title: Dietary flavonoid intake and Barrett's esophagus in western Washington State.
abstract: OBJECTIVE
  Flavonoids, concentrated in fruits and vegetables, demonstrate in experimental studies chemopreventive properties in relation to Barrett's esophagus (BE), a precursor lesion for esophageal adenocarcinoma. One case-control investigation reported an inverse association between isoflavone intake and odds of BE, yet no epidemiologic study has considered other flavonoid classes, which are more commonly consumed by Americans.
  
  
  METHODS
  We examined intake of total flavonoids, six flavonoid classes, and lignans among case-control study participants in western Washington State. Food frequency questionnaires were self-completed by BE cases with specialized intestinal metaplasia (n = 170) and matched controls (n = 183).
  
  
  RESULTS
  In logistic regression models adjusted for age, sex, body mass index, and energy intake, the odds ratio (OR) for specialized intestinal metaplasia BE associated with anthocyanidin intake was 0.49 (95% confidence interval: 0.30-0.80, for quartiles 2-4 combined vs. quartile 1), for which wine and fruit juice were major dietary sources. More moderate decreased ORs were noted for flavanones, flavonols, isoflavones, and lignans. A modest increased OR was observed for flavones, for which pizza was the main dietary source in our population.
  
  
  CONCLUSIONS
  Our findings of an inverse association between anthocyanidins and odds of BE suggest that adequate dietary intake of these compounds may lower risk of this cancer precursor lesion.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill. Electronic address: jessica.petrick@unc.edu.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Petrick
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina, Columbia.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Steck
authors.affiliation: Department of Nutrition, University of North Carolina, Chapel Hill.
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Bradshaw
authors.affiliation: Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston.
authors.forename: Wong-Ho
authors.initials: WH
authors.lastname: Chow
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill.
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Engel
authors.affiliation: Department of Epidemiology and Biostatistics, Indiana University, Bloomington.
authors.forename: Ka
authors.initials: K
authors.lastname: He
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT.
authors.forename: Harvey A
authors.initials: HA
authors.lastname: Risch
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Vaughan
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill.
authors.forename: Marilie D
authors.initials: MD
authors.lastname: Gammon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000872:Anthocyanins / Q000008:administration & dosage; D001471:Barrett Esophagus / Q000453:epidemiology*; D015992:Body Mass Index; D016022:Case-Control Studies; D004032:Diet; D018450:Disease Progression; D005260:Female; D005419:Flavonoids / Q000008:administration & dosage*; D005638:Fruit; D006801:Humans; D007422:Intestines / Q000473:pathology*; D017705:Lignans / Q000008:administration & dosage*; D016015:Logistic Models; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D014675:Vegetables; D014861:Washington / Q000453:epidemiology
chemical_list: D000872:Anthocyanins; D005419:Flavonoids; D017705:Lignans
keywords: Barrett's esophagus; Diet; Epidemiologic studies; Flavonoids