Dietary Patterns and Oncological Morbidity in European and Mediterranean Countries

Research Article

Clin Oncol Res. 2018; 1(2): 1006.

Dietary Patterns and Oncological Morbidity in European and Mediterranean Countries

Radkevich LA and Radkevich DA*

FGBUN Center of Theoretical Problems of Physico- Chemical Pharmacology RAS, Kosygina, Moscow, Russia

*Corresponding author: Radkevich DA, FGBUN Center of Theoretical Problems of Physico-Chemical Pharmacology RAS; 119991, Kosygina st. 4, Moscow, Russia

Received: April 17, 2018; Accepted: August 23, 2018; Published: August 30, 2018


Purpose of the study is an analysis of the impact of per capita income, latitude and nutrition structure on the cancer incidence in European (Euro) and Mediterranean (Med) countries.

Materials and Methods: Study design is observational. Nutrition structures for countries are presented as a general level of food consumption (g/person/ day) and as the percentage contribution of 4 blocks: animal products; grains and vegetables; fruit and drinks; alcoholic beverages.

Results: In European countries, compared with the Med countries, the incidence of 7 cancer types in Euro countries depend on per capita income and latitude. In Euro countries, the incidence of 5 cancer types depends on “clean” per capita income. The incidence of 5 cancer types depends on “clean” latitude. The incidence of 7 cancer types in Euro and Mediterranean countries does not depend on per capita income, nor on latitude.

The nutrition structure in Euro and Med countries depends on per capita income. The higher is per capita income in Euro countries, the higher is a share of animal products and alcoholic beverages in the nutrition structure. (p = 0.004). The level of macronutrients of animal in Euro countries is 1.5, 2.3 and 3.0 times higher than in Med countries and depends on per capita income (p = 0.001).

Conclusions: The nutrition structure as a risk factor for cancer in the Euro and Med countries depends on per capita income. The composition and sources of macronutrients play an important role in the nutrition structure.

Keywords: Dietarypatterns; Cancer; European; Mediterranean countries


NCD: Chronic Noncommunicable Diseases; Euro: European countries; Med: Mediterranean Countries; BMI: Body Mass Index; BH: Blood Cholesterol Level; BG: Blood Glucose; BP: Blood Pressure; GDP: Per Capita Income; EEI: Ecological Efficiency Index; HDI: Human Development Index; QR: Interquartile Range; FAO: Food and Agriculture Organization of the United Nations.


Each year, 15 million people die from a Chronic Noncommunicable Diseases (NCD) between the ages of 30 and 69 years; over 59% of these followed by cancers (8.8 million), which pose a threat to human longevity [1]. Cancer is the main cause of morbidity and mortality in developed countries [2].

It is shown that in the Mediterranean countries the incidence of breast cancer and Alzheimer’s disease are lower [3-9]. The authors point out the protective effect of the Mediterranean diet, with low share of animal protein containing products and high share of unsaturated fatty acids [3-9]. It is shown that eating disorders in prenatal period can contribute to predisposition to non-infectious chronic diseases (NCD) at an older age [10]. Diets with high share of fats and calories are risk factors for cancer [11,12]. There is little information about the risk of high-calorie diets with different sources of calories (fats, proteins, carbohydrates) [13,14]. We have shown that a risk factor for breast cancer may be a Western diet that contains the same level of total energy as the Mediterranean diet, but a different source of Proteins and Fats [6,7]. It is shown that food behavior, the regulation of which is complicated, may be a risk factor for obesity and breast cancer, as well as other cancer types [15,16]. But food is a modifiable factor. Therefore, the negative impact of nutrition on NCD can be reduced by developing safe, low-immune diets.

A number of authors believe that observational studies can be used to study nutrition as a risk of NCD, since they operate with large data sources [17-19]. However, observational analyzes based on correlation methods are considered weakly evidence-based. This is due to the possible influence of hidden variables [8]. At the same time, case-control studies on the effect of animal fats on the risk of breast cancer have not been repeated [9]. Objective: comparative analysis of oncological morbidity in European and Mediterranean countries. The study of the influence of GDP (per capita income) and latitude on the incidence of cancer of different locations and the nutrition structure, including macronutrients, in the European and Mediterranean countries.

Materials and Methods

Studies design is observational. Incidence rates in 160 countries standardized by age per 100,000 of population was selected from the GLOBOCAN database for 2008; WHO 2004 [20,21].

Data on and life expectancy were selected from the database of the Internet resource [22]. The level of food consumption for each country was selected from the FAO for 2005 [23]. The countries’ dietary patterns were presented as a general level of food consumption (g / person / day), and also in the form of 4 blocks as a percentage of the total consumption level: 1 - animal products; 2 - cereals and vegetables; 3 - fruit and drinks; 4 - alcoholic beverages (6).

In order to characterize the social conditions in countries, the following indicators were used: GDP (Per Capita Income), (Human development index) 2008 and 2016 ($/person/day) [24]; Health care Indices [25], Environmental Performance Index [26] and Happiness Index 2016 [27]. The geographical position of each country was judged by the latitude [28]. As predictors of the Metabolic Syndrome [29].

The statistical analysis of the comparative country samples was carried out using the nonparametric Mann-Whitney-Wilcoxon U-test for independent samples, since some of the country sample indicators were not normally distributed. The central trend in the distribution of data in the sample was represented by the Median. The variance of the data in the samples was estimated using the Interquartile range (QR) between the first and third quartiles, that is, between the 25th and 75th percentiles (StatSoft 13) [30].

Study Results

Analysis of the nutrition structure and cancer incidence in European and Mediterranean countries with a 2 times difference in per capita income

For the study were used 16 European countries, in which the average per capita income was 2 times higher than in 16 Mediterranean countries (Table 1). The per capita income of Euro countries was $39 (QR-6.7), in 16 Med countries it was $14 (QR-23.4), (p=0.001). Euro countries are located in high latitudes - 52°(QR-8.5), Med countries are located in mid-latitudes - 36°(QR-7.0) (p=0.001) (Table1).