Abstract

Simple SummaryGastric cancer (GC) has the fifth highest incidence of any cancer type worldwide and the third highest mortality rate, so its prevention is very important. Among dietary factors, the consumption of fruit and vegetables has been inversely related to GC risk. Phenolic compounds may exert a favorable effect on the risk of several cancer types, including gastric cancer. However, selected polyphenol classes have not been adequately investigated in relation to GC. There is, however, no comprehensive analysis of polyphenols and GC risk methods to date. In order to provide a detailed evaluation of the relationship between dietary intake of polyphenols and GC risk, we analyzed data from the Stomach cancer Pooling (StoP) Project consortium.Phenolic compounds may exert a favorable effect on the risk of several cancer types, including gastric cancer (GC). However, selected polyphenol classes have not been adequately investigated in relation to GC. The aim of this study is to evaluate the association between the intake of polyphenols in relation to GC risk. We used data from the Stomach cancer Pooling (StoP) Project, including 10 studies from six countries (3471 GC cases and 8344 controls). We carried out an individual participant data pooled analysis using a two-stage approach. The summary odds ratios (ORs) of GC for each compound, and the corresponding 95% confidence intervals (95% CI), were computed by pooling study specific ORs obtained through multivariate logistic regression, using random effect models. Inverse associations with GC emerged for total polyphenols (OR = 0.67, 95% CI = 0.54–0.81, for the highest versus lowest quartile of intake), total flavonoids (OR = 0.73, 95% CI = 0.55–0.90), anthocyanidins (OR = 0.74, 95% CI = 0.56–0.92), flavanols (OR = 0.77, 95% CI = 0.66–0.88), flavanones (OR = 0.57, 95%CI = 0.44–0.69), total phenolic acids (OR = 0.75, 95%CI = 0.55–0.94), and hydroxybenzoic acids (OR = 0.73, 95%CI = 0.57–0.89). Results were consistent across strata of age, sex, social class, and smoking habit. Suggestive inverse associations were also found for flavonols (OR = 0.76, 95%CI = 0.51–1.01) and hydroxycinnamic acids (OR = 0.82, 95%CI = 0.58–1.06). Further investigations from longitudinal data are needed to confirm this association.

Highlights

  • The incidence rates of gastric cancer (GC) show a wide geographical variability, which has been attributed to different exposures, including Helicobacter pylori infection, smoking, diet, and nutrition, besides genetic factors [1,2,3]

  • The ORs were lower in the highest quartile intake, as compared to preceding ones, though in the absence of a linear trend

  • We found a reduced risk of GC associated with higher intake of anthocyanidins, flavanols, and flavanones; among phenolic acids, hydroxybenzoic acids intake was inversely related to GC risk

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Summary

Introduction

The incidence rates of gastric cancer (GC) show a wide geographical variability, which has been attributed to different exposures, including Helicobacter pylori infection, smoking, diet, and nutrition, besides genetic factors [1,2,3]. The consumption of fruit and vegetables has been inversely related to GC risk [4,5,6] This inverse relationship has been attributed to the intake of nutrients, micronutrients, and other food compounds, including polyphenols [7]. Polyphenols are secondary phenolic metabolites present in a wide variety of vegetables fruits, cereals, dry legumes, chocolate, and spices. They can be classified into five classes, flavonoids, phenolic acids, stilbenes, lignans, and other polyphenols. A meta-analysis based on six studies, three case–control and three cohort studies from Europe, Asia, and USA, showed that dietary total flavonoids intake was inversely associated with the risk of GC in the European population, but not in US or Asia [11]. In order to provide a detailed evaluation of the relationship between dietary intake of polyphenols and GC risk, we analyzed data from the Stomach cancer Pooling (StoP) Project consortium [13]

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