Table 2 Correlation of dietary factors with incidence of gastric cancer

ɑ-Tocopherol, ß-Carotene Cancer Prevention Study [64]

Nouraie et al. in 2005

29,133 male smokers (1985-1988)

13.7

243 incident gastric adenocarcinomas (64 Gastric cardia cancer (GCC) and 179 Gastric non cardia cancer (GNCC))

Benefit: it was reported For GCC, high dietary intake of retinol was protective. For GNCC, higher intakes of fruits, vitamin C, ɑ-tocopherol, β tocopherol.

Risk: For GCC, high intake of ɑ-tocopherol and β-tocopherol increased risk.

Cancer Prevention Study II Nutrition Cohort [65]

Mccullough et al

60,041 participants

18

299 cases

PREVENTION: It was reported that high dietary intake of fruits and vegetables was protective

RISK: For stomach cancer, obesity and hot beverages; coffee increased the risk.

Copenhagen Centre for Prospective Population Study [37]

Barstad et al

Three population studies conducted in 1964-1992, a total of 15,236 men and 13,227 women

389,051 person-years

122 cases

PREVENTION: protective effect of wine drinking on the risk of gastric cancer with a 40% decrease in risk of gastric cancer for each glass of wine per day attributed to antioxidant properties of wine, while no association between beer or spirits intake and gastric cancer.

European Prospective Investigation into Cancer and Nutrition (EPIC)

Buckland et al. [66]

485,044 subjects (144,577 men) aged 35-70 y from 10 European countries

8.9

449 validated incident GC cases

PREVENTION: Greater adherence to an rMED is associated with a significant reduction in the risk of incident GC.

Duell et al. [67]

444 cases of first primary gastric adenocarcinoma

PREVENTION: Lower consumption of alcohol amounts (< 60 g/d) were not associated with increased risk to gastric cancer.

RISK: Heavy (compared with very light) alcohol consumption (≥60 compared with 0.1-4.9 g/d) at baseline was positively associated with GC risk.

Gonza’lez et al. 2006 [68]

521,457 men and women aged 35-70 years in 10 European countries

6.5

330 gastric adenocarcinoma

RISK: Gastric non-cardia cancer risk was statistically significantly associated with intakes of total meat, red meat, and processed meat.

EPIC-EURGAST STUDY [69]

477,312

11

683 gastric adenocarcinoma

PREVENTION: They found an inverse association between total intake of vegetables and fruit and GC risk, between fresh fruit and risk of the diffuse type and an inverse association between citrus fruit and risk of cardia cancer. Fresh fruit and citrus fruit consumption may protect against diffuse and cardia GC, respectively.

Jakszyn et al. [70], 2006

521,457 individuals

6.6

314 cases

dietary intake of nitrosodimethylamine (NDMA) and endogenous formation of nitroso compounds was significantly associated with non-cardia cancer risk but not with cardia cancer.

Zamora-Ros et al. 2012 [71]

36,037 individuals from 10 European countries, aged 35-74 years

Hisayama Study

Miyazaki et al. 2012 [72]

2467, age 40 years or more

14

93 cases

The age- and sex-adjusted incidence of gastric cancer rose progressively with increasing levels of dietary vitamin A

Hisayama Study

Shikata et al. [73], 2006

2476 subjects aged 40 years or olde

14

93 cases

high dietary salt intake is a significant risk factor for gastric cancer; strong in the presence of Helicobacter pylori infection with atrophic gastritis.

Hokkaido Study

Khan et al. [74], 2004

1524 men and 1634 women separately aged 40 and over.

2.5

379 cases

For men, two dietary factors, miso soup and pickled vegetables were associated with lower risk for stomach and colorectal cancer respectively. For women, three factors, namely salty confectionery, black tea, and carbonated drink/juice appeared related to an elevated risk of stomach cancer.

Kaunas Rotterdam Intervention Study & Multifactorial Ischemic Heart Disease Prevention Study

Everatt et al. [75], 2012

7150 men in Kaunas, Lithuania

30

185 gastric cancer cases

Although an association with heavy wine consumption was observed, the effect of exposure to acetaldehyde on the development of gastric cancer in this cohort was not confirmed

Korean MultiCenter Cancer Cohort

Ko et al. [76], 2013

19,688

25 years

166 gastric cancer cases

inverse association between soybean/tofu intake and gastric cancer risk among women. Men with a high soybean/tofu intake had a lower risk of gastric cancer, but the reduction was not statistically significant

Miyako Study

Murata et al. [77] 2010

6830

8.9 years

87 gastric cancer

the HR for stomach cancer in males with high salt intake was 2.05 (95% CI:1.25 - 3.38), but not in women

Netherlands Cohort Study

Steevens et al. [78], 2011

120,852

16.3 years

156 GCA, 460 GNCA cases

Significant inverse associations were observed for Brassica vegetables and GCA risk. Citrus fruits were inversely associated with GCA risk

NIH-AARP Diet and Health Study

O’Doherty et al. [79], 2012

218,854 participants

40 years

191 gastric cardia adenocarcinomas and 125 gastric non-cardia adenocarcinomas

Overall obesity (BMI) was positively associated with gastric cardia adenocarcinoma risk (highest (≥35 kg/m(2)) vs referent (18.5- < 25 kg/m(2) Waist circumference was also positively associated with gastric cardia adenocarcinoma risk. In contrast, the majority of the anthropometric variables were not associated with adenocarcinomas of the gastric non-cardia.

Shanghai Cohort Study

Moy et al. [80], 2010

18,244

20 years

391 incident gastric cancer cases

Ever smokers experienced a statistically significant increased risk of gastric cancer. Heavy drinkers experienced a statistically significant increase in risk of gastric cancer (HR, 1.46; 95% CI, 1.05-2.04)

Shanghai Women’s and Men’s Health Studies

Epplein et al. [14], 2010

74,942 women aged 40–70 years

61,500 men aged 40–74

8 years

incident distal gastric cancers Shanghai Women’s Health Study (n = 206) and the Shanghai Men’s Health Study (n = 132)

For women, no associations were found between gastric cancer risk and the highest intake of fruits or vegetables. For men, increased fruit intake was associated with decreased risk of distal gastric cancer but no association was seen with increased intake of vegetables.