title: Diet and risk of oral potentially malignant disorders in rural Sri Lanka.
abstract: BACKGROUND
  While the protective role of antioxidant nutrients against cancer is well established, data on Asian diets in patients with oral cancer are meagre.
  
  
  METHODS
  A total of 1029 subjects over 30 years of age were investigated on their dietary practices in the Sabaragamuwa province (Sri Lanka) in 2006-07. Data collection tools were an interviewer-administered questionnaire, a three-day food diary and an examination of the oral cavity. Subjects identified with Oral Potentially Malignant Disorders (OPMD) and disease-free controls were analysed in a case-control fashion. Among the OPMDs, those with leukoplakia were separately considered. A further subgroup analysis was undertaken for β-carotene-rich foods. The analysis was stratified by portions of fruit/vegetables consumed as five or more portions and two or more portions daily.
  
  
  RESULTS
  A low BMI (<18.5) was a significant independent risk factor for the development of OPMD. More than half of both cases and controls consumed less than two portions of fruit/vegetables per day and only 20 subjects consumed more than five portions per day. Intake of more than two portions per day of β-carotene-containing fruits/vegetables significantly reduced the risk of having an OPMD and leukoplakia (OR = 0.5; 95% CI, 0.3-0.9). The significant differences observed with BMI and fruits/vegetables were attenuated when adjusted for betel quid chewing, smoking and alcohol use.
  
  
  CONCLUSIONS
  This study discloses prevailing under-nutrition in this rural population with very low daily consumption of fruit/vegetables. Cancer preventive properties in their diets are limited and are swamped by the known carcinogenic agents associated with use of betel quid, tobacco and alcohol.
authors.affiliation: National Cancer Control Programme, Colombo 05, Sri Lanka.
authors.forename: Hemantha K
authors.initials: HK
authors.lastname: Amarasinghe
authors.forename: Udaya
authors.initials: U
authors.lastname: Usgodaarachchi
authors.forename: Menaka
authors.initials: M
authors.lastname: Kumaraarachchi
authors.forename: Newell W
authors.initials: NW
authors.lastname: Johnson
authors.forename: Saman
authors.initials: S
authors.lastname: Warnakulasuriya
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D001114:Areca; D015992:Body Mass Index; D002212:Capsicum; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data*; D015930:Diet Records; D005260:Female; D005638:Fruit; D006801:Humans; D007972:Leukoplakia, Oral / Q000453:epidemiology; D008297:Male; D009062:Mouth Neoplasms / Q000453:epidemiology*; D011230:Precancerous Conditions / Q000453:epidemiology*; D064167:Recommended Dietary Allowances; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology; D013188:Sri Lanka / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013662:Tea; D013851:Thinness / Q000453:epidemiology; D014675:Vegetables; D014815:Vitamins / Q000032:analysis; D019207:beta Carotene / Q000032:analysis
chemical_list: D013662:Tea; D014815:Vitamins; D019207:beta Carotene
keywords: BMI; Sri Lanka; fruit and vegetables; oral cancer; oral potentially malignant disorders; risk factors; β-carotene