Dietary Antioxidants, Fruits, and Vegetables and the Risk of Barrett's Esophagus

Abstract

OBJECTIVE The present study evaluated the associations between antioxidants, fruit and vegetable intakes and the risk of Barrett’s esophagus, a potential precursor to esophageal adenocarcinoma. METHODS We conducted a case-control study within the Kaiser Permanente Northern California population. Incident Barrett’s esophagus cases (n=296) were matched to persons with gastroesophageal reflux disease (GERD) (GERD controls, n=308) and to population controls (n=309). Nutrient intake was measured using a validated 110-item food frequency questionnaire. The antioxidant results were stratified by dietary vs. total intake of antioxidants. RESULTS Comparing cases to population controls, dietary intake of vitamin C and beta-carotene were inversely associated with the risk of Barrett’s esophagus [4th vs. 1st quartile, adjusted odds ratio [OR]=0.48 95% confidence interval [CI] (0.26–0.90); OR=0.56 95%CI(0.32–0.99), respectively], and the inverse association was strongest for vitamin E [OR=0.25 95%CI (0.11–0.59)]. The inverse trends for antioxidant index (total and dietary) and fruit and vegetable intake were statistically significant, while most total intakes were not associated with reduced risk. The use of antioxidant supplements did not influence the risk of Barrett’s esophagus, and antioxidants and fruits and vegetables were inversely associated with a GERD diagnosis. CONCLUSION Dietary antioxidants, fruit and vegetable are inversely associated with the risk of Barrett’s esophagus, while no association was observed for supplement intake. Our results suggest that fruits and vegetables themselves or associated undetected confounders may influence early events in the carcinogenesis of esophageal adenocarcinoma.

Barrett's Esophagus and β-carotene Therapy: Symptomatic Improvement in GERD and Enhanced HSP70 Expression in Esophageal Mucosa

“…This histological improvement supported disappearance and/ or alleviation of symptoms in these patients. Our finding is in contrast to earlier case-control reports by Kubo et al (2008) and Murphy et al (2010) where the intake of antioxidant supplements assessed by food-frequency questionnaire did not appear to influence the risk of Barrett's esophagus. Kubo reported dietary intake of β-carotene was inversely associated with the risk of BE (adjusted OR=0.48 and 95%CI=026-0.90), while no association was observed for supplement intake (Kubo, 2008).…”

“…Our finding is in contrast to earlier case-control reports by Kubo et al (2008) and Murphy et al (2010) where the intake of antioxidant supplements assessed by food-frequency questionnaire did not appear to influence the risk of Barrett's esophagus. Kubo reported dietary intake of β-carotene was inversely associated with the risk of BE (adjusted OR=0.48 and 95%CI=026-0.90), while no association was observed for supplement intake (Kubo, 2008). In contrast to this epidemiological study, in our study a specific amount of β-carotene was administered for six-months and endoscopic, histological markers of Barrett's were objectively measured.…”

Understanding the association between diet and nutrition in upper gastrointestinal cancer

“…However, subsequent systematic reviews continue to show a protective role of fruits against gastric cancer [9], and both fruits and vegetables against ESCC [10] and EAC [11]. Importantly, given the growing importance of EAC, there is some evidence that the risk of its precursor lesion, Barrett's esophagus, is also inversely related to fruit and vegetable intake [12,13]. A recent study of patients referred for gastroesophageal endoscopy showed that adherence to WCRF guidelines on diet and exercise, previously shown to be protective against gastric and esophageal cancers amongst others [14], was also associated with a lower risk of both Barrett's esophagus and its progression to EAC [15].…”

Place de la surveillance endoscopique de l’œsophage de Barrett

“…Quand un OB est diagnostiqué, les facteurs prédictifs reconnus d'évolution vers le cancer sont le sexe masculin, la longueur de l'OB, un régime alimentaire pauvre en fruits et légumes, et riche en graisse, le tabagisme et l'obésité [6][7][8]. Les facteurs protecteurs décrits seraient un régime alimentaire riche en fruits et légumes [9], et de manière étonnante une infection gastrique à Helicobacter pylori [10].…”