Fruit and salt consumption are related to the risk of gastric cancer incidence in Asian populations: a comprehensive systematic review and meta-analysis of cohort studies.

Gastric cancer is the fifth most common cancer and a leading cause of death worldwide. Despite a substantial body of research exploring individual food groups or dietary patterns in isolation, few studies have assessed the overall strength of the association between multiple dietary factors and gastric cancer risk. The aim for this meta-analysis was to identify the associations between dietary factors and gastric cancer risk in the Asian population. The PubMed, Web of Science, Embase, and Scopus databases were systematically searched up to December 31, 2022. Hazard ratios (HRs) with their 95% CIs were used to calculate pooled risk estimates, and Cochran's Q and I2 statistics were used to assess heterogeneity. Funnel plot and Egger's tests were used to estimate publication bias. Through stepwise screening, 30 cohort studies were deemed eligible for inclusion in this review. Results indicated a high total fruit consumption may reduce gastric cancer risk by 11% (HR = 0.89; 95% CI, 0.83-0.96), whereas high salt consumption potentially increases the risk by 97% (HR = 1.97; 95% CI, 1.34-2.90) in the Asian population. However, no associations of the other 21 food groups and 2 dietary patterns (healthy and unhealthy dietary patterns) with gastric cancer risk were found. Overall, this review demonstrates that consumption of high amounts of fruit and low amounts of salt may effectively prevent gastric cancer incidence in the Asian population. More cohort studies based on the Asian population are required to confirm the association of fish, meat, coffee consumption, and dietary pattern with gastric cancer risk.