How the Mediterranean Diet Lowers Obesity-Related Cancer Risk

THE GLOBAL prevalence of excess body weight has risen significantly over recent decades, contributing to a growing cancer burden. Between 1975 and 2016, the percentage of overweight and obese adults increased from approximately 21% in men and 24% in women to nearly 40% in both sexes. Despite ongoing public health efforts, 39% of the global population remains overweight or obese. Excess body weight has been strongly linked to an increased risk of cancer at 13 anatomical sites, including the endometrium, oesophagus, kidney, pancreas, liver, and breast.

The Mediterranean diet (MedDiet) has been widely studied for its beneficial effects on weight management and overall health. Epidemiological research suggests that adherence to the MedDiet is associated with lower obesity risk and improved cancer outcomes. The EPIC-Spain cohort study found an inverse relationship between high MedDiet adherence and obesity risk, with participants following the diet displaying a smaller waist circumference and reduced likelihood of weight gain. Other studies indicate that MedDiet adherence may also improve survival rates following a breast cancer diagnosis.

Beyond its impact on body weight, the MedDiet has been associated with a reduced risk of various cancers. The EPIC study found that higher MedDiet adherence correlated with a 4% reduction in overall cancer risk per 2-point increase in the MedDiet score. Strong protective associations were observed for colorectal, gastric, and breast cancers, particularly when alcohol consumption was excluded. A meta-analysis further supported the diet’s role in lowering cancer incidence and mortality. Research from Italian EPIC centres also found that the MedDiet was linked to a reduced risk of colorectal cancer, independent of abdominal adiposity.

The mechanisms linking obesity and cancer are complex, involving adipokines, insulin resistance, hypoxia, genetic susceptibility, and inflammation. However, limited studies have explored whether body mass index (BMI) or waist-to-hip ratio (WHR) mediate the relationship between the MedDiet and obesity-related cancers (ORCs). This study aimed to assess the association between MedDiet adherence and ORC risk in the EPIC cohort while investigating the mediating role of BMI and WHR in this relationship.

Katie Wright, EMJ

Reference

Aguilera-Buenosvinos I et al. Adherence to the mediterranean diet and obesity-linked cancer risk in EPIC. JAMA Netw Open. 2025;8(2):e2461031.