McLeod Andrew, Gabel Kelsey, Chakos Kaitlin, Wefel Jeffrey S, Tussing-Humphreys Lisa, Oddo Vanessa M
Institute for Health Research and Policy, University of Illinois Chicago (UIC), Chicago, IL, USA.
Department of Kinesiology and Nutrition, UIC, Chicago, IL, USA.
J Cancer Surviv. 2025 Aug 11. doi: 10.1007/s11764-025-01879-1.
BACKGROUND/OBJECTIVES: Up to 75% of cancer survivors experience cognitive impairment from cancer or its treatment. No modifiable risk factor has been identified; however, a Mediterranean Diet may be protective. We sought to determine if the relationship between cognitive performance and cancer survivorship depends on Mediterranean Diet adherence.
We used the latest data from the National Health and Nutrition Examination Survey (NHANES). Mediterranean Diet adherence was defined as the aMed score which gives 1 point for intake above/below the sample-specific median for healthful/unhealthful food groups (range 0-9). Cognitive processes assessed included processing speed, attention, working memory, learning, short-term memory, and executive function. Linear regression models adjusting for demographics, diet, and health behavior were used to determine the relationship between cognition and cancer history.
Among 2450 participants, 385 had cancer. Mean age was 68.9 years (SE = 0.2). The most common cancer was breast cancer (24%). Cancer history was not associated with cognition (p > 0.05). Among high aMed scores, cancer history was more negatively associated with number of Intrusions compared to low aMed scores (β (95% CI): 0.61 (0.07, 1.16), p = 0.03 for aMed*Cancer interaction term).
Cancer history was more negatively associated with cognition among high versus low aMed scores. Because of the cross-sectional nature of NHANES, the limited number of cancer survivors, and the lack of treatment information, larger prospective studies with treatment data are needed.
Cancer survivors may require dietary recommendations different from that of the general population. More studies, however, are needed to confirm this.
背景/目的：高达75%的癌症幸存者会因癌症或其治疗而出现认知障碍。尚未确定可改变的风险因素；然而，地中海饮食可能具有保护作用。我们试图确定认知表现与癌症 survivorship 之间的关系是否取决于对地中海饮食的依从性。
我们使用了美国国家健康与营养检查调查（NHANES）的最新数据。地中海饮食依从性被定义为 aMed 评分，对于健康/不健康食物组中摄入量高于/低于特定样本中位数的情况分别给予1分（范围为0 - 9）。评估的认知过程包括处理速度、注意力、工作记忆、学习、短期记忆和执行功能。使用调整了人口统计学、饮食和健康行为的线性回归模型来确定认知与癌症病史之间的关系。
在2450名参与者中，385人患有癌症。平均年龄为68.9岁（标准误 = 0.2）。最常见的癌症是乳腺癌（24%）。癌症病史与认知无关（p > 0.05）。在高 aMed 评分者中，与低 aMed 评分者相比，癌症病史与侵入次数的负相关性更强（β（95%置信区间）：0.61（0.07，1.16），aMed*癌症交互项的 p = 0.03）。
与低 aMed 评分者相比，高 aMed 评分者中癌症病史与认知的负相关性更强。由于NHANES的横断面性质、癌症幸存者数量有限以及缺乏治疗信息，需要开展有治疗数据的更大规模前瞻性研究。
癌症幸存者可能需要与一般人群不同的饮食建议。然而，需要更多研究来证实这一点。
