OA Epidemiology

Vegetable, Fruit, and Nitrate Intake in Relation to the Risk of Barrett?s Esophagus in a Large Dutch Cohort

Proceedings of the 2013 annual meeting of the Netherlands Epidemiology Society

Volume 1 Issue S1 Abstract 49


A.P. Keszei, Maastricht University, Maastricht, the Netherlands
L.J. Schouten, Maastricht University, Maastricht, the Netherlands
A.L.C. Driessen, Maastricht University, Maastricht, the Netherlands
C.J.R. Huysentruyt, Maastricht University, Maastricht, the Netherlands
Y.C.A. Keulemans, Maastricht University Medical Center, the Netherlands
R.A. Goldbohm, TNO Quality of Life, Leiden, the Netherlands
P.A. van den Brandt, Maastricht University, Maastricht, the Netherlands

There are few epidemiological data about dietary risk factors of Barrett’s esophagus. This study investigated associations between vegetable, fruit, and nitrate intake and the risk of Barrett’s esophagus in a large prospective cohort.

The Netherlands Cohort Study recruited 120,852 individuals aged 55-69 years in 1986. Vegetable and fruit intake was assessed using a 150-item food frequency questionnaire, and nitrate intake was measured from dietary sources and drinking water. During 16.3 years of follow-up, 433 cases of Barrett’s esophagus were detected by linkage to the nationwide network and registry of histopathology and cytopathology in the Netherlands. Cases and 3717 subcohort members were analyzed in a case-cohort design using Cox-proportional hazards models.

Men showed a lower risk of Barrett’s esophagus in the highest compared to the lowest quintile of total (multivariable  adjusted hazard ratio(HR):0.66 ; 95% confidence interval (CI): 0.43,1.01), raw (HR: 0.63; CI: 0.40, 0.99), raw leafy (HR: 0.55; CI: 0.36, 0.86), and Brassica vegetables (HR: 0.64; CI: 0.41,1.00). No association was found for other vegetable groups and fruits. Among women, the strongest association was found with the intake of Brassica vegetables, but the estimate was not significant (HR: 0.65; CI: 0.40, 1.07). Total nitrate intake was inversely associated with Barrett’s disease in men (HR: 0.50; CI: 0.25, 0.99), and positively in women  (HR: 3.77; CI: 1.68, 8.45) (p for interaction 0.04).

Vegetable intake may contribute to the prevention of Barrett’s esophagus. The possible differential effect of nitrate in men and women should be further evaluated.

Published: 06 Jun, 2013

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