Adherence to Dietary Recommendations and Risk of Esophageal Squamous Cell Carcinoma: A Case-Control Study in Iran

Abstract

Background/Aim: The Dietary Guidelines for Americans Adherence Index (DGAI) 2005 was developed to assess the contribution of dietary patterns to chronic disease risk. The objective of this study was to evaluate the association of dietary patterns as measured by the DGAI 2005 with the esophageal squamous cell carcinoma (ESCC) risk in Iran. Methods: This case-control study was conducted on 50 ESCC cases and 100 hospital controls aged 40–75 years. Participants were interviewed using validated food frequency questionnaires and the DGAI score was calculated subsequently. Results: Generally, the mean DGAI 2005 score for this population was low (9.54 ± 1.79) and the control group scored significantly higher compared to the ESCC cases (p < 0.001). Being in the highest tertile of DGAI scores reduced the risk of ESCC by 31%. Consumption of salty, peppery, and sour foods in combination increased the ESCC risk by 7.23%, followed by consumption of fried/barbecued meals (OR 3.79; 95% CI 1.10–5.44; p < 0.001) and high-temperature food/beverages (OR 3.68; 95% CI 1.20–8.99; p < 0.001). Conclusions: Consumption of a diet in accordance with dietary recommendations was associated with a lower risk of ESCC. Preventive strategies to reduce the ESCC risk in high-risk regions of the world should focus on overall dietary patterns and dietary habits in order to be effective.