Inflammatory potential of the diet and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Antonio Agudo, Valerie Cayssials, Catalina Bonet, Anne Tjønneland, Kim Overvad, Marie Christine Boutron-Ruault, Aurélie Affret, Guy Fagherazzi, Verena Katzke, Ruth Schübel, Antonia Trichopoulou, Anna Karakatsani, Carlo La Vecchia, Domenico Palli, Sara Grioni, Rosario Tumino, Fulvio Ricceri, Salvatore Panico, Bas Bueno-De-Mesquita, Petra H. PeetersElisabete Weiderpass, Guri Skeie, Theresa H. Nøst, Cristina Lasheras, Miguel Rodríguez-Barranco, Pilar Amiano, María Dolores Chirlaque, Eva Ardanaz, Bodil Ohlsson, Joana A. Dias, Lena M. Nilsson, Robin Myte, Kay Tee Khaw, Aurora Perez-Cornago, Marc Gunter, Inge Huybrechts, Amanda J. Cross, Kostas Tsilidis, Elio Riboli, Paula Jakszyn

Research output: Contribution to journalArticlepeer-review


Background Chronic inflammation plays a critical role in the pathogenesis of the 2 major types of gastric cancer. Several foods, nutrients, and nonnutrient food components seem to be involved in the regulation of chronic inflammation. Objective We assessed the association between the inflammatory potential of the diet and the risk of gastric carcinoma, overall and for the 2 major subsites: cardia cancers and noncardia cancers. Design A total of 476,160 subjects (30% men, 70% women) from the European Investigation into Cancer and Nutrition (EPIC) study were followed for 14 y, during which 913 incident cases of gastric carcinoma were identified, including 236 located in the cardia, 341 in the distal part of the stomach (noncardia), and 336 with overlapping or unknown tumor site. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated with the use of 28 dietary components and their corresponding inflammatory scores. The association between the ISD and gastric cancer risk was estimated by HRs and 95% CIs calculated by multivariate Cox regression models adjusted for confounders. Results The inflammatory potential of the diet was associated with an increased risk of gastric cancer. The HR (95% CI) for each increase in 1 SD of the ISD were 1.25 (1.12, 1.39) for all gastric cancers, 1.30 (1.06, 1.59) for cardia cancers, and 1.07 (0.89, 1.28) for noncardia cancers. The corresponding values for the highest compared with the lowest quartiles of the ISD were 1.66 (1.26, 2.20), 1.94 (1.14, 3.30), and 1.07 (0.70, 1.70), respectively. Conclusions Our results suggest that low-grade chronic inflammation induced by the diet may be associated with gastric cancer risk. This pattern seems to be more consistent for gastric carcinomas located in the cardia than for those located in the distal stomach. This study is listed on the ISRCTN registry as ISRCTN12136108.

Original languageEnglish
Pages (from-to)607-616
Number of pages10
JournalAmerican Journal of Clinical Nutrition
Issue number4
Publication statusPublished - 2018 Apr 1

Subject classification (UKÄ)

  • Nutrition and Dietetics
  • Cancer and Oncology

Free keywords

  • chronic inflammation
  • gastric cancer
  • inflammatory score of the diet
  • nutrition
  • prospective studies


Dive into the research topics of 'Inflammatory potential of the diet and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study'. Together they form a unique fingerprint.

Cite this