title: Vegetable, fruit and nitrate intake in relation to the risk of Barrett's oesophagus in a large Dutch cohort.
abstract: There are few epidemiological data on the dietary risk factors of Barrett's oesophagus, a precursor of oesophageal adenocarcinoma. The present study investigated the association between vegetable, fruit and nitrate intake and Barrett's oesophagus risk in a large prospective cohort. The Netherlands Cohort Study recruited 120,852 individuals aged 55-69 years in 1986. Vegetable and fruit intake was assessed using a 150-item FFQ, and nitrate intake from dietary sources and drinking water was determined. After 16.3 years of follow-up, 433 cases (241 men and 192 women) of Barrett's oesophagus with specialised intestinal metaplasia and 3717 subcohort members were analysed in a case-cohort design using Cox proportional hazards models while adjusting for potential confounders. Men exhibited a lower risk of Barrett's oesophagus in the highest v. the lowest quintile of total (multivariable-adjusted hazard ratio (HR): 0.66, 95% CI 0.43, 1.01), raw (HR 0.63, 95% CI 0.40, 0.99), raw leafy (HR 0.55, 95% CI 0.36, 0.86) and Brassica (HR 0.64, 95% CI 0.41, 1.00) vegetable intake. No association was found for other vegetable groups and fruits. No significant associations were found between vegetable and fruit intake and Barrett's oesophagus risk among women. Total nitrate intake was inversely associated with Barrett's disease risk in men (HR 0.50, 95% CI 0.25, 0.99) and positively associated with it in women (HR 3.77, 95% CI 1.68, 8.45) (P for interaction = 0.04). These results suggest that vegetable intake may contribute to the prevention of Barrett's oesophagus. The possible differential effect in men and women should be evaluated further.
authors.affiliation: Department of Epidemiology, School for Oncology and Developmental Biology (Grow), Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: András P
authors.initials: AP
authors.lastname: Keszei
authors.affiliation: Department of Epidemiology, School for Oncology and Developmental Biology (Grow), Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Schouten
authors.affiliation: Department of Pathology, School for Oncology and Developmental Biology (Grow), Maastricht University, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Ann L C
authors.initials: AL
authors.lastname: Driessen
authors.affiliation: Department of Pathology, School for Oncology and Developmental Biology (Grow), Maastricht University, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Clément J R
authors.initials: CJ
authors.lastname: Huysentruyt
authors.affiliation: Department of Gastroenterology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
authors.forename: Yolande C A
authors.initials: YC
authors.lastname: Keulemans
authors.affiliation: TNO, PO Box 2215, 2301 CE Leiden, The Netherlands.
authors.forename: R Alexandra
authors.initials: RA
authors.lastname: Goldbohm
authors.affiliation: Department of Epidemiology, School for Oncology and Developmental Biology (Grow), Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
mesh_terms: D000368:Aged; D001471:Barrett Esophagus / Q000517:prevention & control*; D001937:Brassica; D004032:Diet; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009566:Nitrates / Q000627:therapeutic use; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014675:Vegetables
chemical_list: D009566:Nitrates