Title
Vegetable, fruit and nitrate intake in relation to the risk of Barrett's oesophagus in a large Dutch cohort
Author
Keszei, A.P.
Schouten, L.J.
Driessen, A.L.C.
Huysentruyt, C.J.R.
Keulemans, Y.C.A.
Goldbohm, R.A.
van den Brandt, P.A.
Publication year
2014
Abstract
There are few epidemiological data on the dietary risk factors of Barrett's oesophagus, a precursor of oesophageal adenocarcinoma. The present study investigated the association between vegetable, fruit and nitrate intake and Barrett's oesophagus risk in a large prospective cohort. The Netherlands Cohort Study recruited 120 852 individuals aged 55-69 years in 1986. Vegetable and fruit intake was assessed using a 150-item FFQ, and nitrate intake from dietary sources and drinking water was determined. After 16.3 years of follow-up, 433 cases (241 men and 192 women) of Barrett's oesophagus with specialised intestinal metaplasia and 3717 subcohort members were analysed in a case-cohort design using Cox proportional hazards models while adjusting for potential confounders. Men exhibited a lower risk of Barrett's oesophagus in the highest v. the lowest quintile of total (multivariable-adjusted hazard ratio (HR): 0.66, 95 % CI 0.43, 1.01), raw (HR 0.63, 95 % CI 0.40, 0.99), raw leafy (HR 0.55, 95 % CI 0.36, 0.86) and Brassica (HR 0.64, 95 % CI 0.41, 1.00) vegetable intake. No association was found for other vegetable groups and fruits. No significant associations were found between vegetable and fruit intake and Barrett's oesophagus risk among women. Total nitrate intake was inversely associated with Barrett's disease risk in men (HR 0.50, 95 % CI 0.25, 0.99) and positively associated with it in women (HR 3.77, 95 % CI 1.68, 8.45) (P for interaction = 0.04). These results suggest that vegetable intake may contribute to the prevention of Barrett's oesophagus. The possible differential effect in men and women should be evaluated further. © The Authors 2013.
Subject
ELSS - Earth, Life and Social Sciences
Behavioural Changes
Healthy Living
Biomedical Innovation
Barrett's oesophagus
Cohort studies
Fruits
Nitrate
Vegetables
LS - Life Style
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http://resolver.tudelft.nl/uuid:473b2f30-fe22-4aad-bd64-eaabf1e1a6f6
DOI
https://doi.org/10.1017/s0007114513003929
TNO identifier
492946
ISSN
1475-2662
Source
British Journal of Nutrition, 111 (111), 1452-1462
Document type
article