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Does dietary inflammation impact your risk of oesophageal cancer?

A study conducted in Northwest China focused on exploring a possible link between inflammation from the diet and risk of oesophageal cancer.

Oesophageal cancer is the eighth most commonly occurring type of cancer with a worldwide death toll of 400,200 in the year 2012. Since the incidence of this type of cancer varies across geographical regions, lifestyle and nutritional factors have a considerable impact on its occurrence.

According to the Chinese National Central Cancer Registry, oesophageal squamous cell cancer (ESCC) is responsible for nearly 90% of cancer occurring in China. ESCC risks increase when people frequently drink hot beverages and consume a lot of processed meat.  Oesophageal adenocarcinoma occurs more in persons with greater body mass index and high waist circumference. Lowered intake of fruits and vegetables is closely associated with higher risk of both types of oesophageal cancer.

Chronic inflammation: an important symptom

Chronic inflammation is an important symptom in a number of epithelial cancers and points to an increased risk of developing oesophageal cancer. By modifying dietary variables we may be able to influence inflammation and in turn oesophageal cancer. A study conducted in China between January 2008 and December 2009 examined a sample size of 359 patients and 380 controls to establish a possible link between pro-inflammatory diets and an increased risk of developing oesophageal cancer. This research study was published in the British Journal of Nutrition in January 2018.

The researchers interviewed participants in the presence of a next-of-kin to facilitate a recall of dietary habits. A questionnaire was developed to examine anthropometry, personal health, demographic particulars, family medical history, diet, and lifestyle habits, including the consumption of alcohol and smoking. The amount of intake and frequency of intake was carefully recorded. For cases, the reference recall period was at five years prior to diagnosis and for controls, it was five years before the interview. Persons in the study who consumed 500ml of alcoholic beverages every week were categorized as ‘often’ drinking while others were categorized as drinking ‘seldom or never’.

Diets promoting inflammation were associated with oesophageal cancer

The researchers used the dietary inflammatory index score, or DII, to measure the level of inflammation in the diet. A positive DII score indicates a more inflammatory diet, while a negative score indicates lower inflammatory diet. Pro-inflammatory diets are higher in saturated fatty acids and carbohydrates and lower in fiber and antioxidants. The research indicated that those with a higher dietary inflammatory index were more likely to develop oesophageal cancer than those with less inflammatory diets.  This study demonstrates the importance of inflammation from the diet in the development of cancer, and a possible strategy to reduce the risk of cancer. Diets that are less likely to induce inflammation may help to reduce the risk of developing oesophageal cancer.

Compared to the control group, the patients with oesophageal cancer were more likely to belong to an ethnic minority group, have a lower education level, and a family history of oesophageal cancer. This study was one of the first conducted in China, wherein a relationship between the dietary inflammation scores and oesophageal cancer was established.  These findings are in line with similar findings from a population based case-control study conducted in Sweden. One limitation of the study is a difficulty in identifying a specific sub-type of oesophageal cancer as being more closely linked to dietary factors. The study indicates that healthcare practitioners and policymakers should encourage the consumption of low inflammation foods to reduce the risk of oesophageal cancer.

Written by Sonia Leslie Fernandez, Medical News Writer

Reference: Tang, L., Xu, F., Zhang, T., Lei, J., Binns, C. W., & Lee, A. H. (2013). Dietary fibre intake associated with reduced risk of oesophageal cancer in Xinjiang, China. Cancer epidemiology37(6), 893-896.

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