Cancer Epidemiology Unit, National Centre for Epidemiology, Instituto de Salud Carlos III, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.
Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.
Gastric Cancer. 2018 May;21(3):372-382. doi: 10.1007/s10120-017-0774-x. Epub 2017 Nov 14.
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.
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.
A high adherence to the Western pattern increased gastric adenocarcinoma risk [odds ratio (95% confidence interval), 2.09 (1.31; 3.33)] even at low levels [odds ratio (95% confidence interval), 1.63 (1.05; 2.52)]. High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma [odds ratio (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.
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.
饮食习惯对胃腺癌发展的影响尚不清楚。本研究旨在探讨三种已确定的饮食模式与胃腺癌之间的关联，分析因素包括性别、年龄、肿瘤部位和组织形态。
MCC-Spain 是一项多病例对照研究，包括 295 例胃腺癌新发病例和 3040 名对照。采用多变量逻辑回归模型，随机纳入省级特定截距，并考虑性别和年龄的可能交互作用，评估了另一个西班牙病例对照研究中确定的西方、谨慎和地中海饮食模式与胃腺癌之间的关联。采用多项回归模型评估了肿瘤部位（贲门、非贲门）和形态（肠型/弥漫型）的风险。
高西方饮食模式的依从性增加了胃腺癌的风险[比值比（95%置信区间），2.09（1.31；3.33)]，即使是低水平的[比值比（95%置信区间），1.63（1.05；2.52)]。高地中海饮食模式的依从性可能预防胃腺癌[比值比（95%置信区间），0.53（0.34；0.82)]。尽管未观察到效应的显著异质性，但西方模式的有害效应在年龄较大的参与者和非贲门腺癌中更强，而地中海模式的保护效应仅在年龄较小的参与者和非贲门肿瘤中观察到。
减少脂肪和糖含量高的产品以及红色和加工肉类的摄入，增加水果、蔬菜、豆类、橄榄油、坚果和鱼类的摄入，可能预防胃腺癌。
