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Dietary Fiber Intake Reduces Risk for Gastric Cancer: A Meta-analysis

  • Author Footnotes
    ∗ Authors share co-first authorship.
    Zhizhong Zhang
    Footnotes
    ∗ Authors share co-first authorship.
    Affiliations
    Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Jiangsu Province, China
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  • Author Footnotes
    ∗ Authors share co-first authorship.
    Gelin Xu
    Footnotes
    ∗ Authors share co-first authorship.
    Affiliations
    Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Jiangsu Province, China
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  • Minmin Ma
    Affiliations
    Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Jiangsu Province, China
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  • Jie Yang
    Affiliations
    Department of Neurology, Nanjing First Hospital, Nanjing, China
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  • Xinfeng Liu
    Correspondence
    Reprint requests Address requests for reprints to: Xinfeng Liu, MD, PhD, Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Road, Nanjing 210002, Jiangsu Province, China. fax: (86) 25-84664563.
    Affiliations
    Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Jiangsu Province, China
    Search for articles by this author
  • Author Footnotes
    ∗ Authors share co-first authorship.

      Background & Aims

      The association between dietary fiber intake and gastric cancer risk has been investigated by many studies, with inconclusive results. We conducted a meta-analysis of case-control and cohort studies to analyze this association.

      Methods

      Relevant studies were identified by searching PubMed and Embase through October 2012. We analyzed 21 articles, which included 580,064 subjects. Random-effects models were used to estimate summary relative risks. Dose-response, subgroup, sensitivity, meta-regression, and publication bias analyses were performed.

      Results

      The summary odds ratios of gastric cancer for the highest, compared with the lowest, dietary fiber intake was 0.58 (95% confidence interval, 0.49−0.67) with significant heterogeneity among studies (P < .001, I2 = 62.2%). Stratified analysis for study design, geographic area, source and type of fiber, Lauren’s classification, publication year, sample size, and quality score of study yielded consistent results. Dose-response analysis associated a 10-g/day increment in fiber intake with a significant (44%) reduction in gastric cancer risk. Sensitivity analysis restricted to studies with control for conventional risk factors produced similar results, and omission of any single study had little effect on the combined risk estimate.

      Conclusions

      In a meta-analysis, we show that dietary fiber intake is associated inversely with gastric cancer risk; the effect probably is independent of conventional risk factors. The direction of the protective association of dietary fiber was consistent among all studies, but the absolute magnitude was less certain because of heterogeneity among the studies. Further studies therefore are required to establish this association.

      Keywords

      Abbreviations used in this paper:

      CI (confidence interval), OR (odds ratio), RR (relative risk)
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