Fruit and vegetable intake in relation to gastric cancer risk: a systematic review and dose-response meta-analysis of cohort studies

Introduction: Since the release of previous meta-analyses, some studies on the associations between fruit and vegetable intake with gastric cancer risk have been published. Therefore, we aimed to update the previous meta-analyses on these associations by including recently published studies as well as considering the main limitations of those meta-analyses.Search Method: A comprehensive search was conducted in online databases including PubMed, Scopus, ISI Web of Science, and Google Scholar to detect relevant prospectivecohort studies published up to October ۲۰۲۱. Summary relative risks (RRs) were estimated using a random-effects model.Results: Overall, ۱۷ articles containing ۱۸ prospective studies with a total sample size of ۱,۵۲۷,۹۹۵ participants, aged between ۱۸ and ۹۰ years, were included in the current metaanalysis. During the follow-up periods ranging between ۴.۵ and ۲۱ years, ۷۶۶۳ cases of gastric cancer were diagnosed. A higher intake of total fruit, citrus, and total fruit and vegetable was associated with a ۱۰% (RR: ۰.۹۰, ۹۵% CI: ۰.۸۳ to ۰.۹۷, I۲=۰%), ۱۵% (RR: ۰.۸۵, ۹۵% CI: ۰.۷۳ to ۱.۰۰, I۲=۲۵.۳%), and ۲۹% (RR: ۰.۷۱, ۹۵% CI: ۰.۵۷ to ۰.۸۸, I۲=۶۰.۲%) lower risk of gastric cancer, respectively. For total vegetable intake, a significant inverse association was found among studies that controlled their analysis for energy intake. Based on the linear doseresponse analysis, each ۱۰۰ g/day increase in total fruit intake and ۲۰۰ g/day increase in total fruit and vegetable intake were associated with a ۶% (Pooled RR: ۰.۹۴, ۹۵% CI: ۰.۹۱ to ۰.۹۷, I۲=۵.۴%) and ۹% (RR: ۰.۹۱, ۹۵% CI: ۰.۸۷ to ۰.۹۵, I۲=۰%) lower risk of gastric cancer, respectively.Conclusion: Fruit and vegetable consumption has a protective association with gastric cancer risk.

کلیدواژه ها:

Fruit ، Gastric cancer ، Vegetable ، Citrus ، Meta-analysis