title: Dietary intake of vegetables, folate, and antioxidants and the risk of Barrett's esophagus.
abstract: OBJECTIVE
  Diet is a potentially modifiable risk factor for Barrett's esophagus (BE). We investigated the associations between intakes of fruits and vegetables and risk of BE.
  
  
  METHODS
  We identified study subjects from 1,859 participants who underwent the endoscopy in a single VA Medical Center in the US between 2008 and 2011. Dietary intake in the previous year was elicited using a self-administered Block food frequency questionnaire (FFQ). Logistic regression model was used to estimate odds ratio (OR) and its 95 % confidence interval (CI) for BE.
  
  
  RESULTS
  A total of 151 cases with definite BE and 777 controls completed the FFQ. When highest tertile of intake was compared with the lowest, the OR (95 % CI) was 0.46 (0.26-0.81) for dark green vegetables, 0.52 (0.30-0.90) for legumes, 0.50 (0.28-0.90) for total fiber, 0.45 (0.25-0.81) for isoflavones, 0.52 (0.30-0.67) for total folate, and 0.45 (0.26-0.79) for lutein, adjusting for multiple confounding factors including use of aspirin or proton pump inhibitor, gastro-esophageal reflux symptoms, and physical activity. The association for dark green vegetables was attenuated after adjustment for lutein, total fiber, and total folate (OR = 0.82; 95 % CI 0.30-2.22).
  
  
  CONCLUSIONS
  Higher intake of dark green vegetables was associated with a decreased risk of BE in a veteran population. Such an inverse association may be partially mediated by lutein, fiber, and folate. The novel findings on the association between intake of lutein, total folate, or isoflavones and risk of BE need further confirmation.
authors: Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA. jiao@bcm.edu
authors: Li
authors: L
authors: Jiao
authors: Jennifer R
authors: JR
authors: Kramer
authors: Massimo
authors: M
authors: Rugge
authors: Paola
authors: P
authors: Parente
authors: Gordana
authors: G
authors: Verstovsek
authors: Abeer
authors: A
authors: Alsarraj
authors: Hashem B
authors: HB
authors: El-Serag
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000008:administration & dosage*; D001471:Barrett Esophagus / Q000453:epidemiology* / Q000517:prevention & control; D016022:Case-Control Studies; D004032:Diet; D004043:Dietary Fiber / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D014675:Vegetables
chemical_list: D000975:Antioxidants; D004043:Dietary Fiber; D005492:Folic Acid