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Am J Clin Nutr. 2018 Apr 1;107(4):607-616. doi: 10.1093/ajcn/nqy002.

Inflammatory potential of the diet and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

Author information

1
Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
2
Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
3
Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark.
4
CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France.
5
Gustave Roussy, Villejuif, France.
6
German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany.
7
Hellenic Health Foundation, Athens, Greece.
8
WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece.
9
2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece.
10
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
11
Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy.
12
Epidemiology and Prevention Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
13
Cancer Registry and Histopathology Department, "Civic-M.P.Arezzo" Hospital, Ragusa, Italy.
14
Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
15
Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy.
16
Dipartamento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
17
Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
18
Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands.
19
Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, United Kingdom.
20
Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
21
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
22
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
23
Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
24
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
25
Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
26
Departamento de Biología Funcional, Facultad de Medicina, Universidad de Oviedo, Asturias, Spain.
27
Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
28
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
29
Public Health Department of Gipuzkoa, Government of the Basque Country, San Sebastian, Spain.
30
BioDonostia Research Institute, San Sebastian, Spain.
31
Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
32
Department of Health and Social Sciences, University of Murcia, Murcia, Spain.
33
Navarra Public Health Institute, IdiSNA (Navarra Institute for Health Research), Pamplona, Spain.
34
Lund University, Skane University Hospital, Division of Internal Medicine, Malmö, Sweden.
35
Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University. Malmö, Sweden.
36
Public Health and Clinical Medicine, Nutritional Research and.
37
Public Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.
38
University of Cambridge, Cambridge, United Kingdom.
39
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
40
Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
41
School of Public Health, Imperial College London, United Kingdom.
42
Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
43
Facultat Ciències Salut Blanquerna, Universitat Ramon Llull, Barcelona, Spain.

Abstract

Background:

Chronic inflammation plays a critical role in the pathogenesis of the 2 major types of gastric cancer. Several foods, nutrients, and nonnutrient food components seem to be involved in the regulation of chronic inflammation.

Objective:

We assessed the association between the inflammatory potential of the diet and the risk of gastric carcinoma, overall and for the 2 major subsites: cardia cancers and noncardia cancers.

Design:

A total of 476,160 subjects (30% men, 70% women) from the European Investigation into Cancer and Nutrition (EPIC) study were followed for 14 y, during which 913 incident cases of gastric carcinoma were identified, including 236 located in the cardia, 341 in the distal part of the stomach (noncardia), and 336 with overlapping or unknown tumor site. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated with the use of 28 dietary components and their corresponding inflammatory scores. The association between the ISD and gastric cancer risk was estimated by HRs and 95% CIs calculated by multivariate Cox regression models adjusted for confounders.

Results:

The inflammatory potential of the diet was associated with an increased risk of gastric cancer. The HR (95% CI) for each increase in 1 SD of the ISD were 1.25 (1.12, 1.39) for all gastric cancers, 1.30 (1.06, 1.59) for cardia cancers, and 1.07 (0.89, 1.28) for noncardia cancers. The corresponding values for the highest compared with the lowest quartiles of the ISD were 1.66 (1.26, 2.20), 1.94 (1.14, 3.30), and 1.07 (0.70, 1.70), respectively.

Conclusions:

Our results suggest that low-grade chronic inflammation induced by the diet may be associated with gastric cancer risk. This pattern seems to be more consistent for gastric carcinomas located in the cardia than for those located in the distal stomach. This study is listed on the ISRCTN registry as ISRCTN12136108.

PMID:
29635497
DOI:
10.1093/ajcn/nqy002

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