@article{MTMT:35162223,
	title = {Adherence to the Mediterranean diet and its protective effects against colorectal cancer: a meta-analysis of 26 studies with 2,217,404 participants},
	url = {https://m2.mtmt.hu/api/publication/35162223},
	author = {Ungvári, Zoltán István and Fekete, Mónika and Fekete, János Tibor and Grosso, Giuseppe and Ungvári, Anna Sára and Győrffy, Balázs},
	doi = {10.1007/s11357-024-01296-9},
	journal-iso = {GEROSCIENCE},
	journal = {GEROSCIENCE: OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE)},
	volume = {47},
	unique-id = {35162223},
	issn = {2509-2715},
	abstract = {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.},
	keywords = {[Meta-analysis]},
	year = {2025},
	eissn = {2509-2723},
	pages = {1105-1121},
	orcid-numbers = {Ungvári, Zoltán István/0000-0002-6035-6039; Fekete, Mónika/0000-0001-8632-2120; Fekete, János Tibor/0000-0002-6672-6563; Győrffy, Balázs/0000-0002-5772-3766}
}

@article{MTMT:35195205,
	title = {LPA suppresses HLA-DR expression in human melanoma cells: a potential immune escape mechanism involving LPAR1 and DR6-mediated release of IL-10},
	url = {https://m2.mtmt.hu/api/publication/35195205},
	author = {Major, Enikő and Lin, Kuan-Hung and Lee, Sue Chin and Káldi, Krisztina and Győrffy, Balázs and Tigyi, Gabor and Benyó, Zoltán},
	doi = {10.1038/s41401-024-01373-x},
	journal-iso = {ACTA PHARMACOL SIN},
	journal = {ACTA PHARMACOLOGICA SINICA},
	volume = {46},
	unique-id = {35195205},
	issn = {1671-4083},
	abstract = {While immune checkpoint inhibitors (ICIs) are promising in the treatment of metastatic melanoma, about half of patients do not respond well to them. Low levels of human leukocyte antigen-DR (HLA-DR) in tumors have been shown to negatively influence prognosis and response to ICIs. Lysophosphatidic acid (LPA) is produced in large amounts by melanoma and is abundantly present in the tumor microenvironment. LPA induces the release of various cytokines and chemokines from tumor cells, which affect cancer development, metastasis, and tumor immunity. In the present study, we investigated the role of LPA-induced IL-10 release in regulating HLA-DR expression and the underlying mechanisms in human melanoma cells. We showed that LPA (0.001–10 μM) dose-dependently increased DR6 transcript levels through activating LPAR1 in HEK293T cells. Knockdown of NF-κB1 abrogated the LPA-increased DR6 expression without affecting basal DR6 expression in both A2058 and A375 melanoma cell lines. LPA (10 µM) significantly increased IL-10 transcripts in A2058 and A375 melanoma cells, the effect was abolished by pharmacological inhibition of LPAR1 or knockdown of DR6. We found a statistically significant correlation between the expression of LPAR1, DR6 and IL-10 in human melanoma tissue and an association between increased expression of LPAR1 and reduced effectiveness of ICI therapy. We demonstrated that LPA (10 µM) markedly suppressed HLA-DR expression in both A375 and A2058 melanoma cells via activating the LPAR1-DR6-IL-10 pathway. These data suggest that the LPAR1-DR6-IL-10 autocrine loop could constitute a novel mechanism used by tumor cells to evade immunosurveillance by decreasing HLA-DR expression.},
	year = {2025},
	eissn = {1745-7254},
	pages = {222-230},
	orcid-numbers = {Major, Enikő/0000-0001-5854-9395; Káldi, Krisztina/0000-0002-5724-0182; Győrffy, Balázs/0000-0002-5772-3766; Tigyi, Gabor/0000-0001-5371-171X; Benyó, Zoltán/0000-0001-6015-0359}
}

@article{MTMT:35447386,
	title = {Overweight and obesity significantly increase colorectal cancer risk: a meta-analysis of 66 studies revealing a 25–57% elevation in risk},
	url = {https://m2.mtmt.hu/api/publication/35447386},
	author = {Ungvári, Zoltán István and Fekete, Mónika and Varga, Péter and Lehoczki, Andrea Marianna and Fekete, János Tibor and Ungvári, Anna Sára and Győrffy, Balázs},
	doi = {10.1007/s11357-024-01375-x},
	journal-iso = {GEROSCIENCE},
	journal = {GEROSCIENCE: OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE)},
	unique-id = {35447386},
	issn = {2509-2715},
	abstract = {The incidence of colorectal cancer (CRC) has been steadily rising, and obesity has been identified as a significant risk factor. Numerous studies suggest a strong correlation between excess body weight and increased risk of CRC, but comprehensive quantification through pooled analysis remains limited. This study aims to systematically review and meta-analyze the existing literature to evaluate the association between obesity and CRC risk, considering variations across sex and study designs. A systematic literature search was conducted in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science to identify randomized controlled trials and human clinical trials from 1992 to 2024. Statistical analysis was performed using the https://metaanalysisonline.com web application using a random effects model to estimate the pooled hazard rates (HR). Forest plots, funnel plots, and Z-score plots were utilized to visualize results. We identified 52 clinical trials and 14 case–control studies, encompassing a total of 83,251,050 and 236,877 subjects, respectively. The pooled analysis indicated that obesity significantly increased the prevalence of CRC (HR = 1.36, 95% CI = 1.24–1.48, p  < 0.01). This effect was consistent across sexes, with HRs of 1.57 (95% CI = 1.38–1.78, p  = 0.01) for males and 1.25 (95% CI = 1.14–1.38, p  < 0.01) for females. Case–control studies specifically showed an effect, but with marginal significance only (HR = 1.27, 95% CI = 0.98–1.65, p  = 0.07). The Z-score plot indicated the need for additional analysis in the case–control group. A significant heterogeneity was observed across studies in all four settings. This meta-analysis provides robust evidence that obesity is a significant risk factor for colorectal cancer, with an overall hazard rate indicating a 36% increased risk. The effect is pronounced across both sexes, with males showing a slightly higher risk compared to females. Although case–control studies showed a weaker association, the overall trend supports the link between obesity and CRC. These results underscore the importance of public health interventions aimed at reducing obesity to potentially lower the risk of colorectal cancer.},
	keywords = {[Meta-analysis]},
	year = {2025},
	eissn = {2509-2723},
	orcid-numbers = {Ungvári, Zoltán István/0000-0002-6035-6039; Fekete, Mónika/0000-0001-8632-2120; Fekete, János Tibor/0000-0002-6672-6563; Győrffy, Balázs/0000-0002-5772-3766}
}

@article{MTMT:35469385,
	title = {A gene set enrichment analysis for the cancer hallmarks},
	url = {https://m2.mtmt.hu/api/publication/35469385},
	author = {Menyhart, Otilia and Kothalawala, William Jayasekara and Győrffy, Balázs},
	doi = {10.1016/j.jpha.2024.101065},
	journal-iso = {J PHARM ANAL},
	journal = {JOURNAL OF PHARMACEUTICAL ANALYSIS},
	volume = {15},
	unique-id = {35469385},
	issn = {2095-1779},
	year = {2025},
	eissn = {2214-0883},
	orcid-numbers = {Menyhart, Otilia/0000-0003-4129-4589; Kothalawala, William Jayasekara/0009-0003-6203-9744; Győrffy, Balázs/0000-0002-5772-3766}
}

@article{MTMT:35473003,
	title = {Senescence-related genes as prognostic indicators in breast cancer survival.},
	url = {https://m2.mtmt.hu/api/publication/35473003},
	author = {Ungvári, Zoltán István and Ungvári, Anna Sára and Fekete, Mónika and Kiss, Csaba and Győrffy, Balázs},
	doi = {10.1007/s11357-024-01384-w},
	journal-iso = {GEROSCIENCE},
	journal = {GEROSCIENCE: OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE)},
	unique-id = {35473003},
	issn = {2509-2715},
	abstract = {Breast cancer is a leading cause of cancer-related mortality among women worldwide, particularly affecting those in their later years. As the incidence of breast cancer increases with age, understanding the biological mechanisms that link aging and cancer becomes crucial. Cellular senescence, a hallmark of aging, plays a dual role in cancer by inhibiting tumorigenesis while also contributing to tumor progression through the senescence-associated secretory phenotype (SASP). This study aims to investigate the prognostic significance of senescence-related genes in breast cancer. We utilized the SenMayo gene list, a comprehensive set of senescence-related genes, to analyze gene expression data from a large cohort of breast cancer samples. The data was sourced from the Kaplan-Meier plotter, an integrated database that compiles gene expression information from multiple independent cohorts. Cox proportional hazards regression and false discovery rate (FDR) corrections were employed to evaluate the correlation between gene expression and survival outcomes, aiming to establish a prognostic signature. Our findings demonstrate that higher expression levels of senescence-related genes are significantly associated with improved survival, while lower expression levels correlate with shorter survival outcomes. These results suggest that senescence-related pathways play a protective role in breast cancer, potentially serving as valuable prognostic indicators. The identification of a prognostic signature based on senescence-related genes underscores the importance of cellular senescence in breast cancer progression and survival. Our study highlights the potential of senescence-related biomarkers in enhancing patient stratification and informing treatment strategies, contributing to the growing body of literature on the intersection of aging and cancer.},
	keywords = {PHARMACOLOGY; SURVIVAL; Prognosis; Aging; breast cancer; senescence; senescent; Gero-oncology},
	year = {2025},
	eissn = {2509-2723},
	orcid-numbers = {Ungvári, Zoltán István/0000-0002-6035-6039; Fekete, Mónika/0000-0001-8632-2120; Győrffy, Balázs/0000-0002-5772-3766}
}

@article{MTMT:35601054,
	title = {Enhancing risk stratification models in localized prostate cancer by novel validated tissue biomarkers},
	url = {https://m2.mtmt.hu/api/publication/35601054},
	author = {Olah, Csilla and Mairinger, Fabian and Wessolly, Michael and Joniau, Steven and Spahn, Martin and Kruithof-de, Julio Marianna and Hadaschik, Boris and Soós, Áron Roland and Nyirády, Péter and Győrffy, Balázs and Reis, Henning and Szarvas, Tibor},
	doi = {10.1038/s41391-024-00918-9},
	journal-iso = {PROSTATE CANCER P D},
	journal = {PROSTATE CANCER AND PROSTATIC DISEASES},
	unique-id = {35601054},
	issn = {1365-7852},
	abstract = {BackgroundLocalized prostate cancer (PCa) is a largely heterogeneous disease regarding its clinical behavior. Current risk stratification relies on clinicopathological parameters and distinguishing between indolent and aggressive cases remains challenging. To improve risk stratification, we aimed to identify new prognostic markers for PCa.MethodsWe performed an in silico analysis on publicly available PCa transcriptome datasets. The top 20 prognostic genes were assessed in PCa tissue samples of our institutional cohort (n = 92) using the NanoString nCounter technology. The three most promising candidates were further assessed by immunohistochemistry (IHC) in an institutional (n = 121) and an independent validation cohort from the EMPACT consortium (n = 199). Cancer-specific survival (CSS) and progression-free survival (PFS) were used as endpoints.ResultsOur in silico analysis identified 113 prognostic genes. The prognostic values of seven of the top 20 genes were confirmed in our institutional radical prostatectomy (RPE) cohort. Low CENPO, P2RX5, ABCC5 as well as high ASF1B, NCAPH, UBE2C, and ZWINT gene expressions were associated with shorter CSS. IHC analysis confirmed the significant associations between NCAPH and UBE2C staining and worse CSS. In the external validation cohort, higher NCAPH and ZWINT protein expressions were associated with shorter PFS. The combination of the newly identified tissue protein markers improved standard risk stratification models, such as D'Amico, CAPRA, and Cambridge prognostic groups.ConclusionsWe identified and validated high tissue levels of NCAPH, UBE2C, and ZWINT as novel prognostic risk factors in clinically localized PCa patients. The use of these markers can improve routinely used risk estimation models.},
	keywords = {Overexpression; diagnosis; Oncology; POOR-PROGNOSIS},
	year = {2025},
	eissn = {1476-5608},
	orcid-numbers = {Nyirády, Péter/0000-0002-7037-4919; Győrffy, Balázs/0000-0002-5772-3766; Reis, Henning/0000-0003-1373-5295; Szarvas, Tibor/0000-0002-6321-0799}
}

@article{MTMT:35657254,
	title = {Unbiased Drug Target Prediction Reveals Sensitivity to Ferroptosis Inducers, HDAC and RTK Inhibitors in Melanoma Subtypes},
	url = {https://m2.mtmt.hu/api/publication/35657254},
	author = {Pla, Indira and Szabolcs, Botond and Péter, Petra Nikolett and Újfaludi, Zsuzsanna and Kim, Yonghyo and Horvatovich, Peter and Sanchez, Aniel and Pawlowski, Krzysztof and Wieslander, Elisabet and Kuras, Magdalena and Murillo, Jimmy Rodriguez and Guedes, Jéssica and Pál, Dorottya and Ascsillán, Anna and Betancourt, Lazaro Hiram and Németh, István Balázs and Gil, Jeovanis and de Almeida, Natália Pinto and Szeitz, Beáta and Szadai, Leticia and Doma, Viktória and Woldmar, Nicole and Bartha, Áron and Páhi, Zoltán Gábor and Pankotai, Tibor and Győrffy, Balázs and Szász, Attila Marcell and Domont, Gilberto and Nogueira, Fábio and Kwon, Ho Jeong and Appelqvist, Roger and Kárpáti, Sarolta and Fenyö, David and Malm, Johan and Marko‐Varga, György and Kemény, Lajos Vince},
	doi = {10.1111/ijd.17586},
	journal-iso = {INT J DERMATOL},
	journal = {INTERNATIONAL JOURNAL OF DERMATOLOGY},
	volume = {64},
	unique-id = {35657254},
	issn = {0011-9059},
	abstract = {Background
		The utilization of PD1 and CTLA4 inhibitors has revolutionized the treatment of malignant melanoma (MM). However, resistance to targeted and immune-checkpoint-based therapies still poses a significant problem.
		
		Objective
		Here, we mine large-scale MM proteogenomic data to identify druggable targets and forecast treatment efficacy and resistance.
		
		Methods
		Leveraging protein profiles from established MM subtypes and molecular structures of 82 cancer treatment drugs, we identified nine candidate hub proteins, mTOR, FYN, PIK3CB, EGFR, MAPK3, MAP4K1, MAP2K1, SRC, and AKT1, across five distinct MM subtypes. These proteins are potential drug targets applicable to one or multiple MM subtypes. Additionally, by integrating proteogenomic profiles obtained from MM subtypes with MM cell line dependency and drug sensitivity data, we identified a total of 162 potentially targetable genes. Lastly, we identified 20 compounds exhibiting potential drug impact in at least one melanoma subtype.
		
		Results
		Employing these unbiased approaches, we have uncovered compounds targeting ferroptosis demonstrating a striking 30× fold difference in sensitivity among different subtypes.
		
		Conclusions
		Our results suggest innovative and novel therapeutic strategies by stratifying melanoma samples through proteomic profiling, offering a spectrum of novel therapeutic interventions and prospects for combination therapy.},
	year = {2025},
	eissn = {1365-4632},
	pages = {870-881},
	orcid-numbers = {Pla, Indira/0000-0002-0839-7829; Szabolcs, Botond/0009-0002-5304-7032; Újfaludi, Zsuzsanna/0000-0003-4738-0963; Pál, Dorottya/0000-0002-9426-487X; Gil, Jeovanis/0000-0003-3601-3893; Szeitz, Beáta/0000-0001-6414-0537; Páhi, Zoltán Gábor/0000-0002-3428-553X; Pankotai, Tibor/0000-0001-9810-5465; Győrffy, Balázs/0000-0002-5772-3766; Szász, Attila Marcell/0000-0003-2739-4196; Kárpáti, Sarolta/0000-0002-8472-0712; Kemény, Lajos Vince/0000-0002-8233-1844}
}

@article{MTMT:35676781,
	title = {Impact of adherence to the Mediterranean diet on stroke risk},
	url = {https://m2.mtmt.hu/api/publication/35676781},
	author = {Ungvári, Zoltán István and Fekete, Mónika and Varga, Péter and Fekete, János Tibor and Buda, Annamária and Szappanos, Ágnes and Lehoczki, Andrea Marianna and Mózes, Noémi and Grosso, Giuseppe and Menyhart, Otilia and Munkácsy, Gyöngyi and Tarantini, Stefano and Yabluchanskiy, Andriy and Ungvári, Anna Sára and Győrffy, Balázs},
	doi = {10.1007/s11357-024-01491-8},
	journal-iso = {GEROSCIENCE},
	journal = {GEROSCIENCE: OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE)},
	volume = {2025},
	unique-id = {35676781},
	issn = {2509-2715},
	abstract = {Stroke is a leading cause of morbidity and mortality worldwide, and dietary patterns have emerged as a significant modifiable factor in stroke prevention. The Mediterranean diet, characterized by high intake of fruits, vegetables, whole grains, nuts, olive oil, and fish, has been widely recognized for its cardiovascular benefits. However, its specific impact on stroke risk requires further elucidation. We conducted a comprehensive meta-analysis of 30 studies, including both cohort and case-control designs, to evaluate the relationship between adherence to the Mediterranean diet and the risk of stroke. A systematic search was performed across multiple databases, and a random-effects model was used to estimate pooled hazard ratios (HRs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic, and publication bias was examined through funnel plots and Egger's regression test. Additionally, trial sequential analysis was conducted to determine the adequacy of the sample size. The meta-analysis revealed a significant reduction in stroke risk among individuals adhering to the Mediterranean diet, with a pooled HR of 0.88 (95% CI: 0.84-0.91). Notably, a significant heterogeneity was detected (I2 = 34%). The Z-score plot from trial sequential analysis confirmed that the sample sizes were sufficient to draw definitive conclusions. However, a potential publication bias was identified. The case-control studies confirmed a highly significant effect (HR = 0.54, 95% CI: 0.4-0.73). The funnel plots in both settings hinted at the presence of a potential publication bias, supported by a significant Egger's test. Our findings provide robust evidence supporting the protective effect of the Mediterranean diet against stroke. Despite the presence of some heterogeneity and potential publication bias, the cumulative evidence suggests that promoting the Mediterranean diet could serve as an effective public health strategy for stroke prevention. Further research is recommended to explore the underlying mechanisms and to assess the diet's impact across diverse populations.},
	keywords = {DIET; Meta-analysis; Stroke prevention; case-control; dietary intervention},
	year = {2025},
	eissn = {2509-2723},
	orcid-numbers = {Ungvári, Zoltán István/0000-0002-6035-6039; Fekete, Mónika/0000-0001-8632-2120; Fekete, János Tibor/0000-0002-6672-6563; Menyhart, Otilia/0000-0003-4129-4589; Munkácsy, Gyöngyi/0000-0001-9124-4788; Tarantini, Stefano/0000-0001-5627-1430; Győrffy, Balázs/0000-0002-5772-3766}
}

@article{MTMT:35676827,
	title = {Prognostic impact of glucagon-like peptide-1 receptor (GLP1R) expression on cancer survival and its implications for GLP-1R agonist therapy : an integrative analysis across multiple tumor types.},
	url = {https://m2.mtmt.hu/api/publication/35676827},
	author = {Ungvári, Zoltán István and Bartha, Áron and Ungvári, Anna Sára and Fekete, Mónika and Bianchini, Giampaolo and Győrffy, Balázs},
	doi = {10.1007/s11357-024-01494-5},
	journal-iso = {GEROSCIENCE},
	journal = {GEROSCIENCE: OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE)},
	volume = {In press},
	unique-id = {35676827},
	issn = {2509-2715},
	abstract = {Glucagon-like peptide-1 receptor (GLP-1R) agonists, such as exenatide (Byetta, Bydureon), liraglutide (Victoza, Saxenda), albiglutide (Tanzeum), dulaglutide (Trulicity), lixisenatide (Lyxumia, Adlyxin), semaglutide (Ozempic, Rybelsus, Wegovy), and tirzepatide (Mounjaro, Zepbound), are widely used for the treatment of type 2 diabetes mellitus (T2DM) and obesity. While these agents are well known for their metabolic benefits, there is growing interest in their potential effects on cancer biology. However, the role of GLP-1R agonists in cancer remains complex and not fully understood, particularly across different tumor types. This study aimed to evaluate the prognostic significance of GLP1R expression on overall survival across various cancer types. Using a comprehensive analysis of gene expression data and survival outcomes a large cohorts of different tumor types, we employed Cox proportional hazards survival analyses, coupled with false discovery rate determinations, to explore correlations between GLP1R expression and survival. The integrated database included thousands of cancer specimens with available overall survival time and event data from numerous independent cohorts, providing a robust platform for survival analysis. Our findings reveal that increased GLP1R expression is associated with improved overall survival in cancers such as bladder cancer, breast cancer, esophageal adenocarcinoma, renal clear cell carcinoma, and thyroid carcinoma. Conversely, higher GLP1R expression is linked to poorer survival outcomes in cervical squamous cell carcinoma, lung squamous cell carcinoma, stomach adenocarcinoma, and uterine corpus endometrial carcinoma. Additionally, GLP1R expression showed no significant impact on overall survival in cancers such as esophageal squamous cell carcinoma, colon cancer, head-neck squamous cell carcinoma, renal papillary cell carcinoma, hepatocellular carcinoma, lung adenocarcinoma, ovarian cancer, and pancreatic cancer. In conclusion, GLP1R expression levels serve as an important biomarker with potential prognostic significance across multiple cancers, demonstrating both protective and adverse associations depending on the tumor type. These findings highlight the complex role of GLP-1R agonists in cancer risk and survival, suggesting that the therapeutic use of these agents should be carefully tailored to the individual patient's cancer risk profile.},
	keywords = {Survival Analysis; Gene Expression; cancer prognosis; GLP-1 receptor agonists; Tumor biomarkers; KM plotter; Type 2 diabetes treatment},
	year = {2025},
	eissn = {2509-2723},
	orcid-numbers = {Ungvári, Zoltán István/0000-0002-6035-6039; Fekete, Mónika/0000-0001-8632-2120; Győrffy, Balázs/0000-0002-5772-3766}
}

@article{MTMT:35681038,
	title = {The role of the Mediterranean diet in reducing the risk of cognitive impairement, dementia, and Alzheimer's disease: a meta-analysis},
	url = {https://m2.mtmt.hu/api/publication/35681038},
	author = {Fekete, Mónika and Varga, Péter and Ungvári, Zoltán István and Fekete, János Tibor and Buda, Annamária and Szappanos, Ágnes and Lehoczki, Andrea Marianna and Mózes, Noémi and Grosso, Giuseppe and Godos, Justyna and Menyhart, Otilia and Munkácsy, Gyöngyi and Tarantini, Stefano and Yabluchanskiy, Andriy and Ungvári, Anna Sára and Győrffy, Balázs},
	doi = {10.1007/s11357-024-01488-3},
	journal-iso = {GEROSCIENCE},
	journal = {GEROSCIENCE: OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE)},
	volume = {2025},
	unique-id = {35681038},
	issn = {2509-2715},
	abstract = {Age-related cognitive impairment and dementia pose a significant global health, social, and economic challenge. While Alzheimer's disease (AD) has historically been viewed as the leading cause of dementia, recent evidence reveals the considerable impact of vascular cognitive impairment and dementia (VCID), which now accounts for nearly half of all dementia cases. The Mediterranean diet-characterized by high consumption of fruits, vegetables, whole grains, fish, and olive oil-has been widely recognized for its cardiovascular benefits and may also reduce the risk of cognitive decline and dementia. To investigate the protective effects of the Mediterranean diet on cognitive health, we conducted a systematic literature review using PubMed, Web of Science, and Google Scholar, focusing on studies published between 2000 and 2024. The studies included in the meta-nalysis examined the adherence to the Mediterranean diet and the incidence of dementia and AD. We applied a random-effects model to calculate pooled hazard ratios (HRs) with 95% confidence intervals (CIs) and assessed heterogeneity through I-square statistics. Forest plots, funnel plots, and Z-score plots were used to visualize study outcomes. Of the 324 full-text records reviewed, 23 studies met the inclusion criteria. The combined HR for cognitive impairment among those adhering to the Mediterranean diet was 0.82 (95% CI 0.75-0.89); for dementia, the HR was 0.89 (95% CI 0.83-0.95); and for AD, the HR was 0.70 (95% CI 0.60-0.82), indicating substantial protective effects. Significant heterogeneity was observed across studies, though Z-score plots suggested sufficient sample sizes to support reliable conclusions for each condition. In conclusion, this meta-analysis confirms that adherence to the Mediterranean diet is associated with an 11-30% reduction in the risk of age-related cognitive disorders, including cognitive impairment, dementia, and AD. These findings underscore the Mediterranean diet's potential as a central element in neuroprotective public health strategies to mitigate the global impact of cognitive decline and dementia and to promote healthier cognitive aging.},
	keywords = {[Meta-analysis]},
	year = {2025},
	eissn = {2509-2723},
	orcid-numbers = {Fekete, Mónika/0000-0001-8632-2120; Ungvári, Zoltán István/0000-0002-6035-6039; Fekete, János Tibor/0000-0002-6672-6563; Menyhart, Otilia/0000-0003-4129-4589; Munkácsy, Gyöngyi/0000-0001-9124-4788; Tarantini, Stefano/0000-0001-5627-1430; Győrffy, Balázs/0000-0002-5772-3766}
}