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Nutrients. 2019 Apr 27;11(5). pii: E967. doi: 10.3390/nu11050967.

Flavonoids and the Risk of Gastric Cancer: An Exploratory Case-Control Study in the MCC-Spain Study.

Author information

1
Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain. fvits@unileon.es.
2
Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain. ajmolt@unileon.es.
3
Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat (Barcelona), Spain. raulzamoraros@gmail.com.
4
Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain. tferv@unileon.es.
5
Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain. vasilirous@gmail.com.
6
Instituto de Investigación Sanitaria Illes Balears (IdISBa), Spain. dora.romaguera@isglobal.org.
7
Instituto de Salud Global de Barcelona (ISGlobal), 08003 Barcelona, Spain. dora.romaguera@isglobal.org.
8
CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain. dora.romaguera@isglobal.org.
9
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. nuria.aragones@salud.madrid.org.
10
Cancer Epidemiology Section, Public Health Division, Department of Health of Madrid, 28035 Madrid, Spain. nuria.aragones@salud.madrid.org.
11
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. mobon@iconcologia.net.
12
Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, 08003 Barcelona, Spain. mobon@iconcologia.net.
13
ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain. mobon@iconcologia.net.
14
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. mp.guevara.eslava@navarra.es.
15
Public Health Institute of Navarra-IDISNA, 31003 Pamplona, Spain. mp.guevara.eslava@navarra.es.
16
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. ines.gomez@unican.es.
17
University of Cantabria⁻IDIVAL, Santander, Spain. ines.gomez@unican.es.
18
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. gftardon@uniovi.es.
19
University of Cantabria⁻IDIVAL, Santander, Spain. gftardon@uniovi.es.
20
Cancer and Public Health Area, FISABIO-Public Health, 46020 Valencia, Spain. molina_anabar@gva.es.
21
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. rocioolmedo@ugr.es.
22
Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain. rocioolmedo@ugr.es.
23
Centro de Investigación en Recursos Naturales, Salud, y Medio Ambiente (RENSMA), Universidad de Huelva, 21071 Huelva, Spain. rocio.capelo@dbasp.uhu.es.
24
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. mdolores.chirlaque@carm.es.
25
Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, 30007 Murcia, Spain. mdolores.chirlaque@carm.es.
26
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. bperez@isciii.es.
27
Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain. bperez@isciii.es.
28
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. v.moreno@iconcologia.net.
29
Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, 08908 Barcelona, Spain. v.moreno@iconcologia.net.
30
ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain. v.moreno@iconcologia.net.
31
Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, 08907 Barcelona, Spain. v.moreno@iconcologia.net.
32
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. jcastilc@navarra.es.
33
Public Health Institute of Navarra-IDISNA, 31003 Pamplona, Spain. jcastilc@navarra.es.
34
Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain. mrubig02@estudiantes.unileon.es.
35
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. mpollan@isciii.es.
36
Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain. mpollan@isciii.es.
37
Instituto de Salud Global de Barcelona (ISGlobal), 08003 Barcelona, Spain. manolis.kogevinas@isglobal.org.
38
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. manolis.kogevinas@isglobal.org.
39
IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain. manolis.kogevinas@isglobal.org.
40
Universitat Pompeu Fabra (UPF), Departament de Ciències Experimentals i de la Salut, 08002 Barcelona, Spain. manolis.kogevinas@isglobal.org.
41
Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain. jpbarl@unileon.es.
42
Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain. vicente.martin@unileon.es.
43
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain. vicente.martin@unileon.es.

Abstract

Several epidemiological studies have investigated the association between the dietary flavonoid intake and gastric cancer (GC) risk; however, the results remain inconclusive. Investigating the relationship between the different classes of flavonoids and the histological types and origin of GC can be of interest to the research community. We used data from a population-based multi-case control study (MCC-Spain) obtained from 12 different regions of Spain. 2700 controls and 329 GC cases were included in this study. Odds ratios (ORs) were calculated using the mixed effects logistic regression considering quartiles of flavonoid intakes and log2. Flavonoid intake was associated with a lower GC risk (ORlog2 = 0.76; 95% CI = 0.65-0.89; ORq4vsq1 = 0.60; 95%CI = 0.40-0.89; ptrend = 0.007). Inverse and statistically significant associations were observed with anthocyanidins, chalcones, dihydroflavonols and flavan-3-ols. The isoflavanoid intake was positively associated with higher cancer risk, but without reaching a statistical significance. In general, no differences were observed in the GC risk according to the location and histological type. The flavonoid intake seems to be a protective factor against GC within the MCC-study. This effect may vary depending on the flavonoid class but not by the histological type and location of the tumor. Broader studies with larger sample size and greater geographical variability are necessary.

KEYWORDS:

MCC-Spain; case-control study; flavonoids; gastric cancer; intake

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