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Examination of Daily Diet and Nutritional Risk Factors for Gastric Cancer Incidence Using a Food Frequency Questionnaire in a Japanese Population

Authors
Ayaka Takasu1,2, Takuji Gotoda2, Sho Suzuki3, Chika Kusano4, Chiho Goto5, Hideaki Ishikawa6, Hirohumi Kogure1

Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo
  2. Department of Gastroenterology, Cancer Institute Hospital, Tokyo
  3. Department of Gastroenterology, International University of Health and Welfare Ichikawa Hospital, Chiba
  4. Department of Gastroenterology, Kitasato University School of Medicine, Kanagawa, Japan
  5. Department of Health and Nutrition, Nagoya Bunri University, Aichi
  6. Department of Molecular-Targeting Prevention, Kyoto Prefectural University of Medicine, Osaka

Introduction
Nutritional factors contributing to gastric cancer (GC) are not fully understood. This study aimed to evaluate the impact of nutrient intake on GC incidence.

Methods
This was a post hoc analysis of a prospective trial that evaluated modalities for GC screening in participants aged 30 to 74 years living in high-risk areas for GC in Japan between June 2011 and March 2013. They were followed up for GC incidence for 6 years. All participants completed a self-administered food frequency questionnaire (FFQ) upon enrollment before GC screening. Daily nutrient intake was calculated from the FFQ and dichotomized at each cutoff value using receiver operating characteristic analysis. Risk factors associated with GC incidence were investigated in terms of nutrient intake and participant characteristics using Cox proportional hazards regression analysis.

This post hoc analysis was based on a prospective trial assessing GC screening methods among participants aged 30 to 74 years in high-risk area for GC in Japan between June 2011 and March 2013. Participants were followed up for GC incidence over 6 years. At enrollment, they completed a self-administered food frequency questionnaire (FFQ). Daily nutrient intake was calculated from the FFQ and dichotomized using receiver operating characteristic analysis. Cox proportional hazards regression analysis was used to investigate the association between nutrient intake, participant characteristics, and GC incidence.

Results
The analysis included 1,147 participants with a median age of 62 years; 50.7% were men. The median follow-up period was 2,184 days. During follow-up, 25 participants developed GC. Multivariate analysis showed that high sodium intake (adjusted hazards ratio [aHR], 3.905; 95% CI, 1.520 to 10.035; p=0.005) and vitamin D intake (aHR, 2.747; 95% CI, 1.111 to 6.788; p=0.029) were significantly associated with increased GC incidence. Conversely, high soluble dietary fiber intake was inversely associated with GC incidence (aHR, 0.104; 95% CI, 0.012 to 0.905; p=0.040).

Conclusion
Daily high intake of sodium and vitamin D and low soluble dietary fiber intake are associated with GC incidence.