Page 240 - EJMO-9-1

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

associated with increased GC risk, making its inhibition genetic susceptibility, and environmental exposures may
an important dietary intervention for GC prevention. influence individual vulnerability to acrylamide-related
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Moreover, flavanols in legumes, specifically quercetin, carcinogenesis. Our findings are consistent with previous
act as antiproliferative agents that inhibit cell growth and research highlighting the potential risks associated with
induce cell cycle cessation in GC cells. Phenolic acids, thermally processed foods. Several studies have linked
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including hydroxybenzoic and hydroxycinnamic acid acrylamide exposure to an increased risk of GC and other
derivatives, serve as antioxidants through mechanisms cancers; however, the evidence remains inconclusive. The
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such as hydrogen atom transfer and single electron observed trend in our study reinforces the need to consider
transfer. These actions help neutralize free radicals, falafel consumption as a potential dietary factor in GC risk,
thereby protecting essential biomolecules, such as DNA, particularly in populations where it is a dietary staple.
lipids, and proteins, from oxidative stress. In addition, In Jordan, food preparation methods can significantly
phenolic acids stimulate natural antioxidant defenses by impact the nutritional content and potential health
enhancing the production of enzymes such as superoxide benefits of meals. Traditional cooking methods for grains
dismutase and catalase, helping to maintain a balance and legumes, such as boiling, frying, or stewing, might
between prooxidants and antioxidants. Collectively, alter the nutrient profiles of these foods, thereby affecting
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these polyphenols provide a protective effect against GC
through their combined anti-inflammatory, antioxidant, their impact on GC risk. The use of added fats like olive
and antiproliferative activities. Phytosterols are plant- oil, which is common in Jordanian cuisine, can influence
derived compounds structurally similar to cholesterol and the health benefits of otherwise nutrient-rich foods. While
olive oil is a staple of the Mediterranean diet, excessive
are recognized for their anticancer properties against GC. consumption or high-fat cooking methods may counteract
Their primary mechanism involves inducing apoptosis some protective effects associated with whole grains and
in GC cells by triggering intrinsic apoptosis pathways,
significantly reducing cell viability and contributing vegetables. In addition, certain regions in Jordan may rely
to overall anticancer effects. The combined action of more heavily on refined grains or processed foods, which
polyphenols and phytosterols underscores legumes’ could reduce the beneficial effects of whole grains and
potential to reduce GC risk through anti-inflammatory, legumes in those populations.
antioxidant, and apoptosis-inducing mechanisms. 5. Study limitations and strengths
In the context of falafel consumption, we observed While the FFQ is a suitable tool for assessing food intake
a potential trend of increased odds of GC in the fourth in this study, it has inherent limitations, particularly the
quartile (OR: 1.90, p = 0.679), although this finding is not potential for recall bias in dietary reporting. This bias arises
statistically significant. This observation may align with when participants do not accurately recall or report their
the biological rationale of acrylamide as a carcinogen past dietary habits, potentially affecting the reliability of
formed during the thermal processing of falafel. Falafel is the findings. To address this issue, we used an ethnically
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a staple food in the Middle East and is increasingly popular validated FFQ, incorporated food models, and ensured that
worldwide; for example, it is typically prepared through trained dietitians conducted the assessments. The FFQ was
frying at high temperatures in Tehran, Iran. This cooking specifically tailored to the Jordanian population, including
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process is known to produce acrylamide, a compound local foods, common portion sizes, and seasonal variations
classified as a potential human carcinogen by the in food availability. These measures facilitated a more
International Agency for Research on Cancer. Acrylamide accurate estimation of participants’ long-term dietary habits
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forms during the thermal processing of carbohydrate-rich and ensured a culturally relevant and precise approach to
foods and undergoes metabolic conversion to glycidamide, dietary assessment. We matched cases with controls based
a mutagenic and carcinogenic compound, through the on age, sex, and marital status to reduce confounding from
cytochrome P450 2E1 pathway. These metabolites have these factors. In addition, we adjusted for other potential
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been implicated in mutagenic and carcinogenic effects
in laboratory studies, providing a rational biological confounders, including caloric intake, education level, body
mechanism for the observed association, even if statistical weight status, smoking status and duration, family history
significance was not achieved. The variability in falafel of cancer, history of stomach ulcers and stomachaches, as
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recipes across different regions may also contribute to well as physical activity levels. These adjustments accounted
the inconsistency in results. Common variations include for the impact of these variables on the outcomes and
helped ensure the validity of our findings.
chickpea-based, bean-based, and chickpea-potato-based
falafel, with differences in preparation methods, frying Despite these limitations, our study has several
oils, and serving practices. In addition, dietary patterns, important strengths. One of the main strengths is the
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Volume 9 Issue 1 (2025) 232 doi: 10.36922/ejmo.6606