Skip to main content
PMC home page
Cancer Science logoLink to Cancer Science
. 2005 Aug 19;94(4):372–377. doi: 10.1111/j.1349-7006.2003.tb01449.x

Food/nutrient intake and risk of atrophic gastritis among the Helicobacter pylori‐infected population of northeastern Japan

Ai Montani 1,2, Shizuka Sasazuki 1, Manami Inoue 1, Kazuhide Higuchi 2, Tetsuo Arakawa 2, Shoichiro Tsugane 1,✉
PMCID: PMC11160215  PMID: 12824907

Abstract

Although Helicobacter pylori (H. pylori) infection is considered a key risk factor for atrophic gastritis, along with other environmental factors, it is still unclear which factor is involved in the development of atrophic gastritis among H. pylori‐infected subjects. In the present cross‐sectional study, therefore, we analyzed various dietary factors in relation to the presence of atrophic gastritis among H. pylori‐infected subjects who participated in a health check‐up program in a town in northeastern Japan. One thousand and seventy‐one subjects (362 males and 709 females) who provided both self‐administered validated food frequency questionnaires and blood samples were the basis for the study, and all of them were serologically positive for H. pylori immunoglobulin G (IgG) antibody. Among them, 663 (223 males and 440 females) were diagnosed as having atrophic gastritis on the basis of serum pepsinogen levels. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated based on tertile categories of subjects without atrophic gastritis, using logistic regression analysis. Among females, high consumptions of rice (OR=1.6, 95% CI: 1.1–2.3), cod roe (OR=1.5, 95% CI: 1.0–2.2) and cuttlefish (OR=1.5, 95% CI: 1.0–2.3) were associated with a moderately increased risk of atrophic gastritis after adjustment for age (P for trend=0.02 for these items). Among males, high consumptions of rice and miso soup showed a tendency toward an increased risk (P for trend=0.12 and 0.13, respectively). Vegetables and fruits showed no association among either males or females. From these results, it is suggested that the dietary habits of consumers of traditional Japanese foods may play a role in the development of atrophic gastritis after H. pylori infection. (Cancer Sci 2003; 94: 372–377)

References

  • 1. Kato I, Tominaga S, Ito Y, Kobayashi S, Yoshii Y, Matsuura A, Kameya A, Kano T. Atrophic gastritis and stomach cancer risk; cross‐sectional analyses. Jpn J Cancer Res 1992; 83: 1041–6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2. Takahashi S. Long‐term Helicobacter pylori infection and development of atrophic gastritis and gastric cancer in Japan. J Gastroenterol 2002; 37 Suppl 8; 24–7. [DOI] [PubMed] [Google Scholar]
  • 3. Inoue M, Tajima K, Kobayashi S, Suzuki T, Matsuura A, Nakamura T, Shirai M, Nakamura S, Inuzuka K, Tominaga S. Protective factor against progression from atrophic gastritis to gastric cancer–data from a cohort study in Japan. Int J Cancer 1996; 66: 309–14. [DOI] [PubMed] [Google Scholar]
  • 4. Watanabe Y, Kurata JH, Mizuno S, Mukai M, Inokuchi H, Miki K, Ozasa K, Kawai K. Helicobacter pylori infection and gastric cancer. A nested case‐control study in a rural area of Japan. Dig Dis Sci 1997; 42: 1383–7. [DOI] [PubMed] [Google Scholar]
  • 5. Palli D, Decarli A, Cipriani F, Forman D, Amandori D, Avellini C, Giacosa A, Manca P, Russo A, Salkeld RM et al. Plasma pepsinogens, nutrients, and diet in areas of Italy at varying gastric cancer risk. Cancer Epidemiol Biomarkers Prev 1991; 1: 45–50. [PubMed] [Google Scholar]
  • 6. Kato I, Tominaga S, Ito Y, Kobayashi S, Yoshii Y, Matsuura A, Kameya A, Kano T, Ikari A. A prospective study of atrophic gastritis and stomach cancer risk. Jpn J Cancer Res 1992; 83: 1137–42. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, Taniyama K, Sasaki N, Schilemper RJ. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 2001; 345: 784–9. [DOI] [PubMed] [Google Scholar]
  • 8. Ozasa K, Kurata JH, Higashi A, Hayashi K, Inokuchi H, Miki K, Tada M, Kawai K, Watanabe Y. Helicobacter pylori infection and atrophic gastritis. A nested case‐control study in a rural town in Japan. Dig Dis Sci 1999; 44: 253–6. [DOI] [PubMed] [Google Scholar]
  • 9. Shibata K, Moriyama M, Fukushima T, Une H, Miyazaki M, Yamaguchi N. Relation of Helicobacter pylori infection and lifestyle to the risk of chronic atrophic gastritis: a cross‐sectional study in Japan. J Epidemiol 2002; 12: 105–11. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10. Kuwahara Y, Kono S, Eguchi H, Hamada H, Shinchi K, Imanishi K. Relationship between serologically diagnosed chronic atrophic gastritis, Helicobacter pylori, and environmental factors in Japanese men. Scand J Gastroenterol 2000; 35: 476–81. [DOI] [PubMed] [Google Scholar]
  • 11. Fontham ETH, Ruiz B, Perez A, Hunter F, Correa P. Determinants of Helicobacter pylori infection and chronic gastritis. Am J Gastroenterol 1995; 90: 1094–101. [PubMed] [Google Scholar]
  • 12. Tsugane S, Kabuto M, Imai H, Grey F, Tei Y, Hanaoka T, Sugano K, Watanabe S. Helicobacter pylori, dietary factors, and atrophic gastritis in five Japanese populations with different gastric cancer mortality. Cancer Causes Control 1993; 4: 297–305. [DOI] [PubMed] [Google Scholar]
  • 13. Watanabe Y, Ozasa K, Higashi A, Hayashi K, Mizuno S, Mukai M, Inokuchi H, Miki K, Kawai K. Helicobacter pylori infection and atrophic gastritis. A case‐control study in a rural town of Japan. J Clin Gastroenterol 1997; 25: 391–4. [DOI] [PubMed] [Google Scholar]
  • 14. Namekata T, Miki K, Kimmey M, Fritche T, Hughes D, Moore D, Suzuki K. Chronic atrophic gastritis and Helicobacter pylori infection among Japanese Americans in Seattle. Am. J Epidemiol 2000; 151: 820–30. [DOI] [PubMed] [Google Scholar]
  • 15. Ohkuma K, Okada M, Murayama H, Seo M, Maeda K, Kanda M, Okabe N. Association of Helicobacter pylori infection with atrophic gastritis and intestinal metaplasia. J Gastroenterol Hepatol 2000; 15: 1105–12. [DOI] [PubMed] [Google Scholar]
  • 16. Shibata K, Moriyama M, Fukushima T, Kaetsu A, Miyazaki M, Une H. Green tea consumption and chronic atrophic gastritis: a cross‐sectional study in a green tea production village. J Epidemiol 2000; 10: 310–6. [DOI] [PubMed] [Google Scholar]
  • 17. Kabuto M, Imai H, Tsugane S, Watanabe S. Correlation between atrophic gastritis prevalence and gastric cancer mortality among middle aged men in 5 areas in Japan. J Epidemiol 1993; 3: 35–9. [Google Scholar]
  • 18. Samloff IM, Varis K, Ihamaki T, Siurala M, Rotter JI. Relationships among serum pepsinogen I, serum pepsinogen II, and gastric mucosal histology. A study in relatives of patients with pernicious anemia. Gastroenterology 1982; 83: 204–9. [PubMed] [Google Scholar]
  • 19. Chen VW, Abu‐Elyazeed RR, Zavala DE, Ktsanes VK, Haenszel W, Cuello C, Montes G, Correa P. Risk factors of gastric precancerous lesions in a high‐risk Colombian population. I. Salt. Nutr Cancer 1990; 13: 59–65. [DOI] [PubMed] [Google Scholar]
  • 20. Watanabe S, Tsugane S, Sobue T, Konishi M, Baba S, for the JPHC Study Group. Study design and organization of JPHC study. J Epidemiol 2002; 11 Suppl: S3–7. [DOI] [PubMed] [Google Scholar]
  • 21. Tsubono Y, Takamori S, Kobayashi M, Takahashi T, Iwase Y, Litoi Y, Akabane M, Yamaguchi M, Tsugane S. A data‐based approach for designing a semiquantitative food frequency questionnaire for a population‐based prospective study in Japan. J Epidemiol 1996; 6: 45–53. [DOI] [PubMed] [Google Scholar]
  • 22. Science and Technology Agency . Standard Tables of Food Composition in Japan–4th Revised ed. Tokyo : Printing Bureau, Ministry of Finance; 1982. in Japanese. [Google Scholar]
  • 23. Sasaki S, Kobayashi M, Ishihara J, Tsugane S. Self‐administered food frequency questionnaire used in the 5‐year follow‐up survey of the JPHC study: questionnaire structure, computation algorithms, and area‐based mean intake. J Epidemiol 2003; 13: S–13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24. Sasaki S, Kobayashi M, Tsugane S. Validity of the self‐administered food frequency questionnaire used in the 5‐year follow‐up survey of the JPHC study cohort I: comparison with dietary records for food groups. J Epidemiol 2003; 13: S–57. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25. Talley NJ, Kost L, Haddad A, Zinsmeister AR. Comparison of commercial serological tests for detection of Helicobacter pylori antibodies. J Clin Microbiol 1992; 30: 3146–50. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26. SAS Institute Inc. SAS user's guide. Cary NC : SAS Institute Inc; 1990. [Google Scholar]
  • 27. Mathew A, Gangadharan P, Varghese C, Nair MK. Diet and stomach cancer: a case‐control study in South India. Em J Cancer Prev 2000; 9: 89–97. [DOI] [PubMed] [Google Scholar]
  • 28. Kim HJ, Chang WK, Kim MK, Lee SS, Choi BY. Dietary factors and gastric cancer in Korea: a case‐control study. Int J Cancer 2002; 97: 531–5. [DOI] [PubMed] [Google Scholar]
  • 29. Watabe K, Nishi M, Miyake H, Hirata K. Lifestyle and gastric cancer: a case‐control study. Oncol Rep 1998; 5: 1191–4. [DOI] [PubMed] [Google Scholar]
  • 30. Ramon JM, Serra L, Cerdo C, Oromi J. Dietary factors and gastric cancer risk. A case‐control study in Spain. Cancer 1993; 71: 1731–5. [DOI] [PubMed] [Google Scholar]
  • 31. Kato I, Miki K, Munoz N, Vivas JH, Lopez G, Peraza S, Carillo E, Castro D, Andrade O, Sanchez V, Cano E, Ramirez H, Muggli Reto, Benz F, Oliver W. Determinants of plasma pepsinogen levels in a population at high risk for stomach cancer in Venezuela. Int J Cancer 1995; 62: 512–8. [DOI] [PubMed] [Google Scholar]
  • 32. Ji BT, Chow WH, Yang G, McLaughlin JK, Zheng W, Shu XO, Jin F, Gao RN, Gao YT, Fraumeni JF. Dietary habits and stomach cancer in Shanghai, China. Int J Cancer 1998; 76: 659–64. [DOI] [PubMed] [Google Scholar]
  • 33. Tanigawa T, Kawamori T, Limuro M, Ohta T, Higuchi K, Arakawa T, Sugimura T, Wakabayashi K. Marked enhancement by fish meal of Helicobacter pylori‐induced gastritis in Mongolian gerbils. Jpn. J Cancer Res 2000; 91: 769–73. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34. Kato I, Tominaga S, Ito Y, Kobayashi S, Yoshii Y, Matsuura A, Kameya A, Kano T. A comparative case‐control analysis of stomach cancer and atrophic gastritis. Cancer Res 1990; 50: 6559–64. [PubMed] [Google Scholar]
  • 35. Palli D, Russo A, Ottini L, Masala G, Saieva C, Amorosi A, Cama A, ĎAmico C, Falchetti M, Palmirotta R, Decarli A, Costantini RM, Fraumeni JF Jr. Red meat, family history, and increased risk of gastric cancer with mi‐crosatellite instability. Cancer Res 2001; 61: 5415–9. [PubMed] [Google Scholar]
  • 36. Takahashi M, Nishikawa A, Furukawa F, Enami T, Hasegawa T, Hayashi Y. Dose‐dependent promoting effects of sodium chloride (NaCl) on rat glandular stomach carcinogenesis initiated with N‐methyl‐N'‐nitro‐N‐nitrosoguani‐dine. Carcinogenesis 1994; 15: 1429–32. [DOI] [PubMed] [Google Scholar]
  • 37. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process–first American Cancer Society award lecture on cancer epidemiology and prevention. Cancer Res 1992; 52: 6735–40. [PubMed] [Google Scholar]
  • 38. Sasaki S, Ishihara J, Tsugane S. Validity of the self‐administered food frequency questionnaire in the 5‐year follow‐up survey of the JPHC study cohort I to assess sodium and potassium intake: comparison with dietary records and 24‐hour urinary excretion level. J Epidemiol 2003; 13: S–102. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 39. Tsubono Y, Takamori S, Kobayashi M, Takahashi T, Iwase Y, Litoi Y, Akabane M, Yamaguchi M, Tsugane S. A data‐based approach for designing a semiquantitative food frequency questionnaire for a population‐based prospective study in Japan. J Epidemiol 1996; 6: 45–53. [DOI] [PubMed] [Google Scholar]
  • 40. Tsugane S, Akabane M, Inami T, Matsushima S, Ishibashi T, Ichinowatari Y, Miiyajima Y, Watanabe S. Urinary salt excretion and stomach cancer mortality among four Japanese populations. Cancer Causes Control 1991; 2: 165–8. [DOI] [PubMed] [Google Scholar]
  • 41. Fox JG, Dangler CA, Taylor NS, King A, Koh TJ, Wang TC. High‐salt diet induced gastric epithelial hyperplasia and parietal cell loss, and enhances Helicobacter pylori colonization in C57BL/6 mice. Cancer Res 1999; 59: 4823–8. [PubMed] [Google Scholar]
  • 42. Inoue M, Tajima K, Hirose K, Kuroishi T, Gao CM, Kitoh T. Life‐style and subsite of gastric cancer–joint effect of smoking and drinking habits. Int J Cancer 1994; 56: 494–9. [DOI] [PubMed] [Google Scholar]
  • 43. Mirvish S. The etiology of gastric cancer: intragastric nitrosamide formation and other theories. J Natl Cancer Inst 1983; 71: 629–47. [PubMed] [Google Scholar]
  • 44. Tsubono Y, Kobayashi M, Tsugane S. Food consumption and gastric cancer mortality in five regions of Japan. Nutr Cancer 1997; 27: 60–4. [DOI] [PubMed] [Google Scholar]

Articles from Cancer Science are provided here courtesy of Wiley

RESOURCES