New research indicates that cancer survivors who adhere closely to a Mediterranean-style diet may experience longer lifespans. Published in the European Heart Journal, the study highlights a link between following this diet – characterized by its richness in fruit, vegetables, whole grains, legumes, fish, and olive oil – and a reduced risk of death among individuals previously diagnosed with cancer. Researchers suggest these findings bolster the existing evidence that lifestyle habits known to safeguard heart health can also enhance survival rates post-cancer diagnosis.

The analysis leveraged data from the extensive Moli-sani Study conducted in southern Italy, involving 779 Italian adults with a history of cancer. Participants were monitored for an average period of approximately 14 years. At the commencement of the study, their health was evaluated using the American Heart Association's Life's Simple 7 (LS7) score, a metric designed to gauge cardiovascular health. This score incorporates seven modifiable factors: smoking, physical activity, diet, body mass index (BMI), blood pressure, total cholesterol, and blood glucose. The LS7's diet component utilizes general healthy-eating principles, such as consuming ample fruits and vegetables, choosing fiber-rich foods, including fish, and limiting salt and sugary beverages, rather than advocating for a specific named diet.

During the follow-up period, 269 participants passed away, with 141 deaths attributed to cancer, 67 to heart disease, and 54 to other causes, including respiratory, cerebrovascular, and neurodegenerative conditions. A clearer pattern emerged when researchers substituted the general LS7 diet measure with a score reflecting adherence to a Mediterranean-style diet. Those whose dietary patterns most closely resembled the Mediterranean approach were approximately 15 to 20 percent less likely to die during the study, a benefit that varied slightly depending on the specific cause of death. This study suggests that the Mediterranean diet's previously established benefits, which include lower risks of heart disease and premature death in the general population, may also extend to individuals living with or beyond cancer.

Beyond specific dietary patterns, the research also revealed a strong connection between overall cardiovascular health, as measured by the complete LS7 score, and survival after cancer. Participants classified with 'ideal' cardiovascular health (an LS7 score of 10 to 14) demonstrated a 38 percent lower risk of death from any cause compared to those with 'poor' cardiovascular health (LS7 score zero to six). This finding accounted for various confounding factors such as age, sex, cancer type, cancer treatment, prior cardiovascular disease, and social determinants. Furthermore, a graded relationship was observed: each one-point increase in the LS7 score correlated with a 10 percent reduction in cancer mortality.

Marialaura Bonaccio, first author and researcher at the Epidemiology and Prevention Unit of IRCCS Neuromed, commented, "Our study 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." These findings lend support to the "common soil" hypothesis, which posits that cancer and cardiovascular disease share underlying biological pathways. To investigate this, researchers analyzed blood markers related to inflammation, heart rate, and vitamin D status. Collectively, these factors accounted for more than half of the observed link between healthier lifestyles and reduced mortality. Low-grade inflammation alone explained nearly one-fifth of the association between cardiovascular health and overall survival, while resting heart rate contributed approximately 30 percent, and vitamin D levels also played a notable role.

The researchers further compared results in cancer survivors with those from over 21,000 cancer-free participants from the same study. The relationship between lifestyle-related cardiovascular health and mortality was found to be similar across both groups, indicating that the same risk factors are relevant irrespective of a cancer history. However, the authors emphasize that the study establishes an association, not a definitive cause-and-effect relationship. Lifestyle and cardiovascular health assessments were conducted at the initial visit, on average 8.4 years after a cancer diagnosis, meaning individuals with more aggressive disease might not have been included. Nevertheless, the results underscore the critical importance of diet and other healthy habits, including physical activity, smoking avoidance, and weight management, in the long-term care for cancer survivors. The study advocates for more integrated approaches to prevention and follow-up, bridging cancer care and cardiovascular health within the emerging field of cardio-oncology.