Dietary patterns and adenocarcinoma of the esophagus and distal stomach.

BACKGROUND Dietary pattern analysis is a unique approach to studying relations between diet and disease. OBJECTIVE Our objective was to describe the dietary patterns of an eastern Nebraska population and investigate the associations between those dietary patterns and risks of adenocarcinoma of the esophagus and distal stomach. DESIGN We recruited 124 subjects with esophageal adenocarcinoma, 124 subjects with distal stomach adenocarcinoma, and 449 control subjects in a population-based, case-control study. RESULTS Six dietary patterns were identified with the use of cluster analysis. The first dietary pattern represented healthy food choices and had higher energy contributions from fruit and vegetables and grain products and lower energy contributions from red meats, processed meats, and gravy than did the other dietary patterns. In contrast, a second dietary pattern was high in meats and low in fruit and cereals. The other 4 dietary patterns were each characterized by a concentrated energy source: salty snacks, desserts, milk, and white bread, respectively. The test of overall difference in cancer risk across dietary patterns was significant for distal stomach adenocarcinoma (P = 0.04) but not for esophageal adenocarcinoma. Risk of esophageal adenocarcinoma was inversely associated with intakes of dairy products, fish, all vegetables, citrus fruit and juices, and dark bread and was positively associated with gravy intake. Risk of distal stomach adenocarcinoma was positively associated with red meat intake. CONCLUSIONS Our study suggests that a diet high in fruit and vegetables may decrease the risk of esophageal adenocarcinoma and that a diet high in meats may increase the risk of distal stomach adenocarcinoma.