Authors of a recent study state  that the Mediterranean dietary pattern is believed to protect against cancer, although evidence from cohort studies that have examined particular cancer sites is limited.
The research aimed to explore the association between adherence to a relative Mediterranean diet (rMED) and incident gastric adenocarcinoma (GC) within the European Prospective Investigation into Cancer and Nutrition study.
The study included 485,044 subjects (144,577 men) aged 35–70 from 10 European countries. At recruitment, dietary and lifestyle information was collected. Alcohol intake was included together with 8 key food components of the Mediterranean diet to construct an 18-unit rMED score to estimate the level of adherence for each subject in the cohort study. Researchers also analysed the effect of moderate alcohol intake separately on risk of gastric cancer.
The scoring system used was a modification of the original Mediterranean diet score by Trichopoulou et al (1995)  BMJ, and used the same sex specific ranges of alcohol to define moderate alcohol intake within the Mediterranean dietary pattern (Women: 5-25g ethanol/day, Men: 10 -50g ethanol/day).
The association between rMED and GC with respect to anatomic location (cardia and noncardia) and histologic types (diffuse and intestinal) was investigated. A calibration study in a subsample was used to control for dietary measurement error.
After a mean follow-up of 8.9 y, 449 validated incident GC cases were identified and used in the analysis. After stratification by center and age and adjustment for recognised cancer risk factors, high compared with low rMED adherence was associated with a significant reduction in GC risk (hazard ratio: 0.67; 95% CI: 0.47, 0.94).
The results did not show any association (positive nor negative) between moderate alcohol intake and risk of gastric cancer (using intakes outside this range as the reference category).
Genevieve Buckland commented that ’ future analyses using a Mediterranean diet score may explore the possibility of analysing moderate wine intake, as it is more characteristic of the Mediterranean diet (apart from the fact that it is rich in polyphenols)’.
The authors conclude that a greater adherence to a relative Mediterranean diet  is associated with a significant reduction in the risk of incident gastric adenocarcinoma.