{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:55:05Z","timestamp":1782514505229,"version":"3.54.5"},"reference-count":39,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,4,11]],"date-time":"2018-04-11T00:00:00Z","timestamp":1523404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Specific foods and nutrients help prevent the progression of persistent high-risk human papillomavirus (hrHPV) infection to cervical cancer (CC). The aim of this study was to investigate dietary patterns which may be associated with hrHPV status and the risk of high-grade cervical intraepithelial neoplasia (CIN2+). Overall, 539 eligible women, including 127 with CIN2+, were enrolled in a cross-sectional study, and tested for hrHPV infection. Food intake was estimated using a food frequency questionnaire. Logistic regression models were applied. Using the Mediterranean Diet Score, we demonstrated that, among 252 women with a normal cervical epithelium, medium adherence to the Mediterranean diet decreased the odds of hrHPV infection when compared to low adherence (adjOR = 0.40, 95%CI = 0.22\u20130.73). Using the principal component analysis, we also identified two dietary patterns which explained 14.31% of the variance in food groups intake. Women in the third and fourth quartiles of the \u201cWestern pattern\u201d had higher odds of hrHPV infection when compared with first quartile (adjOR = 1.77, 95% CI = 1.04\u20133.54 and adjOR = 1.97, 95%CI = 1.14\u20134.18, respectively). Adjusting for hrHPV status and age, women in the third quartile of the \u201cprudent pattern\u201d had lower odds of CIN2+ when compared with those in the first quartile (OR = 0.50, 95%CI = 0.26\u20130.98). Our study is the first to demonstrate the association of dietary patterns with hrHPV infection and CC and discourages unhealthy habits in favour of a Mediterranean-like diet.<\/jats:p>","DOI":"10.3390\/nu10040469","type":"journal-article","created":{"date-parts":[[2018,4,11]],"date-time":"2018-04-11T12:16:50Z","timestamp":1523449010000},"page":"469","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["The Association of Dietary Patterns with High-Risk Human Papillomavirus Infection and Cervical Cancer: A Cross-Sectional Study in Italy"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0905-5003","authenticated-orcid":false,"given":"Martina","family":"Barchitta","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, via S. Sofia, 87, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Maugeri","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, via S. Sofia, 87, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Quattrocchi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, via S. Sofia, 87, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3496-3097","authenticated-orcid":false,"given":"Ottavia","family":"Agrifoglio","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, via S. Sofia, 87, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Scalisi","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa di Screening Ginecologico, Azienda Sanitaria Provinciale di Catania, 95126 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4405-8162","authenticated-orcid":false,"given":"Antonella","family":"Agodi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, via S. Sofia, 87, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,4,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"K1","DOI":"10.1016\/j.vaccine.2008.05.064","article-title":"Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia","volume":"26","author":"Bosch","year":"2008","journal-title":"Vaccine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.bpobgyn.2017.08.006","article-title":"Epidemiology and burden of HPV-related disease","volume":"47","author":"Serrano","year":"2018","journal-title":"Best. Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1038\/nrc798","article-title":"Papillomaviruses and cancer: From basic studies to clinical application","volume":"2","year":"2002","journal-title":"Nat. Rev. Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1080\/01635581.2013.757630","article-title":"A review of dietary prevention of human papillomavirus-related infection of the cervix and cervical intraepithelial neoplasia","volume":"65","author":"Chih","year":"2013","journal-title":"Nutr. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1002\/ijc.25679","article-title":"Dietary factors and in situ and invasive cervical cancer risk in the European prospective investigation into cancer and nutrition study","volume":"129","author":"Travier","year":"2011","journal-title":"Int. J. Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.ygyno.2011.10.012","article-title":"Vitamin a and risk of cervical cancer: A meta-analysis","volume":"124","author":"Zhang","year":"2012","journal-title":"Gynecol. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1007\/s00404-015-3852-5","article-title":"Association between serum folate level and cervical cancer: A meta-analysis","volume":"293","author":"Zhou","year":"2016","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1080\/01635581.2016.1115101","article-title":"Association between vitamin C intake and the risk of cervical neoplasia: A meta-analysis","volume":"68","author":"Cao","year":"2016","journal-title":"Nutr. Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s10552-009-9433-9","article-title":"The association between fruit and vegetable consumption and HPV viral load in high-risk HPV-positive women with cervical intraepithelial neoplasia","volume":"21","author":"Hwang","year":"2010","journal-title":"Cancer Causes. Control."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.ygyno.2010.05.022","article-title":"Dietary consumption of antioxidant nutrients and risk of incident cervical intraepithelial neoplasia","volume":"118","author":"Siegel","year":"2010","journal-title":"Gynecol. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"13607","DOI":"10.1038\/srep13607","article-title":"Associations between antioxidant vitamins and the risk of invasive cervical cancer in chinese women: A case-control study","volume":"5","author":"Guo","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1080\/01635580903305326","article-title":"Intakes of vitamin A, C, and E, and beta-carotene are associated with risk of cervical cancer: A case-control study in Korea","volume":"62","author":"Kim","year":"2010","journal-title":"Nutr. Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1002\/ijc.24793","article-title":"Diet and serum micronutrients in relation to cervical neoplasia and cancer among low-income Brazilian women","volume":"126","author":"Tomita","year":"2010","journal-title":"Int. J. Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"8788","DOI":"10.1158\/0008-5472.CAN-04-2402","article-title":"Folate is associated with the natural history of high-risk human papillomaviruses","volume":"64","author":"Piyathilake","year":"2004","journal-title":"Cancer Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1002\/ijc.21193","article-title":"The role of diet and nutrition in cervical carcinogenesis: A review of recent evidence","volume":"117","author":"Bosch","year":"2005","journal-title":"Int. J. Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0163-7258(03)00042-1","article-title":"Natural products for cancer prevention: A global perspective","volume":"99","author":"Reddy","year":"2003","journal-title":"Pharmacol. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1189\/jlb.71.1.16","article-title":"Nutrients and their role in host resistance to infection","volume":"71","author":"Field","year":"2002","journal-title":"J. Leukoc. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Barchitta, M., Quattrocchi, A., Maugeri, A., Canto, C., La Rosa, N., Cantarella, M.A., Spampinato, G., Scalisi, A., and Agodi, A. (2017). Line-1 hypermethylation in white blood cell DNA is associated with high-grade cervical intraepithelial neoplasia. BMC Cancer, 17.","DOI":"10.1186\/s12885-017-3582-0"},{"key":"ref_19","first-page":"1","article-title":"Physical status: The use and interpretation of anthropometry. Report of a WHO expert committee","volume":"854","author":"Eveleth","year":"1995","journal-title":"World Health Organ. Tech. Rep. Ser."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1038\/ejcn.2011.125","article-title":"Increase in the prevalence of the MTHFR 677 TT polymorphism in women born since 1959: Potential implications for folate requirements","volume":"65","author":"Agodi","year":"2011","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/oxfordjournals.aje.a114366","article-title":"Total energy intake: Implications for epidemiologic analyses","volume":"124","author":"Willett","year":"1986","journal-title":"Am. J. Epidemiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1136\/bmj.311.7018.1457","article-title":"Diet and overall survival in elderly people","volume":"311","author":"Trichopoulou","year":"1995","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1038\/bjc.2011.106","article-title":"Mediterranean dietary pattern and cancer risk in the epic cohort","volume":"104","author":"Couto","year":"2011","journal-title":"Br. J. Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"742620","DOI":"10.1155\/2014\/742620","article-title":"Tumor necrosis factor-alpha -308 g>a polymorphism, adherence to mediterranean diet, and risk of overweight\/obesity in young women","volume":"2014","author":"Barchitta","year":"2014","journal-title":"Biomed. Res. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/CEJ.0000000000000266","article-title":"Dietary patterns and endometrial cancer: A meta-analysis","volume":"26","author":"Si","year":"2017","journal-title":"Eur. J. Cancer Prev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.3945\/ajcn.2009.28796","article-title":"Dietary patterns and breast cancer risk: A systematic review and meta-analysis","volume":"91","author":"Brennan","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3476","DOI":"10.1002\/cncr.25839","article-title":"Racial variation in willingness to trade financial resources for life-prolonging cancer treatment","volume":"117","author":"Martin","year":"2011","journal-title":"Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s13063-017-1776-z","article-title":"Erratum to: Diet and exercise in uterine cancer survivors (DEUS pilot)\u2014Piloting a healthy eating and physical activity program: Study protocol for a randomized controlled trial","volume":"18","author":"Koutoukidis","year":"2017","journal-title":"Trials"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e018015","DOI":"10.1136\/bmjopen-2017-018015","article-title":"Recruitment, adherence, and retention of endometrial cancer survivors in a behavioural lifestyle programme: The diet and exercise in uterine cancer survivors (DEUS) parallel randomised pilot trial","volume":"7","author":"Koutoukidis","year":"2017","journal-title":"BMJ Open"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1017\/S1368980013003169","article-title":"Mediterranean diet and health status: An updated meta-analysis and a proposal for a literature-based adherence score","volume":"17","author":"Sofi","year":"2014","journal-title":"Public. Health. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/CEJ.0b013e328354d2d7","article-title":"Cancer prevention in Europe: The mediterranean diet as a protective choice","volume":"22","author":"Giacosa","year":"2013","journal-title":"Eur. J. Cancer Prev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1158\/1940-6207.CAPR-11-0387","article-title":"A dietary pattern associated with line-1 methylation alters the risk of developing cervical intraepithelial neoplasia","volume":"5","author":"Piyathilake","year":"2012","journal-title":"Cancer Prev. Res."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Moga, M.A., Dimienescu, O.G., Arvatescu, C.A., Mironescu, A., Dracea, L., and Ples, L. (2016). The role of natural polyphenols in the prevention and treatment of cervical cancer\u2014An overview. Molecules, 21.","DOI":"10.3390\/molecules21081055"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"503","DOI":"10.2217\/epi.11.71","article-title":"Epigenetic diet: Impact on the epigenome and cancer","volume":"3","author":"Hardy","year":"2011","journal-title":"Epigenomics"},{"key":"ref_35","first-page":"8067972","article-title":"The role of miRNAs as biomarkers for pregnancy outcomes: A comprehensive review","volume":"2017","author":"Barchitta","year":"2017","journal-title":"Int. J. Genom."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1007\/s12263-015-0480-4","article-title":"Low fruit consumption and folate deficiency are associated with line-1 hypomethylation in women of a cancer-free population","volume":"10","author":"Agodi","year":"2015","journal-title":"Genes Nutr."},{"key":"ref_37","first-page":"275","article-title":"Targeting the epigenome with bioactive food components for cancer prevention","volume":"4","author":"Ong","year":"2011","journal-title":"J. Nutrigenet. Nutrigenom."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Barchitta, M., Quattrocchi, A., Maugeri, A., Vinciguerra, M., and Agodi, A. (2014). Line-1 hypomethylation in blood and tissue samples as an epigenetic marker for cancer risk: A systematic review and meta-analysis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0109478"},{"key":"ref_39","unstructured":"International Agency for Research on Cancer (2007). IARC Monographs on the Evaluation of Carcinogenic Risks to Human, World Health Organization."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/4\/469\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:00:19Z","timestamp":1760194819000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/4\/469"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,11]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,4]]}},"alternative-id":["nu10040469"],"URL":"https:\/\/doi.org\/10.3390\/nu10040469","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints201803.0109.v1","asserted-by":"object"}]},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,11]]}}}