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Open Access 01-12-2024 | Gastric Cancer | Research

Exploring the link between dietary patterns and gastric adenocarcinoma in Brazil: a mediation analysis

Authors: Alex Richard Costa Silva, Gianfranco Alicandro, Valdete Regina Guandalini, Patrícia Paula da Fonseca Grili, Paulo Pimentel Assumpção, Mônica Santiago Barbosa, Rosane Oliveira de Sant’Ana, Felipe José Fernández Coimbra, Maria Paula Curado

Published in: BMC Medicine | Issue 1/2024

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Abstract

Background

The causal pathway between different dietary patterns (DPs) and gastric adenocarcinoma (GA) remains largely unexplored. The study aimed to identify DPs and evaluate how selected nutrients mediate the relationship between DPs and GA.

Methods

This multicenter case–control study in Brazil involved 1751 participants (600 cases, 377 endoscopic controls, and 774 hospital controls). DPs were identified through exploratory factor analysis. A counterfactual-based mediation analysis was performed to decompose the total effect of DPs on GA into direct and indirect effects mediated by saturated fatty acids, added sugars, total fiber, and sodium intakes. Effects were expressed as ORs and 95% CIs.

Results

Two DPs were identified—“unhealthy dietary pattern” (UDP) and “healthy dietary pattern” (HDP), which were associated with an increased and decreased risk of GA, respectively. Added sugars partly mediated the association between UDP and GA (percentage mediated between 7.3 and 21.7%), while sodium intake mediated most of the association between HDP and GA (percentage mediated between 52.4 and 100%). No significant mediating effects were detected for saturated fatty acids and total fiber.

Conclusions

This study contributes innovative insights into the DPs-GA relationships, highlighting the significant mediating roles of sodium and added sugars, offering valuable information for preventive strategies and public health interventions targeting GA.

Graphical Abstract

Appendix
Available only for authorised users
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Metadata
Title
Exploring the link between dietary patterns and gastric adenocarcinoma in Brazil: a mediation analysis
Authors
Alex Richard Costa Silva
Gianfranco Alicandro
Valdete Regina Guandalini
Patrícia Paula da Fonseca Grili
Paulo Pimentel Assumpção
Mônica Santiago Barbosa
Rosane Oliveira de Sant’Ana
Felipe José Fernández Coimbra
Maria Paula Curado
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2024
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-024-03785-2

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