Association of Mediterranean diet with survival after breast cancer diagnosis in women from nine European countries: results from the EPIC cohort study

Table 3 Sensitivity analysis: association between overall mortality and adherence to the arMED score by additional adjustments for time from baseline to diagnosis, period of diagnosis, presence of comorbidities, and other dietary patterns (N = 13,270, events/deaths = 2340)

	Categories of adherence of the arMED score^a			arMED score, continuous
	Low (N = 3427)	Medium (N = 5162)	High (N = 4681)	3-units increase
Reference model^b	1.13 (1.01–1.25)	1.00 Reference	0.94 (0.84–1.05)	0.92 (0.87–0.97)
Model further adjusted for:
Time from baseline to diagnosis^c	1.13 (1.02–1.26)	1.00 Reference	0.94 (0.84–1.04)	0.92 (0.87–0.97)
Period of diagnosis^d	1.13 (1.01–1.25)	1.00 Reference	0.94 (0.84–1.05)	0.92 (0.87–0.97)
Comorbidities^e	1.13 (1.02–1.26)	1.00 Reference	0.93 (0.84–1.04)	0.92 (0.86–0.97)
Mechanistic dietary patterns (DRRD-ISD)^f	1.10 (0.99–1.23)	1.00 Reference	0.98 (0.87–1.09)	0.95 (0.89–1.01)

Abbreviations: arMED Adapted relative Mediterranean diet, N Number of breast cancer cases
^aCategories of arMED: low adherence, 0–5; medium adherence, 6–8; high adherence, 9–16
^bModel stratified by country, stage (metastatic, non-metastatic, unknown) and menopausal status at diagnosis and adjusted for age at diagnosis, attained level of education, physical activity, body mass index (modeled as restricted cubic spline), alcohol consumption reported at recruitment, smoking habit and intensity at recruitment, ever use of hormones for menopause at diagnosis, grade of differentiation, and tumor receptor status (ER, PR, HER2)
^cCategories of time from baseline to diagnosis are < 5 years, 5 to < 8 years, 8 to < 12 years, and equal or more than 12 years
^dCategories for period of diagnosis are before 2000, between 2000 and < 2004, between 2004 and < 2008, 2008 onwards
^eComorbidities include the presence of diabetes (categories yes, no, unknown) and the presence of cardiovascular problem reported at recruitment (categories yes, no, unknown)
^fAdjusted for a 4-level variable that combines two dietary patterns in high-low adherence categories: Diabetes Reduced Risk Diet (DRRD) and Inflammatory Score of Diet (ISD)

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