LETTER TO THE EDITOR Polyphenols, Mediterranean diet, and colon cancer Anna Vittoria Mattioli 1 & Alberto Farinetti 1 & Roberta Gelmini 1 Received: 1 March 2019 /Accepted: 23 April 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019 Dear Editor, We have read with great interest the manuscript BRisk factors affecting hospital stay among patients undergoing colon can- cer surgery: a prospective cohort study.^ by Orive M and coworkers [1] and we found it very important with a view to clinical prevention. The article aimed to identify and validate risk factors that contribute to prolonged length of hospital stay (LOS) in a prospective cohort study that included 1955 pa- tients undergoing resection for colorectal cancer. They found that some of the strongest independent predictors of prolonged LOS, such as surgical infections or open surgery, could be modified to reduce LOS and, in turn, other adverse outcomes. With reference to the findings reported in the paper, we would like to make the following contribution to the discus- sion. Lifestyle and nutrition strongly influence the develop- ment and outcome of colon cancer [2]. In a recent paper, we analyzed 3 components of the Mediterranean diet that seems to be associated with reduction of colon cancer [3]. We analyzed the effects of olive oil (poly- phenols), red grapes (resveratrol), and tomatoes (lycopene). The most active component in term of prevention is olive oil that exerts a protective effect in reducing risk for CRC and other types of cancer, including prostatic cancer. Olive oil acts on polyamine metabolism in cells, leading to a reduction in carcinogenesis progression [4]. The Mediterranean diet is characterized by high intake of olive oil, a source of polyphenols [5, 6]. It is well known that these antioxidants prevent the development of atherosclerosis both in men and in women and prevent the onset of atrial fibrillation [7, 8]. In addition, resveratrol, a polyphenol from grapes and wine, has many pharmacologic properties, such as the reduction of platelet aggregation and eicosanoid synthesis. It promotes protection against damage from reactive oxygen species and from inflammation, resulting in cardiovascular protective benefits and, certainly, anticancer activities [2, 3]. Because resveratrol is a naturally occurring compound, it has been highly studied for the prevention and treatment of many diseases including cancer. Numerous in vitro studies have shown that resveratrol has multiple anticancer effects, protecting against both tumor initiation and cancer progres- sion pathways. Resveratrol promotes cell cycle arrest leading to apoptosis of tumor cells, prevents tumor-derived nitric ox- ide synthase expression to block tumor growth and migration, and acts as an antioxidant to prevent DNA damage that can lead to cancer formation [9]. However, clinical evidence for resveratrol as an effective supplement for cancer prevention and treatment is scarce. In our review of the literature, we concluded that the beneficial effects of Mediterranean diet belong to the synergistic effects of several components more than to the effect of a single food [3, 7]. Among the healthy dietary patterns, the MedDiet emerges in terms of beneficial properties associated with longevity. Current evidence highlights the protective effect exerted by MedD on the different components of MetS. Interestingly, the effect exerted by polyphenols contained within the representative MedD components (i.e., olive oil, red wine, and coffee) seems to be accountable for the beneficial properties associated to this dietary pattern [10]. Anti-inflammatory diets contain mainly fi- ber, polyunsaturated fatty acids, minerals, vitamins, anthocyanidins, isoflavones, and b-carotene. However, the Letter related to BOrive M, Aguirre U, Gonzalez N, Lázaro S, Redondo M, Bare M, Anula R, Briones E, Escobar A, Sarasqueta C, Garcia- Gutierrez S, Quintana JM; REDISSEC-CARESS/CCR group. Risk fac- tors affecting hospital stay among patients undergoing colon cancer sur- gery: a prospective cohort study. Support Care Cancer. 2019 Feb 22. 10.1007/s00520-019-04683-7. [Epub ahead of print].^ * Anna Vittoria Mattioli annavittoria.mattioli@unimore.it 1 Department of Surgical, Medical and Dental, Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Via del pozzo, 71, 41100 Modena, Italy Supportive Care in Cancer https://doi.org/10.1007/s00520-019-04835-9