Zalaquett Nader, Lidoriki Irene, Lampou Maria, Saab Jad, Hadkhale Kishor, Christophi Costas, Kales Stefanos N
Faculty of Medicine, American University of Beirut, Beirut 1107, Lebanon.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
Nutrients. 2025 Jan 14;17(2):287. doi: 10.3390/nu17020287.
BACKGROUND/OBJECTIVES: Head and neck cancer (HNC) is the seventh most common cancer worldwide, with rising incidence rates and significant mortality. While tobacco use, alcohol consumption, and viral infections are established risk factors, the role of dietary patterns, particularly adherence to the Mediterranean diet (MD), in HNC prevention has gained increasing attention. The aim of the current systematic review and meta-analysis is to investigate the association between adherence to the MD and the risk of HNC.
A comprehensive search was conducted, following PRISMA guidelines, to identify relevant studies published up to January 2024 that assessed the association between MD adherence and HNC risk in adults. Pooled odds ratios (OR) for a three-unit increase in MD adherence scores and corresponding 95% confidence intervals (CI) were calculated using a random-effects model. Study quality was assessed using the Newcastle-Ottawa Scale (NOS).
Eleven case-control studies comprising 6106 HNC cases and 9166 controls met the inclusion criteria for the systematic review. High adherence to the MD was significantly associated with a reduced risk of HNC (pooled OR = 0.561, 95% CI: 0.368-0.856, = 0.007, I = 92%). Individual component analyses from three studies revealed that higher fruit and vegetable consumption significantly decreased HNC risk, whereas legumes, fish, and low meat intake showed no statistically significant associations.
Adherence to the Mediterranean diet is associated with a significantly reduced risk of head and neck cancer. These findings support the role of the MD in cancer prevention and highlight the potential benefits of MD adherence in reducing HNC risk. Further prospective studies and randomized controlled trials are needed to confirm these findings and explore the underlying mechanisms.
背景/目的：头颈癌（HNC）是全球第七大常见癌症，发病率不断上升，死亡率颇高。虽然吸烟、饮酒和病毒感染是既定的风险因素，但饮食模式，特别是坚持地中海饮食（MD），在头颈癌预防中的作用日益受到关注。本系统评价和荟萃分析的目的是研究坚持地中海饮食与头颈癌风险之间的关联。
按照PRISMA指南进行全面检索，以识别截至2024年1月发表的评估成人地中海饮食依从性与头颈癌风险之间关联的相关研究。使用随机效应模型计算地中海饮食依从性得分增加三个单位时的合并比值比（OR）及相应的95%置信区间（CI）。采用纽卡斯尔-渥太华量表（NOS）评估研究质量。
11项病例对照研究（包括6106例头颈癌病例和9166例对照）符合系统评价的纳入标准。高度坚持地中海饮食与头颈癌风险降低显著相关（合并OR = 0.561，95% CI：0.368 - 0.856，P = 0.007，I² = 92%）。三项研究的个体成分分析显示，较高的水果和蔬菜摄入量显著降低了头颈癌风险，而豆类、鱼类和低肉类摄入量则无统计学显著关联。
坚持地中海饮食与头颈癌风险显著降低相关。这些发现支持了地中海饮食在癌症预防中的作用，并突出了坚持地中海饮食在降低头颈癌风险方面的潜在益处。需要进一步的前瞻性研究和随机对照试验来证实这些发现并探索潜在机制。
