“…The effect of CagA induced chronic atrophic gastritis and decreased secretion of vitamin C into the gastric lumen may explain, in part, the variable efficacy of dietary phytochemicals from fruit and vegetables in prevention studies of gastric dysplasia and adenocarcinoma. There have been positive [ 85 , 145 , 146 , 147 ], negative and equivocal results [ 148 , 149 , 150 , 151 , 152 , 153 ], some of which relate to study power and design, H. pylori virulence, endoscopic assessment, baseline histology, heterogeneity, controlling for other risk factors, assessment of plasma vitamin C status, dietary recall and length of follow-up [ 146 , 147 , 148 , 149 ]. For example, a pooled analysis was performed of 810 prospectively collected non-cardia gastric cancer cases and 1160 matched controls from East Asian countries (Korea, Japan, China), with associated H. pylori CagA status, demographic, lifestyle, smoking and dietary data.…”