Effects of High Altitude and Diet on Gastric Disease Severity in Helicobacter pylori Infection in Peru

ABSTRACT Helicobacter pylori is a bacterium that infects approximately half of the world's population, being more prevalent in low‐ and middle‐income countries. H. pylori can cause gastritis, peptic ulcer disease, mucosa‐associated lymphoid tissue lymphoma, and gastric cancer, which is among the five most frequent cancers worldwide. Other factors such as a diet low in vegetables and high in processed red meat have been associated with gastric cancer. Here, we studied the effects of high altitude and diet on gastric disease severity in H. pylori infection in a multicenter cross‐sectional study in Peru (N = 343). We recruited people from villages with distinct eating habits (high meat consumption, mixed, and limited meat consumption diet) in the Andes (Puno), and compared them to people living at sea level with a mixed diet (Lima). H. pylori infection prevalence was higher at high altitude than at sea level. High altitude, diet, and age showed a significant correlation with the severity of gastric disease, whereas H. pylori infection and sex did not. However, high altitude was not found to be a risk factor for intestinal metaplasia, while diet and age were. At high altitude, a meat‐rich diet was associated with a higher incidence of metaplasia compared to a plant‐based diet. This study provides a comparison of communities living at high altitude with spontaneously different diets, showing that high processed red meat consumption is a risk factor for gastric disease. Further studies are needed to explain this phenomenon and its impact on the development and progression of gastric pathologies.