Nemzeti Kardiovaszkuláris Laboratórium(RRF-2.3.1-21-2022-00003) Támogató: NKFIH
Nemzeti Gyógyszerkutatási és Fejlesztési Laboratórium (PharmaLab)(RRF-2.3.1-21-2022-00015)
Támogató: NKFIH
(101004093/EUniWell/EAC-A02- 2019/EAC-A02-2019-1)
Colorectal cancer (CRC) is a major global health concern and represents a significant
public health challenge in Hungary, where it exhibits some of the highest morbidity
and mortality rates in the European Union. The Mediterranean diet has been suggested
to reduce the incidence of CRC, but comprehensive evidence from diverse study designs
is needed to substantiate this effect. A systematic literature search was conducted
in PubMed, ClinicalTrials.gov, CENTRAL, and the Web of Science to identify randomized
controlled trials and human clinical trials from 2008 to 2024 to identify relevant
studies. Statistical analysis was performed using the https://metaanalysisonline.com
web application using a random effects model to estimate the pooled hazard rates (HRs).
Forest plots, funnel plots, and Z -score plots were utilized to visualize results.
We identified 15 clinical trials and 9 case–control studies, encompassing a total
of 2,217,404 subjects. The pooled analysis indicated that adherence to the Mediterranean
diet significantly reduced the prevalence of CRC (HR = 0.84, 95% CI = 0.78–0.91, p
< 0.01). This protective effect was consistent across sexes, with HRs of 0.85 (95%
CI = 0.75–0.97, p = 0.01) for males and 0.88 (95% CI = 0.79–0.99, p = 0.03) for
females. Case–control studies specifically showed a substantial effect (HR = 0.51,
95% CI = 0.38–0.68, p < 0.01). Notable heterogeneity was observed across studies,
yet the a priori information size was substantially below the cumulative sample size,
ensuring sufficient data for reliable conclusions. The findings from this meta-analysis
reinforce the protective role of the Mediterranean diet against CRC. The results of
this meta-analysis will inform dietary interventions designed to mitigate CRC risk,
which are conducted within the framework of the Semmelweis Study, an ongoing comprehensive
cohort study at Semmelweis University, designed to explore the multifaceted causes
of unhealthy aging in Hungary. These interventions aim to explore the practical application
of Mediterranean dietary patterns in reducing CRC incidence among the Hungarian population.
