High adherence to the Western, Prudent, and Mediterranean dietary patterns and risk of gastric adenocarcinoma: MCC-Spain study

  • Adela Castelló
  • Nerea Fernández de Larrea
  • Vicente Martín
  • Verónica Dávila-Batista
  • Elena Boldo
  • Marcela Guevara
  • Víctor Moreno
  • Gemma Castaño-Vinyals
  • Inés Gómez-Acebo
  • Guillermo Fernández-Tardón
  • Rosana Peiró
  • Rocío Olmedo-Requena
  • Rocio Capelo
  • Carmen Navarro
  • Silvino Pacho-Valbuena
  • Beatriz Pérez-Gómez
  • Manolis Kogevinas
  • Marina Pollán
  • Nuria Aragonés
  • On behalf of the MCC-Spain researchers
Original Article

Abstract

Background

The influence of dietary habits on the development of gastric adenocarcinoma is not clear. The objective of the present study was to explore the association of three previously identified dietary patterns with gastric adenocarcinoma by sex, age, cancer site, and morphology.

Methods

MCC-Spain is a multicase–control study that included 295 incident cases of gastric adenocarcinoma and 3040 controls. The association of the Western, Prudent, and Mediterranean dietary patterns—derived in another Spanish case–control study—with gastric adenocarcinoma was assessed using multivariable logistic regression models with random province-specific intercepts and considering a possible interaction with sex and age. Risk according to tumor site (cardia, non-cardia) and morphology (intestinal/diffuse) was evaluated using multinomial regression models.

Results

A high adherence to the Western pattern increased gastric adenocarcinoma risk [odds ratiofourth_vs._first_quartile (95% confidence interval), 2.09 (1.31; 3.33)] even at low levels [odds ratiosecond_vs._first_quartile (95% confidence interval), 1.63 (1.05; 2.52)]. High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma [odds ratiofourth_vs._first_quartile (95% confidence interval), 0.53 (0.34; 0.82)]. Although no significant heterogeneity of effects was observed, the harmful effect of the Western pattern was stronger among older participants and for non-cardia adenocarcinomas, whereas the protective effect of the Mediterranean pattern was only observed among younger participants and for non-cardia tumors.

Conclusion

Decreasing the consumption of fatty and sugary products and of red and processed meat in favor of an increase in the intake of fruits, vegetables, legumes, olive oil, nuts, and fish might prevent gastric adenocarcinoma.

Keywords

Diet, Mediterranean Diet, Western Stomach neoplasms Adenocarcinoma Prevention and control Principal component analysis Population attributable fraction 

Notes

Funding

The study was supported by the “Acción Transversal del Cáncer,” approved by the Spanish Ministry Council on 11 October 2007, by the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), by the Instituto de Salud Carlos III grants, co-funded by FEDER funds: a way to build Europe-PI08/1770 (to M. Kogevinas), PI09/0773 (to J. Llorca), PI09/1286 (to V. Martín), PI09/1903 (to R. Peiró), PI09/2078 (to F.J. Caballero), PI09/1662 (to J.J. Jiménez-Moleón), PI11/01403 (to N. Aragonés), and PI12/00150 (to B. Pérez-Gómez), by the Fundación Marqués de Valdecilla grant API 10/09 (to J. Llorca), by Catalan Government DURSI grant 2014SGR647 (to V. Moreno) and 2014SGR756 (to S. de Sanjose), by the Junta de Castilla y León Grant LE22A10-2 (to V. Martín), by the Consejería de Salud of the Junta de Andalucía Grant 2009-S0143 (to J. Alguacil), by the Conselleria de Sanitat of the Generalitat Valenciana grant AP061/10 (to R. Peiró), by the Regional Government of the Basque Country, by the Consejería de Sanidad de la Región de Murcia, by the Fundación Caja de Ahorros de Asturias, by the University of Oviedo, by the Spanish Association Against Cancer (AECC) Scientific Foundation, and by the Spanish Ministry of Economy and Competitiveness Juan de la Cierva de Incorporación Grant IJCI-2014-20900 (to A. Castelló). None of the sponsors intervened in any stage of the research.

Compliance with ethical standards

Conflict of interest

The authors do not have conflicts of interest in connection with this paper.

Ethical statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute for it was obtained from all patients for being included in the study.

Supplementary material

10120_2017_774_MOESM1_ESM.docx (19 kb)
Table S1. Sensitivity analysis to choose the most adequate model to explore the association between gastric adenocarcinoma incidence and scores of adherence to Western, Prudent, and Mediterranean dietary patterns. (DOCX 18 kb)

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2017

Authors and Affiliations

  • Adela Castelló
    • 1
    • 2
    • 3
  • Nerea Fernández de Larrea
    • 1
    • 2
  • Vicente Martín
    • 4
  • Verónica Dávila-Batista
    • 4
  • Elena Boldo
    • 1
    • 2
  • Marcela Guevara
    • 2
    • 5
  • Víctor Moreno
    • 2
    • 6
    • 7
  • Gemma Castaño-Vinyals
    • 2
    • 8
    • 9
    • 10
  • Inés Gómez-Acebo
    • 11
  • Guillermo Fernández-Tardón
    • 12
  • Rosana Peiró
    • 2
    • 13
  • Rocío Olmedo-Requena
    • 2
    • 14
    • 15
  • Rocio Capelo
    • 16
  • Carmen Navarro
    • 2
    • 17
    • 18
  • Silvino Pacho-Valbuena
    • 19
  • Beatriz Pérez-Gómez
    • 1
    • 2
  • Manolis Kogevinas
    • 2
    • 8
    • 9
    • 10
  • Marina Pollán
    • 1
    • 2
  • Nuria Aragonés
    • 1
    • 2
  • On behalf of the MCC-Spain researchers
  1. 1.Cancer Epidemiology Unit, National Centre for Epidemiology, Instituto de Salud Carlos IIIMadridSpain
  2. 2.Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of HealthMadridSpain
  3. 3.Faculty of MedicineUniversity of AlcaláAlcalá de HenaresSpain
  4. 4.The Research Group in Gene-Environment and Health Interactions, Vegazana CampusUniversity of LeónLeónSpain
  5. 5.Public Health Institute of Navarra, IdiSNAPamplonaSpain
  6. 6.Department of Clinical Sciences, Faculty of MedicineUniversity of Barcelona, Campus de BellvitgeL’Hospitalet de LlobregatSpain
  7. 7.Unit of Biomarkers and Susceptibility, Cancer Prevention and Control ProgramCatalan Institute of Oncology (ICO), IDIBELLL’Hospitalet de LlobregatSpain
  8. 8.ISGlobal, Centre for Research in Environmental Epidemiology (CREAL)BarcelonaSpain
  9. 9.Universitat Pompeu Fabra (UPF)BarcelonaSpain
  10. 10.IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
  11. 11.Universidad de Cantabria-IDIVALSantanderSpain
  12. 12.IUOPA, University of OviedoOviedoSpain
  13. 13.Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana FISABIO-Salud PúblicaValenciaSpain
  14. 14.Department of Preventive Medicine and Public HealthUniversity of GranadaGranadaSpain
  15. 15.Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de GranadaGranadaSpain
  16. 16.Centro de Investigación en Salud y Medio Ambiente (CYSMA)Universidad de HuelvaHuelvaSpain
  17. 17.Department of EpidemiologyMurcia Regional Health Council, IMIB-ArrixacaMurciaSpain
  18. 18.Department of Health and Social SciencesUniversidad de MurciaMurciaSpain
  19. 19.Servicio de Cirugía General, Complejo Asistencial Universitario de LeónLeónSpain

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