneity using the I² statistic and assessing publication bias. Results: The pooled analysis of 31 studies indicated a significant association between adherence to the MD and a 13% risk reduction in risk of breast cancer (HR: 0.87, 95% CI: 0.82–0.92; I2 = 70%). Specifically, postmenopausal women exhibited a 12% significant reduction in the risk of breast cancer (HR: 0.88; 95% CI: 0.84, 0.92), while premenopausal women showed no significant effect (HR: 0.98, 95% CI: 0.90, 1.06). Geographically, the effect was most pronounced in Asia (OR: 0.59, 95% CI: 0.50, 0.68), while from America (OR: 0.92, 95% CI: 0.82, 1.02) and Europe (OR: 0.90, 95% CI: 0.83, 0.97) showed moderate associations. Subgroup analysis suggested a stronger significant association in case-control studies (HR: 0.77, 95% CI: 0.70, 0.85), whereas no significant association was observed in cohort studies (HR: 0.96, 95% CI: 0.90, 1.02). Conclusion: Adherence to the Mediterranean diet is associated with a significant reduction in breast cancer risk, particularly among postmenopausal women and in regions such as Asia. These findings suggest that the Mediterranean diet may be an important dietary factor in reducing breast cancer risk, especially in certain populations. However, further research is needed to confirm its impact in different study designs and geographical areas. © 2025 The Author(s). Health Science Reports published by Wiley Periodicals LLC.
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