Page 233 - EJMO-9-1

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

(BMI) was subsequently calculated by dividing the weight standard deviation (SD), while frequency and percentage
in kilograms by the square of the height in meters. 17 were used for normally distributed categorical variables.
One-way ANOVA and independent-sample t-test were
2.4. Physical activity questionnaire applied to compare means of continuous variables, and the

Data on participants’ physical activity levels were gathered Pearson Chi-square test was utilized to assess differences
using a validated 7-day physical activity recall (PAR). 18,19 in categorical variables. Fisher’s least significant difference
The 7-day PAR is a structured questionnaire that prompts post hoc tests were employed to determine the differences
participants to recall the amount of time spent exercising in continuous variables among participants according to
each day over a week. It includes questions about the their daily grain consumption.
frequency, intensity, and duration of physical activities. Participants’ consumption of grains and legumes was
Overall, physical activity was quantified by calculating the categorized into quartiles based on their intake levels, with
total hours spent at different intensity levels and converting the first quartile representing the lowest intake and the
that into metabolic equivalents (METs) per minute per fourth quartile indicating the highest intake. Odds ratios
week. (ORs) and corresponding 95% confidence intervals (CIs)

2.5. Dietary intake assessment for different quartiles of grains and legumes intake were
derived using multinomial logistic regression with the
To estimate the intake of grains and legumes, a validated first quartile as the reference group. Potential confounding
Arabic quantitative food frequency questionnaire (FFQ) factors associated with GC risk, include age, sex, marital
was utilized. Participants were asked about their status, education level, previous BMI, smoking status and
20
consumption of specific grains and legumes (white bread, duration, family history of cancer, history of stomach ulcer
whole wheat bread, refined rice, stuffed vegetables with and stomachache, physical activity (MET-min/week), and
rice, macaroni and pasta, bulgur and cracked wheat, green daily caloric intake were controlled for. 21,22 The p-values for
beans, green peas, cooked dried beans [fava beans and navy trends were calculated using linear logistic regression.
beans], falafel, Hummus [mashed chickpeas], and lentil
soup) over the past 12 months. The study participants were 3. Results
asked to recall how often, on average, they consumed one
standard serving of each food item within 11 frequency Table 1 presents the sociodemographic and health
categories: never, 1 – 6 times/year, 7 – 11 times/year, 1 time/ characteristics of the case group (n = 173) based on daily
month, 2 – 3 times/month, 1 time/week, 2 times/week, 3 – grain servings. The mean previous weight was significantly
4 times/week, 5 – 6 times/week, 1 time/day, and 2 or more higher in the group consuming more than seven servings
times/day. Portion sizes for each food item were classified per day (91.9 ± 17.3 kg) compared to those consuming
into three categories (small, medium, or large) based on less than three servings (74.6 ± 18.7 kg) and 3 – 5 servings
commonly used measuring standards. These portion per day (77.5 ± 23.3 kg; p < 0.001). There was a significant
sizes were standardized using a combination of life-size difference in current weight among the GC group, with the
food models and standard measuring tools, such as cups, highest average weight found in the group of participants
tablespoons, teaspoons, and glasses, which were shown to consuming more than seven servings per day (74.4 ± 14.5 kg,
participants during the interviews to help in accurately p = 0.050). Total caloric intake significantly increases with
estimating the portion sizes of the grains and legumes higher grain servings (p < 0.001). Cases consuming 6 – 7
consumed. These visual aids were carefully selected to servings (3,832.2 ± 1,046.6 kcal/day) and more than seven
accurately represent local foods and typical portion sizes. servings per day (3815.4 ± 1287.4 kcal/day) showed greater
Participants’ responses were converted into average daily caloric intake compared to those consuming less than
intake in grams for grains and legumes. three servings (2569.3 ± 593.5 kcal/day) and 3 – 5 servings
per day (2,646.9 ± 699.1 kcal/day; p < 0.001). In addition,
2.6. Statistical analysis cases consuming more than seven servings per day had
Statistical analyses were conducted using the Statistical significantly longer smoking durations (17.0 ± 18.2 years)
Package for the Social Sciences version 29 (IBM compared to those consuming 3 – 5 servings (8.3 ±
Corporation, USA), with a significance threshold set at p 14.7 years) and 6 – 7 servings (6.3 ± 12.2 years; p = 0.005).
< 0.05. Descriptive analyses were performed to identify In addition, sex distribution (p < 0.001) and employment
variations among participants based on their daily grain status (p = 0.006) varied significantly among the groups,
consumption (<3 servings per day, 3 – 5 servings per day, with a higher proportion observed among males.
6 – 7 servings per day, and more than seven servings). The sociodemographic and health characteristics of
Continuous data were summarized using mean and the control group (n = 314) based on daily grain servings

Volume 9 Issue 1 (2025) 225 doi: 10.36922/ejmo.6606