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      Effect of dietary cholesterol intake on the risk of esophageal cancer: a meta-analysis

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          Abstract

          Objective

          This systematic review aimed to explore the potential association between dietary cholesterol intake and esophageal cancer risk.

          Methods

          A literature search was conducted using PubMed, Embase, and Web of Science databases from inception to March 2019 according to specific inclusion and exclusion criteria. Pooled estimates with odds ratio (ORs) and 95% confidence intervals (CIs) were obtained using random effects models.

          Results

          Nine articles of 12 independent studies were included in the final meta-analysis. Pooled analysis suggested that dietary cholesterol intake may increase the risk of esophageal cancer (summarized OR = 1.424, 95% CI = 1.191–1.704). Consistent results were found in American (summarized OR = 1.410, 95% CI = 1.130–1.758) and European populations (summarized OR = 1.556, 95% CI = 1.021–2.373). Subgroup analysis by disease type showed that dietary cholesterol intake had a significant association with the development of esophageal adenocarcinoma and esophageal squamous cell carcinoma.

          Conclusion

          Our findings indicated that dietary cholesterol intake could significantly increase the risk of developing esophageal cancer in both European and American populations. Further high-quality studies are necessary to confirm the effects of cholesterol intake.

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          Most cited references24

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          Bioactive compounds of beetroot and utilization in food processing industry: A critical review

          Navnidhi Chhikara, Komal P. Kushwaha, Paras Sharma … (2019)
          Beetroot is recognized as health promoting food due to presence of essential components such as vitamins, minerals, phenolics, carotenoids, nitrate, ascorbic acids and betalains that promote health. Betalains occur in two forms i.e. betacyanin (red-violet pigment) and betaxanthin (yellow-orange pigment) and are recognizable commercially as a food dye due to non-precarious, non-toxic, non-carcinogenic and non-poisonous nature. Beetroot is premeditated as a boon for the food industry and used as food colorant or additive in food products such as ice-cream, yogurts and other products. The beetroot extract is used to improve the redness in tomato pastes, soups, sauces, desserts, jams, jellies, sweets and breakfast cereals. Overall objective of this review is to provide a brief knowledge about the valuable phytochemicals and bioactive compounds present in beetroot and their association with health benefits, beetroot processing for food application and their effect on beetroot pigment.
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            Nutrient intake and risk of subtypes of esophageal and gastric cancer.

            S Mayne, H A Risch, R. Dubrow … (2001)
            Incidence rates for adenocarcinoma of the esophagus and gastric cardia have been rising rapidly. We examined nutrient intake as a risk factor for esophageal and gastric cancers in a population-based case-control study in Connecticut, New Jersey, and western Washington state. Interviews were completed for cases with histologically confirmed esophageal adenocarcinoma (n = 282), adenocarcinoma of the gastric cardia (n = 255), esophageal squamous cell carcinoma (n = 206), and noncardia gastric adenocarcinoma (n = 352), along with population controls (n = 687). Associations between nutrient intake and risk of cancer were estimated by adjusted odds ratios (ORs), comparing the 75th versus the 25th percentile of intake. The following nutrients were significantly inversely associated with risk of all four tumor types: fiber, beta-carotene, folate, and vitamins C and B6. In contrast, dietary cholesterol, animal protein, and vitamin B12 were significantly positively associated with risk of all four tumor types. Dietary fat [OR, 2.18; 95% confidence interval (CI), 1.27-3.76] was significantly associated with risk of esophageal adenocarcinoma only. Dietary nitrite (OR, 1.65; 95% CI, 1.26-2.16) was associated with noncardia gastric cancer only. Vitamin C supplement use was associated with a significantly lower risk for noncardia gastric cancer (OR, 0.60; 95% CI, 0.41-0.88). Higher intake of nutrients found primarily in plant-based foods was associated with a reduced risk of adenocarcinomas of the esophagus and gastric cardia, whereas higher intake of nutrients found primarily in foods of animal origin was associated with an increased risk.
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              Systematic review and meta-analysis suggest that dietary cholesterol intake increases risk of breast cancer.

              Li Yang, Changkun Li, Wenjie Jiang … (2016)
              Several epidemiological investigations have been conducted to evaluate the relationship between dietary cholesterol intake and risk of breast cancer, but the results are inconsistent. This meta-analysis was performed to summarize the evidence from observational studies to test the hypothesis that dietary cholesterol intake increases the risk of breast cancer. PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure were searched for relevant articles published up to July 2015. Pooled relative risks were calculated with random effects model. Dose-response relationship was assessed by restricted cubic spline model. Overall, 9 articles involving 6 cohort studies and 3 case-control studies were included in this study. The pooled relative risk with 95% confidence intervals of breast cancer for the highest vs lowest category of dietary cholesterol intake was 1.29 (1.06-1.56). For dose-response analysis, a nonlinear relationship was found between dietary cholesterol and breast cancer, and the association became statistically significant when the cholesterol intake was greater than 370 mg/d. Results from this meta-analysis indicated that dietary cholesterol was associated with an increased risk of breast cancer.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Int Med Res
                Journal ID (iso-abbrev): J. Int. Med. Res
                Journal ID (publisher-id): IMR
                Journal ID (hwp): spimr
                Title: The Journal of International Medical Research
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Print): 0300-0605
                ISSN (Electronic): 1473-2300
                Publication date (Electronic): 13 August 2019
                Publication date (Print): September 2019
                Volume: 47
                Issue: 9
                Pages: 4059-4068
                Affiliations
                [1-0300060519865632]Department of General Surgery, Tianjin First Center Hospital, Tianjin, China
                Author notes
                [*]Yanyu Jin, Department of General Surgery, Tianjin First Center Hospital, No. 24, Fukang Road, Nankai District, Tianjin 300192, China. Email: jin_yanyu@ 123456163.com
                Author information
                https://orcid.org/0000-0002-1588-5791
                Article
                Publisher ID: 10.1177_0300060519865632
                DOI: 10.1177/0300060519865632
                PMC ID: 6753542
                PubMed ID: 31407608
                SO-VID: a3fab5fe-1444-4015-8b80-695952248261
                Copyright © © The Author(s) 2019
                License:

                Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 14 April 2019
                Date accepted : 3 July 2019
                Categories
                Subject: Meta-Analysis and Systematic Review

                Keywords: diet,cholesterol,esophageal cancer,meta-analysis,risk factor,adenocarcinoma
                Data availability:
                Keywords: diet, cholesterol, esophageal cancer, meta-analysis, risk factor, adenocarcinoma

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