Exploring the Link Between Dietary Patterns and Gastric Adenocarcinoma in Brazil: a Mediation Analysis

Overview

Journal BMC Med

Publisher Biomed Central

Specialty General Medicine

Date 2024 Nov 28

PMID 39609810

Authors

Alex Richard Costa Silva

Gianfranco Alicandro

Valdete Regina Guandalini

Patricia Paula da Fonseca Grili

Paulo Pimentel Assumpcao

Monica Santiago Barbosa

Rosane Oliveira de SantAna

Felipe Jose Fernandez Coimbra

Maria Paula Curado

Affiliations

Soon will be listed here.

Abstract

Background: The causal pathway between different dietary patterns (DPs) and gastric adenocarcinoma (GA) remains largely unexplored. The study aimed to identify DPs and evaluate how selected nutrients mediate the relationship between DPs and GA.

Methods: This multicenter case-control study in Brazil involved 1751 participants (600 cases, 377 endoscopic controls, and 774 hospital controls). DPs were identified through exploratory factor analysis. A counterfactual-based mediation analysis was performed to decompose the total effect of DPs on GA into direct and indirect effects mediated by saturated fatty acids, added sugars, total fiber, and sodium intakes. Effects were expressed as ORs and 95% CIs.

Results: Two DPs were identified-"unhealthy dietary pattern" (UDP) and "healthy dietary pattern" (HDP), which were associated with an increased and decreased risk of GA, respectively. Added sugars partly mediated the association between UDP and GA (percentage mediated between 7.3 and 21.7%), while sodium intake mediated most of the association between HDP and GA (percentage mediated between 52.4 and 100%). No significant mediating effects were detected for saturated fatty acids and total fiber.

Conclusions: This study contributes innovative insights into the DPs-GA relationships, highlighting the significant mediating roles of sodium and added sugars, offering valuable information for preventive strategies and public health interventions targeting GA.

Citing Articles

Mala flavor preference increases risk of excessive gestational weight gain mediated by high-carbohydrate dietary patterns in Chongqing, China: an ambispective cohort study.

Li J, Wang D, Mao Y, Zhang W, Zhu Q, Liu J Front Nutr. 2025; 11():1464748.

PMID: 39839299 PMC: 11747814. DOI: 10.3389/fnut.2024.1464748.

References

Alagesan P, Goodwin J, Garman K, Epplein M . Cancer Progress and Priorities: Gastric Cancer. Cancer Epidemiol Biomarkers Prev. 2023; 32(4):473-486. PMC: 10071414. DOI: 10.1158/1055-9965.EPI-22-0994. View

Stefani E, Correa P, Boffetta P, Deneo-Pellegrini H, Ronco A, Mendilaharsu M . Dietary patterns and risk of gastric cancer: a case-control study in Uruguay. Gastric Cancer. 2004; 7(4):211-20. DOI: 10.1007/s10120-004-0295-2. View

Serrano D, Pozzi C, Guglietta S, Fosso B, Suppa M, Gnagnarella P . Microbiome as Mediator of Diet on Colorectal Cancer Risk: The Role of Vitamin D, Markers of Inflammation and Adipokines. Nutrients. 2021; 13(2). PMC: 7911673. DOI: 10.3390/nu13020363. View

Maimaitiyiming M, Yang H, Zhou L, Zhang X, Cai Q, Wang Y . Associations between an obesity-related dietary pattern and incidence of overall and site-specific cancers: a prospective cohort study. BMC Med. 2023; 21(1):251. PMC: 10332028. DOI: 10.1186/s12916-023-02955-y. View

Wang N, Liu F, Chen Y, Xie M, Gao B, Qiu Y . The role of rare earth elements and dietary intake in tongue cancer: a mediation analysis in southeast China. Front Public Health. 2023; 11:1058013. PMC: 10169683. DOI: 10.3389/fpubh.2023.1058013. View

Ilic M, Ilic I . Epidemiology of stomach cancer. World J Gastroenterol. 2022; 28(12):1187-1203. PMC: 8968487. DOI: 10.3748/wjg.v28.i12.1187. View

de Lolio C, De Souza J, Santo A, Buchalla C . [Smoking prevalence in the urban locality of southeastern Brazil]. Rev Saude Publica. 1993; 27(4):262-5. DOI: 10.1590/s0034-89101993000400005. View

Luo M, Shu L, Ye X . Association between priori and posteriori dietary patterns and gastric cancer risk: an updated systematic review and meta-analysis of observational studies. Eur J Cancer Prev. 2024; 34(2):157-172. PMC: 11781554. DOI: 10.1097/CEJ.0000000000000900. View

Denova-Gutierrez E, Hernandez-Ramirez R, Lopez-Carrillo L . Dietary patterns and gastric cancer risk in Mexico. Nutr Cancer. 2014; 66(3):369-76. DOI: 10.1080/01635581.2014.884237. View

10.

Boffetta P, GARFINKEL L . Alcohol drinking and mortality among men enrolled in an American Cancer Society prospective study. Epidemiology. 1990; 1(5):342-8. DOI: 10.1097/00001648-199009000-00003. View

11.

Hui Y, Tu C, Liu D, Zhang H, Gong X . Risk factors for gastric cancer: A comprehensive analysis of observational studies. Front Public Health. 2023; 10:892468. PMC: 9845896. DOI: 10.3389/fpubh.2022.892468. View

12.

Thrift A, Wenker T, El-Serag H . Global burden of gastric cancer: epidemiological trends, risk factors, screening and prevention. Nat Rev Clin Oncol. 2023; 20(5):338-349. DOI: 10.1038/s41571-023-00747-0. View

13.

Campbell P, Sloan M, Kreiger N . Dietary patterns and risk of incident gastric adenocarcinoma. Am J Epidemiol. 2007; 167(3):295-304. DOI: 10.1093/aje/kwm294. View

14.

Santiago S, Sousa G, Ramos A, Fernandes G, Curado M, Barbosa M . EXPLORATORY ANALYSIS OF DIETARY PATTERNS OF PATIENTS WITH GASTRIC ADENOCARCINOMA: A CASE-CONTROL STUDY IN CENTRAL BRAZIL. Arq Gastroenterol. 2023; 60(4):419-430. DOI: 10.1590/S0004-2803.230402023-67. View

15.

Felix P, de Castro M, Nogueira-de-Almeida C, Fisberg M . Prevalence of Excess Sodium Intake and Their Corresponding Food Sources in Adults from the 2017-2018 Brazilian National Dietary Survey. Nutrients. 2022; 14(19). PMC: 9571186. DOI: 10.3390/nu14194018. View

16.

Abd Rashid A, Ashari L, Shafiee N, Ali R, Yeong Yeh L, Shahril M . Dietary patterns associated with colorectal cancer risk in the Malaysian population: a case-control study with exploratory factor and regression analysis. BMC Public Health. 2023; 23(1):1386. PMC: 10354999. DOI: 10.1186/s12889-023-16283-6. View

17.

Stefani E, Deneo-Pellegrini H, Boffetta P, Ronco A, Aune D, Acosta G . Dietary patterns and risk of cancer: a factor analysis in Uruguay. Int J Cancer. 2008; 124(6):1391-7. DOI: 10.1002/ijc.24035. View

18.

Pu K, Feng Y, Tang Q, Yang G, Xu C . Review of dietary patterns and gastric cancer risk: epidemiology and biological evidence. Front Oncol. 2024; 14:1333623. PMC: 10912593. DOI: 10.3389/fonc.2024.1333623. View

19.

Morales-Berstein F, Biessy C, Viallon V, Goncalves-Soares A, Casagrande C, Hemon B . Ultra-processed foods, adiposity and risk of head and neck cancer and oesophageal adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition study: a mediation analysis. Eur J Nutr. 2023; 63(2):377-396. PMC: 10899298. DOI: 10.1007/s00394-023-03270-1. View

20.

Tayyem R, Al-Awwad N, Allehdan S, Ajeen R, Al-Jaberi T, Rayyan Y . Mediterranean Dietary Pattern is Associated with Lower Odds of Gastric Cancer: A Case-Control Study. Cancer Manag Res. 2022; 14:2017-2029. PMC: 9211070. DOI: 10.2147/CMAR.S360468. View