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

描述(申请人提供)：本申请的目的是研究某些饮食元素对Barrett‘s食道(BE)和胃食道反流病(GERD)风险的影响。巴雷特的食道是食管腺癌的先兆，食管腺癌在美国的发病率正在急剧上升。由于这种癌症的低存活率和对治疗的不良反应，识别可改变的危险因素对于预防这种致命的疾病并不重要。GERD是食管腺癌和BE的主要危险因素之一。GERD也是美国人最常见的疾病，它的症状强烈地影响着受影响的人的生活质量。饮食调整是GERD患者的常规建议，尽管几乎没有流行病学证据表明其有效性。更好地了解饮食对GERD的影响不仅有助于改善受影响个人的生活质量，还可以降低Barrett‘s食道和食管腺癌的风险。这项拟议的研究是对申请者博士论文研究的延续，在该研究中，她发现水果和蔬菜与BE风险之间存在强烈的负相关。这项研究将利用2004-2005年间使用北加州Kaiser Permanente人群对Barrett‘s食道进行的基于人群的病例对照研究获得的现有数据。研究对象包括296例BE事件、308例GERD对照和309例人群对照。对照组的年龄、性别和性别频率匹配。 诊断的位置。在家庭访谈中，每个受试者使用经过验证的食物提供信息 频率问卷和GERD症状问卷；人体测量和血液样本也由训练有素的采访者收集。具体目标如下：1)评估膳食脂肪(总脂肪和饱和脂肪)、蛋白质(动物和蔬菜)、胆固醇、 炭化食物和纤维对巴雷特食道的风险。2)评价高脂肪食物、咖啡因、巧克力、酒精和柑橘类水果对胃食道反流病症状的影响。与公共健康相关：这项研究具有重要的公共健康意义，因为1)它检查了饮食对食管腺癌风险的影响，食管腺癌是发病率迅速增加的一种癌症；2)它评估了通常认为会影响酸反流的食物的影响，这是一种很大比例的美国人患有胃酸反流的症状。

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.