Journal
GASTRIC CANCER
Volume 21, Issue 3, Pages 372-382Publisher
SPRINGER
DOI: 10.1007/s10120-017-0774-x
Keywords
Diet, Mediterranean; Diet, Western; Stomach neoplasms; Adenocarcinoma; Prevention and control; Principal component analysis; Population attributable fraction
Categories
Funding
- Accion Transversal del Cancer
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)
- Instituto de Salud Carlos III
- FEDER [PI08/1770, PI09/0773, PI09/1286, PI09/1903, PI09/2078, PI09/1662, PI11/01403, PI12/00150]
- Fundacion Marques de Valdecilla [API 10/09]
- Catalan Government DURSI grant [2014SGR647, 2014SGR756]
- Junta de Castilla y Leon [LE22A10-2]
- Consejeria de Salud of the Junta de Andalucia [2009-S0143]
- Conselleria de Sanitat of the Generalitat Valenciana [AP061/10]
- Regional Government of the Basque Country
- Consejeria de Sanidad de la Region de Murcia
- Fundacion Caja de Ahorros de Asturias
- University of Oviedo
- Spanish Association Against Cancer (AECC) Scientific Foundation
- Spanish Ministry of Economy and Competitiveness Juan de la Cierva de Incorporacion [IJCI-2014-20900]
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Background The influence of dietary habits on the development of gastric adenocarcinoma is not clear. The objective of the present study was to explore the association of three previously identified dietary patterns with gastric adenocarcinoma by sex, age, cancer site, and morphology. Methods MCC-Spain is a multicase-control study that included 295 incident cases of gastric adenocarcinoma and 3040 controls. The association of the Western, Prudent, and Mediterranean dietary patterns-derived in another Spanish case-control study-with gastric adenocarcinoma was assessed using multivariable logistic regression models with random province-specific intercepts and considering a possible interaction with sex and age. Risk according to tumor site (cardia, non-cardia) and morphology (intestinal/diffuse) was evaluated using multinomial regression models. Results A high adherence to the Western pattern increased gastric adenocarcinoma risk [odds ratio(fourth_vs._first_quartile) (95% confidence interval), 2.09 (1.31; 3.33)] even at low levels [odds ratio(second_vs._first_quartile) (95% confidence interval), 1.63 (1.05; 2.52)]. High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma [odds ratio(fourth_vs._first_quartile) (95% confidence interval), 0.53 (0.34; 0.82)]. Although no significant heterogeneity of effects was observed, the harmful effect of the Western pattern was stronger among older participants and for non-cardia adenocarcinomas, whereas the protective effect of the Mediterranean pattern was only observed among younger participants and for non-cardia tumors. Conclusion Decreasing the consumption of fatty and sugary products and of red and processed meat in favor of an increase in the intake of fruits, vegetables, legumes, olive oil, nuts, and fish might prevent gastric adenocarcinoma.
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