Volume 24, Issue 2 (8-2025)
TB 2025, 24(2): 88-99 |
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Motevalli M, Alizadeh-Navaei R, Shekarriz R. Investigating The Inflammatory Content of The Diet of Gastric Cancer Patients Referred to Mazandaran Comprehensive Cancer Center, a Case-Control Study. TB 2025; 24 (2) :88-99
URL: http://tbj.ssu.ac.ir/article-1-3702-en.html
URL: http://tbj.ssu.ac.ir/article-1-3702-en.html
Mazandaran University of Medical Sciences , drraminshekarriz@yahoo.com
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Investigating The Inflammatory Content of The Diet of Gastric Cancer Patients Referred to Mazandaran Comprehensive Cancer Center, a Case-Control Study
Mina Motavali(M.D.)1, Reza Alizadeh Navaei(M.D.)2, Ramin Shekarriz(M.D.)3
1.Resident of Internal Medicine, Non-Communicable Diseases Institute, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
2.Associate Professor of Biomedicine, Non-Communicable Diseases Institute, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
3.Corresponding Author: Associate Professor of Adult Hematology and Oncology, Non-Communicable Diseases Institute, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
Email:drraminshekarriz@yahoo.com Tel:01133361640
Abstract
Introduction: Gastric cancer is one of the most common cancers in Iran and worldwide, and the role of dietary factors in its incidence and progression has attracted researchers' attention. The inflammatory potential of the diet has been introduced as a risk factor in the development of certain malignancies. The present study aimed to assess the inflammatory potential of the diet in gastric cancer patients and compare it with a control group.
Methods: This case-control study was conducted in 2022 on 80 pathologically confirmed gastric cancer patients referred to the Imam Khomeini Cancer Center, Sari, and 79 controls who were healthy volunteers without gastrointestinal symptoms or a previous history of cancer. The PERISAN cohort food frequency questionnaire (FFQ) was used to record the frequency and types of consumed foods. Data collection and statistical analysis were performed using SPSS version 21. Statistical tests including the T-test and Chi-square test were applied with a significance level of P< 0/05.
Results: The consumption of red meat (P=0/054), organ meat (P=0/013), and tomato products (P=0/000) were higher in the control group. In the category of anti-inflammatory foods, yellow leafy vegetables were consumed significantly more by the control group (P=0/003).
Conclusion: The study results showed no significant association between red meat consumption and the risk of gastric cancer; however, higher vegetable intake may have a protective role. These findings highlight the importance of increasing vegetable consumption for gastric cancer prevention. Due to methodological limitations, prospective studies are necessary to confirm these results.
Keywords: Food, Inflammation, Stomach Neoplasms, Risk Factors.
Conflict of interest: The authors declared no conflict of interest.
References
1-Balkwill F, Mantovani A. Cancer and inflammation: implications for pharmacology and therapeutics. Clinical Pharmacology & Therapeutics. 2010;87(4):401-6.
2-Okada F, Fujii J. Molecular mechanisms of inflammation-induced carcinogenesis. Journal of Clinical Biochemistry and Nutrition. 2006;39(3):103-13.
3-Armstrong H, Bording-Jorgensen M, Dijk S & et al. The Complex Interplay between Chronic Inflammation, the Microbiome, and Cancer: Understanding Disease Progression and What We Can Do to Prevent It. Cancers. 2018;10(3):83.
4-Rawla P, Barsouk A. Epidemiology of gastric cancer: global trends, risk factors and prevention. Przeglad gastroenterologiczny. 2019;14(1):26.
5-Liang Y, Jiao H, Qu L & etal.Positive association between dietary inflammatory index and gastric cancer risk: A systematic review and meta-analysis. Nutrition and cancer. 2020;72(8):1290-6.
6-Wang C, He S, Jin W & et al. Dietary Factors and the Risk of Gastric Cancer in Hanzhong Area of China. Iran J Public Health. 2022;51(8):1790-1797
7-Barbaresko J, Koch M, Schulze MB & et al. Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review. Nutrition reviews. 2013;71(8):511-27.
8-Hébert JR, Shivappa N, Wirth MD & et al. Perspective: the Dietary Inflammatory Index (DII)-lessons learned, improvements made, and future directions. Advances in Nutrition. 2019;10(2):185-95.
9-Shivappa N, Steck SE, Hurley TG & et al. A population-based dietary inflammatory index predicts levels of C-reactive protein in the Seasonal Variation of Blood Cholesterol Study (SEASONS). Public health nutrition. 2014;17(8):1825-33.
10-Jovičić-Bata J, Sazdanić-Velikić D, Ševo M & et al. Lifestyle, Environmental, Occupational, and Dietary Risk Factors in Small-Cell vs. Non-Small-Cell Advanced Lung Cancer Patients: Is There a Connection? Cancers. 2025; 17(5):864.
11-Kalan Farmanfarma K, Mahdavifar N, Hassanipour S & et al. Epidemiologic Study of Gastric Cancer in Iran: A Systematic Review. Clin Exp Gastroenterol. 2020;13:511-42.
12-Mahmoodi E, Omran AH, Moosazadeh M & et al. Five-Year Trend of Gastric Cancer in Northern Iran. International Journal of Cancer Management. 2025;18(18).
13-Malekzadeh R, Derakhshan MH, Malekzadeh Z. Gastric cancer in Iran: epidemiology and risk factors. Arch Iran Med. 2009;12(6):576-83.
14-Eghtesad S, Masoudi S, Sharafkhah M & et al. Validity and reproducibility of the PERSIAN Cohort food frequency questionnaire: assessment of major dietary patterns. Nutr J. 2024;23(1):35.
15-Kianfar H, Ghafarpour M, Hooshiarrad A. Guide to household scales, conversion coefficients and edible percentages of foods. 1st edition. Tehran: National Nutrition & Food Technology Research Institute; 1999.
16-Payandeh N, Shahinfar H, Babaei N & et al. Association between the empirical dietary inflammatory index and cardiorespiratory fitness in Tehranian adults in 2017–2018. Frontiers in Nutrition. 2022;9.
17-Bouras E, Tsilidis KK, Triggi M & et al. Diet and risk of gastric cancer: an umbrella review. Nutrients. 2022;14(9):1764.
18-Nikniaz Z, Somi M H, Asghati Jafarabadi M & et al. Is Dietary Pattern Associated with Gastric Cancer Risk? A Case-control Study in Iran. Iranian Journal of Blood and Cancer 2022; 14 (1):12-17
19-Nomura AM, Hankin JH, Kolonel LN & et al. Case–control study of diet and other risk factors for gastric cancer in Hawaii (United States). Cancer causes & control. 2003;14:547-58.
20-Kim SR, Kim K, Lee SA & et al. Effect of red, processed, and white meat consumption on the risk of gastric cancer: an overall and dose–response meta-analysis. Nutrients. 2019;11(4):826.
21-Wilunda C, Yamaji T, Iwasaki M & et al. Meat consumption and gastric cancer risk: the Japan Public Health Center-based Prospective Study. Am J Clin Nutr. 2022 Mar 4;115(3):652-661.
22-Collatuzzo G, Etemadi A, Sotoudeh M & et al. Meat consumption and risk of esophageal and gastric cancer in the Golestan Cohort Study, Iran. Int J Cancer. 2022; 151(7): 1005-1012.
23-Wu B, Yang D, Yang S & et al. Dietary Salt Intake and Gastric Cancer Risk: A Systematic Review and Meta-Analysis. Front Nutr. 2021;8:801228.
24-Ferguson LR. Meat and cancer. Meat science. 2010;84(2):308-13.
25-Wang C, He S, Jin W & et al. Dietary Factors and the Risk of Gastric Cancer in Hanzhong Area of China. Iranian Journal of Public Health. 2022;51(8):1790.
26-Ferro A, Costa AR, Morais S & et al. Fruits and vegetables intake and gastric cancer risk: A pooled analysis within the Stomach cancer Pooling Project. Int J Cancer. 2020;147(11):3090-3101.
27-Kuang R, Levinthal DJ, Ghaffari AA & et al. Nightshade Vegetables: A Dietary Trigger for Worsening Inflammatory Bowel Disease and Irritable Bowel Syndrome? Digestive Diseases and Sciences. 2023;68(7):2853-60.
28-Salehi B, Sharifi-Rad R, Sharopov F & et al. Beneficial effects and potential risks of tomato consumption for human health: An overview. Nutrition. 2019;62:201-8.
29-Ghavipour M, Saedisomeolia A, Sotoudeh G & et al. The effect of tomato juice on serum concentrations of IL-6, IL-8, CRP and TNF-α of over-weight or obese girl students of Tehran University of Medical Science. Journal of School of Public Health and Institute of Public Health Research. 2012;10(2):29-38.
30-Taherireykande M, Saedisomeolia A, Gaeini AA & et al. Effect of tomato juice consumption on the inflammatory biomarkers of male athletes following exhaustive exercise. J Nutr Sci & Diet. 2018;4(2).
31-Li N, Wu X, Zhuang W & et al. Tomato and lycopene and multiple health outcomes: Umbrella review. Food Chem. 2021;343:128396.
32-Zhou Y, Fu R, Yang M & et al. Lycopene suppresses gastric cancer cell growth without affecting normal gastric epithelial cells. J Nutr Biochem. 2023;116:109313.
Mina Motavali(M.D.)1, Reza Alizadeh Navaei(M.D.)2, Ramin Shekarriz(M.D.)3
1.Resident of Internal Medicine, Non-Communicable Diseases Institute, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
2.Associate Professor of Biomedicine, Non-Communicable Diseases Institute, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
3.Corresponding Author: Associate Professor of Adult Hematology and Oncology, Non-Communicable Diseases Institute, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
Email:drraminshekarriz@yahoo.com Tel:01133361640
Abstract
Introduction: Gastric cancer is one of the most common cancers in Iran and worldwide, and the role of dietary factors in its incidence and progression has attracted researchers' attention. The inflammatory potential of the diet has been introduced as a risk factor in the development of certain malignancies. The present study aimed to assess the inflammatory potential of the diet in gastric cancer patients and compare it with a control group.
Methods: This case-control study was conducted in 2022 on 80 pathologically confirmed gastric cancer patients referred to the Imam Khomeini Cancer Center, Sari, and 79 controls who were healthy volunteers without gastrointestinal symptoms or a previous history of cancer. The PERISAN cohort food frequency questionnaire (FFQ) was used to record the frequency and types of consumed foods. Data collection and statistical analysis were performed using SPSS version 21. Statistical tests including the T-test and Chi-square test were applied with a significance level of P< 0/05.
Results: The consumption of red meat (P=0/054), organ meat (P=0/013), and tomato products (P=0/000) were higher in the control group. In the category of anti-inflammatory foods, yellow leafy vegetables were consumed significantly more by the control group (P=0/003).
Conclusion: The study results showed no significant association between red meat consumption and the risk of gastric cancer; however, higher vegetable intake may have a protective role. These findings highlight the importance of increasing vegetable consumption for gastric cancer prevention. Due to methodological limitations, prospective studies are necessary to confirm these results.
Keywords: Food, Inflammation, Stomach Neoplasms, Risk Factors.
Conflict of interest: The authors declared no conflict of interest.
References
1-Balkwill F, Mantovani A. Cancer and inflammation: implications for pharmacology and therapeutics. Clinical Pharmacology & Therapeutics. 2010;87(4):401-6.
2-Okada F, Fujii J. Molecular mechanisms of inflammation-induced carcinogenesis. Journal of Clinical Biochemistry and Nutrition. 2006;39(3):103-13.
3-Armstrong H, Bording-Jorgensen M, Dijk S & et al. The Complex Interplay between Chronic Inflammation, the Microbiome, and Cancer: Understanding Disease Progression and What We Can Do to Prevent It. Cancers. 2018;10(3):83.
4-Rawla P, Barsouk A. Epidemiology of gastric cancer: global trends, risk factors and prevention. Przeglad gastroenterologiczny. 2019;14(1):26.
5-Liang Y, Jiao H, Qu L & etal.Positive association between dietary inflammatory index and gastric cancer risk: A systematic review and meta-analysis. Nutrition and cancer. 2020;72(8):1290-6.
6-Wang C, He S, Jin W & et al. Dietary Factors and the Risk of Gastric Cancer in Hanzhong Area of China. Iran J Public Health. 2022;51(8):1790-1797
7-Barbaresko J, Koch M, Schulze MB & et al. Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review. Nutrition reviews. 2013;71(8):511-27.
8-Hébert JR, Shivappa N, Wirth MD & et al. Perspective: the Dietary Inflammatory Index (DII)-lessons learned, improvements made, and future directions. Advances in Nutrition. 2019;10(2):185-95.
9-Shivappa N, Steck SE, Hurley TG & et al. A population-based dietary inflammatory index predicts levels of C-reactive protein in the Seasonal Variation of Blood Cholesterol Study (SEASONS). Public health nutrition. 2014;17(8):1825-33.
10-Jovičić-Bata J, Sazdanić-Velikić D, Ševo M & et al. Lifestyle, Environmental, Occupational, and Dietary Risk Factors in Small-Cell vs. Non-Small-Cell Advanced Lung Cancer Patients: Is There a Connection? Cancers. 2025; 17(5):864.
11-Kalan Farmanfarma K, Mahdavifar N, Hassanipour S & et al. Epidemiologic Study of Gastric Cancer in Iran: A Systematic Review. Clin Exp Gastroenterol. 2020;13:511-42.
12-Mahmoodi E, Omran AH, Moosazadeh M & et al. Five-Year Trend of Gastric Cancer in Northern Iran. International Journal of Cancer Management. 2025;18(18).
13-Malekzadeh R, Derakhshan MH, Malekzadeh Z. Gastric cancer in Iran: epidemiology and risk factors. Arch Iran Med. 2009;12(6):576-83.
14-Eghtesad S, Masoudi S, Sharafkhah M & et al. Validity and reproducibility of the PERSIAN Cohort food frequency questionnaire: assessment of major dietary patterns. Nutr J. 2024;23(1):35.
15-Kianfar H, Ghafarpour M, Hooshiarrad A. Guide to household scales, conversion coefficients and edible percentages of foods. 1st edition. Tehran: National Nutrition & Food Technology Research Institute; 1999.
16-Payandeh N, Shahinfar H, Babaei N & et al. Association between the empirical dietary inflammatory index and cardiorespiratory fitness in Tehranian adults in 2017–2018. Frontiers in Nutrition. 2022;9.
17-Bouras E, Tsilidis KK, Triggi M & et al. Diet and risk of gastric cancer: an umbrella review. Nutrients. 2022;14(9):1764.
18-Nikniaz Z, Somi M H, Asghati Jafarabadi M & et al. Is Dietary Pattern Associated with Gastric Cancer Risk? A Case-control Study in Iran. Iranian Journal of Blood and Cancer 2022; 14 (1):12-17
19-Nomura AM, Hankin JH, Kolonel LN & et al. Case–control study of diet and other risk factors for gastric cancer in Hawaii (United States). Cancer causes & control. 2003;14:547-58.
20-Kim SR, Kim K, Lee SA & et al. Effect of red, processed, and white meat consumption on the risk of gastric cancer: an overall and dose–response meta-analysis. Nutrients. 2019;11(4):826.
21-Wilunda C, Yamaji T, Iwasaki M & et al. Meat consumption and gastric cancer risk: the Japan Public Health Center-based Prospective Study. Am J Clin Nutr. 2022 Mar 4;115(3):652-661.
22-Collatuzzo G, Etemadi A, Sotoudeh M & et al. Meat consumption and risk of esophageal and gastric cancer in the Golestan Cohort Study, Iran. Int J Cancer. 2022; 151(7): 1005-1012.
23-Wu B, Yang D, Yang S & et al. Dietary Salt Intake and Gastric Cancer Risk: A Systematic Review and Meta-Analysis. Front Nutr. 2021;8:801228.
24-Ferguson LR. Meat and cancer. Meat science. 2010;84(2):308-13.
25-Wang C, He S, Jin W & et al. Dietary Factors and the Risk of Gastric Cancer in Hanzhong Area of China. Iranian Journal of Public Health. 2022;51(8):1790.
26-Ferro A, Costa AR, Morais S & et al. Fruits and vegetables intake and gastric cancer risk: A pooled analysis within the Stomach cancer Pooling Project. Int J Cancer. 2020;147(11):3090-3101.
27-Kuang R, Levinthal DJ, Ghaffari AA & et al. Nightshade Vegetables: A Dietary Trigger for Worsening Inflammatory Bowel Disease and Irritable Bowel Syndrome? Digestive Diseases and Sciences. 2023;68(7):2853-60.
28-Salehi B, Sharifi-Rad R, Sharopov F & et al. Beneficial effects and potential risks of tomato consumption for human health: An overview. Nutrition. 2019;62:201-8.
29-Ghavipour M, Saedisomeolia A, Sotoudeh G & et al. The effect of tomato juice on serum concentrations of IL-6, IL-8, CRP and TNF-α of over-weight or obese girl students of Tehran University of Medical Science. Journal of School of Public Health and Institute of Public Health Research. 2012;10(2):29-38.
30-Taherireykande M, Saedisomeolia A, Gaeini AA & et al. Effect of tomato juice consumption on the inflammatory biomarkers of male athletes following exhaustive exercise. J Nutr Sci & Diet. 2018;4(2).
31-Li N, Wu X, Zhuang W & et al. Tomato and lycopene and multiple health outcomes: Umbrella review. Food Chem. 2021;343:128396.
32-Zhou Y, Fu R, Yang M & et al. Lycopene suppresses gastric cancer cell growth without affecting normal gastric epithelial cells. J Nutr Biochem. 2023;116:109313.
Type of Study: Research |
Subject:
Nutrition
Received: 2024/12/10 | Accepted: 2025/03/12 | Published: 2025/09/11
Received: 2024/12/10 | Accepted: 2025/03/12 | Published: 2025/09/11
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