Sleep

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

TL;DR

A joint Mediterranean diet-sleep pattern was associated with a 43% lower risk of lung cancer compared to the lowest combined diet-sleep level in a prospective study of 192,034 UK Biobank participants followed for a median of 14 years.

Key Findings

Participants in the highest joint Mediterranean diet-sleep pattern level had a 43% lower risk of lung cancer compared to those in the lowest level.

  • SHR 0.57, 95% CI 0.41-0.79; P = 0.001
  • Mediterranean diet and sleep scores were each categorized into tertiles and jointly classified into nine levels of a diet-sleep pattern
  • Analysis used Fine-Gray proportional subdistribution hazards models accounting for competing risks from all-cause mortality
  • 192,034 participants were included with a median age of 57 years; 54% were female

A total of 1,156 incident lung cancer cases occurred over the follow-up period in the study cohort.

  • Participants were followed for a median of 14 years
  • The study drew participants from the UK Biobank
  • Mediterranean diet adherence was assessed using an adapted Mediterranean Diet Adherence Screener
  • Sleep was evaluated using a composite score based on five sleep behaviors

No evidence was found that siesta (daytime napping) modified the association between Mediterranean diet adherence and lung cancer risk.

  • Siesta was evaluated as a potential effect modifier of the diet-lung cancer association
  • The null finding for siesta modification was explicitly reported in both the abstract and the study objectives
  • The study specifically investigated whether siesta modified the Mediterranean diet-lung cancer relationship as a secondary aim

Mediterranean diet adherence was assessed using an adapted Mediterranean Diet Adherence Screener applied to UK Biobank participants.

  • Sleep was evaluated using a composite score based on five sleep behaviors
  • Both diet and sleep scores were categorized into tertiles for joint classification
  • The joint classification resulted in nine levels of a combined diet-sleep pattern
  • Competing risks from all-cause mortality were accounted for using Fine-Gray subdistribution hazard models

The authors interpreted the joint Mediterranean diet-sleep pattern association with lung cancer risk as an observational association rather than evidence of causality.

  • The prospective observational design of the UK Biobank study precludes causal inference
  • The authors explicitly noted this limitation in the abstract conclusion
  • The study represents one of the first investigations of a joint diet-sleep pattern in relation to lung cancer risk

What This Means

This research suggests that combining a Mediterranean-style diet with healthy sleep habits is associated with a substantially lower risk of developing lung cancer. The study followed nearly 200,000 adults in the UK for about 14 years and found that people who both closely followed a Mediterranean diet (rich in fruits, vegetables, whole grains, fish, and olive oil) and had healthy sleep patterns were 43% less likely to develop lung cancer compared to those with poor diet and sleep habits. Over the study period, 1,156 participants developed lung cancer. The researchers also looked at whether taking regular daytime naps (siesta) changed the relationship between diet and lung cancer risk, but found no evidence that it did. The study used careful statistical methods that account for the fact that some participants may have died from other causes before potentially developing lung cancer, which helps provide a more accurate picture of the diet-sleep-cancer relationship. This research suggests that lifestyle factors like diet and sleep may together play a role in lung cancer risk, though the authors emphasize this is an observational finding — meaning it shows an association but cannot prove that a Mediterranean diet and good sleep directly cause lower cancer risk. Other unmeasured factors could contribute to these patterns, and further research would be needed to understand the underlying biological mechanisms.

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Citation

Chen Y, Tong E, Jin X, Rao Y, Yu E, Al-Zalabani A, et al.. (2026). Mediterranean diet adherence, healthy sleep, and lung cancer risk: a prospective study of 192,034 UK Biobank participants.. European journal of nutrition. https://doi.org/10.1007/s00394-026-04080-x