The protective effect of dietary folate intake on gastric cancer is modified by alcohol consumption

Dietary folate intake has been identified as a potentially modifiable factor of gastric cancer (GC) risk, although the evidence is still inconsistent. Researchers evaluated the association between dietary folate intake and the risk of GC as well as the potential modification effect of alcohol consumption. Data for 2,829 histologically confirmed GC cases and 8,141 controls from 11 case-control studies from the international Stomach Cancer Pooling Consortium were pooled. Dietary folate intake was estimated using food frequency questionnaires. Linear mixed models with random intercepts for each study were used to calculate adjusted odds ratios (OR) and 95% confidence interval (CI).
Higher folate intake was associated with a lower risk of GC. The OR for the highest quartile of folate intake, compared with the lowest quartile, was 0.78 (95% CI, 0.67-0.90). The OR per each quartile increment was 0.92 (95% CI, 0.87-0.96) and, per every 100 μg/day of folate intake, was 0.89 (95% CI, 0.84-0.95). However, there was a significant interaction between folate intake and alcohol consumption. The lower risk of GC associated with higher folate intake was not observed in participants who consumed >2.0 drinks per day, in this group the OR for the highest quartile of folate intake, compared with the lowest quartile, was 1.15 (95% CI, 0.85-1.56), and the OR per each quartile increment was 1.02 (95% CI, 0.92-1.15).
The study supports a beneficial effect of folate intake on GC risk, although the consumption of >2.0 alcoholic drinks/day counteracts this beneficial effect.
Source: Gonzalez-Palacios S, Compañ-Gabucio L-M, Torres-Collado L, et al. The protective effect of dietary folate intake on gastric cancer is modified by alcohol consumption: A pooled analysis of the StoP Consortium. Int J Cancer. 2024; 155(8): 1367-1375.