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Dietary Factors and Gastric Intestinal Metaplasia Risk Among US Veterans

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Abstract

Background

Studies on diet and gastric intestinal metaplasia (GIM) risk are lacking in US populations.

Aim

To determine the associations of dietary factors and risk of GIM among a US population with typical American diet.

Methods

We analyzed data from a cross-sectional study of veterans attending primary care and endoscopy clinics at the Houston VA Medical Center. Patients completed a 110-item Block Food Frequency Questionnaire then underwent upper endoscopy with gastric mapping biopsies. We compared cases defined by GIM on ≥ 1 non-cardia gastric biopsy to controls without GIM. Associations of dietary factors and GIM were estimated using logistic regression models as odds ratios (OR) and 95% confidence intervals (CI).

Results

Among 423 GIM cases and 1796 controls, cases were older (62.1 vs. 59.9 years) and more likely to be male (97.2% vs. 90.8%) and non-White (58.6% vs. 39.0%). GIM cases had lower fat intake (percent kcal from fat tertile 1: 43.6% vs. 33.4%) and higher carbohydrate intake (percent kcal from carbohydrate T3: 41.8% vs. 33.3%) than controls. Adjusting for age, gender, race, smoking, and Helicobacter pylori, percent kcal from carbohydrates (T3 vs. T1: OR 1.35, 95% CI 1.08–1.67), fruit intake (T3 vs. T1: OR 1.28, 95% CI 1.02–1.61), and fiber intake (T3 vs. T1: OR 1.37, 95% CI 1.04–1.80) were associated with GIM. In subgroup analyses, these associations were primarily seen in non-White patients.

Conclusions

Few dietary factors, including high carbohydrate intake, are associated with increased risk of GIM in US populations, independent of H. pylori or smoking.

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Acknowledgments

This work was supported in part by National Institutes of Health grant P30 DK056338 (Study Design and Clinical Research Core), which supports the Texas Medical Center Digestive Diseases Center. This research was supported in part with resources at the VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (#CIN 13-413), at the Michael E. DeBakey VA Medical Center, Houston, TX. The opinions expressed reflect those of the authors and not necessarily those of the Department of Veterans Affairs, the US government or Baylor College of Medicine. Mimi C. Tan, MD, MPH is guarantor of the article.

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Authors and Affiliations

  1. Section of Gastroenterology and Hepatology, Baylor College of Medicine, Baylor College of Medicine, One Baylor Plaza, MS: BCM 285, Houston, TX, 77030-3498, USA

    Mimi C. Tan, Quynh Ho & Yan Liu

  2. Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Niharika Mallepally & Hashem B. El-Serag

  3. University of St. Thomas, Houston, TX, USA

    Quynh Ho

  4. Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA

    Yan Liu & Hashem B. El-Serag

  5. Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Aaron P. Thrift

  6. Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA

    Aaron P. Thrift

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  1. Mimi C. Tan
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Contributions

APT, HBE, and MCT analyzed the data, designed the research study, wrote the paper, and contributed to the design of the study. NM collected the data and contributed to the design of the study. QH wrote the paper. YL analyzed the data and contributed to the design of the study. All authors have approved the final version of the manuscript.

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Correspondence to Mimi C. Tan.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Tan, M.C., Mallepally, N., Ho, Q. et al. Dietary Factors and Gastric Intestinal Metaplasia Risk Among US Veterans. Dig Dis Sci 66, 1600–1610 (2021). https://doi.org/10.1007/s10620-020-06399-9

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  • DOI: https://doi.org/10.1007/s10620-020-06399-9

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