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Diet Quality and UGI Cancer Risk: Golestan Study

February, 02, 2024 | Gastric Cancer, Gastrointestinal Cancer

KEY TAKEAWAYS

  • The Golestan study aimed to investigate the association between overall diet quality and the risk of esophageal and stomach cancers in a high-risk region for UGI cancer patients.
  • Researchers observed that patients following dietary recommendations from high-income countries correlated with reduced risks of esophageal and gastric cancers in high-risk regions.

Recent evidence highlights the potential impact of overall diet quality, assessed through dietary scores, on developing upper gastrointestinal (UGI) cancers. Notably, existing dietary scores are predominantly derived from high-income countries, presenting a disparity in dietary habits compared to regions with the highest burden of UGI cancers, where data is limited. In response to this gap, Majid Namaki and his team aimed to explore the association between overall diet quality and the risk of esophageal and stomach cancers in a high-risk region for UGI cancers.

They performed an inclusive analysis, enrolling 50,045 individuals aged 40-75 from northeastern Iran between 2004-2008, and diligently followed them annually until July 2020. Demographic information, dietary details, and various exposures were meticulously collected through validated questionnaires. To evaluate diet quality, the study utilized five established scoring systems: Healthy Eating Index (HEI), Alternative Healthy Eating Index (AHEI), Alternative Mediterranean Diet (AMED), Dietary Approaches to Stop Hypertension (DASH), and World Cancer Research Fund-American Institute for Cancer Research (WCRF-AICR) scores. 

About 359 participants developed esophageal cancer, and 358 developed stomach cancer during an average of 12 years of follow-up. Following adjustments, each standard deviation increase in baseline dietary scores exhibited a notable association, revealing a potential 12% reduction in esophageal cancer risk and a substantial up to 17% reduction in stomach cancer risk. Specifically, esophageal cancer demonstrated a stronger inverse association with adherence to the Alternative Mediterranean Diet (AMED) (HRQ4-vs-Q1=0.69 (0.49-0.98), P-trend=0.038). Stomach cancer, on the other hand, exhibited a stronger inverse correlation with the WCRF-AICR (HRQ4-vs-Q1=0.58 (0.41-0.83), P-trend=0.004) and the DASH (HRC4-vs-C1=0.72 (0.54-0.96), P-trend=0.041) scores.

These associations remained consistent across various population subgroups, indicating robustness across different demographic characteristics. Importantly, no significant associations were observed between HEI and AHEI scores and UGI cancers in this population. 

The study concluded that adherence to dietary recommendations from high-income countries, despite differences in individual food group consumption, was linked to a lower risk of subsequent esophageal and gastric cancers in this high-risk population. Emphasizing educating the public to adopt healthy eating patterns emerged as a potentially effective strategy for preventing upper gastrointestinal cancers in such high-risk regions.

Source:https://pubmed.ncbi.nlm.nih.gov/38310404/

Namaki M, Hashemian M, Arj A, et al (2024). “Diet Quality and Subsequent Incidence of Upper Gastrointestinal Cancers: Results from the Golestan Cohort Study.” Arch Iran Med. 2023 Sep 1;26(9):489-498. doi: 10.34172/aim.2023.74. PMID: 38310404.

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