Page 232 - EJMO-9-1

Eurasian Journal of Medicine and
Oncology
Grains, legumes, and gastric cancer

1. Introduction chickpeas and beans, protect against oxidative stress
and inflammation – two processes central to cancer
According to the World Health Organization (WHO) development. 16
2022 estimates, gastric cancer (GC) ranks as the fifth most
prevalent cancer worldwide, with more than 960,000 new Understanding the relationship between dietary
cases for both sexes. In the WHO East Mediterranean components and GC risk is crucial for developing
Region, over 37,000 new cases were documented, effective prevention strategies. Accordingly, this study
accounting for nearly 3.9% of all new cancer cases in 2022. 1 aims to explore the association between grain and legume
consumption and the GC risk. This research seeks to
GC originates in the stomach’s inner lining and contribute to the expanding body of evidence supporting
encompasses various subtypes classified by tumor cell dietary interventions as modifiable factors in reducing
histopathology, with adenocarcinoma being the most GC incidence, with a particular emphasis on the potential
2
commonly diagnosed type. Approximately 90 – 95% of protective effects of grains and legumes.
GC cases develop from the stomach’s mucosal lining and
are classified as adenocarcinomas, while the remaining 2. Methods
5 – 10% are categorized as malignant stromal tumors,
gastric lymphomas, or other rarer forms when arising from 2.1. Study design and participants
different gastric cell types. Most GC forms are resistant to The current case–control study was conducted at the
3,4
chemotherapy and radiotherapy, making surgery the most four largest hospitals with oncology units in Jordan: King
effective treatment option. However, despite improvements Hussein Cancer Center (KHCC), King Abdullah University
in diagnosis and treatment, GC remains the leading cause Hospital, Jordan University Hospital, and Al-Bashir
of cancer-related fatalities globally. 5 Hospital, from March 2015 to August 2017. The study

GC is a complex disease influenced by genetic, protocol received approval from the Institutional Review
behavioral, and environmental variables that contribute Board (IRB) Ethics Committee of KHCC (IRB No. 15
to the development of clinical symptoms. Established KHCC 03, Amman, Jordan) and the other participating
risk factors include family history, advanced age, male hospitals, adhering to the ethical standards outlined in the
sex, and Helicobacter pylori infection. In addition, 1975 Declaration of Helsinki.
lifestyle factors such as smoking, alcohol consumption, Participants enrolled in the study were Jordanians
and unhealthy dietary habits – like high intake of red aged 18 and older who were verbally competent and did
meat and salt alongside poor intake of whole grains, not have chronic food-related disorders. Those in the case
fruits, and vegetables – are reported to be associated group were required to have a confirmed diagnosis of GC,
with approximately 50% of GC cases. In contrast, high while the control group included individuals without GC.
6,7
consumption of fresh fruits and vegetables, whole grains, A total of 487 participants were involved in the study,
and healthy fats has been shown to reduce the risk of GC, consisting of 173 GC cases and 314 controls selected from
positioning these dietary factors as potential targets for the community. The controls were matched to the cases
preventive interventions. Whole grains and legumes based on age, sex, and marital status.
7-9
have demonstrated a protective role in reducing GC risk.
A meta-analysis indicated that increased consumption 2.2. Data collection
of whole grains lowers the likelihood of developing Data on sociodemographic and health factors, physical
GC, while refined grains, particularly rice, elevate this activity, and dietary intake were collected using structured
risk. Legumes such as lentils, chickpeas, and beans also questionnaires. Trained nutritionists administered these
10
contribute to reducing GC risk due to their antioxidant questionnaires to both cases and controls through face-to-
properties and fiber content. 11,12 face interviews.
Emerging evidence highlights several mechanisms
through which dietary components may influence GC 2.3. Anthropometric assessment
risk. High-glycemic foods, such as refined grains, may Trained nutritionists were also responsible for obtaining
contribute to glycemic overload, leading to elevated plasma anthropometric measurements. Participants were
insulin and insulin-like growth factor-I (IGF-I) levels – instructed to wear minimal clothing and no shoes, and
both implicated in tumor growth. 13,14 In contrast, dietary their weight was measured to the nearest 0.1 kg using a Seca
fiber from whole grains and legumes can reduce GC risk scale (Seca GmbH and Co. KG, Germany). In addition,
by accelerating intestinal transit, reducing carcinogen participants stood straight and barefoot while their height
exposure, and inhibiting the formation of nitrosamines. 12,15 was recorded to the nearest 0.1 cm with a Seca stadiometer
Antioxidants found abundantly in legumes, such as (Seca GmbH and Co. KG, Germany). Body mass index

Volume 9 Issue 1 (2025) 224 doi: 10.36922/ejmo.6606