Low sodium diet for gastric cancer prevention in the United States: Results of a Markov model

Review of dietary patterns and gastric cancer risk: epidemiology and biological evidence

Due to rapid research expansion on dietary factors and development of cancer prevention guidelines, the field of dietary pattern and its relationship to cancer risk has gained more focus. Numerous epidemiology studies have reported associations between Gastric Cancer (GC) and both data-driven posteriori dietary pattern and priori dietary pattern defined by predetermined dietary indexes. As dietary patterns have evolved, a series of patterns based on biological markers has advanced, offering deeper insights into the relationship between diet and the risk of cancer. Although researches on dietary patterns and cancer risk are booming, there is limited body of literature focusing specifically on GC. In this study, we compare the similarities and differences among the specific components of dietary patterns and indices, summarize current state of knowledge regarding dietary patterns related to GC and illustrate their potential mechanisms for GC prevention. In conclusion, we offer suggestions for future research based on the emerging themes within this rapidly evolving field.

Diet Quality and Subsequent Incidence of Upper Gastrointestinal Cancers: Results from the Golestan Cohort Study

BACKGROUND

Recent evidence suggests overall diet quality, as assessed by dietary scores, may play a role in the development of upper gastrointestinal (UGI) cancers. However, the existing dietary scores are derived from high-income countries with different dietary habits than regions with the highest burden of UGI cancers, where limited data is available. This study aimed to investigate the association between overall diet quality and risk of esophageal and stomach cancers in a high-risk region for UGI cancers.

METHODS

We recruited 50045 individuals aged 40-75 between 2004-2008 from northeastern Iran and followed them annually through July 2020. Data on demographics, diet, and various exposures were collected using validated questionnaires. Diet quality was assessed by calculating the Healthy Eating Index (HEI), Alternative Healthy Eating Index (AHEI), Alternative Mediterranean Diet (AMED), Dietary Approaches to Stop Hypertension (DASH), and World Cancer Research Fund-American Institute for Cancer Research (WCRF-AICR) scores.

RESULTS

During an average 12 years of follow-up, 359 participants developed esophageal cancer and 358 developed stomach cancer. After adjustments, each standard deviation increase in baseline dietary scores was associated with up to 12% reduction in esophageal cancer risk and up to 17% reduction in stomach cancer risk. Esophageal cancer showed stronger inverse associations with adherence to AMED (HRQ4-vs-Q1=0.69 (0.49-0.98), P-trend=0.038). Stomach cancer showed stronger inverse correlation with WCRF-AICR (HRQ4-vs-Q1=0.58 (0.41-0.83), P-trend=0.004), and DASH (HRC4-vs-C1=0.72 (0.54-0.96), P-trend=0.041). These associations were comparable across different population subgroups. We did not observe significant associations between HEI and AHEI scores and UGI cancers in this population.

CONCLUSION

Despite the differences in consuming individual food groups, adherence to the available dietary recommendations (derived from high-income countries) was associated with lower risk for subsequent esophageal and gastric cancers in this high-risk population. Educating the public to have a healthy eating pattern might be an effective strategy towards prevention of UGI cancers in high-risk regions.

Sirtuins (SIRTs) As a Novel Target in Gastric Cancer

Gastric cancer is a major health burden worldwide. Among all neoplasms, gastric cancer is the fifth most common and the third most deadly type of cancer. It is known that sirtuins (SIRTs), are NAD⁺-dependent histone deacetylases regulating important metabolic pathways. High expression of SIRTs in the human body can regulate metabolic processes; they prevent inflammation but also resist cell death and aging processes. The seven members of this family enzymes can also play a fundamental role in process of carcinogenesis by influencing cell viability, apoptosis and metastasis. This review collects and discusses the role of all seven sirtuins (SIRT1-SIRT7) in the pathogenesis of gastric cancer (GC).

The Epidemiological Characteristics of Noncommunicable Diseases and Malignant Tumors in Guiyang, China: Cross-sectional Study

Background

Studies that address the changing characteristics of diseases are of great importance for preventing and controlling the occurrence and development of diseases and for improving health. However, studies of the epidemiological characteristics of noncommunicable diseases (NCDs) and malignant tumors (MTs) of the residents in Guiyang, China, are lacking.

Objective

The aim of this study was to evaluate the prevalences of NCDs and MTs in residents of Guiyang, Guizhou Province, China, and analyze differences among ages, genders, and regions.

Methods

A multistage stratified cluster sampling method was used. Based on the inclusion and exclusion criteria, 81,517 individuals were selected for the study. Of these, 77,381 (94.9%) participants completed the study. Structured questionnaires were used to collect information on demographic characteristics, NCDs, and MTs. The chi-square test (with 95% confidence intervals) was used to analyze differences in disease prevalence among genders, ages, and geographical regions.

Results

The major chronic NCDs of Guiyang residents are obesity, hypertension, and diabetes. MTs in women are mostly breast cancer, cervical cancer, and endometrial cancer, whereas in men, MTs are mainly lung cancer, rectal cancer, and gastric cancer. The prevalences of hypertension and diabetes in women are higher than in men, but the prevalences of lung cancer and gastric cancer in men are higher than in women. The epidemiological characteristics of individuals in different life stages are dissimilar. In terms of regional distribution, the prevalences of the above diseases in the Baiyun and Yunyan districts of Guiyang are relatively high.

Conclusions

Several NCDs (obesity, hypertension, and diabetes) and MTs (women: breast cancer, cervical cancer, and endometrial cancer; men: lung cancer, rectal cancer, and gastric cancer) should be the focus for the prevention and control of chronic diseases in the future. In particular, the Baiyun and Yunyan districts of Guiyang are the important regions to emphasize.

Avoidable burden of stomach cancer and potential gains in healthy life years from gradual reductions in salt consumption in Vietnam, 2019-2030: a modelling study

OBJECTIVE

Excess salt consumption is causally linked with stomach cancer, and salt intake among adults in Vietnam is about twice the recommended levels. The aim of this study was to quantify the future burden of stomach cancer that could be avoided from population-wide salt reduction in Vietnam.

DESIGN

A dynamic simulation model was developed to quantify the impacts of achieving the 2018 National Vietnam Health Program (8 g/d by 2025 and 7 g/d by 2030) and the WHO (5 g/d) salt reduction policy targets. Data on salt consumption were obtained from the Vietnam 2015 WHO STEPS survey. Health outcomes were estimated over 6-year (2019-2025), 11-year (2019-2030) and lifetime horizons. We conducted one-way and probabilistic sensitivity analyses.

SETTING

Vietnam.

PARTICIPANTS

All adults aged ≥ 25 years (61 million people, 48·4 % men) alive in 2019.

RESULTS

Achieving the 2025 and 2030 national salt targets could result in 3400 and 7200 fewer incident cases of stomach cancer, respectively, and avert 1900 and 4800 stomach cancer deaths, respectively. Achieving the WHO target by 2030 could prevent 8400 incident cases and 5900 deaths from stomach cancer. Over the lifespan, this translated to 344 660 (8 g/d), 411 060 (7 g/d) and 493 633 (5 g/d) health-adjusted life years gained, respectively.

CONCLUSIONS

A sizeable burden of stomach cancer could be avoided, with gains in healthy life years if national and WHO salt targets were attained. Our findings provide impetus for policy makers in Vietnam and Asia to intensify salt reduction strategies to combat stomach cancer and mitigate pressure on the health systems.

Predicting the effectiveness of interventions on population‐level sodium reduction: A simulation modeling study

Background and Aims

Methods

Results

Conclusion