Healthy plant-based diet might be inversely associated with gastric precancerous lesions: new evidence from a case-control study based on dietary pattern and fecal metabolic profiling

Abstract

Preventing the progression of gastric precancerous lesions (GPLs) can reduce the morbidity and mortality of gastric cancer (GC). The preventive effect of a plant-based diet on cancers has been widely recognised. In this case–control study, 1,130 subjects were included using 1:1 propensity score matching for age and sex. Dietary habits, anthropometry and sample collection were conducted using standard and effective methods. Plant-based diet indices (PDIs) were calculated using a previously reported method. Faecal samples were analysed by untargeted metabolomics. Our study found that adherence to a healthy plant-based diet was inversely associated with the occurrence of GPLs. Metabolomic analysis identified six different metabolites correlated with GPLs, among which luteolin-related metabolites may be used as biomarkers of the association between PDIs and GPLs. In addition, the difference in N-acyl amides found in PDIs needs further verification. Our findings suggest that a healthy plant-based diet may have a protective effect against GPLs.

Keywords:

• Gastric precancerous lesions
• plant-based diet
• metabolomics
• dietary pattern
• case–control study

Acknowledgments

The authors thank all the study participants, Dr. Peilin Wu for his help on data analysis, and professor Gensheng He, School of Public Health, Fudan University, for her advice on this manuscript.

Author contributions

The authors’ responsibilities were as follows: MT, XPX, YLW, and QHZ designed the research; WLC, XL, TTW, XHZ, and FX conducted the research; TX, SQQ, MT, and DMZ provided essential materials; WLC, XL, and LW analysed data and performed statistical analysis; WLC wrote initial paper; WLC, MW, and MZ critically revised the manuscript; MT, XPX, YLW, QHZ, WSY, and ALH read, revised and approved the final manuscript.

Ethical approval

The study protocol was approved by the Ethics Committee of Anhui Medical University (Approval Number: 20190292).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [Grant number: 81973049]; Anhui Province Peak Discipline Construction Plan [Grant number: 0301001861]; Anhui Medical University Promotion Program [Grant number: 2022xkjT006], and Anhui Medical University Basic Medicine and Clinic Cooperative [Grant number: 2020xkjT031].