TY - JOUR
T1 - High intake of folate from food sources is associated with reduced risk of esophageal cancer in an Australian population
AU - Ibiebele, Torukiri I.
AU - Hughes, Maria Celia
AU - Pandeya, Nirmala
AU - Zhao, Zhen
AU - Montgomery, Grant
AU - Hayward, Nick
AU - Green, Adèle C.
AU - Whiteman, David C.
AU - Webb, Penelope M.
PY - 2011/2/1
Y1 - 2011/2/1
N2 - Folate plays a key role in DNA synthesis and methylation. Limited evidence suggests high intake may reduce risks of esophageal cancer overall; however, associations with esophageal cancer subtypes and Barrett's esophagus (BE), a precancerous lesion, remain unexplored. We evaluated the relation between intake of folate, B vitamins, and methyl-group donors (methionine, choline, betaine) from foods and supplements, polymorphisms in key folate-metabolizing genes, and risk ofBE, esophageal adenocarcinoma(EAC), andesophageal squamous cell carcinoma (ESCC) in 2 population-basedcase-control studies inAustralia. BE patientswithout (n=266)orwith (n=101) dysplasiawere comparedwith population controls (n=577); similarly, EAC (n = 636) or ESCC (n = 245) patients were compared with population controls (n = 1507) using multivariable adjusted logistic regression. Increasing intake of folate from foods was associated with reduced EAC risk (P-trend = 0.01) and mitigated the increased risks of ESCC associated with smoking and alcohol consumption. In contrast, high intake of folic acid from supplements was associated with a significantly elevated risk of BE with dysplasia. High intakes of riboflavin and methionine from food were associated with increased EAC risk, whereas increasing betaine intake was associated with reduced risks of BE without (P-trend = 0.004) or with dysplasia (P-trend = 0.02). Supplemental thiamin, riboflavin, niacin, and vitamin B-12 were associated with increased EAC risk. There were no consistent associations between genetic polymorphisms studied and BE or EAC risk. High intake of folate-containing foods may reduce risk of EAC, but our data raise the possibility that folic acid supplementation may increase risks of BE with dysplasia and EAC. © 2011 American Society for Nutrition.
AB - Folate plays a key role in DNA synthesis and methylation. Limited evidence suggests high intake may reduce risks of esophageal cancer overall; however, associations with esophageal cancer subtypes and Barrett's esophagus (BE), a precancerous lesion, remain unexplored. We evaluated the relation between intake of folate, B vitamins, and methyl-group donors (methionine, choline, betaine) from foods and supplements, polymorphisms in key folate-metabolizing genes, and risk ofBE, esophageal adenocarcinoma(EAC), andesophageal squamous cell carcinoma (ESCC) in 2 population-basedcase-control studies inAustralia. BE patientswithout (n=266)orwith (n=101) dysplasiawere comparedwith population controls (n=577); similarly, EAC (n = 636) or ESCC (n = 245) patients were compared with population controls (n = 1507) using multivariable adjusted logistic regression. Increasing intake of folate from foods was associated with reduced EAC risk (P-trend = 0.01) and mitigated the increased risks of ESCC associated with smoking and alcohol consumption. In contrast, high intake of folic acid from supplements was associated with a significantly elevated risk of BE with dysplasia. High intakes of riboflavin and methionine from food were associated with increased EAC risk, whereas increasing betaine intake was associated with reduced risks of BE without (P-trend = 0.004) or with dysplasia (P-trend = 0.02). Supplemental thiamin, riboflavin, niacin, and vitamin B-12 were associated with increased EAC risk. There were no consistent associations between genetic polymorphisms studied and BE or EAC risk. High intake of folate-containing foods may reduce risk of EAC, but our data raise the possibility that folic acid supplementation may increase risks of BE with dysplasia and EAC. © 2011 American Society for Nutrition.
U2 - 10.3945/jn.110.131235
DO - 10.3945/jn.110.131235
M3 - Article
C2 - 21178085
SN - 1541-6100
VL - 141
SP - 274
EP - 283
JO - Journal Of Nutrition
JF - Journal Of Nutrition
IS - 2
ER -