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@ARTICLE{Solans:143595,
      author       = {M. Solans and Y. Benavente and M. Saez and A. Agudo and S.
                      Naudin and F. S. Hosnijeh and H. Noh and H. Freisling and P.
                      Ferrari and C. Besson and Y. Mahamat-Saleh and M.-C.
                      Boutron-Ruault and T. Kühn$^*$ and R. Kaaks$^*$ and H.
                      Boeing and C. Lasheras and M. Rodríguez-Barranco and P.
                      Amiano and J. M. Huerta and A. Barricarte and J. A. Schmidt
                      and P. Vineis and E. Riboli and A. Trichopoulou and C. Bamia
                      and E. Peppa and G. Masala and C. Agnoli and R. Tumino and
                      C. Sacerdote and S. Panico and G. Skeie and E. Weiderpass
                      and M. Jerkeman and U. Ericson and F. Späth and L. M.
                      Nilsson and C. C. Dahm and K. Overvad and A. K. Bolvig and
                      A. Tjønneland and S. de Sanjose and G. Buckland and R.
                      Vermeulen and A. Nieters and D. Casabonne},
      title        = {{A}dherence to the mediterranean diet and lymphoma risk in
                      the european prospective investigation into cancer and
                      nutrition.},
      journal      = {International journal of cancer},
      volume       = {145},
      number       = {1},
      issn         = {1097-0215},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2019-01175},
      pages        = {122 - 131},
      year         = {2019},
      abstract     = {There is a growing evidence of the protective role of the
                      Mediterranean diet (MD) on cancer. However, no prospective
                      study has yet investigated its influence on lymphoma. We
                      evaluated the association between adherence to the MD and
                      risk of lymphoma and its subtypes in the European
                      Prospective Investigation into Cancer and Nutrition (EPIC)
                      study. The analysis included 476,160 participants, recruited
                      from 10 European countries between 1991 and 2001. Adherence
                      to the MD was estimated through the adapted relative MD
                      (arMED) score excluding alcohol. Cox proportional hazards
                      regression models were used while adjusting for potential
                      confounders. During an average follow-up of 13.9 years,
                      3,136 lymphomas (135 Hodgkin lymphoma [HL], 2,606 non-HL and
                      395 lymphoma not otherwise specified) were identified.
                      Overall, a 1-unit increase in the arMED score was associated
                      with a $2\%$ lower risk of lymphoma $(95\%$ CI: 0.97; 1.00,
                      p-trend = 0.03) while a statistically nonsignificant inverse
                      association between a high versus low arMED score and risk
                      of lymphoma was observed (hazard ratio [HR]: 0.91 $[95\%$ CI
                      0.80; 1.03], p-trend = 0.12). Analyses by lymphoma subtype
                      did not reveal any statistically significant associations.
                      Albeit with small numbers of cases (N = 135), a suggestive
                      inverse association was found for HL (HR 1-unit increase =
                      0.93 $[95\%$ CI: 0.86; 1.01], p-trend = 0.07). However, the
                      study may have lacked statistical power to detect small
                      effect sizes for lymphoma subtype. Our findings suggest that
                      an increasing arMED score was inversely related to the risk
                      of overall lymphoma in EPIC but not by subtypes. Further
                      large prospective studies are warranted to confirm these
                      findings.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30588620},
      doi          = {10.1002/ijc.32091},
      url          = {https://inrepo02.dkfz.de/record/143595},
}