Dietary Factors and Gastric Intestinal Metaplasia Risk Among US Veterans

Authors

Mimi C Tan
Niharika Mallepally
Quynh Ho
Yan Liu
Hashem B El-Serag
Aaron P Thrift

Publication Date

5-1-2021

Journal

Digestive Diseases and Sciences

DOI

10.1007/s10620-020-06399-9

PMID

32535778

PMCID

PMC8845052

PubMedCentral® Posted Date

2-15-2022

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Adult, Aged, Aged, 80 and over, Biopsy, Case-Control Studies, Cross-Sectional Studies, Diet, Diet Records, Dietary Carbohydrates, Dietary Fiber, Energy Intake, Female, Fruit, Humans, Male, Metaplasia, Middle Aged, Nutritive Value, Prevalence, Risk Assessment, Risk Factors, Stomach Neoplasms, Texas, Veterans Health, Veterans Health Services, Diet, Dietary factors, Nutrition, Gastric intestinal metaplasia, Gastric cancer

Abstract

BACKGROUND: Studies on diet and gastric intestinal metaplasia (GIM) risk are lacking in US populations.

AIM: To determine the associations of dietary factors and risk of GIM among a US population with typical American diet.

METHODS: We analyzed data from a cross-sectional study of veterans attending primary care and endoscopy clinics at the Houston VA Medical Center. Patients completed a 110-item Block Food Frequency Questionnaire then underwent upper endoscopy with gastric mapping biopsies. We compared cases defined by GIM on ≥ 1 non-cardia gastric biopsy to controls without GIM. Associations of dietary factors and GIM were estimated using logistic regression models as odds ratios (OR) and 95% confidence intervals (CI).

RESULTS: Among 423 GIM cases and 1796 controls, cases were older (62.1 vs. 59.9 years) and more likely to be male (97.2% vs. 90.8%) and non-White (58.6% vs. 39.0%). GIM cases had lower fat intake (percent kcal from fat tertile 1: 43.6% vs. 33.4%) and higher carbohydrate intake (percent kcal from carbohydrate T3: 41.8% vs. 33.3%) than controls. Adjusting for age, gender, race, smoking, and Helicobacter pylori, percent kcal from carbohydrates (T3 vs. T1: OR 1.35, 95% CI 1.08-1.67), fruit intake (T3 vs. T1: OR 1.28, 95% CI 1.02-1.61), and fiber intake (T3 vs. T1: OR 1.37, 95% CI 1.04-1.80) were associated with GIM. In subgroup analyses, these associations were primarily seen in non-White patients.

CONCLUSIONS: Few dietary factors, including high carbohydrate intake, are associated with increased risk of GIM in US populations, independent of H. pylori or smoking.

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