Polyphenol intake and gastric cancer: A case-control study in the Brazilian Amazon region

Polyphenol intake has been associated with a decreased risk of some types of cancer, including gastric cancer (GC). However, few studies address this topic in the Latin American population. In the present study, we evaluated the association between polyphenol intake and the risk of GC in the Brazilian Amazon region. A case-control study was conducted in Belém (Amazon region) from July 2017 to February 2021. A total of 193 GC cases and 194 controls of both sexes, between 18 and 75 years old, were included in the study. Dietary data were collected using a validated food-frequency questionnaire and polyphenol intake identified using the Phenol-Explorer database. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI), with adjustement for potential confounders. Cases and controls had similar total polyphenol intake (356.4 mg/1000 kcal/d and 331.1 mg/1000 kcal/d, respectively; p = 0.086). After adjusting for potential confounders, high consumption of flavan-3-ols (highest vs. lowest tertile: OR 0.41, 95% CI 0.18–0.94) and hydroxybenzoic acids (highest vs. lowest tertile: OR 0.24, 95% CI 0.10–0.56) was associated with a decreased risk of GC. The opposite was true regarding the intake of flavones (OR 2.46, 95% IC 1.17–5.18) and other polyphenols (OR 2.54, 95% IC 1.16–5.54). When stratifying according to anatomical topography, we observed that the intake of total flavonoids, flavan-3-ols, and flavanones reduced the risk of cardia GC while that of hydroxybenzoic acids reduced the risk of non-cardia GC. In addition, the intake of flavones and other polyphenols was associated with an increased risk of non-cardia GC. According to histologic subtypes, hydroxybenzoic acid intake was associated with a reduced risk of intestinal-type GC (OR 0.21, 95% IC 0.07–0.64), while flavone consumption was associated with an increased risk of diffuse-type GC (OR 2.59, 95% IC 1.05–6.42). Our findings suggest that in the Brazilian Amazon region the high intake of flavan-3-ols and hydroxybenzoic acids is associated with a reduced risk of GC, suggesting a potential beneficial role of these compounds against GC. •It is a pioneer study in rating association between phenol intake and GC in Brazil.•Flavan-3-ols and hydroxybenzoic acids decreased the chance of GC overall.•The high intake of total flavonoids and flavanones decreased the chance of cardia GC.•Μay be a strategy to reduce risk of GC is increase of foods rich in phenols intake.