Is there any Relationship between Food Habits in the Last Two Decades and Gastric Cancer in North-western Iran?

  • Somi, Mohammad Hossein (Liver & Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences) ;
  • Mousavi, Seyed Mohsen (Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ)) ;
  • Naghashi, Shahnaz (Liver & Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences) ;
  • Faramarzi, Elnaz (Liver & Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences) ;
  • Jafarabadi, Mohammad Asghari (Medical Education Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences) ;
  • Ghojazade, Morteza (Liver & Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences) ;
  • Majidi, Alireza (Liver & Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences) ;
  • Alavi, Seyed Ahmad Naseri (Liver & Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences)
  • Published : 2015.02.04


Purpose: The aims of this case-control study were to assess the correlation between some food habits in the last two decades and gastric cancer in East Azerbaijan of Iran. Materials and Methods: In this hospital based case control study, 616 patients (212 gastric cancer patients, 404 cancer free patients) were recruited. Food habits of patients over the past two decades were assessed with a structured questionnaire. We used conditional logistic regression analysis for estimating crude and adjusted odds ratios (OR) and their respective 95% confidence intervals (95%CI). Results: In this study, over-eating, consumption of high fat milk and yogurt and especial types of cheese increased the risk of gastric cancer (All<0.05). Consumption of such especial cheeses such as Koze and Khiki increased the risk of gastric cancer by 12.6 fold (95% CI:1.99-79.36) and 7.36 fold (95% CI:1.33-40.54), respectively. In addition, high fat food, moldy food, and pickled vegetables consumption as well as reuse of cooking oil for frying were significantly associated with gastric cancer risk. Furthermore, intake of Ghorme (deep fried meat) was positively correlated with gastric cancer risk (OR:1.31;95%CI: 0.91-1.87). Conclusions: It can be confirmed that particular food habits which have been very common in East-Azerbaijan in the last two past decades increase risk of gastric cancer. According to our results and taking into account the long latency period of gastric cancer it can be concluded that nutrition education for a healthy diet should be performed from early childhood. However, further well designed cohort studies are needed to achieve more clear results.


Supported by : Tabriz University


  1. Tian SB, Yu JC, Kang WM, et al (2014). Association between dairy intake and gastric cancer: a meta-analysis of observational studies. PLoS One, 9, 101728.
  2. Tsugane S, Sasazuki S (2007). Diet and the risk of gastric cancer: review of epidemiological evidence. Gastric Cancer, 10, 75-83.
  3. van der Pols JC, Bain C, Gunnell D, et al (2007). Childhood dairy intake and adult cancer risk: 65-y follow-up of the Boyd Orr cohort. Am J Clin Nutr, 86, 1722-9.
  4. Wang Q, Chen Y, Wang X, et al (2014). Consumption of fruit, but not vegetables, may reduce risk of gastric cancer: results from a meta-analysis of cohort studies. Eur J Cancer, 50, 1498-509.
  5. Yang T, Yang X, Wang X, et al (2013). The role of tomato products and lycopene in the prevention of gastric cancer: a meta-analysis of epidemiologic studies. Medical hypotheses, 80, 383-8.
  6. Yassibas E, Arslan P, Yalcin S (2012). Evaluation of dietary and life-style habits of patients with gastric cancer: a case-control study in Turkey. Asian Pac J Cancer Prev, 13, 2291-7.
  7. Zhang ZW, Farthing MJ (2005). The roles of vitamin C in Helicobacter pylori associated gastric carcinogenesis. Chinese J Digest Diseases, 6, 53-8.
  8. Zhong C, Li K-N, Bi J-W, et al (2012). Sodium intake, salt taste and gastric cancer risk according to Helicobacter pylori infection, smoking, histological type and tumor site in China. Asian Pac J Cancer Prev, 13, 2481-4.
  9. Nouraie M, Pietinen P, Kamangar F, et al (2005). Fruits, vegetables, and antioxidants and risk of gastric cancer among male smokers. Cancer Epidemiol Biomarkers Prev, 14, 2087-92.
  10. Othman NH (2012). Honey and cancer: sustainable inverse relationship particularly for developing nations-a review. Evid Based Complement Alternat Med, 2012, 410406.
  11. Pakseresht M, Forman D, Malekzadeh R, et al (2011). Dietary habits and gastric cancer risk in north-west Iran. Cancer Causes Control, 22, 725-36.
  12. Pandey MK, Yadav S, Parmar D, et al (2006). Induction of hepatic cytochrome P450 isozymes, benzo (a) pyrene metabolism and DNA binding following exposure to polycyclic aromatic hydrocarbon residues generated during repeated fish fried oil in rats. Toxicol Applied Pharmacol, 213, 126-34.
  13. Parkin D, Pisani P, Ferlay J (1993). Estimates of the worldwide incidence of eighteen major cancers in 1985. Intern J Cancer, 54, 594-606.
  14. Parkin DM, Bray F, Ferlay J, et al (2005). Global cancer statistics, 2002. CA Cancer J Clin, 55, 74-108.
  15. Pourfarzi F, Whelan A, Kaldor J, et al (2009). The role of diet and other environmental factors in the causation of gastric cancer in Iran--a population based study. Int J Cancer, 125, 1953-60.
  16. Rao AV, Agarwal S (2000). Role of antioxidant lycopene in cancer and heart disease. J Am College Nutr, 19, 563-9.
  17. Ren JS, Kamangar F, Forman D, et al (2012). Pickled food and risk of gastric cancer--a systematic review and metaanalysis of English and Chinese literature. Cancer Epidemiol Biomarkers Prev, 21, 905-15.
  18. Rohani-Rasaf M, Abdollahi M, Jazayeri S, et al (2013). Correlation of cancer incidence with diet, smoking and socio- economic position across 22 districts of Tehran in 2008. Asian Pac J Cancer Prev, 14, 1669-76.
  19. Schrauwen P, Westerterp KR (2000). The role of high-fat diets and physical activity in the regulation of body weight. British J Nutr, 84, 417-27.
  20. Somi MH, Farhang S, Mirinezhad SK, et al (2008). Cancer in East Azerbaijan, Iran: results of a population-based cancer registry. Asian Pac J Cancer Prev, 9, 327-30.
  21. Stefani ED, Deneo-Pellegrini H, Ronco AL, et al (2012). Meat consumption, cooking methods, mutagens, and risk of squamous cell carcinoma of the esophagus: a case-control study in Uruguay. Nutr Cancer, 64, 294-9.
  22. Stevel Taylor JLb (2014). In 'Modern Nutrition IN HEALTH AND DISEASE', Eds Lippincott Williams & Wilkins, a Wolters Kluwer business, China, 1415
  23. Sun CQ, Chang YB, Cui LL, et al (2013). A population-based case-control study on risk factors for gastric cardia cancer in rural areas of Linzhou. Asian Pac J Cancer Prev, 14, 2897-901.
  24. Takahashi M, Hasegawa R (1986). Enhancing effects of dietary salt on both initiation and promotion stages of rat gastric carcinogenesis. In, Diet, Nutrition and Cancer, Japan Science Society Press, Utrecht, 169-82.
  25. Hu J, La Vecchia C, Augustin LS, et al (2013). Glycemic index, glycemic load and cancer risk. Ann Oncol, 24, 245-51.
  26. Humans IWGotEoCRt, Cancer IAfRo (1993). Some naturally occurring substances: food items and constituents, heterocyclic aromatic amines and mycotoxins.
  27. Ito LS, Inoue M, Tajima K, et al (2003). Dietary factors and the risk of gastric cancer among Japanese women: a comparison between the differentiated and non-differentiated subtypes. Ann Epidemiol, 13, 24-31.
  28. Jarosz M, Dzieniszewski J, Dabrowska-Ufniarz E, et al (1998). Effects of high dose vitamin C treatment on Helicobacter pylori infection and total vitamin C concentration in gastric juice. Eur J Cancer Prev, 7, 449-54.
  29. Jenab M, Riboli E, Ferrari P, et al (2006). Plasma and dietary vitamin C levels and risk of gastric cancer in the European prospective investigation into cancer and nutrition (EPICEURGAST). Carcinogenesis, 27, 2250-7.
  30. Key TJ, Schatzkin A, Willett WC, et al (2004). Diet, nutrition and the prevention of cancer. Public Health Nutr, 7, 187-200.
  31. Larsson SC, Bergkvist L, Wolk A (2006). Glycemic load, glycemic index and carbohydrate intake in relation to risk of stomach cancer: a prospective study. Intern J Cancer, 118, 3167-9.
  32. Lazarevic K, Nagorni A, Bogdanovic D, et al (2011). Dietary micronutrients and gastric cancer: hospital based study. Central European J Med, 6, 783-7.
  33. Lee YY, Derakhshan MH (2013). Environmental and lifestyle risk factors of gastric cancer. Arch Iran Med, 16, 358-65.
  34. Lin S-H, Li Y-H, Leung K, et al (2014). Salt processed food and gastric cancer in a Chinese population. Asian Pac J Cancer Prev, 15, 5293-8.
  35. Liu C, Russell RM (2008). Nutrition and gastric cancer risk: an update. Nutrition Rev, 66, 237-49.
  36. Mayne ST, Navarro SA (2002). Diet, obesity and reflux in the etiology of adenocarcinomas of the esophagus and gastric cardia in humans. J Nutr, 132, 3467-70.
  37. Mulholland HG, Murray LJ, Cardwell CR, et al (2009). Glycemic index, glycemic load, and risk of digestive tract neoplasms: a systematic review and meta-analysis. Am J Clin Nutr, 89, 568-76.
  38. Nagini S (2012). Carcinoma of the stomach: a review of epidemiology, pathogenesis, molecular genetics and chemoprevention. World J Gastrointestinal Oncol, 4, 156.
  39. Navarro Silvera SA, Mayne ST, Risch H, et al (2008). Food group intake and risk of subtypes of esophageal and gastric cancer. Intern J Cancer, 123, 852-60.
  40. Gonzalez CA, Sala N, Rokkas T (2013). Gastric cancer: epidemiologic aspects. Helicobacter, 18, 34-8.
  41. Hakami R, Etemadi A, Kamangar F, et al (2014). Cooking Methods and Esophageal Squamous Cell Carcinoma in highrisk Areas of Iran. Nutrition Cancer, 66, 500-5.
  42. Babaei M, Pourfarzi F, Yazdanbod A, et al (2010). Gastric cancer in Ardabil, Iran--a review and update on cancer registry data. Asian Pac J Cancer Prev, 11, 595-9.
  43. Bastos J, Lunet N, Peleteiro B, et al (2010). Dietary patterns and gastric cancer in a Portuguese urban population. Int J Cancer, 127, 433-41.
  44. Campbell PT, Sloan M, Kreiger N (2008). Dietary patterns and risk of incident gastric adenocarcinoma. Am J Epidemiol, 167, 295-304.
  45. Cancer IAfRo, Cancer IAfRo 1987. Overall evaluations of carcinogenicity: an updating of IARC monographs volumes 1 to 42, international agency for research on cancer lyon, France.
  46. Chen H, Ward MH, Graubard BI, et al (2002). Dietary patterns and adenocarcinoma of the esophagus and distal stomach. Am J Clin Nutr, 75, 137-44.
  47. Correa P (2004). Is gastric cancer preventable? Gut, 53, 1217-9.
  48. Crew KD, Neugut AI (2006). Epidemiology of gastric cancer. World J Gastroenterol, 12, 354-62.
  49. D'Elia L, Rossi G, Ippolito R, et al (2012). Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr, 31, 489-98.
  50. De Stefani E, Deneo-Pellegrini H, Ronco A, et al (2003). Food groups and risk of squamous cell carcinoma of the oesophagus: a case-control study in Uruguay. Br J Cancer, 89, 1209-14.
  51. Erejuwa OO, Sulaiman SA, Wahab MS (2014). Effects of honey and its mechanisms of action on the development and progression of cancer. Molecules, 19, 2497-522.
  52. Etminan M, Takkouche B, Caamano-Isorna F (2004). The role of tomato products and lycopene in the prevention of prostate cancer: a meta-analysis of observational studies. Cancer Epidemiol Biomarkers Prev, 13, 340-5.
  53. Forman D, Burley VJ (2006). Gastric cancer: global pattern of the disease and an overview of environmental risk factors. Best Pract Res Clin Gastroenterol, 20, 633-49.
  54. Fox JG, Dangler CA, Taylor NS, et al (1999). High-salt diet induces gastric epithelial hyperplasia and parietal cell loss, and enhances Helicobacter pylori colonization in C57BL/6 mice. Cancer Res, 59, 4823-8.
  55. Ghaffari A, Somi MH, Safaiyan A, et al (2012). Honey and apoptosis in human gastric mucosa. Health Promotion Perspectives, 2, 53.
  56. Goldman R, Shields PG (2003). Food mutagens. J Nutr, 133, 965-73.
  57. Agarwal S, Rao AV (2000). Tomato lycopene and its role in human health and chronic diseases. Canadian Med Assoc J, 163, 739-44.
  58. Babaei M, Jaafarzadeh H, Sadjadi A, et al (2009). Cancer incidence and mortality in Ardabil: report of an ongoing population-based cancer registry in Iran, 2004-2006. Iranian J Pub Health, 38, 35-45.
  59. Gonzalez CA, Pera G, Agudo A, et al (2006). Fruit and vegetable intake and the risk of stomach and oesophagus adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). Int J Cancer, 118, 2559-66.

Cited by

  1. Prevalência de sinais e sintomas digestórios em trabalhadoras rurais e fatores associados vol.28, pp.5, 2015,
  2. Impact of consumption of repeatedly heated cooking oils on the incidence of various cancers- A critical review pp.1549-7852, 2017,
  3. Dietary Flavonols Intake and Risk of Esophageal and Gastric Cancer: A Meta-Analysis of Epidemiological Studies vol.8, pp.2, 2016,
  4. Local Acetaldehyde—An Essential Role in Alcohol-Related Upper Gastrointestinal Tract Carcinogenesis vol.10, pp.1, 2018,
  5. Bayesian spatio-temporal analysis of stomach cancer incidence in Iran, 2003–2010 vol.32, pp.10, 2018,
  6. Rising Cancer Incidence and Role of the Evolving Diet in Kenya pp.1532-7914, 2019,
  7. Environmental etiology of gastric cancer in Iran: a systematic review focusing on drinking water, soil, food, radiation, and geographical conditions pp.1614-7499, 2019,