Nutritional Studies and Diet Open access Peer reviewed

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

Yiming Chen, Enyu Tong, Xiaoman Jin, Yufeng Rao and 4 more

European Journal of Nutrition | Aug 27, 2026

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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.

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PURPOSE: 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. METHODS: 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). RESULTS: 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. CONCLUSIONS: 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.

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Yiming Chen

first | Maastricht University | ORCID 0000-0003-1211-4366

Enyu Tong

middle | Maastricht University

Xiaoman Jin

middle | Maastricht University

Yufeng Rao

middle | Maastricht University

Evan Y. W. Yu

middle | Southeast University

Abdulmohsen Al-Zalabani

middle | Taibah University

Maurice Zeegers

middle | Maastricht University

Anke Wesselius

last | Maastricht School of Management | ORCID 0000-0003-4474-9665

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BibTeX

@article{Chen2026Mediterranean,
  title = {Mediterranean diet adherence, healthy sleep, and lung cancer risk: a prospective study of 192,034 UK Biobank participants},
  author = {Yiming Chen and Enyu Tong and Xiaoman Jin and Yufeng Rao and Evan Y. W. Yu and Abdulmohsen Al-Zalabani and Maurice Zeegers and Anke Wesselius},
  journal = {European Journal of Nutrition},
  year = {2026},
  doi = {10.1007/s00394-026-04080-x},
  url = {https://doi.org/10.1007/s00394-026-04080-x}
}

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