Mediterranean diet and healthy habits improve cancer survival rates

Being more physically active, following a balanced diet, not smoking, and keeping body weight and blood pressure under control: the same habits that protect the heart also prove decisive after a cancer diagnosis. This is the message emerging from a study carried out as part of the UMBERTO Project, conducted by the Joint Platform of Fondazione Umberto Veronesi ETS and the Research Unit of Epidemiology and Prevention of the I.R.C.C.S. Neuromed in Pozzilli (IS), in collaboration with LUM "Giuseppe Degennaro" University in Casamassima (BA).

Published in the European Heart Journal, the official journal of the European Society of Cardiology, the research is based on data from the Moli-sani Study, one of the largest population-based studies worldwide, coordinated by the Research Unit of Epidemiology and Prevention at Neuromed.

Researchers followed 779 Italian adults, men and women, for 15 years. At the time of their enrolment in the Moli-sani study, all participants had already been diagnosed with cancer. Their health status was assessed through the Life's Simple 7 (LS7) score, an index developed by the American Heart Association that measures seven classic factors linked to lifestyle and cardiovascular risk: smoking, physical activity, diet, body weight, blood pressure, cholesterol, and blood glucose. Using this tool, the researchers evaluated how closely participants with cancer adhered to healthy behaviours and analysed their impact on overall mortality risk.

The findings showed that those who maintained healthier habits had a 38% lower risk of mortality compared to participants with unhealthy lifestyles. Moreover, each one-point improvement in the LS7 score was associated with a 10 % reduction in cancer mortality.

"Our study – says Marialaura Bonaccio, first author of the paper and Co-Principal Investigator of the Joint Platform Fondazione Umberto Veronesi ETS – I.R.C.C.S. Neuromed at the Epidemiology and Prevention Unit – shows that a score based on traditional cardiovascular risk factors, already validated in the general population, can also predict better survival in people with a history of cancer. Adopting healthy habits such as eating well, exercising regularly, and maintaining an adequate body weight provides concrete support for those who have faced or are currently facing this disease."

When the "diet" component of the LS7 score, which in its American version is based on general criteria for healthy eating, was replaced with specific adherence to the Mediterranean Diet, the link between healthy behaviours and survival became even stronger, including for mortality related to cardiovascular diseases. The Mediterranean dietary pattern, typical of Southern European countries and rich in fruit, vegetables, whole grains, legumes, fish, and extra-virgin olive oil, once again proved to be a key ally not only for heart health but also for the well-being of people living with cancer.

According to the study, much of the relationship between healthy lifestyles and reduced mortality can be explained by three biological factors common to both cardiovascular diseases and cancer: low-grade inflammation, heart rate, and blood vitamin D levels. These findings confirm the existence of a shared biological background linking the two conditions.

This study confirms a scientifically fascinating hypothesis, namely that chronic diseases that appear to be different, such as cancer and cardiovascular conditions, may share biological foundations and mechanisms of development and progression. In the scientific literature, this concept is known as the common soil hypothesis – a shared terrain of molecular mechanisms and risk or protective factors from which different clinical conditions may arise."

Maria Benedetta Donati, Principal Investigator, Joint Platform Fondazione Umberto Veronesi ETS – I.R.C.C.S. 

"The results – explains Licia Iacoviello, Head of the Epidemiology and Prevention Unit at Neuromed and Full Professor of Hygiene at LUM University in Casamassima – reinforce the idea that healthy lifestyles and primary prevention are not only effective in reducing the risk of chronic diseases in healthy individuals but also in improving prognosis and quality of life in people who have already faced cancer. It is a message for public health that connects two fields that are only apparently separate: the cardiovascular and the oncological."

A broad and integrated vision, as underlined by Chiara Tonelli, President of the Scientific Committee of Fondazione Umberto Veronesi ETS, Professor Emeritus of Genetics at the University of Milan and President of the Italian Federation of Life Sciences (FISV): "This study confirms the importance of the UMBERTO Project, which has always adopted an integrated approach, placing the individual at the centre of a global lifestyle model. The project enhances the interconnection between diet, physical activity, and other healthy behaviours, which are crucial to influencing the shared mechanisms underlying cardiovascular and oncological diseases."