The effects of Diet on Barrett's esophagus and gastroesophageal reflux disease

描述（由申请人提供）：本申请的目的是研究某些饮食元素对巴雷特食管（BE）和胃食管反流病（GERD）风险的影响。巴雷特食管是食管腺腺瘤的前兆，在美国，这种癌症的发病率正在急剧上升。由于这种癌症的生存率低，治疗反应差，确定可改变的危险因素对于预防这种致命疾病是不必要的。胃食管反流是食管腺癌和BE的主要危险因素之一。反流胃食管反流也是美国人中最常见的疾病，其症状严重影响患者的生活质量。饮食改变是胃食管反流患者的常规建议，尽管很少有流行病学证据表明其有效性。更好地了解饮食对胃食管反流的影响不仅有助于改善患者的生活质量，还能降低巴雷特食管和食管腺癌的风险。拟议的研究是申请人博士论文研究的延续，她发现水果和蔬菜与BE风险之间存在强烈的负相关关系。本研究将利用一项基于人群的巴雷特食管病例对照研究中获得的现有数据，该研究在2004-2005年期间对北加州Kaiser Permanente人群进行了研究。研究对象包括296例BE病例，308例GERD对照组和309例人口对照组。对照组的频率与年龄，性别和

DESCRIPTION (provided by applicant): The objective of this application is to examine the effects of certain dietary elements on the risk of Barrett's esophagus (BE) and gastroesophageal reflux disease (GERD). Barrett's esophagus is a precursor to esophageal adenocracinoma, a cancer that is experiencing a dramatic increase in its incidence in the United States. Because of this cancer's low survival rate and poor response to treatments, identification of modifiable risk factors inessential in preventing this lethal disease. GERD is one of the major risk factors for esophageal adenocarcinoma and BE. GERD is also the most common diseases among Americans, and it symptoms strongly affects the quality of life of those affected. Dietary modification is routinely advised for GERD patients, though there has been little epidemiological evidence on its effectiveness. Better understanding of the effects of diet on GERD would not only help improve the quality of life of affected individuals, but also reduce the risk of Barrett's esophagus and esophageal adenocarcinoma. The proposed study is a continuation from the applicant's doctoral dissertation research where she found a strong inverse association between fruits and vegetables and the risk of BE. This study will utilize existing data obtained from a population-based case-control study of Barrett's esophagus conducted using Northern California Kaiser Permanente population during the years 2004-2005. Subjects include 296 incident BE cases, 308 GERD controls, and 309 population controls. Controls were frequency matched by age, sex, and location of the diagnosis. At in-home interview, each subject provided information using validated food frequency questionnaire and GERD symptom questionnaire; anthropometric measures and blood samples were also collected by trained interviewers. The specific aims are as follows: 1) To evaluate the effects of dietary fat (total and saturated), protein (animal vs. vegetable), cholesterol, charbroiled food, and fiber on the risk of Barrett's esophagus. 2) To evaluate the effects of fatty foods, caffeine, chocolate, alcohol, and citrus fruits on the symptoms of gastroesophageal reflux diseases. PUBLIC HEALTH RELEVANCE: This study has an important public health implication because 1) it examines the effects of diet, one of the most modifiable risk factors on the risk of esophageal adenocarcinoma, a cancer that is increasing in its incidence rapidly, and 2) it evaluates the effects of food items that are commonly thought to affect acid reflux, a symptom from which a large proportion of Americans suffer.