Dados do Trabalho

Título

Dietary patterns and risk of gastric adenocarcinoma: Preliminary results of a Brazilian multicenter case-control study

Introdução

The relationship between diet and risk of gastric adenocarcinoma (GA) using a single food or nutritional approach is widely conducted in opposition to the dietary pattern approach in several studies. The analysis of dietary patterns has been considered an approach to capturing complex interactions of the general diet, which is less possible in previous approaches. To date, the evidence between dietary patterns and the risk of GA in the Brazilian population is limited.

Objetivo

This study aims to determine the main dietary patterns and their association with the risk of GA in the Brazilian population.

Métodos

This is a multicenter case-control study conducted in four capitals located in different regions of Brazil. The study was approved by the Committee on Ethics in Human Research of Antônio Prudente Foundation—A.C.Camargo Cancer Center, as well as the local ethics committees of the study centers, under registration on the Brazil platform linked to the National Health Council of Brazil (grant nº 4708881—February 2016, registration CAAE: 53166915.9.1001.5432). A total of 1752 participants — 601 cases, 377 endoscopy controls and 774 hospital controls — aged between 18-75 years. Dietary patterns were extracted and identified using principal component analysis (PCA) and factor analysis (FA) based on 30 predefined food groups by semi-quantitative food frequency questionnaire responses. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated across the tertiles of dietary pattern scores using multiple logistic regression models.

Resultados

Six main dietary patterns were extracted – westernized (pattern 1), plant-based and citrus fruits (2), prudent (3), low-fat dairy products and non-citrus fruits (4), Brazilian breakfast (5), flour, white meat, boiled egg, and green condiment (6) – and those patterns explained 38.3% of the total variation in food intake. The final model when analyzing cases versus endoscopy controls, comparing the highest with the lowest tertiles of dietary pattern scores, the adjusted ORs (95% CIs) were 2.00 (1.10, 3.76; Ptrend: 0.03) for the westernized pattern, 0.34 (0.19, 0.59; Ptrend: < 0.001) for the plant-based and citrus fruits pattern, 3.10 (1.60, 5.94; Ptrend: < 0.001) for the Brazilian breakfast pattern. In cases versus hospital controls, were 1.71 (0.17, 2.51; Ptrend: 0.07) for the westernized pattern, 0.40 (0.26, 0.62; Ptrend: < 0.001) for the plant-based and citrus fruits pattern, 2.60 (1.74, 3.84; Ptrend: < 0.001) for the Brazilian breakfast pattern, and for the other patterns, no associations were found.

Conclusões

Our findings suggest that adherence to the plant-based and citrus fruits dietary pattern was associated with lower GC risk. However, adherence to westernized dietary pattern and Brazilian breakfast pattern increase the risk of GA. This study has implications for the prevention of gastric cancer.

Palavras-chave

Gastric cancer, dietary patterns, Brazilian population

Financiador do resumo

This research received funding São Paulo Research Foundation (FAPESP) (grant: 2014/26897-0). Moreover, this study was financed in part by the Brazilian Coordination for the Improvement of Higher Education Personnel (CAPES), which provided a research fellowship.