Dietary flavonoid intake and Barrett's esophagus in western Washington State

Ann Epidemiol. 2015 Oct;25(10):730-5.e2. doi: 10.1016/j.annepidem.2015.05.010. Epub 2015 Jun 5.

Abstract

Purpose: Flavonoids, concentrated in fruits and vegetables, demonstrate in experimental studies chemopreventive properties in relation to Barrett's esophagus (BE), a precursor lesion for esophageal adenocarcinoma. One case-control investigation reported an inverse association between isoflavone intake and odds of BE, yet no epidemiologic study has considered other flavonoid classes, which are more commonly consumed by Americans.

Methods: We examined intake of total flavonoids, six flavonoid classes, and lignans among case-control study participants in western Washington State. Food frequency questionnaires were self-completed by BE cases with specialized intestinal metaplasia (n = 170) and matched controls (n = 183).

Results: In logistic regression models adjusted for age, sex, body mass index, and energy intake, the odds ratio (OR) for specialized intestinal metaplasia BE associated with anthocyanidin intake was 0.49 (95% confidence interval: 0.30-0.80, for quartiles 2-4 combined vs. quartile 1), for which wine and fruit juice were major dietary sources. More moderate decreased ORs were noted for flavanones, flavonols, isoflavones, and lignans. A modest increased OR was observed for flavones, for which pizza was the main dietary source in our population.

Conclusions: Our findings of an inverse association between anthocyanidins and odds of BE suggest that adequate dietary intake of these compounds may lower risk of this cancer precursor lesion.

Keywords: Barrett's esophagus; Diet; Epidemiologic studies; Flavonoids.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anthocyanins / administration & dosage
  • Barrett Esophagus / epidemiology*
  • Body Mass Index
  • Case-Control Studies
  • Diet*
  • Disease Progression
  • Female
  • Flavonoids / administration & dosage*
  • Fruit
  • Humans
  • Intestines / pathology*
  • Lignans / administration & dosage*
  • Logistic Models
  • Male
  • Metaplasia
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Vegetables
  • Washington / epidemiology

Substances

  • Anthocyanins
  • Flavonoids
  • Lignans