Worldwide burden of gastric cancer in 2012 that could have been prevented by increasing fruit and vegetable intake and predictions for 2025

Abstract

The regional and temporal variation in patterns of fruit and vegetable intake contributes to differences in the impact on gastric cancer burden across regions and over the years. We aimed to estimate the proportion and absolute number of gastric cancer cases that could have been prevented in 2012 with an increase in fruit and vegetable intake up to the levels defined by the Global Burden of Disease as the theoretical minimum-risk exposure distribution (300 and 400 g/d, respectively), as well as the corresponding figures expected for 2025. Preventable fractions (PF) were computed for 161 countries, using data on fruit and vegetable availability in 1997 and 2010 and published estimates of the magnitude of the association between fruit and vegetable intake and gastric cancer, assuming a time lag of approximately 15 years. Countries classified as very high Human Development Index (HDI) presented median PF in 2012 much lower than low-HDI countries for both fruits (3·0 v. 10·2 %, P < 0·001) and vegetables (6·0 v. 11·9 %, P < 0·001). For vegetables only, PF significantly decreased until 2025 in most settings; however, this corresponded to a reduction in the absolute number of preventable gastric cancer cases in less than half of the countries. Increasing fruit and vegetable intake would allow preventing a relatively high proportion of gastric cancer cases, mostly in developing countries. Although declines in PF are predicted in the near future, changes in order to achieve healthier lifestyles may be insufficient to overcome the load of demographic variation to further reduce the gastric cancer burden.

Preventable lifestyle and eating habits associated with gastric adenocarcinoma: A case-control study

“…The associations for those receiving high school and college/university education were insignificant in overall patients and most subgroups, which could be partly explained by the small case numbers in these groups. People having majorly vegetables for food had significantly less frequent GaC, which is also supported by previous studies [20,21]. Furthermore, we found that more frequent vegetable/fruit intake was significantly associated with a reduced frequency of cardia cancer but not of non-cardia cancer.…”

“…The FS for passive smoking was also significantly associated with GaC (OR=1. 21). No significant associations of GaC with marital status, or histories of hepatitis, diabetes, hypertension, or allergy were observed.…”

Fruits and vegetables intake and gastric cancer risk: A pooled analysis within the Stomach cancer Pooling Project

“…The worldwide consumption of fruits and vegetables is low, particularly in low and middle-income countries 61 and, when assuming a causal relationship between fruits and vegetables intake and the occurrence of gastric cancer, an increase in the overall consumption to at least 300 g of fruits/day and 400 g vegetables/day, was estimated to prevent 6.0% to 11.5% of gastric cancer cases in these settings, by 2025. 62 The main limitation of the current study is the case-control design of the included studies, which may have potentially yielded inaccurate measures of fruit and vegetable consumption. As past dietary habits were reported by participants, recall bias may have occurred, particularly among patients, as changes in lifestyle may occur as cancer develops and becomes symptomatic.…”

“…Both cases and controls reported low levels of fruits and vegetables intake, with the median of consumption not reaching the amount recommended of five portions a day (at least two of fruits and three of vegetables) 44 in most studies. The worldwide consumption of fruits and vegetables is low, particularly in low and middle‐income countries 61 and, when assuming a causal relationship between fruits and vegetables intake and the occurrence of gastric cancer, an increase in the overall consumption to at least 300 g of fruits/day and 400 g vegetables/day, was estimated to prevent 6.0% to 11.5% of gastric cancer cases in these settings, by 2025 62 …”

Protective Role of Dietary Berries in Cancer

“…Furthermore, notably the Mediterranean diet is often viewed as a set of practices and a life-style much more so than a mere diet or dietary scheme. Interestingly, a study showed that if fruit and vegetable intake levels increased to 300 and 400 g/day respectively, that could lead to a significant reduction in gastric cancers, particularly in the developing countries [92]. …”