| OBJECTIVEAccording to the result of epidemiological questionaires and baseline databses of the large cohort population including H.pylori infection,gastroscopy and pathological information from a high incidence region of gastric cancer in Wuwei district of Northwest China,the association between dietary pattern and gastric cancer and precancerous lesions and H.pylori infection were discussed to creat a theoretical proof applicable for the system and strategy building of gastric cancer preventation and control.METHODSThe food information of cohort population was evaluated and quantified by food frequency questionnaire?FFQ?,then,the dietary patterns of cohort population were analyzed by using the method of principal component analysis?PCA?,and finally the association between dietary patterns and gastric cancer,gastric precancerous lesions and H.pylori infection of cohort population were discussed according to the results of gastroscopy and pathological diagnosis and14C urea breath test of cohort.RESULTS1.From the prospective of dietary structure in cohort population of Wuwei district,the foods intake of wheat buns,wheat flour,cereals,rice porridge,vegetables,fresh fruits and stir meats were more than other foods category.But wheat foods and vegetables were regarded as the main foods for intake.Moreover,the fresh fruits,fish and dairy products intake were reduced comparing with the reference of Chinese dietary guidelines.The total energy,cholesterol,fiber,vitamins?vit C,vit B1,niacin,vit A and vit E?,and the selenium and calcium of foods intake from cohort population diets were also lower than the reference level.2.The dietary patterns of the Wuwei cohort were mainly divided into four patterns:the traditional northern pattern with higher intake of vegetables and fruits than other patterns,the processed meat pattern with higher intake of processed meat than other pattern,the modern pattern with higher intake of rice and dairy products than other pattern,and the tobacco and alcohol patterns with the habits of smoking and drinking in dietary.3.There are significantly different in food components and nutrient intakes in various dietary patterns.In contrast to other patterns,higher consumption of vegetables and fruits and lower consumption of wheaten foods,cereals and meat was in the traditional northern pattern.more intake of processed meat,offal meat,noodles and fried food,and less intake of cereals,vegetables,fruits and dairy products were in the processed meat pattern.More consumption of cereal,rice soup,potato,dairy products and nuts,and less intake of wheaten foods and meat intake were observed in modern pattern.In the dietary pattern of tobacco and alcohol,more consumption of cigarettes and various kinds of alcohol,and less intake of fresh vegetables were found in tobacco and alcohol pattern.Secondly,the energy,protein,carbohydrate,fat,fiber,vitamins?vit B1,vit B2,vit B3,vit C,and vit E?and mineral element intakes in processed meat and tobacco and alcohol patterns.4.The demographic distribution of dietary patterns:The cohort population of traditional northern pattern characterized with the higher proportion of older,males and underweight than other dietary patterns.However,the cohort population of processed meat pattern characterized with the higher proportion of illiterate and overweight than other dietary patterns.Besides,the population of modern pattern characterized with the higher proportion of older,less education,farmers and normal weight people than other dietary patterns.The population of tobacco and alcohol pattern owned with the higher proportion of high-education,non-farming,overweight and obese people than other dietary patterns.Additionally,there were different distribution of annual income in four dietary patterns.The lifestyle distribution of dietary pattern:H.pylori had a higher infected proportion in processed meats and modern patterns with 54.1%and 54.6%.The higher proportion of people with smoking and drinking,and the habits of hot-foods and fast-intake were found in tobacco and alcohol pattern.There were different distribution of physical activity?PA?among people with four dietary patterns,especially less PA for the people from processed meat and modern patterns.The family history of disease and tumor distribution in various dietary patterns:the higher proportion of family history of gastritis?31.6%and 30.7%?,gallbladder disease?13.5%and 13.5%?,and hypertension?15.6%and 15.1%?were distributed from the cohort population with processed meat and traditional northern patterns.Meanwhile,the population with family history of gastric cancer was mainly represented in processed meat pattern?0.8%?,and seldom represented in the modern pattern?0.3%?.5.It was found that cohort population adhered to modern pattern could decrease the 39%risk of gastric cancer in the male cohort comparing with the traditional northern dietary patterns in associated analysis between dietary patterns and gastric cancer?OR:0.61,95%CI 0.99-0.96?.6.the association results between dietary patterns and gastric precancerous lesions found that people with the adherence to modern dietary pattern could reduce intestinal metaplasia risk by19%?OR:0.81,95%CI 0.68-0.97?.Especially the risk of intestinal meaplasia could be reduced by33%?OR:0.67,95%CI 0.45-1.00?in people over 60 years or 37%?OR:0.63,95%CI 0.49-0.81?in male.Meanwhile,it also found that people over 60 years with adherence to processed meat pattern could increase the risk of low-grade intraepithelial neoplasia to 1.33 fold?OR:1.33,95%CI1.03-1.72?,comparing with the traditional northern pattern.7.The association between dietary pattern and H.pylori infection showed cohort population with annual income?30,000 yuan and adherence to processed meat and modern dietary patterns could increase the risk of H.pylori infection to 1.41 fold?95%CI 1.20-1.65?and 1.16 fold?95%CI1.02-1.32?compared with the traditional northern dietary pattern.CONCLUSION1.The dietary structure of the Wuwei cohort was mainly from the wheaten foods and vegetables,meanwhile,the total energy and many nutrients?fiber,cholesterol,several vitamins,calcium and selenium?intake of cohort population were below the reference intake.2.The dietary patterns of Wuwei cohort population included traditioanal northern pattern,processed meat pattern,modern pattern and tobacco and alcohol pattern3.The cohort population with higher intake of vegetables and fruits in traditional northern pattern,higher intake of processed meat,offal meat and fried foods in processed meat pattern,and higher intake of rice,porridge and dairy products in modern pattern and high adherence to smoking and alcohol habit in tobacco and alcohol pattern were observed comparing with other dietary patterns.Moreover,some nutrients intake of population with processed meat and tobacco and alcohol patterns were more than other patterns.4.Comparing with the basic characteristics of dietary patterns,the cohort population adhered to traditional northern pattern owned higher proportion of the older,male and underweight,and processed meat pattern owned higher proportion of illiteracy,overweight and H.pylori infection rate,and modern pattern characterized with high proportion of the older,lower education,farming,normal-weight and H.pylori infection rate,and tobacco and alcohol pattern characterized with the higher proportion of higher education,non-farming,overweight,obesity and the habits of hot-foods and fast-intake.Meanwhile,there were also different distribution of household income and PA of cohort population from the four patterns.Furthermore,population adherent to processed meat and traditional northern patterns owned the higher proportion of history of gastritis,gallbladder disease and hypertension in contrast to other patterns,additionally,adeherence to the processed meat pattern also had a high proportion of family history of gastric cancer.5.Compared with the traditional northern dietary pattern,males with adherence to the modern pattern could reduce the risk of gastric cancer.Meanwhile,males or population over 60years old with dherence to the modern dietary pattern could decrease the risk of intestinal metaplasia.Neverthelss,population under 60 years old with adherence to the processed meat pattern could increase the risk of low-grade intraepithelial neoplasm.In addition,population with annual income?30,000 RMB and adherence to the processed meats and modern dietary pattern were prone to increase the risk of H.pylori infection. |
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