Inflammatory potential of the diet and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study
Agudo, Antonio; Cayssials, Valerie; Bonet, Catalina; Tjønneland, Anne; Overvad, Kim; Boutron-Ruault, Marie Christine; Affret, Aurélie; Fagherazzi, Guy; Katzke, Verena; Schübel, Ruth; Trichopoulou, Antonia; Karakatsani, Anna; La Vecchia, Carlo; Palli, Domenico; Grioni, Sara; Tumino, Rosario; Ricceri, Fulvio; Panico, Salvatore; Bueno-De-Mesquita, Bas; Peeters, Petra H.; Weiderpass, Elisabete; Skeie, Guri; Nøst, Theresa H.; Lasheras, Cristina; Rodríguez-Barranco, Miguel; Amiano, Pilar; Chirlaque, María Dolores; Ardanaz, Eva; Ohlsson, Bodil; Dias, Joana A.; Nilsson, Lena M.; Myte, Robin; Khaw, Kay Tee; Perez-Cornago, Aurora; Gunter, Marc; Huybrechts, Inge; Cross, Amanda J.; Tsilidis, Kostas; Riboli, Elio; Jakszyn, Paula
(2018) American Journal of Clinical Nutrition, volume 107, issue 4, pp. 607 - 616
(Article)
Abstract
Background Chronic inflammation plays a critical role in the pathogenesis of the 2 major types of gastric cancer. Several foods, nutrients, and nonnutrient food components seem to be involved in the regulation of chronic inflammation. Objective We assessed the association between the inflammatory potential of the diet and the risk
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of gastric carcinoma, overall and for the 2 major subsites: cardia cancers and noncardia cancers. Design A total of 476,160 subjects (30% men, 70% women) from the European Investigation into Cancer and Nutrition (EPIC) study were followed for 14 y, during which 913 incident cases of gastric carcinoma were identified, including 236 located in the cardia, 341 in the distal part of the stomach (noncardia), and 336 with overlapping or unknown tumor site. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated with the use of 28 dietary components and their corresponding inflammatory scores. The association between the ISD and gastric cancer risk was estimated by HRs and 95% CIs calculated by multivariate Cox regression models adjusted for confounders. Results The inflammatory potential of the diet was associated with an increased risk of gastric cancer. The HR (95% CI) for each increase in 1 SD of the ISD were 1.25 (1.12, 1.39) for all gastric cancers, 1.30 (1.06, 1.59) for cardia cancers, and 1.07 (0.89, 1.28) for noncardia cancers. The corresponding values for the highest compared with the lowest quartiles of the ISD were 1.66 (1.26, 2.20), 1.94 (1.14, 3.30), and 1.07 (0.70, 1.70), respectively. Conclusions Our results suggest that low-grade chronic inflammation induced by the diet may be associated with gastric cancer risk. This pattern seems to be more consistent for gastric carcinomas located in the cardia than for those located in the distal stomach. This study is listed on the ISRCTN registry as ISRCTN12136108.
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Keywords: chronic inflammation, gastric cancer, inflammatory score of the diet, nutrition, prospective studies, Medicine (miscellaneous), Nutrition and Dietetics
ISSN: 0002-9165
Publisher: American Society for Nutrition
Note: Funding Information: The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by: Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC-Murcia, Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, the Red Temática de Investigación Cooperativa en Cáncer of the Instituto de Salud Carlos III (ISCIII RTICC RD12/0036/0018), cofounded by FEDER funds/European Regional Development Fund (ERDF) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (UK). Funding Information: Supported by a grant (ref. PI15-00639) from the Health Research Fund (FIS), ISCIII, Spain. The participation of centres from Navarra and Granada (Spain) was also funded by a grant (PIE14/00045) of the Health Research Fund (FIS), ISCIII, Spain. Publisher Copyright: © 2018 American Society for Nutrition. All rights reserved.
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