title: Dietary antioxidant and mineral intake in humans is associated with reduced risk of esophageal adenocarcinoma but not reflux esophagitis or Barrett's esophagus.
abstract: The role of antioxidants in the pathogenesis of reflux esophagitis (RE), Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) remains unknown. We evaluated the associations among dietary antioxidant intake and these diseases. We performed an assessment of dietary antioxidant intake in a case control study of RE (n = 219), BE (n = 220), EAC (n = 224), and matched population controls (n = 256) (the Factors Influencing the Barrett's Adenocarcinoma Relationship study) using a modification of a validated FFQ. We found that overall antioxidant index, a measure of the combined intake of vitamin C, vitamin E, total carotenoids, and selenium, was associated with a reduced risk of EAC [odds ratio (OR) = 0.57; 95% CI = 0.33-0.98], but not BE (OR = 0.95; 95% CI = 0.53-1.71) or RE (OR = 1.60; 95% CI = 0.86-2.98), for those in the highest compared with lowest category of intake. Those in the highest category of vitamin C intake had a lower risk of EAC (OR = 0.37; 95% CI = 0.21-0.66; P-trend = 0.001) and RE (OR = 0.46; 95% CI = 0.24-0.90; P-trend = 0.03) compared with those in the lowest category. Vitamin C intake was not associated with BE, and intake of vitamin E, total carotenoids, zinc, copper, or selenium was not associated with EAC, BE, or RE. In conclusion, the overall antioxidant index was associated with a reduced risk of EAC. Higher dietary intake of vitamin C was associated with a reduced risk of EAC and RE. These results suggest that antioxidants may play a role in the pathogenesis of RE and EAC and may be more important in terms of progression rather than initiation of the disease process.
authors: Centre for Public Health, Queen's University Belfast, Belfast BT12 6BJ, Northern Ireland. s.murphy@qub.ac.uk
authors: Seamus J
authors: SJ
authors: Murphy
authors: Lesley A
authors: LA
authors: Anderson
authors: Heather R
authors: HR
authors: Ferguson
authors: Brian T
authors: BT
authors: Johnston
authors: Peter R
authors: PR
authors: Watson
authors: Jim
authors: J
authors: McGuigan
authors: Harry
authors: H
authors: Comber
authors: John V
authors: JV
authors: Reynolds
authors: Liam J
authors: LJ
authors: Murray
authors: Marie M
authors: MM
authors: Cantwell
mesh_terms: D000230:Adenocarcinoma / Q000517:prevention & control*; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage; D001471:Barrett Esophagus / Q000517:prevention & control*; D002338:Carotenoids / Q000008:administration & dosage; D016022:Case-Control Studies; D003300:Copper / Q000008:administration & dosage; D004032:Diet; D004938:Esophageal Neoplasms / Q000517:prevention & control; D005260:Female; D005764:Gastroesophageal Reflux / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000008:administration & dosage*; D016017:Odds Ratio; D012307:Risk Factors; D012643:Selenium / Q000008:administration & dosage; D014810:Vitamin E / Q000008:administration & dosage; D015032:Zinc / Q000008:administration & dosage
chemical_list: D000975:Antioxidants; D008903:Minerals; D014810:Vitamin E; D002338:Carotenoids; D003300:Copper; D012643:Selenium; D015032:Zinc; D001205:Ascorbic Acid