Fruit And Veg May Slash Gullet Cancer Risk

An increased intake of fruit and vegetables may cut the risk of Barrett’s oesophagus, a precursor to oesophageal cancer, suggests a new study form California.
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Healthy dietary habits, rich in fruit and vegetables, was associated with a 65 per cent reduction in the occurrence of Barrett’s oesophagus, according to the new study involving 913 people and published in the American Journal of Epidemiology.

The study, by researchers from Kaiser Permanente Northern California and the University of California, also heaps more pressure on the Western diet pattern, high in fast food and meat, with the data indicating an adverse effect on the risk of Barrett’s oesophagus

Barrett’s oesophagus is cause by acid reflux, and although it can occur early in life, most sufferers are in their 40s and 50s. Although it has been reported to be a precursor to oesophageal cancer, 90 per cent of patients are said to never develop into cancer, and although some speculation as to dietary and drug history, the reason why this is so is not really known.

The new study, which recruited 296 people with Barrett’s oesophagus, 308 people with gastroesophageal reflux disease but no Barrett’s oesophagus, and 309 healthy controls, used a 110-item food frequency questionnaire to evaluate dietary patterns.

Lead author Ai Kubo and co-workers report that two major dietary patterns were observed amongst the participants, with subjects classified as eating either the Western or “health-conscious” diet. The latter was characterised by being high in fruits, vegetables, and non-fried fish.

The researchers report that strong adherence to the health-conscious diet was associated with a 65 per cent reduction in the risk of developing Barrett’s oesophagus.

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Moreover, while an increased risk was suggested by stronger adherence to the Western diet pattern, no dose-effect relation was reported by Kubo and co-workers.

“Results suggest strong associations between a diet rich in fruits and vegetables and the risk of Barrett’s oesophagus,” concluded Kubo.

The study does have limitations, most notable is the use of the FFQ to establish dietary patterns. Such questionnaires are susceptible to recall errors by the participants, and may no reflect dietary changes. Significant further research is needed. A mechanistic study to elucidate the bioactive constituents of the fruit and vegetables which may be responsible for the benefits is also necessary.

The “five-a-day” message is well known, but applying this does not seem to be filtering down into everyday life. Recent studies have shown that consumers in both Europe and the US are failing to meet recommendations from the WHO to eat 400 grams of fruit and vegetables a day.

A report from the European Union showed that global fruit and vegetable production was over 1,230 million tonnes in 2001-2002, worth over $50 bn (€41 bn). Asia produced 61 per cent, while Europe and North/Central America both producing nine per cent.

Source: American Journal of Epidemiology
Published online ahead of print, doi:10.1093/aje/kwm381
“Dietary Patterns and the Risk of Barrett’s Esophagus”
Authors: A. Kubo, T. R. Levin, G. Block, G.J. Rumore, C.P. Quesenberry Jr, P. Buffler, D.A. Corley

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