title: Dietary patterns and gastric cancer risk: a systematic review and meta-analysis.
abstract: BACKGROUND
  Declines in gastric cancer (GC) incidence and mortality have been related to improvements in diet. It is therefore important to consider dietary patterns.
  
  
  METHODS
  We conducted a systematic review and meta-analysis of the literature through Medline and Embase databases.
  
  
  RESULTS
  We identified 16 papers, of these 9 derived dietary patterns through an a posteriori method, 5 through a priori scores, and 2 used both approaches. Eight studies that used the a posteriori approach were considered for the meta-analysis. A favorable role on GC emerged for the 'Prudent/healthy', with an odds ratio (OR) of 0.75 [95% confidence interval (CI): 0.63-0.90], for the highest versus the lowest category. Similar results emerged for separate anatomical subtypes. An unfavorable role on GC emerged for the 'Western/unhealthy' dietary pattern, with an OR of 1.51 (95% CI: 1.21-1.89). This association was weaker for the distal/NOS (not otherwise specified) category (OR = 1.36) compared with the cardia GC (OR = 2.05). Among the a priori scores, the ORs ranged from 0.2 to 0.7 for the favorable and from 1.8 to 6.9 for the unfavorable ones.
  
  
  CONCLUSIONS
  There is a ~2-fold difference in GC risk between a 'Prudent/healthy' diet-rich in fruits and vegetables, and a 'Western/unhealthy' diet-rich in starchy foods, meat and fats.
authors.affiliation: Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milan, Italy. paola.bertuccio@marionegri.it
authors.forename: P
authors.initials: P
authors.lastname: Bertuccio
authors.forename: V
authors.initials: V
authors.lastname: Rosato
authors.forename: A
authors.initials: A
authors.lastname: Andreano
authors.forename: M
authors.initials: M
authors.lastname: Ferraroni
authors.forename: A
authors.initials: A
authors.lastname: Decarli
authors.forename: V
authors.initials: V
authors.lastname: Edefonti
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
mesh_terms: D004041:Dietary Fats / Q000009:adverse effects; D019422:Dietary Sucrose / Q000009:adverse effects; D005247:Feeding Behavior; D005638:Fruit; D006801:Humans; D008460:Meat / Q000009:adverse effects; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D014675:Vegetables
chemical_list: D004041:Dietary Fats; D019422:Dietary Sucrose
keywords: dietary patterns; gastric cancer; meta-analysis; review; score