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.

Risk factors for esophageal squamous cell carcinoma and its histological precursor lesions in China: a multicenter cross-sectional study

“…Both high frequency and long-term intakes were associated with elevated risk of ESCC. This observation is consistent with other studies [16,24,25]. However, the underlying mechanism was still unclear.…”

Diet Quality and Upper Gastrointestinal Cancers Risk: A Meta-Analysis and Critical Assessment of Evidence Quality

“…Of the 53 studies retrieved for full-text review, 24 met the selection criteria ( Figure 1 and Table 1 ). UGI cancers were identified by self-reported questionnaire [ 7 , 8 , 10 ], physician-reviewed pathology records [ 7 , 8 , 10 ], linkage to cancer registry system [ 5 , 6 , 7 , 8 , 10 , 11 ], or pathological confirmation [ 9 , 12 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. All included cohort studies were rated as high-quality (7–9 points) ( Supplementary Material 1 ).…”

“…Findings from investigations quantifying diet quality based on Chinese Healthy Food Patterns [ 38 ], Dietary Guidelines for Americans Adherence Index [ 24 ], Diet Quality Index [ 12 ], Food Diet Score [ 39 ]; Index of Nutritional Quality [ 40 ] and empirically defined food indices [ 32 ] have demonstrated the beneficiary role of high diet quality in the prevention of UGI cancers. Pooling the findings from two studies assessing diet quality based on HEI [ 6 , 12 ] revealed the preventive effect of high diet quality on UGI cancers.…”

Dietary patterns and oesophageal squamous cell carcinoma: a systematic review and meta-analysis

“…The complicate interaction of dietary components has promoted the adoption of comprehensive methods to derive dietary patterns. Some priori techniques related to dietary index were adopted to describe dietary patterns (Bosetti et al , 2003; Jessri et al , 2011), but these techniques based on the previous knowledge may not reflect the current status (Reedy et al , 2010). The dietary patterns derived from the posteriori method, such as cluster analysis, factor analysis, and principal component analysis, aggregate variables into the factors representing broad eating patterns of specific population (Reedy et al , 2010).…”