title: Dietary factors in oral leukoplakia and submucous fibrosis in a population-based case control study in Gujarat, India.
abstract: OBJECTIVE
  To investigate the relationship of specific nutrients and food items with oral precancerous lesions among tobacco users.
  
  
  METHODS
  A population-based case-control study.
  
  
  METHODS
  Villages in Palitana taluk of Bhavnagar district, Gujarat, India.
  
  
  METHODS
  An interviewer-administered food frequency questionnaire, developed and validated for this population, was used to estimate nutrient intake in blinded, house-to-house interviews. Among 5018 male tobacco users, 318 were diagnosed as cases. An equal number of controls matched on age (+/- 5 years), sex, village, and use of tobacco were selected.
  
  
  METHODS
  Odds ratios (OR) from multiple logistic regression analysis controlling for relevant variables (type of tobacco use and economic status).
  
  
  RESULTS
  A protective effect of fibre was observed for both oral submucous fibrosis (OSF) and leukoplakia, with 10% reduction in risk per g day-1 (P < 0.05). Ascorbic acid appeared to be protective against leukoplakia with the halving of risk in the two highest quartiles of intake (versus the lowest quartile: OR = 0.46 and 0.44, respectively; P < 0.10). A protective effect of tomato consumption was observed in leukoplakia and a suggestion of a protective effect of wheat in OSF.
  
  
  CONCLUSIONS
  In addition to tobacco use, intake of specific nutrients may have a role in the development of oral precancerous lesions.
authors.affiliation: Epidemiology Research Unit, Tata Institute of Fundamental Research, Bombay, India.
authors.forename: P C
authors.initials: PC
authors.lastname: Gupta
authors.forename: J R
authors.initials: JR
authors.lastname: Hebert
authors.forename: R B
authors.initials: RB
authors.lastname: Bhonsle
authors.forename: P N
authors.initials: PN
authors.lastname: Sinor
authors.forename: H
authors.initials: H
authors.lastname: Mehta
authors.forename: F S
authors.initials: FS
authors.lastname: Mehta
mesh_terms: D000328:Adult; D001205:Ascorbic Acid; D016022:Case-Control Studies; D004032:Diet; D004034:Diet Surveys; D004043:Dietary Fiber; D005247:Feeding Behavior; D006801:Humans; D007194:India / Q000453:epidemiology; D007972:Leukoplakia, Oral / Q000453:epidemiology* / Q000209:etiology; D016015:Logistic Models; D018551:Solanum lycopersicum; D008297:Male; D018977:Micronutrients; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D009914:Oral Submucous Fibrosis / Q000453:epidemiology* / Q000209:etiology; D010947:Plants, Toxic; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000209:etiology; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014030:Tobacco, Smokeless / Q000009:adverse effects; D014908:Triticum