Fruit and vegetable consumption, Helicobacter pylori antibodies, and gastric cancer risk: A pooled analysis of prospective studies in China, Japan, and Korea

Int J Cancer. 2017 Feb 1;140(3):591-599. doi: 10.1002/ijc.30477. Epub 2016 Oct 31.

Abstract

Epidemiological findings on the association between fruit and vegetable consumption and gastric cancer risk remain inconsistent. The present analysis included 810 prospectively ascertained non-cardia gastric cancer cases and 1,160 matched controls from the Helicobacter pylori Biomarker Cohort Consortium, which collected blood samples, demographic, lifestyle, and dietary data at baseline. Conditional logistic regression adjusting for total energy intake, smoking, and H. pylori status, was applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for gastric cancer risk across cohort- and sex-specific quartiles of fruit and vegetable intake. Increasing fruit intake was associated with decreasing risk of non-cardia gastric cancer (OR = 0.71, 95% CI: 0.52-0.95, p trend = 0.02). Compared to low-fruit consumers infected with CagA-positive H. pylori, high-fruit consumers without evidence of H. pylori antibodies had the lowest odds for gastric cancer incidence (OR = 0.12, 95% CI: 0.06-0.25), whereby the inverse association with high-fruit consumption was attenuated among individuals infected with CagA-positive H. pylori (OR = 0.82, 95% CI: 0.66-1.03). To note, the small number of H. pylori negative individuals does influence this finding. We observed a weaker, nondose-response suggestion of an inverse association of vegetable intake with non-cardia gastric cancer risk. High fruit intake may play a role in decreasing risk of non-cardia gastric cancer in Asia.

Keywords: Helicobacter pylori; diet; fruit; stomach neoplasms; vegetables.

MeSH terms

  • Aged
  • Antibodies, Bacterial / immunology*
  • Case-Control Studies
  • China
  • Diet
  • Energy Intake / physiology
  • Female
  • Fruit
  • Helicobacter Infections / complications*
  • Helicobacter Infections / immunology
  • Helicobacter pylori
  • Humans
  • Incidence
  • Japan
  • Life Style
  • Logistic Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Republic of Korea
  • Risk Factors
  • Stomach Neoplasms / etiology*
  • Stomach Neoplasms / microbiology
  • Vegetables

Substances

  • Antibodies, Bacterial