EXPLORATORY ANALYSIS OF DIETARY PATTERNS OF PATIENTS WITH GASTRIC ADENOCARCINOMA: A CASE-CONTROL STUDY IN CENTRAL BRAZIL

SANTIAGO, Silvana Barbosa; SOUSA, Gabriela Rodrigues de; RAMOS, Amanda Ferreira Paes Landim; FERNANDES, Gisele Aparecida; CURADO, Maria Paula; BARBOSA, Mônica Santiago

doi:10.1590/S0004-2803.230402023-67

Acessibilidade / Reportar erro

Brasil

Arquivos de Gastroenterologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Arq. Gastroenterol. 60 (04) • Oct-Dec 2023 • https://doi.org/10.1590/S0004-2803.230402023-67 copy

EXPLORATORY ANALYSIS OF DIETARY PATTERNS OF PATIENTS WITH GASTRIC ADENOCARCINOMA: A CASE-CONTROL STUDY IN CENTRAL BRAZIL

Análise exploratória dos padrões alimentares de pacientes com adenocarcinoma gástrico: um estudo de caso-controle na Região Brasil Central

Authorship SCIMAGO INSTITUTIONS RANKINGS

HIGHLIGHTS

• The identification of dietary patterns is useful to show the association between diet and gastric adenocarcinoma.

• Studies on dietary patterns in Brazil are scarce, especially in the Midwest region.

• The “unhealthy” pattern was characterized by the consumption of ultra-processed foods.

ABSTRACT

Background:

Diet is one of the most important modifiable risk factors for the incidence of gastric cancer.

Objective:

To carry out an exploratory analysis on the dietary patterns of individuals with gastric adenocarcinoma (AdG) in the Central Brazil region.

Methods:

This is a case-control study carried out from April 2019 to July 2022, in three reference centers for cancer treatment in Goiânia-GO. The cases were patients diagnosed with AdG, the control 1 dyspeptic patients submitted to upper digestive endoscopy and the control 2 patients without gastric complaints. In the three groups, patients aged 18 to 75 years and of both sexes were recruited. To assess food consumption, a Food Frequency Questionnaire validated for the Brazilian population was used. Dietary patterns were identified by Exploratory Factor Analysis (EFA), using principal component analysis as the extraction method, followed by Varimax rotation.

Results:

The commonality values in the EFA for the foods/food groups consumed by the cases and controls were above 0.30 for all variables. The variance explained by the model was 66.7% for cases, 60.3% for control 1 and 59.7% for control 2. Three eating patterns were identified in cases, control 1 and control 2 that explained 34, 87%, 35.41% and 33.25% respectively of the total variance. The first pattern (“healthy”) was characterized by the consumption of vegetables, fruits, meat and cheese; the second (“unhealthy”) for sausages, pizzas, snacks, ketchup, sweet drinks and instant noodles and the third (“prudent”) rice, beans, meat and fried fish and pasta.

Conclusion:

This study identified three dietary patterns among patients with AdG and controls in the Central Brazil region. According to the identified patterns, it will be possible to establish a relationship between diet and other epidemiological measures aimed at the prevention of gastric cancer.

Keywords:
Gastric neoplasms; feeding behavior; factor analysis; case and control studies

Food groups	Description of food grouping (variables - g/day)
Tuber and Vegetables	Carrot, beet, tomato, onion, chayote, pumpkin, cucumber, zucchini and eggplant.
Fruits in general	Orange, pineapple, grape, red fruits, banana, apple, papaya, melon, mango, avocado, guava, persimmon, cupuaçu, bacuri, pupunha and soursop.
Coffee and tea	Coffee and tea
Sweets in general	Plain cake, stuffed cake, whipped cream, icing, biscuit with and without filling, cereal, chocolate, gelatin, ice cream, candy, and candies.
Vegetables and cruciferous	Kale, cauliflower, cabbage, and salad.
Dark green vegetables	Peppers, parsley, lettuce, spinach, watercress, caruru and green smell.
Meat and fish (fried and baked)	Pork, red meat, chicken, beef grilled, roasted chicken, fried chicken, giblets, barbecue, fried and roasted fish, shrimp and pirarucu.
Oil and butter	Mayonnaise, butter with or without salt, margarine with or without salt, light margarine, and butter with or without light salt.
Pizza, snacks (baked and fried), french fries, popcorn and snacks;	Pizza, snacks (baked and fried), french fries, popcorn, and snacks;
Ketchup, industrialized pepper sauce, ramen noodles and cream soup	Ketchup, industrialized pepper sauce, ramen noodles and cream soup
Sweet drinks	Soda, industrialized juice, and chocolate milk.
Beans and lentils	Beans and lentils
Pasta	Pasta (with and without meat) and lasagna.
Sausages in general	Sausage, bacon, dried meat, sausage, fried meat, feijoada, sausages, processed meat, canned meat, nuggets, and hot dogs.
Rice and brown rice	Rice and brown rice
French bread and whole meal bread	French bread and whole meal bread
Cheese	Cheese
Milk	Milk
Fried egg	Fried egg
Fruit smoothies, yogurt, natural fruit juices, Minas cheese, cupuaçu juice, bacuri juice, soursop juice and açaí	Fruit smoothies, yogurt, natural fruit juices, Minas cheese, cupuaçu juice, bacuri juice, soursop juice and açaí
Egg and potato (boiled)	Egg and potato (boiled)
Farofa, tapioca, oats and peanuts	Farofa, tapioca, oats and peanuts
Soup with vegetables and meat	Soup with vegetables and meat
Spices	Salt, vinaigrette, soy drink, mayonnaise, and soy sauce.
Pequi	Pequi

	Cases n=100	%	Endoscopic control n=158	%	Hospitalar Control n=137	%	P
Sex
Male	56	56.0	59	37.3	40	29.2	≤0.001^a
Female	44	44.0	99	62.7	97	70.8
Age
Age (min-max)	28-73		18-75		19-75		≤0.001^b
Mean age (years) ±SD	56±10.0		47.3±15.5		43.9±14.2
Age range
≤45	16	16.0	69	43.6	79	57.7	≤0.001^a
46-55	25	25.0	36	22.8	26	19
56-65	43	43.0	30	19	21	15.3
66-75	16	16.0	23	14.6	11	8
Level of education
Up to 5 years	23	23.0	24	15.2	7	5.1	≤0.001^a
6 years of high school	58	58.0	123	77.8	102	74.5
Higher education	19	19.0	11	7.0	28	20.4
Marital status
Married	73	73.0	84	53.2	82	59.8	0.006 ^a
Not married ^c	27	27.0	74	46.8	55	40.2
Ethnicity
Withe	33	33.0	37	23.4	49	35.8	0.015 ^a
Not white	67	67.0	121	76.6	88	64.2
BMI (kg/m²) ^d
Low weight (<18,5)	24	24.0	9	5,7	9	6.6	0.084 ^a
Eutrophic (18.5 a 24.9)	43	43.0	67	42.4	56	40.9
Overweight (25.0 a 29.9)	18	18.0	43	27.2	42	30.6
Obesity (30.0 a >60.0)	15	15.0	39	24.7	30	21.9
Tobacco consumption
Smoked regularly	50	50	59	37.3	44	32.1	0.018
Alcohol consumption
Consumed alcohol regularly	59	59	82	52	67	49	0.3

Food groups	Case n=100	Endoscopic control n=158	Hospitalar control n=137
Tuber and legum	91.56	77.75	96.35
Fruit	296.93	207.86	248.12
Coffee and tea	275.70	247.73	171.94
Sweets in general	119.73	104.08	58.82
Vegetables and crucifers	29.34	23.33	29.67
Dark green vegetables	35.14	33.97	36.37
Meat and fish (fried and baked)	148.54	142.18	120.68
Oil and butter	14.89	12.76	10.68
Pizza, French fries, Popcorn and snacks	60.63	64.61	40.78
Catchup, industrialized pepper sauce, noodles and cream soup	19.05	24.48	10.95
Sweet drinks	350.80	207.37	112.41
Beans and lentils	151.87	140.93	102.86
Pasta	58.53	67.35	50.55
Sausage	101.54	90.28	70.21
Rice and brown rice	260.19	237.71	177.31
French bread and whole grain bread	49.14	42.27	39.40
Cheese	7.85	6.57	8.43
Milk	155.17	8.22	67.97
Fried egg	11.66	14.65	11.97
Vitamin, juices, yogurt and Mina’s cheese	161.57	155.72	148.59
Egg and potato (boiled)	42.70	44.14	37.89
Farofa, Tapioca, Oats and Peanuts	46.83	32.41	28.90
Soup with vegetables and meat	47.76	43.48	37.89
Seasonings	4.72	6.03	2.64
Pequi	21.31	9.96	7.87

Food Groups	Commonality
	Case	Endoscopic Control	Hospital Control
Tubers and vegetable	0.669	0.674	0.647
Fruit	0.630	0.557	0.658
Coffee and tea	0.742	0.629	0.585
Sweets in general	0.562	0.527	0.658
Vegetables and cruciferous	0.607	0.599	0.688
Dark green vegetables	0.690	0.595	0.632
Meat and fish (fried and baked)	0.497	0.546	0.547
Oil and butter	0.664	0.657	0.659
Pizza. snacks (fried and baked). french fries. popcorn and snacks	0.661	0.657	0.541
Ketchup. industrialized pepper sauce. ramen noodles and cream soup	0.668	0.586	0.639
Sweet drinks	0.681	0.593	0.581
Beans and lentils	0.787	0.752	0.727
Pasta	0.639	0.467	0.498
Sausages in general	0.680	0.640	0.597
Rice and brown rice	0.785	0.686	0.727
French bread and whole meal bread	0.674	0.653	0.749
Cheese	0.675	0.571	0.515
Milk	0.685	0.586	0.677
Fried egg	0.677	0.737	0.439
Fruit smoothies. yogurt. natural fruit juices. Mina’s cheese	0.569	0.575	0.618
Egg and potato (boiled)	0.737	0.636	0.465
Farofa. tapioca. oats and peanuts	0.792	0.598	0.521
Soup with vegetables and meat	0.668	0.514	0.399
Spices	0.582	0.474	0.407
Pequi	0.653	0.566	0.748
KMO	0.648	0.728	0.661
Sphericity	<0.001	<0.001	<0.001
Explained Variance (%)	66.699	60.303	59.685

Case	Pattern			Endoscopic Control	Pattern			Hospitalar Control	Pattern
	S	NS	P		NS	S	P		S	NS	P
Tubers and vegetables	0.788			Tubers and vegetables	0.752			Tubers and vegetables	0.764
Vegetables and cruciferous	0.755			Vegetables and cruciferous	0.722			Vegetables and cruciferous	0.759
Fruits	0.675			Fruits	0.694			Dark green vegetables	0.699
Vitamin, juice, yogurt and Minas cheese	0.646			Vitamin, juice, yogurt and Minas cheese	0.694			Fried egg	0.439
Soup with vegetables and meat	0.627			Soup with vegetables and meat	0.527			Soup with vegetables and meat	0.374
Dark green vegetables	0.568			Dark green vegetables	0.516			Ketchup, industrialized chili sauce, instant noodles, soup		0.714
Cheese	0.372			Cheese		0.775		Pasta		0.654
Sweet drinks		0.794		Sweet drinks		0.735		Pizza, snacks, french fries and popcorn		0.541
Sausages		0.754		Sausages		0.625		Sausages		0.46
Pizza, snacks, french fries and popcorn		0.529		Pizza, snacks, french fries and popcorn		0.567		Spices		0.333
Oil and butter			0.777	Oil and butter			0.849	Fried and roasted meat, fish, shrimp and pirarucu		0.355
French and wholemeal bread			0.762	French and wholemeal bread			0.808	Vitamin, juice, yogurt and Minas cheese			0.755
Sweets in general			0.428	Sweets in general			0.455	Fruits			0.728
				Tubers and vegetables			0.361	Boiled egg and potato			0.429
								Farofa, tapioca, oats, and peanuts			0.379
KMO		0.648				0.728				0.661
Accumulated variance		34.87%				35.41%				33.25%
Bartllet’s sphericity test P<0.001

Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. Rua Dr. Seng, 320, 01331-020 São Paulo - SP Brasil, Tel./Fax: +55 11 3147-6227 - São Paulo - SP - Brazil
E-mail: secretariaarqgastr@hospitaligesp.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Mônica Santiago Barbosa. E-mail: santiago@ufg.br