Mediterranean Diet and Metabolic Health in Thyroid Cancer Survivors: Clinical Implications

In a study published in Nutrients on patients with papillary thyroid cancer, adherence to the Mediterranean diet at diagnosis was associated with improved metabolic markers within one year. HOMA‑IR declined and HDL‑cholesterol rose (cohort mean increase ≈+4.1 mg/dL), suggesting a potentially modifiable pathway to reduce cardiometabolic risk in survivorship.

This prospective observational cohort enrolled 345 adults with histologically confirmed papillary thyroid cancer and assessed baseline diet using a validated Mediterranean‑diet screener; participants were grouped into low, mid, and high adherence tertiles. Primary endpoints included changes in insulin‑resistance measures (HOMA‑IR, METS‑IR, HOMA‑β), lipid components (HDL, LDL, triglycerides), and composite indices (TyG). Analyses were stratified by BMI (<25 vs ≥25 kg/m2) and estimated with linear mixed‑effects models adjusted for age, sex, comorbidity, medication use, and lifestyle factors.

Across the cohort, the clearest, most generalizable signal was greater reduction in metabolic scores and triglycerides and a larger HDL increase in the high‑adherence group at one year. In BMI‑stratified analyses, declines in fasting insulin and HOMA‑IR occurred primarily among patients with obesity (BMI ≥25 kg/m2) who reported high diet adherence, indicating the insulin‑resistance benefit was concentrated in this subgroup.

HDL and composite nutrition metrics tracked with those insulin findings: patients with obesity and high adherence experienced HDL rises exceeding the cohort mean (~+4.1 mg/dL) and larger declines in METS‑IR and TyG compared with low‑adherence peers. Objective nutrition indices—the baseline Mediterranean‑diet score and calculated metabolic scores—correlated with one‑year metabolic change and were predictive in adjusted longitudinal models, but precision was limited by a single dietary assessment and possible residual confounding.

Next steps include targeted counseling for high‑risk patients, routine metabolic monitoring during the first post‑diagnostic year, and prospective implementation of diet‑adherence scoring within survivorship pathways to test whether structured interventions translate to sustained cardiometabolic benefit.