Esophageal Cancer Risk and Dietary Flavonoids


BARCELONA, SPAIN What are the main findings of the study?

Dr. Zamora-Ros:  Our study shows that diets rich on flavonoids (polyphenols ubiquitously distributed in the plant kingdom, such as in fruit, vegetables, tea, wine and chocolate), particularly flavonols, are associated with less esophageal cancer risk, especially in current smokers. Tobacco smoking causes oxidative stress, and both oxidative stress and smoking tobacco are related to increased esophageal cancer risk. Therefore, our data suggest that the possible protective mechanism of dietary flavonoids may be related to their antioxidant properties, which may not be attributed to the direct antioxidant action, but to the ability to modulate antioxidant enzymatic pathways. Were any of the findings unexpected?

Dr. Zamora-Ros: Our hypothesis was that high flavonoid intakes would have reduced esophageal cancer risk in all participants, and that these protective results would be stronger in participants at higher oxidative risk (current smokers); however, in our study, no significant associations were observed in never and former smokers. What should clinicians and patients take away from your report?

Dr. Zamora-Ros: Diets rich in flavonoids (natural antioxidants) and in general diets rich in plant based foods are inversely associated with esophageal cancer risk, particularly in subjects with high oxidative stress (current smokers). What recommendations do you have for future research as a result of this study?

Dr. Zamora-Ros: The recommendation in epidemiological research would be the replication of the study in other populations with different risk factors, more cases, and different flavonoid intakes. If the results are consistent among the studies, it would allow us to generalize and confirm these findings. In basic science, the recommendation would be the investigation of the underlying mechanisms of action of these flavonoids in the etiology of esophageal cancer.


Dietary Flavonoid Intake and Esophageal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Cohort.

Vermeulen E, Zamora-Ros R, Duell EJ, Luján-Barroso L, Boeing H, Aleksandrova K, Bueno-de-Mesquita HB, Scalbert A, Romieu I, Fedirko V, Touillaud M, Fagherazzi G, Perquier F, Molina-Montes E, Chirlaque MD, Vicente Argüelles M, Amiano P, Barricarte A, Pala V, Mattiello A, Saieva C, Tumino R, Ricceri F, Trichopoulou A, Vasilopoulou E, Ziara G, Crowe FL, Khaw KT, Wareham NJ, Lukanova A, Grote VA, Tjønneland A, Halkjær J, Bredsdorff L, Overvad K, Siersema PD, Peeters PH, May AM, Weiderpass E, Skeie G, Hjartåker A, Landberg R, Johansson I, Sonestedt E, Ericson U, Riboli E, González CA.

Am J Epidemiol. 2013 May 6. [Epub ahead of print]

Last Updated on June 8, 2013 by Marie Benz MD FAAD