American Journal of Epidemiology Advance Access originally published online on January 23, 2008
American Journal of Epidemiology 2008 167(7):839-846; doi:10.1093/aje/kwm381
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ORIGINAL CONTRIBUTIONS |
Dietary Patterns and the Risk of Barrett's Esophagus
1 Division of Research, Kaiser Permanente Northern California, Oakland, CA
2 Department of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA
3 Department of Medicine and Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
Correspondence to Dr. Ai Kubo, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (e-mail: ai.kubo{at}kp.org).
Received for publication July 28, 2007. Accepted for publication December 4, 2007.
The objective of this study was to examine the associations between dietary patterns and the risk of Barrett's esophagus, a precursor to esophageal adenocarcinoma. The authors conducted a case-control study within the Kaiser Permanente Northern California population between 2002 and 2005. Patients with a new diagnosis of Barrett's esophagus (n = 296 cases) were matched to persons with gastroesophageal reflux disease (n = 308) without Barrett's esophagus and to population controls (n = 309). Dietary information was obtained from a validated, 110-item food frequency questionnaire. A principal component analysis was used to identify major dietary patterns. Two major dietary patterns were "Western" (high in fast food and meat) and "health-conscious" (high in fruits, vegetables, and nonfried fish). When cases and population controls were compared, strong adherence to the health-conscious dietary pattern was inversely associated with Barrett's esophagus (odds ratio = 0.35, 95% confidence interval: 0.20, 0.64; fourth vs. first quartile comparison). In contrast, data suggested an adverse effect of the Western dietary pattern on the risk of Barrett's esophagus, although no dose-effect relation was found. Results suggest strong associations between a diet rich in fruits and vegetables and the risk of Barrett's esophagus.
Barrett esophagus; diet; esophageal neoplasms; factor analysis, statistical; food habits
Abbreviations: CI, confidence interval; GERD, gastroesophageal reflux disease; OR, odds ratio
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