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Leone A, De la Fuente-Arrillaga C, Mas MV, Sayon-Orea C, Menichetti F, Martínez-Gonzalez MA, Bes-Rastrollo M. Association between the consumption of ultra-processed foods and the incidence of peptic ulcer disease in the SUN project: a Spanish prospective cohort study. Eur J Nutr 2024:10.1007/s00394-024-03439-2. [PMID: 38809325 DOI: 10.1007/s00394-024-03439-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/14/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE Consumption of ultra-processed foods (UPF) has increased despite potential adverse health effects. Recent studies showed an association between UPF consumption and some gastrointestinal disorders. We evaluated the association between UPF consumption and peptic ulcer disease (PUD) in a large Spanish cohort. METHODS We conducted a prospective analysis of 18,066 participants in the SUN cohort, followed every two years. UPF was assessed at baseline and 10 years after. Cases of PUD were identified among participants reporting a physician-made diagnosis of PUD during follow-ups. Cases were only partially validated against medical records. Cox regression was used to assess the association between baseline UPF consumption and PUD risk. Based on previous findings and biological plausibility, socio-demographic and lifestyle variables, BMI, energy intake, Helicobacter pylori infection, gastrointestinal disorders, aspirin and analgesic use, and alcohol and coffee consumption were included as confounders.We fitted GEE with repeated dietary measurements at baseline and after 10 years of follow-up. Vanderweele's proposed E value was calculated to assess the sensitivity of observed associations to uncontrolled confounding. RESULTS During a median follow-up of 12.2 years, we recorded 322 new PUD cases (1.56 cases/1000 person-years). Participants in the highest baseline tertile of UPF consumption had an increased PUD risk compared to participants in the lowest tertile (HR = 1.52, 95% CI: 1.15, 2.00, Ptrend=0.002). The E-values for the point estimate supported the observed association. The OR using repeated measurements of UPF intake was 1.39 (95% CI: 1.03, 1.87) when comparing extreme tertiles. CONCLUSION The consumption of UPF is associated with an increased PUD risk.
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Affiliation(s)
- Alessandro Leone
- International Center for the Assessment of Nutritional Status and The Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy.
- Clinical Nutrition Unit, Department of Endocrine and Metabolic Medicine, IRCCS Istituto Auxologico Italiano, Milan, 20100, Italy.
| | - Carmen De la Fuente-Arrillaga
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | - Carmen Sayon-Orea
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Navarra Institute of Public Health, Pamplona, Spain
| | - Francesca Menichetti
- International Center for the Assessment of Nutritional Status and The Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
| | - Miguel Angel Martínez-Gonzalez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
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Joshi DC, Joshi N, Kumar A, Maheshwari S. Recent Advances in Molecular Pathways and Therapeutic Implications for Peptic Ulcer Management: A Comprehensive Review. Horm Metab Res 2024. [PMID: 38467155 DOI: 10.1055/a-2256-6592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Peptic ulcers, recognized for their erosive impact on the gastrointestinal mucosa, present a considerable challenge in gastroenterology. Epidemiological insights underscore the global prevalence of peptic ulcers, affecting 5-10+% of individuals, with a yearly incidence of 0.3 to 1.9 cases per thousand. Recent decades have witnessed a decline in complications, attributed to improved diagnostics and therapeutic advancements. The review deepens into H. pylori-associated and NSAID-induced ulcers, emphasizing their distinct prevalence in developing and industrialized nations, respectively. Despite advancements, managing peptic ulcers remains challenging, notably in H. pylori-infected individuals facing recurrence and the rise of antibiotic resistance. The pathophysiology unravels the delicate balance between protective and destructive factors, including the intricate molecular mechanisms involving inflammatory mediators such as TNF-α, ILs, and prostaglandins. Genetic and ethnic factors, rare contributors, and recent molecular insights further enhance our understanding of peptic ulcer development. Diagnostic approaches are pivotal, with upper gastrointestinal endoscopy standing as the gold standard. Current treatment strategies focus on H. pylori eradication, NSAID discontinuation, and proton pump inhibitors. Surgical options become imperative for refractory cases, emphasizing a comprehensive approach. Advances include tailored H. pylori regimens, the emergence of vonoprazan, and ongoing vaccine development. Challenges persist, primarily in antibiotic resistance, side effects of acid suppressants, and translating natural compounds into standardized therapies. Promising avenues include the potential H. pylori vaccine and the exploration of natural compounds, with monoterpenes showing therapeutic promise. This review serves as a compass, guiding healthcare professionals, researchers, and policymakers through the intricate landscape of peptic ulcer management.
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Affiliation(s)
- Deepak Chandra Joshi
- Department of Pharmacy, School of Chemical Sciences and Pharmacy, Central University of Rajasthan, Ajmer, India
| | - Nirmal Joshi
- Department of Pharmacology, Amrapali Institute of Pharmacy and Sciences, Haldwani, India
| | - Ajeet Kumar
- Faculty of Pharmaceutical Sciences, Rama University, Kanpur, India
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Pelucchi C, La Vecchia C, Bonzi R, Negri E, Corso G, Boccia S, Boffetta P, Camargo MC, Curado MP, Lunet N, Vioque J, Zhang ZF. The global gastric cancer consortium: an update from the Stomach cancer Pooling (StoP) project. Eur J Cancer Prev 2024:00008469-990000000-00130. [PMID: 38373049 DOI: 10.1097/cej.0000000000000874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
We updated to December 2023 the main findings of the stomach cancer pooling (StoP) project including about 13 000 cases and 31 000 controls from 29 case-control and 5 nested studies. The StoP project quantified more precisely than previously available the positive associations of tobacco smoking, high alcohol consumption, meat intake, selected occupations (e.g. agricultural and miners), gastric ulcer and family history with gastric cancer and the inverse associations with socioeconomic status and selected aspects of diet (fruits, including citrus fruits, vegetables, including allium and mushrooms, and polyphenols). No consistent associations were found with coffee, yoghurt and leisure-time physical activity, metformin or proton pump inhibitors use.
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Affiliation(s)
- Claudio Pelucchi
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology 'G.A. Maccacaro', Università degli Studi di Milano, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology 'G.A. Maccacaro', Università degli Studi di Milano, Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology 'G.A. Maccacaro', Università degli Studi di Milano, Milan, Italy
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Corso
- Division of Breast Surgery, IEO European Institute of Oncology IRCCS
- European Cancer Prevention Organization (ECP)
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Stefania Boccia
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brasil
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR)
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Jesus Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), Alicante, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
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de Araújo Fagundes M, Alves Carnauba R, Fernandes GA, Pimentel de Assumpção P, Curado MP. Polyphenol intake and gastric cancer: A case-control study in the Brazilian Amazon region. Cancer Epidemiol 2024; 88:102518. [PMID: 38171205 DOI: 10.1016/j.canep.2023.102518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Polyphenol intake has been associated with a decreased risk of some types of cancer, including gastric cancer (GC). However, few studies address this topic in the Latin American population. In the present study, we evaluated the association between polyphenol intake and the risk of GC in the Brazilian Amazon region. METHODS A case-control study was conducted in Belém (Amazon region) from July 2017 to February 2021. A total of 193 GC cases and 194 controls of both sexes, between 18 and 75 years old, were included in the study. Dietary data were collected using a validated food-frequency questionnaire and polyphenol intake identified using the Phenol-Explorer database. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI), with adjustement for potential confounders. RESULTS Cases and controls had similar total polyphenol intake (356.4 mg/1000 kcal/d and 331.1 mg/1000 kcal/d, respectively; p = 0.086). After adjusting for potential confounders, high consumption of flavan-3-ols (highest vs. lowest tertile: OR 0.41, 95% CI 0.18-0.94) and hydroxybenzoic acids (highest vs. lowest tertile: OR 0.24, 95% CI 0.10-0.56) was associated with a decreased risk of GC. The opposite was true regarding the intake of flavones (OR 2.46, 95% IC 1.17-5.18) and other polyphenols (OR 2.54, 95% IC 1.16-5.54). When stratifying according to anatomical topography, we observed that the intake of total flavonoids, flavan-3-ols, and flavanones reduced the risk of cardia GC while that of hydroxybenzoic acids reduced the risk of non-cardia GC. In addition, the intake of flavones and other polyphenols was associated with an increased risk of non-cardia GC. According to histologic subtypes, hydroxybenzoic acid intake was associated with a reduced risk of intestinal-type GC (OR 0.21, 95% IC 0.07-0.64), while flavone consumption was associated with an increased risk of diffuse-type GC (OR 2.59, 95% IC 1.05-6.42). CONCLUSIONS Our findings suggest that in the Brazilian Amazon region the high intake of flavan-3-ols and hydroxybenzoic acids is associated with a reduced risk of GC, suggesting a potential beneficial role of these compounds against GC.
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Affiliation(s)
| | - Renata Alves Carnauba
- Department of Food Science and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-000, Brazil; Food Research Center, CEPID-FAPESP (Research Innovation and Dissemination Centers, São Paulo Research Foundation), São Paulo 05508-080, Brazil
| | - Gisele Aparecida Fernandes
- Postgraduate Program in Oncology, A.C. Camargo Cancer Center, São Paulo 01509-900, Brazil; Group of Epidemiology and Statistics on Cancer, International Research Center, A.C. Camargo Cancer Center, São Paulo 01508-010, Brazil
| | | | - Maria Paula Curado
- Postgraduate Program in Oncology, A.C. Camargo Cancer Center, São Paulo 01509-900, Brazil; Group of Epidemiology and Statistics on Cancer, International Research Center, A.C. Camargo Cancer Center, São Paulo 01508-010, Brazil
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Grantham T, Ramachandran R, Parvataneni S, Budh D, Gollapalli S, Gaduputi V. Epidemiology of Gastric Cancer: Global Trends, Risk Factors and Premalignant Conditions. J Community Hosp Intern Med Perspect 2023; 13:100-106. [PMID: 38596548 PMCID: PMC11000854 DOI: 10.55729/2000-9666.1252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 04/11/2024] Open
Abstract
This review article aims to provide a comprehensive overview of recent epidemiology, pathogenesis, risk factors, and premalignant conditions of gastric cancer. Worldwide, gastric cancer is one of the most common and most fatal cancers. The incidence and mortality remain high in regions such as East Asia and Eastern Europe. Although there is a lower incidence in the United States, it remains a deadly disease. Age, gender, and race are non-modifiable demographic risk factors for developing gastric cancer. There have been several dietary and lifestyle risk factors such as salt preserved foods, N-nitroso compounds containing foods, tobacco smoke, alcohol use, and obesity that have been shown to contribute to the development of gastric cancer. Infections have additionally been shown to have a clear role in the pathogenesis of gastric cancer as Helicobacter pylori eradication has shown a significant reduction in the incidence of gastric cancer as well as other pathogens such as Epstein-Barr virus. There are certain premalignant lesions that increase the risk of developing gastric cancer. These include atrophic gastritis, and intestinal metaplasia amongst others.
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Affiliation(s)
- Tyler Grantham
- Department of Internal Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305,
USA
| | | | - Swetha Parvataneni
- Department of Internal Medicine, Geisinger Lewistown Hospital, 400 Highland Ave, Lewistown, PA 17044,
USA
| | - Deepa Budh
- Department of Internal Medicine, St. Barnabas Hospital, 4422 3rd Avenue, Bronx, NY 10457,
USA
| | - Sindhu Gollapalli
- Department of Internal Medicine, St. Barnabas Hospital, 4422 3rd Avenue, Bronx, NY 10457,
USA
| | - Vinaya Gaduputi
- Department of Gastroenterology, Blanchard Valley Health System, 1900 S Main St, Findlay, OH 45840,
USA
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Kayali S, Marabotto E, Giannini E. Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention. Cancers (Basel) 2023; 15:4634. [PMID: 37760605 PMCID: PMC10527399 DOI: 10.3390/cancers15184634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Gastrointestinal tract cancers, including oral, oesophageal, stomach, liver, pancreas, and colorectal cancers, represent a significant worldwide health concern [...].
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Affiliation(s)
- Stefano Kayali
- Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, 16132 Genoa, Italy; (E.M.); (E.G.)
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
| | - Elisa Marabotto
- Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, 16132 Genoa, Italy; (E.M.); (E.G.)
| | - Edoardo Giannini
- Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, 16132 Genoa, Italy; (E.M.); (E.G.)
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Silva ARC, Guandalini VR, Pereira TSS, Zhao L, Wirth MD, Hébert JR, Fernandes GA, de Assumpção PP, Barbosa MS, Curado MP. Association between Dietary Inflammatory Index and Gastric Adenocarcinoma: A Multicenter Case-Control Study in Brazil. Nutrients 2023; 15:2867. [PMID: 37447193 DOI: 10.3390/nu15132867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 06/18/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Few studies have evaluated the association between diet-related inflammation and gastric adenocarcinoma (GA) and evidence is scarce in Brazil. This study evaluated the association between a pro-inflammatory diet and GA. METHODS A multicenter case-control study was conducted in Brazil. A total of 1645 participants-492 cases, 377 endoscopy controls, and 776 hospital controls-were included. Energy-adjusted Dietary Inflammatory Index (E-DIITM) scores were derived from a validated food frequency questionnaire. We used binary and multinomial logistic regression models for the analysis of total GA, and its subtypes (cardia and non-cardia, intestinal, and diffuse histological subtypes). RESULTS In cases versus endoscopy controls, a pro-inflammatory diet, estimated by higher E-DII scores, was associated with a higher risk GA (ORQ4vsQ1: 2.60, 1.16-5.70), of non-cardia GA (OR: 2.90, 1.06-7.82), and diffuse subtype (OR: 3.93, 1.59-9.70). In cases versus hospital controls, higher E-DII scores were associated with a higher risk of GA (OR: 2.70, 1.60-4.54), of cardia GA (OR: 3.31, 1.32-8.24), non-cardia GA (OR: 2.97, 1.64-5.39), and both intestinal (OR: 2.82, 1.38-5.74) and diffuse GA (OR: 2.50, 1.54-5.11) subtypes. CONCLUSIONS This study provides evidence that a pro-inflammatory diet is associated with an increased risk of GA in Brazil. E-DII requires the inclusion of sodium due to its importance in carcinogenesis.
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Affiliation(s)
| | - Valdete Regina Guandalini
- Postgraduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Vitória 29047-105, Brazil
- Department of Integrated Education, Health Sciences Center, Federal University of Espírito Santo, Vitória 29047-105, Brazil
| | | | - Longgang Zhao
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
- College of Nursing, University of South Carolina, Columbia, SC 29208, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
| | - Gisele Aparecida Fernandes
- Postgraduate Program in Oncology, A.C. Camargo Cancer Center, São Paulo 01509-900, Brazil
- Group of Epidemiology and Statistics on Cancer, International Research Center, A.C. Camargo Cancer Center, São Paulo 01508-010, Brazil
| | | | - Mônica Santiago Barbosa
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia 74605-050, Brazil
| | - Maria Paula Curado
- Postgraduate Program in Oncology, A.C. Camargo Cancer Center, São Paulo 01509-900, Brazil
- Group of Epidemiology and Statistics on Cancer, International Research Center, A.C. Camargo Cancer Center, São Paulo 01508-010, Brazil
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