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

  • Ana Ferro
  • , Ana Rute Costa
  • , Samantha Morais
  • , Paola Bertuccio
  • , Matteo Rota
  • , Claudio Pelucchi
  • , Jinfu Hu
  • , Kenneth C. Johnson
  • , Zuo Feng Zhang
  • , Domenico Palli
  • , Monica Ferraroni
  • , Guo Pei Yu
  • , Rossella Bonzi
  • , Bárbara Peleteiro
  • , Lizbeth López-Carrillo
  • , Shoichiro Tsugane
  • , Gerson Shigueaki Hamada
  • , Akihisa Hidaka
  • , Reza Malekzadeh
  • , David Zaridze
  • Dmitry Maximovich, Jesus Vioque, Eva M. Navarrete-Muñoz, Juan Alguacil, Gemma Castaño-Vinyals, Alicja Wolk, Niclas Håkansson, Raúl Ulises Hernández-Ramírez, Mohammadreza Pakseresht, Mary H. Ward, Farhad Pourfarzi, Lina Mu, Malaquias López-Cervantes, Roberto Persiani, Robert C. Kurtz, Areti Lagiou, Pagona Lagiou, Paolo Boffetta, Stefania Boccia, Eva Negri, Maria Constanza Camargo, Maria Paula Curado, Carlo La Vecchia, Nuno Lunet
  • University of Porto
  • University of Milan
  • University of Brescia
  • Harbin Medical University
  • University of Ottawa
  • University of California at Los Angeles
  • Institute for the Study and Prevention of Cancer
  • Peking University
  • Instituto Nacional de Salud Publica
  • National Cancer Center Japan
  • Nikkei Disease Prevention Center
  • Tehran University of Medical Sciences
  • Russian N.N. Blokhin Cancer Research Centre
  • Centro de Investigación Biomédicaen Red de Epidemiología y Salud Pública (CIBERESP)
  • Miguel Hernández University
  • University of Huelva
  • (ISGlobal) Instituto de Salud Global de Barcelona
  • Hospital del Mar
  • Pompeu Fabra University
  • Karolinska Institutet
  • Yale University
  • University of Alberta
  • University of Leeds
  • National Institutes of Health
  • Ardabil University of Medical Sciences
  • Universidad Nacional Autónoma de México
  • Fondazione Policlinico Universitario A. Gemelli IRCCS
  • Catholic University of the Sacred Heart
  • Memorial Sloan-Kettering Cancer Center
  • University of West Attica
  • National and Kapodistrian University of Athens
  • Harvard University
  • Icahn School of Medicine at Mount Sinai
  • University of Bologna
  • A.C.Camargo Cancer Center

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)3090-3101
Number of pages12
JournalInternational Journal of Cancer
Volume147
Issue number11
DOIs
StatePublished - Dec 1 2020

Keywords

  • fruits
  • gastric cancer
  • nutrition
  • pooled analyses
  • vegetables

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