Diet and Stomach Cancer

Premise

Nutrition is an element that significantly affects the increase or reduction of the risk of stomach cancer.
Not surprisingly, diet is considered one of the major predisposing or preventing factors of this pathology.
Furthermore, the nutritional aspect plays a decisive role in the eventual healing and maintenance process after surgery for the removal of the tumor.
Below we will analyze all the aspects of correlation between diet and stomach cancer.

Excessive consumption of cured meats and meats preserved or cooked at high temperatures increases the risk of stomach cancer.

Stomach

The stomach is the largest organ in the abdomen. It is totally hollow and is used for food processing; more precisely, the stomach participates in the digestion of the food bolus (chewed and saliva-impregnated foods). Its digestive functions include acid-peptic secretion, mixing, trituration and progression of the mass, and digestion.
From a chemical point of view, in the stomach mainly protein denaturation and the secretion of the known intrinsic factor, an element necessary for the intestinal absorption of vitamin B12 (cobalamin), takes place.

Tumor and Carcinoma

Stomach cancers are not all the same. They can consist of benign or malignant formations, with very different invasiveness and tendency to metastasis. Of all the types, the one responsible for the greatest number of deaths is undoubtedly gastric cancer.

Gastric cancer is particularly widespread in Japan and South America; in Italy, the number of diagnoses seems higher in Tuscany and Emilia-Romagna. It affects males more than females (2: 1) and the maximum age of incidence is 45-55 years.
The risk factors for gastric cancer are:

• dietary (see below),
• environmental (air pollution, workplace pollution and cigarette smoke),
• genetic (blood group A) and family members (genetic alteration p-53)
• infection with Helicobacter pylori
• presence of other pre-cancerous pathologies (eg. early gastric cancer and intestinal metaplasia).

NB. The presence of gastritis and / or ulcer may be related to the onset of gastric carcinoma but, in itself, is not a primary factor.

Gastric cancer is a rather subtle form of stomach cancer; in fact, while generating painful and well perceptible symptoms, it is sometimes confused with other less serious diseases (gastritis, ulcers, etc.); moreover, it tends to overlap with other malignant forms. Also for these two reasons, gastric cancer is one of the main causes of cancer death in Italy after lung cancer and colorectal and anus cancers.

An early diagnosis significantly reduces the possibility of death; It is therefore advisable that, in the presence of pain, discomfort and loss of appetite (especially towards meat), you contact your doctor who will evaluate the relevance of a clinical assessment (gastroscopy and possibly biopsy).
In the event of a positive diagnosis, therapy includes resection of the diseased area, radiotherapy and chemotherapy. On the other hand, following the removal of the stomach or part of it, or the formation of a gastro-jejunal bypass, the subject will need to follow a specific diet due to digestive impairment.

Diet as a Cause

As anticipated, on our peninsula the regions most affected by gastric cancer are Tuscany and Emilia Romagna, but this epidemiology varies considerably according to the type of diet. In fact, nutrition of the continental type, or having the characteristics that we will list below, acquires a predisposing role.
The nutritional factors predisposing gastric cancer are:

• Excess of fats, especially saturated or of poor quality (hydrogenated, refined, rich in chains in trans conformation).
• Excess of sodium chloride.
• Excess toxic molecules from smoking or carbonization (aromatic polycyclics, acrylamide, acrolein, formaldehyde, etc.).
• Excess of nitrosamines, carcinogenic molecules deriving from the combination of amines with nitrites; the latter can:
  • being in the environment and on foods (they are added to most cured meats as preservatives);
  • be obtained from nitrates (food preservatives) by bacteria and enzymes present in the environment and in the human body.
• Excess of ethyl alcohol.
• Lack of dietary fiber.
• Deficiency of provitamin A, vitamin C and vitamin E.
• Deficiency of non-vitamin antioxidants (phenolic and non-phenolic).
• Incorrect storage of refrigerated food (in the refrigerator).

In practical terms, the diet that predisposes to the onset of gastric cancer has the following characteristics:

• Too many foods of animal origin, especially butter, fatty cheeses, milk cream, egg yolk and fatty meats
• Too many fried foods or foods that contain processed margarines and oils of tropical origin. They all belong to the junk food category; some examples are: potato chips in bags or fast-food fries, chocolates, other sweet snacks, etc.
• Too many salty foods; these include
  • both preserved foods such as: sausages, salted meats, salted fish (anchovies, herring, cod, etc.), certain cheeses, pickled foods (vegetables, legumes, tuna), fried foods in bags (e.g. chips, nachos and popcorn), dried fruit in bags (e.g. peanuts),
  • both the discretionary addition (ie the one made during home cooking or at the table).
• Too many smoked foods, such as cured meats such as speck, fish such as salmon, etc.
• Too many foods or drinks rich in carbonized molecules, because they are cooked by roasting, irradiation or direct conduction; for example caramel, coffee, grilled and grilled foods; even worse if by means of wood or coal embers.
• Too many preserved and nitrate-rich foods; they are widely used preservatives in the production of cured meats and cheeses.
• Too many alcoholic drinks.
• Lack of whole or unhulled foods belonging to the I and II fundamental food group; they are legumes and cereals rich in fiber and antioxidants.
• Scarcity of foods belonging to the VI and VII fundamental food groups; they are fruits and fresh vegetables rich in provitamin A (carotenoids), vitamin C and antioxidants.
• Percentage scarcity of cold-pressed vegetable origin seasoning oils; these should make up the majority of dietary lipids, as they are rich in vitamin E and other antioxidants.
• Excessive storage of food in plastic bags, in which bacteria easily convert nitrites into nitrosamines.

Diet to Prevent Gastric Carcinoma

Having clarified the predisposing factors for the formation of gastric cancer, let's define more clearly what are the nutritional principles that help prevent the disease:

• Not more than 25-30% of the total energy from fat.
• Nutritional breakdown of fatty acids in favor of the unsaturated ones (at least 15-20% of the total energy) over the saturated ones (not> 10% of the total energy), with a satisfactory share of polyunsaturated ones (5-10% of the total energy ).
• Not more than 1500mg of total sodium; kitchen salt contains about 40%.
• Elimination of toxic molecules typical of roasting, caramelization, smoking and the surface of food cooked on the grill or on the plate (polycyclic aromatic, acrylamide, acrolein, formaldehyde, etc.).
• Significant reduction of nitrates, nitrites and therefore nitrosamines.
• Elimination of ethyl alcohol or drastic limitation.
• Increase of dietary fiber up to 30g / day.
• Increase in provitamin A, vitamin C and vitamin E.
• Increase of non-vitamin antioxidants (phenolic and non-phenolic).
• Short and optimal conservation of refrigerated foods.

In practical terms, all this translates into:

• Consumption of lean foods of animal origin seasoned with a maximum of 5-10g of raw pressed vegetable oil for each portion (for example extra virgin olive oil)
• As a main dish (main course), consume fish 2-3 times a week, meat about 2 times a week, low-fat cheeses 1-2 times and whole eggs once.
• Consume at least 2 portions of fresh vegetables a day, of which at least 50% raw in portions of 50-300g (depending on the type).
• Consume at least 2 servings of fresh fruit per day; portions range from 150 to 300g, depending on the sugar level.
• Consume whole grains and unshelled legumes every day (first courses, side dishes and accompanying bread), in whole form or in foods that contain them (as long as they are not too processed or refined).
• Prefer fresh foods, avoiding those stuffed or preserved in brine or smoked or dried or subjected to salting; moreover, avoiding adding salt in cooking and on dishes, this selection will reduce the intake of sodium, nitrates and toxic molecules.
• Cook with indirect systems, such as boiling, steaming, pressure cooking, bain-marie cooking, sous-vide cooking and pot cooking. This will help decrease total fat and toxic molecules.
• Eliminate all hard and empty drinks; eventually, limit yourself to 2 glasses of red wine a day.
• To moderate the introduction of nitrites, consume above all seasonal fruit and vegetables avoiding greenhouse ones, remove the stem, the outer leaves and the petiole; always wash them carefully. Remember that summer products contain less than winter ones and that food richer are: lettuce, kohlrabi, capuchin lettuce, cress, chard, radish, horseradish, rhubarb, beetroot and spinach.
• The preservation of fruit and vegetable products must be short and possibly carried out after washing, preferably in paper bags or containers covered with a cloth.

Diet after Gastrectomy or By-Pass

As anticipated, the removal of the stomach (gastrectomy) or part of it, or the formation of a gastro-jejunal bypass, require the subject to respect a specific diet.