Higher glycemic index and glycemic load diet is associated with increased risk of esophageal squamous cell carcinoma: a case-control study.

Several studies have indicated the association between intake of foods high in dietary glycemic index (GI) and glycemic load (GL) with an increased risk of digestive tract cancers. We hypothesized that GI and GL may be associated with risk of esophageal squamous cell carcinoma (ESCC) in a high-risk population in Iran. In total, we interviewed 47 cases with incident of ESCC and 96 frequency-matched hospital controls, then calculated the average dietary GI and GL via a validated food frequency questionnaire. Dietary GL was calculated as a function of GI, carbohydrate content, and frequency of intake of certain foods. Dietary GI and GL levels were significantly higher among the ESCC cases compared with the controls (P < .05). After adjustment for potential confounders, those in the highest tertile of dietary GI had 2.95 times higher risk of ESCC compared with those in the lowest (95% confidence interval, 1.68-3.35; P for trend = .002). In addition, being in the highest tertile of dietary GL was positively associated with an ESCC risk (odds ratio, 3.49; 95% confidence interval, 2.98-4.41; P for trend = .001). Findings of the present study indicate that diets with high GI and GL might have potentially unfavorable effects on ESCC risk and suggest a possible role for excess circulating insulin and related insulin-like growth factor 1 in esophageal cancer development.

Adherence to Mediterranean-style dietary pattern and risk of esophageal squamous cell carcinoma: a case-control study in Iran.

OBJECTIVE: The benefit of adherence to a Mediterranean-style dietary pattern in relation to the risk of esophageal squamous cell carcinoma (ESCC) has not been investigated among non-Mediterranean high-risk populations. The objective of the present study was to examine the association of compliance with the Mediterranean dietary pattern as measured by Mediterranean-Style Dietary Pattern Score (MSDPS) and the risk of ESCC in Iranian population. METHODS: This case-control study was conducted on 47 ESCC cases and 96 hospital controls aged 40-75 years. Participants were interviewed using validated questionnaires, and dietary patterns were characterized using the MSDPS. RESULTS: Generally, the mean MSDPS in this population was low (30.84 ± 8.58). MSDPS showed content validity through having expected positive associations with several lifestyle characteristics and dietary intakes. Being in the highest quartile category of MSDPS, compared to the lowest, was independently associated with 37% reduction in risk of ESCC. Two-unit and 3-unit increases in the MSDPS resulted in 41% and 47% reduction in risk of ESCC, respectively. Higher intakes of olive oil (odds ratio [OR] = 0.15, 95% CI: 0.01-0.49), fish and other seafood (OR = 0.48, 95% CI: 0.23-0.98), whole grain (OR = 0.57, 95% CI: 0.28-0.76), and fruits (OR = 0.77, 95% CI: 0.38-0.86) were significantly associated with reduced ESCC risk. In contrast, higher sweet (OR = 1.86, 95% CI: 1.04-2.12) and meat intakes (OR = 1.61, 95% CI: 1.25-2.49) were associated with higher ESCC risk. CONCLUSION: Consuming a diet in concordance with the principles of the Mediterranean dietary pattern may protect against ESCC. Preventive strategies to reduce ESCC risk in high-risk countries should focus on overall dietary pattern and dietary habits to be effective.

Adherence to dietary recommendations and risk of esophageal squamous cell carcinoma: a case-control study in Iran.

BACKGROUND/AIM: The Dietary Guidelines for Americans Adherence Index (DGAI) 2005 was developed to assess the contribution of dietary patterns to chronic disease risk. The objective of this study was to evaluate the association of dietary patterns as measured by the DGAI 2005 with the esophageal squamous cell carcinoma (ESCC) risk in Iran. METHODS: This case-control study was conducted on 50 ESCC cases and 100 hospital controls aged 40-75 years. Participants were interviewed using validated food frequency questionnaires and the DGAI score was calculated subsequently. RESULTS: Generally, the mean DGAI 2005 score for this population was low (9.54 ± 1.79) and the control group scored significantly higher compared to the ESCC cases (p < 0.001). Being in the highest tertile of DGAI scores reduced the risk of ESCC by 31%. Consumption of salty, peppery, and sour foods in combination increased the ESCC risk by 7.23%, followed by consumption of fried/barbecued meals (OR 3.79; 95% CI 1.10-5.44; p < 0.001) and high-temperature food/beverages (OR 3.68; 95% CI 1.20-8.99; p < 0.001). CONCLUSIONS: Consumption of a diet in accordance with dietary recommendations was associated with a lower risk of ESCC. Preventive strategies to reduce the ESCC risk in high-risk regions of the world should focus on overall dietary patterns and dietary habits in order to be effective.

Macronutrients, vitamins and minerals intake and risk of esophageal squamous cell carcinoma: a case-control study in Iran.

BACKGROUND: Although Iran is a high-risk region for esophageal squamous cell carcinoma (ESCC), dietary factors that may contribute to this high incidence have not been thoroughly studied. The aim of this study was to evaluate the effect of macronutrients, vitamins and minerals on the risk of ESCC. METHODS: In this hospital-based case-control study, 47 cases with incident ESCC and 96 controls were interviewed and usual dietary intakes were collected using a validated food frequency questionnaire. Data were modeled through unconditional multiple logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), controlling for age, sex, gastrointestinal reflux, body mass index, smoking history (status, intensity and duration), physical activity, and education. RESULTS: ESCC cases consumed significantly more hot foods and beverages and fried and barbecued meals, compared to the controls (p < 0.05). After adjusting for potential confounders, the risk of ESCC increased significantly in the highest tertiles of saturated fat [OR:2.88,95%CI:1.15-3.08], cholesterol [OR:1.53, 95%CI: 1.41-4.13], discretionary calorie [OR:1.51, 95%CI: 1.06-3.84], sodium [OR:1.49,95%CI:1.12-2.89] and total fat intakes [OR:1.48, 95%CI:1.09-3.04]. In contrast, being in the highest tertile of carbohydrate, dietary fiber and (n-3) fatty acid intake reduced the ESCC risk by 78%, 71% and 68%, respectively. The most cancer-protective effect was observed for the combination of high folate and vitamin E intakes (OR: 0.02, 95%CI: 0.00-0.87; p < 0.001). Controls consumed 623.5 times higher selenium, 5.48 times as much ß-carotene and 1.98 times as much α-tocopherol as the amount ESCC cases consumed. CONCLUSION: This study suggests that high intake of nutrients primarily found in plant-based foods is associated with a reduced esophageal cancer risk. Some nutrients such as folate, vitamin E and selenium might play major roles in the etiology of ESCC and their status may eventually be used as an epidemiological marker for esophageal cancer in Iran, and perhaps other high-risk regions.

Fruits and vegetables consumption and esophageal squamous cell carcinoma: a case-control study.

The authors examined the association of food group intakes and the risk of esophageal squamous cell carcinoma (SCC) in a hospital-based case-control study in Iran. In total, 47 patients with esophageal SCC and 96 controls underwent face-to-face private interviews. Usual dietary intake was assessed using a semiquantitative food frequency questionnaire. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals. Cases had higher tobacco consumption and symptomatic gastresophageal reflux, whereas controls had higher mean body mass index (25.3 vs. 20.4) and years of education. A protective independent effect was observed for the highest tertile of total fruit consumption (OR: 0.13, CI: 0.04-0.45, P value = 0.001). Within the group of fruits, a significant inverse association was observed for bananas and kiwis (P for trends: 0.03 and 0.02, respectively). The risk of SCC decreased monotonically with increasing intake frequency of oranges (P value for trend = 0.01). The effect of total vegetable consumption on esophageal SCC was not significant, although a reduction in risk was observed in the highest tertile of intake (OR: 0.66, CI: 0.23-1.87, P value = 0.43). The results of the present study suggest a reasonable association between fruit consumption and esophageal SCC in a Middle Eastern high-risk population.

Dietary patterns and risk of oesophageal squamous cell carcinoma: a case-control study.

OBJECTIVE: We conducted a hospital-based, case-control study to examine the association between dietary patterns and the risk of oesophageal squamous cell carcinoma in Iran. DESIGN: A total of forty-seven patients with oesophageal squamous cell carcinoma and ninety-six controls underwent face-to-face interviews. Factor analysis was used to detect dietary patterns. Multivariate logistic regression was used to estimate OR and 95% CI. RESULTS: We defined two major dietary patterns in this population: 'healthy diet' (high in vegetables, nuts, fruits, low-fat dairy and fish) and 'western diet' (high in solid oil, sugar, sweets, tea, eggs, pickles and processed meat). Both healthy and western pattern scores were divided into two categories (based on medians). Higher healthy pattern scores were significantly associated with decreased risk of oesophageal squamous cell carcinoma (high: second median v. low: first median, OR = 0.17, 95% CI 0.19, 0.98). An increased risk of oesophageal squamous cell carcinoma was observed with the western pattern (high: second median v. low: first median, OR = 10.13, 95% CI 8.45, 43.68). CONCLUSIONS: The results of the present study suggested that diet might be associated with oesophageal carcinoma.