title: Shorter dinner-to-bed time is associated with gastric cardia adenocarcinoma risk partly in a reflux-dependent manner.
abstract: BACKGROUND
  Gastric cancer remains the second cause of cancer-related death worldwide. The aim of this study was to investigate the effects of shorter dinner-to-bed time, post-dinner walk, and obesity on gastric cardia adenocarcinoma (GCA) risk.
  
  
  METHODS
  The study subjects consisted of 146 GCA patients and 166 healthy controls roughly matched by gender and age. Conditional logistic regression was used to calculated odds ratio (OR) and 95 % confidence intervals (CIs).
  
  
  RESULTS
  The adjusted ORs of GCA for subjects with shorter dinner-to-bed time were 4.18 (95 % CI 2.10-8.33) compared with those with longer dinner-to-bed time. What is more, when reflux symptom was added into the multivariate models, risk estimate for shorter dinner-to-bed time decreased greatly, but still remained statistically significant (p = 0.007). Post-dinner walk was associated with a significantly decreased GCA risk (adjusted OR 0.54; 95 % CI 0.31-0.94). When subjects were analyzed according to post-dinner walk, the adjusted OR of GCA for shorter dinner-to-bed time relative to longer dinner-to-bed time was much higher for non-walking subjects (adjusted OR 20.21) than walking subjects (adjusted OR 1.39). We further found a significant interaction between shorter dinner-to-bed time and post-dinner walk regarding the risk of GCA (adjusted OR 0.07; p = 0.001).
  
  
  CONCLUSIONS
  We found that shorter dinner-to-bed time was associated with significantly increased GCA risk, partly depending on reflux symptoms, while post-dinner walk was related to a significantly decreased GCA risk and could greatly attenuate the GCA risk attributable to shorter dinner-to-bed time.
authors.affiliation: Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, People's Republic of China.
authors.forename: Qingxu
authors.initials: Q
authors.lastname: Song
authors.forename: Jianbo
authors.initials: J
authors.lastname: Wang
authors.forename: Yibin
authors.initials: Y
authors.lastname: Jia
authors.forename: Chuan
authors.initials: C
authors.lastname: Wang
authors.forename: Nana
authors.initials: N
authors.lastname: Wang
authors.forename: Bingxu
authors.initials: B
authors.lastname: Tan
authors.forename: Wei
authors.initials: W
authors.lastname: Ma
authors.forename: Shanghui
authors.initials: S
authors.lastname: Guan
authors.forename: Dong
authors.initials: D
authors.lastname: Jiang
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Cheng
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology* / Q000473:pathology; D002299:Cardia / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D008297:Male; D062407:Meals; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications*; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000209:etiology* / Q000473:pathology; D013997:Time Factors; D016138:Walking