Fruits and vegetables intake and gastric cancer risk: A pooled analysis within the Stomach cancer Pooling Project

• Published in: International journal of cancer Vol. 147; no. 11; pp. 3090 - 3101
• Main Authors: Ferro, Ana, Costa, Ana Rute, Morais, Samantha, Bertuccio, Paola, Rota, Matteo, Pelucchi, Claudio, Hu, Jinfu, Johnson, Kenneth C., Zhang, Zuo‐Feng, Palli, Domenico, Ferraroni, Monica, Yu, Guo‐Pei, Bonzi, Rossella, Peleteiro, Bárbara, López‐Carrillo, Lizbeth, Tsugane, Shoichiro, Hamada, Gerson Shigueaki, Hidaka, Akihisa, Malekzadeh, Reza, Zaridze, David, Maximovich, Dmitry, Vioque, Jesus, Navarrete‐Muñoz, Eva M., Alguacil, Juan, Castaño‐Vinyals, Gemma, Wolk, Alicja, Håkansson, Niclas, Hernández‐Ramírez, Raúl Ulises, Pakseresht, Mohammadreza, Ward, Mary H., Pourfarzi, Farhad, Mu, Lina, López‐Cervantes, Malaquias, Persiani, Roberto, Kurtz, Robert C., Lagiou, Areti, Lagiou, Pagona, Boffetta, Paolo, Boccia, Stefania, Negri, Eva, Camargo, Maria Constanza, Curado, Maria Paula, La Vecchia, Carlo, Lunet, Nuno
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.12.2020; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Cancer; Case-Control Studies; Diet; Female; Food Preferences; Fruit; Fruits; Gastric cancer; Humans; Life Style; Male; Medical research; Medicin och hälsovetenskap; Middle Aged; nutrition; Odds Ratio; pooled analyses; Risk factors; Stomach Neoplasms - epidemiology; Surveys and Questionnaires; Vegetables; nutrition; fruits; gastric cancer; vegetables; pooled analyses
• ISSN: 0020-7136; 1097-0215; 1097-0215
• DOI: 10.1002/ijc.33134

A low intake of fruits and vegetables is a risk factor for gastric cancer, although there is uncertainty regarding the magnitude of the associations. In our study, the relationship between fruits and vegetables intake and gastric cancer was assessed, complementing a previous work on the association betweenconsumption of citrus fruits and gastric cancer. Data from 25 studies (8456 cases and 21 133 controls) with information on fruits and/or vegetables intake were used. A two‐stage approach based on random‐effects models was used to pool study‐specific adjusted (sex, age and the main known risk factors for gastric cancer) odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Exposure‐response relations, including linear and nonlinear associations, were modeled using one‐ and two‐order fractional polynomials. Gastric cancer risk was lower for a higher intake of fruits (OR: 0.76, 95% CI: 0.64‐0.90), noncitrus fruits (OR: 0.86, 95% CI: 0.73‐1.02), vegetables (OR: 0.68, 95% CI: 0.56‐0.84), and fruits and vegetables (OR: 0.61, 95% CI: 0.49‐0.75); results were consistent across sociodemographic and lifestyles categories, as well as study characteristics. Exposure‐response analyses showed an increasingly protective effect of portions/day of fruits (OR: 0.64, 95% CI: 0.57‐0.73 for six portions), noncitrus fruits (OR: 0.71, 95% CI: 0.61‐0.83 for six portions) and vegetables (OR: 0.51, 95% CI: 0.43‐0.60 for 10 portions). A protective effect of all fruits, noncitrus fruits and vegetables was confirmed, supporting further dietary recommendations to decrease the burden of gastric cancer. What's new? Low intake of fruits and vegetables has long been associated with a higher risk of gastric cancer, and citrus fruits may be especially protective. However, results from various studies have been inconsistent. In this large, pooled analysis from a global consortium, the authors found that a higher intake of all types of fruits and vegetables was protective. This effect was seen regardless of gastric cancer location and histological type. These results reinforce current recommendations for an increased intake of both fruits and vegetables to decrease the burden of gastric cancer.