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      Irregular Meal Timing Is Associated with Helicobacter pylori Infection and Gastritis

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          Abstract

          Helicobacter pylori (HP) is associated with chronic gastritis and gastric cancer, and more than half of the world's population is chronically infected. The aim of this retrospective study was to investigate whether an irregular meal pattern is associated with increased risk of gastritis and HP infection. The study involved 323 subjects, divided into three groups as follows: subjects with HP infection and gastritis, subjects with gastritis, and a control group. Subjects were interviewed on eating habits and meal timing. Multivariate logistic regression was used to compare groups. Adjusted odds ratios (OR) were derived controlling for gender, age, stress, and probiotic consumption. Subjects who deviated from their regular meals by 2 hours or more had a significantly higher incidence of HP infection with gastritis (adjusted OR = 13.3; 95% CI 5.3–33.3; P < 0.001) and gastritis (adjusted OR = 6.1; 95% CI 2.5–15.0; P < 0.001). Subjects who deviated their meals by 2 hours or more, twice or more per week, had an adjusted OR of 6.3 and 3.5 of acquiring HP infection with gastritis (95% CI 2.6–15.2; P < 0.001) and gastritis (95% CI 1.5–8.5; P < 0.001), respectively. Frequent deviation in meal timing over a prolonged period appears associated with increased risk of developing HP infection and gastritis.

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          Most cited references36

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          Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994.

          The Sydney System for the classification of gastritis emphasized the importance of combining topographical, morphological, and etiological information into a schema that would help to generate reproducible and clinically useful diagnoses. To reappraise the Sydney System 4 years after its introduction, a group of gastrointestinal pathologists from various parts of the world met in Houston, Texas, in September 1994. The aims of the workshop were (a) to establish an agreed terminology of gastritis; (b) to identify, define, and attempt to resolve some of the problems associated with the Sydney System. This article introduces the Sydney System as it was revised at the Houston Gastritis Workshop and represents the consensus of the participants. Overall, the principles and grading of the Sydney System were only slightly modified, the grading being aided by the provision of a visual analogue scale. The terminology of the final classification has been improved to emphasize the distinction between the atrophic and nonatrophic stomach; the names used for each entity were selected because they are generally acceptable to both pathologists and gastroenterologists. In addition to the main categories and atrophic and nonatrophic gastritis, the special or distinctive forms are described and their respective diagnostic criteria are provided. The article includes practical guidelines for optimal biopsy sampling of the stomach, for the use of the visual analogue scales for grading the histopathologic features, and for the formulation of a comprehensive standardized diagnosis. A glossary of gastritis-related terms as used in this article is provided.
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            Helicobacter pylori uses motility for initial colonization and to attain robust infection.

            Helicobacter pylori has been shown to require flagella for infection of the stomach. To analyze whether flagella themselves or motility is needed by these pathogens, we constructed flagellated nonmotile mutants. This was accomplished by using both an insertion mutant and an in-frame deletion of the motB gene. In vitro, these mutants retain flagella (Fla(+)) but are nonmotile (Mot(-)). By using FVB/N mice, we found that these mutants had reduced ability to infect mice in comparison to that of their isogenic wild-type counterparts. When these mutants were coinfected with wild type, we were unable to detect any motB mutant. Finally, by analyzing the 50% infectious dose, we found that motility is needed for initial colonization of the stomach mucosa. These results support a model in which motility is used for the initial colonization of the stomach and also to attain full infection levels.
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              Association of Helicobacter pylori infection with gastric carcinoma: a meta-analysis.

              As conflicting studies have recently been published, we aimed to determine if Helicobacter pylori (H. pylori) infection is associated with gastric adenocarcinoma. This was a meta-analysis of observational epidemiological studies. A total of 42 studies met the selection criteria and were categorized by the type of study design: eight cohort and 34 case-control studies. The pooled odds ratio for H. pylori in relation to gastric carcinoma was 2.04 (95% CI: 1.69-2.45). Both patient age (OR 0.77, 95% CI: 0.68-0.89) and intestinal type cancers (OR 1.14, 95% CI: 1.05-1.25) were independent effect modifiers. Analysis of other effect modifiers showed no relationship with female gender (OR 0.76, 95% CI: 0.64-0.89), stage of cancer (advanced %) (OR 1.12, 95% CI: 0.88-1.43), anatomical location (cardia %) (OR 1.54, 95% CI: 0.32-7.39) or cohort (nested case-control) studies (OR 1.72, 95% CI: 0.32-9.17). There was significant heterogeneity among the studies (tau2 = 149; p < 0.001). The quality of the studies varied considerably, with the majority of excellent studies producing positive results and the very poor to moderate studies producing mixed results. H. pylori infection is associated with a 2-fold increased risk of developing gastric adenocarcinoma.
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                Author and article information

                Journal
                ISRN Nutr
                ISRN Nutr
                ISRN.NUTRITION
                ISRN Nutrition
                Hindawi Publishing Corporation
                2314-4068
                2013
                30 December 2012
                : 2013
                : 714970
                Affiliations
                1Dietetics Department, National University Hospital, 5 Lower Kent Ridge Road, Main Building, Level 1, Singapore 119074
                2Dietetics and Nutrition Department, Alexandra Hospital, Jurong Health, Level 1, 378 Alexandra Road, Singapore 159964
                3Research and Strategic Planning Division, Research and Evaluation Department, Health Promotion Board, 3 Second Hospital Avenue, Singapore 168937
                4Department of Gastroenterology and Hepatology, National University Hospital, 5 Lower Kent Ridge Road Tower Block, Level 10, Singapore 119074
                5Global Healthcare Practice, KPMG, 16 Raffles Quay No. 22-00, Hong Leong Building, Singapore 048581
                6Biostatistics Unit, Clinical Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Block MD 11, Level 1, Singapore 117597
                Author notes

                Academic Editors: M. S. Buchowski, Y.-H. Chen, and E. Devrim

                Article
                10.5402/2013/714970
                4045282
                dc7d9643-8968-4e4e-919d-98a07f7fd3ad
                Copyright © 2013 Su-Lin Lim et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 7 November 2012
                : 9 December 2012
                Categories
                Research Article

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