Macronutrients Intake and Stomach Cancer Risk in Iran: A Hospital-based Case-Control Study

Abstract

Background: Stomach cancer (SC) is one of the most common cancers in the world. Dietary risk factors of SC are not fully understood. This study aimed to investigate the association between macronutrient intakes and the risk of SC. Study design: A hospital-based case-control study. Methods: The data were obtained from a hospital-based case-control study conducted at the Cancer Institute of Iran from 2010 to 2012. Patients were 40 years or older and were diagnosed with SC in less than one year with no history of any cancers. On the other hand, the controls were healthy subjects who were caregivers or visitors of the patients. Demographic characteristics were collected using a structured questionnaire through face to face interviews by trained interviewers. Dietary data were obtained using a validated Diet History Questionnaire. The age and gender-adjusted odds ratios (ORs), as well as the adjusted ORs of age, gender, energy, education, smoking, and body mass index, were reported for continuous and tertiles of intakes. Results: Totally, 207 SC patients and 217 controls participated in this study. In the full adjusted model, after comparing the highest tertiles to the lowest ones, the intake of sucrose (OR: 2.94; 95% CI: 1.66-5.19; P-trend<0.001), protein (OR: 2.04; 95% CI: 1.17-3.55; P-trend=0.011), cholesterol (OR: 2.22; 95% CI: 1.28-3.85; P-trend=0.005), and percent of calories from protein (OR: 3.09; 95% CI: 1.69-5.61; P-trend<1.001) showed a positive significant association with SC. Moreover, a significantly negative association was found between the percent of calories obtained from carbohydrates and SC (OR: 0. 57; 95% CI: 0.33-0.98; P-trend=0.015). Conclusion: The findings in this study showed that macronutrient intakes might be associated with the etiology of SC in Iran.

Macronutrients Intake and Risk of Stomach Cancer: Findings from Case-Control Study

“…Higher fat consumption in the case group in the present study could also be related to increased intake of saturated fats that constituted 27% of total fats. Saturated fats are known to be strong predictors of GC [17,[20][21][22]36,45] as observed in our study and were found to stimulate tumorigenesis at the molecular level [48].…”

“…Elevated intakes of polyunsaturated fats, specifically omega-6 fatty acids, increased GC risk in the present study. Previous findings on the effects of polyunsaturated fats on GC risk are contradictory, whereby positive [48], negative [25,45], and no associations [36] were observed. Discrepancies could be related to the source of omega-6 fatty acids and whether it is heat-treated.…”

“…Odds ratios (ORs) and 95% confidence intervals (95% CIs) for GC were calculated using a multinomial logistic regression mode according to tertile of energy and energy adjusted macronutrient intakes, with the lowest tertile as the reference group. Potential confounders (age, gender, marital status, education, BMI, smoking, period of smoking, family history of gastric cancer, presence of gastric ulcer, and physical activity (MET-min/week)) were selected based on reported risk factors for GC in previous studies [36,43,44]. p-value for trend was calculated using linear logistic regression model.…”

“…Additionally, our results showed that increased consumption of monounsaturated fats was positively associated with GC risk. Few studies in the literature have examined the link between intakes of monounsaturated fats and GC, and thus, far findings are inconsistent, revealing either positive [25], negative [48], or no association [36,45]. The study conducted in Mexico by Lo'pez-Carrillo et al [25] found a positive association: monounsaturated fat intake was mainly derived from poultry, meat, and milk, all of which are foods from animal sources known to increase the risk of GC [16].…”

“…In summary, and in view of these conflicting results [17,20,[34][35][36], we aimed in the present study to give further understanding into the association between stomach cancer risk and the intake of macronutrients in a case-control study conducted in Jordan, where dietary intake was assessed using a reliable and valid food frequency questionnaire (FFQ).…”