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The effect of Mediterranean Diet adherence on the relationship between cognitive performance and cancer survivorship

J Cancer Surviv. 2025 Aug 11. doi: 10.1007/s11764-025-01879-1. Online ahead of print.

ABSTRACT

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.

METHODS: 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.

RESULTS: 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).

CONCLUSIONS: 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.

IMPLICATIONS FOR CANCER SURVIVORS: Cancer survivors may require dietary recommendations different from that of the general population. More studies, however, are needed to confirm this.

PMID:40789996 | DOI:10.1007/s11764-025-01879-1

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