Daily Diet and Nutrition Risk Factors for Gastric Cancer Incidence in a Japanese Population

Abstract

Background/aims: : Nutritional factors associated with gastric cancer (GC) are not completely understood. We aimed to determine the effect of nutrient intake on the incidence of GC.

Methods: : This was a post hoc analysis of a prospective trial that evaluated modalities for GC screening in participants aged 30 to 74 years living in high-risk areas for GC in Japan between June 2011 and March 2013. The patients were followed up for GC incidence for 6 years. All participants completed a self-administered food frequency questionnaire (FFQ) upon enrollment before GC screening. Daily nutrient intake was calculated from the FFQ and dichotomized at each cutoff value using receiver operating characteristic analysis. Risk factors associated with GC incidence were investigated in terms of nutrient intake and participant characteristics using Cox proportional hazards regression analysis.

Results: : Overall, 1,147 participants were included in this analysis. The median age was 62 years, and 50.7% of the participants were men. The median follow-up period was 2,184 days. GC was detected in 25 participants during the follow-up. Multivariate Cox proportional hazards regression analysis revealed that the intake of sodium (adjusted hazards ratio [aHR], 3.905; 95% confidence interval [CI], 1.520 to 10.035; p=0.005) and vitamin D (aHR, 2.747; 95% CI, 1.111 to 6.788, p=0.029) were positively associated with GC incidence, whereas the intake of soluble dietary fiber (aHR, 0.104; 95% CI, 0.012 to 0.905; p=0.040) was inversely associated with GC incidence.

Conclusions: : Daily high intake of sodium and vitamin D and low soluble dietary fiber intake are associated with GC incidence.

Keywords: Diet; Incidence; Nutrient intake; Risk factors; Stomach neoplasms.

Fig. 1

Cox proportional hazards regression analysis of the relationship between gastric cancer incidence and nutrient intake variables. Hazard ratios (HRs) were calculated for the high-intake group when the low-intake group was set as the reference for each dichotomized nutrition intake variable. The X-axis is log-transformed. BMI, body mass index; H. pylori, Helicobacter pylori; IgG, immunoglobulin G; SFA, saturated fatty acid; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid; n-3 HUFA, n-3 highly unsaturated fatty acid.

Fig. 2

Multivariate Cox proportional hazards regression analysis of the factors associated with gastric cancer incidence. Adjusted hazard ratios (aHRs) were calculated for the higher group when the lower group was set as the reference for each dichotomized variable. The X-axis is log-transformed. H. pylori, Helicobacter pylori; IgG, immunoglobulin G; MUFA, monounsaturated fatty acid.