Mediterranean diet adherence, healthy sleep, and lung cancer risk: a prospective study of 192,034 UK Biobank participants

Diet and sleep have each been associated with cancer risk, but their joint association with lung cancer risk remains unclear. We investigated the association between a joint Mediterranean diet-sleep pattern and lung cancer risk in the UK Biobank. We also evaluated whether siesta modified the association between Mediterranean diet adherence and lung cancer risk.

Participants were drawn from the UK Biobank. Mediterranean diet adherence was assessed using an adapted Mediterranean Diet Adherence Screener, and sleep was evaluated using a composite score based on five sleep behaviors. Mediterranean diet and sleep scores were categorized into tertiles and jointly classified into nine levels of a diet-sleep pattern. Associations were examined using Fine-Gray proportional subdistribution hazards models that accounted for competing risks from all-cause mortality, yielding subdistribution hazard ratios (SHRs) and 95% confidence intervals (CIs).

A total of 192,034 participants (median age 57 years; 54% were female) were included and followed for a median of 14 years, during which 1156 incident lung cancer cases occurred. Compared with participants in the lowest level, those in the highest level had a 43% lower risk of lung cancer (SHR 0.57, 95% CI 0.41-0.79; P = 0.001). No evidence was found that siesta modified the association between Mediterranean diet adherence and lung cancer risk.

The joint Mediterranean diet-sleep pattern was associated with a lower risk of lung cancer, although this finding should be interpreted as an observational association rather than evidence of causality.