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By Pooja Toshniwal Paharia Feb 22 2024 Reviewed by Lily Ramsey, LLM

In a recent review published in Frontiers in Oncology, researchers investigated eating patterns and indices related to gastric cancer and explored their association with stomach cancer risk.

Study:  Review of dietary patterns and gastric cancer risk: epidemiology and biological evidence . Image Credit: Peakstock/Shutterstock.com Background

Gastric cancer is a common cancer worldwide, accounting for considerable global mortality. Despite attempts to minimize Helicobacter pylori prevalence and enhance food storage, the incidence and fatality rates of stomach cancer have decreased.

Epidemiological studies have found links between eating habits and stomach cancer risk. Individual dietary components, on the other hand, have produced inconsistent results in terms of the stated risk of stomach cancer.

Assessing eating patterns yields more reliable effect estimates and outcomes, emphasizing the need for comprehensive cancer prevention recommendations. About the review

In the present review, researchers reviewed existing data on the impact of diet on gastric cancer risk.

Diet patterns can be posteriori (formed from cohort population data) or a priori (created using existing information about food, nutrients, and illness). Posteriori patterns are determined using statistical approaches such as principal component analysis, factor analysis, and cluster analysis.

A priori patterns may derive from country-specific standards, chronic disease-preventive diets, or cultural eating habits. Association between a posteriori eating patterns and stomach cancer

In case-control studies, healthy eating patterns minimized the risk of stomach cancer, but an "unhealthy" dietary pattern raised the risk.

A comprehensive meta-analysis revealed that greater compliance with "prudent" diet patterns was related to a lower incidence of stomach cancer [odds ratio (OR) 0.8].

In contrast, increased compliance with Western diets increased the risk of total stomach cancer (odds ratio, 1.5). The association between poor eating habits and stomach cancer risk was more robust for cardia stomach cancers (OR, 2.1) than for distal stomach cancers (OR, 1.4).

Other meta-analyses showed that individuals consuming healthy foods had decreased stomach cancer risks (OR, 0.7) considerably.

In contrast, following unhealthy diets increased stomach cancer risk (OR, 1.6). A 2017 meta-analysis found that "Western" diets increase gastric cancer risk.

However, meta-analytical research of 13 case-control studies and eight studies of the prospective cohort type found that those abiding by "prudent" diets had a lower chance of developing stomach cancer. A priori dietary patterns, dietary indices, and gastric cancer

The relationship between eating habits and stomach cancer risk is complicated and nuanced. There is limited research on the link between high health eating index (HEI) or alternate HEI (AHEI) scores and the risk of stomach cancer.

A comprehensive review and meta-analysis found that higher adherence to HEI and AHEI dietary patterns was associated with a lower risk of total cancer-specific mortality.

New case-control research from Iran found that eating the dietary approaches to stop hypertension (DASH) diet was related to a 54% lower incidence of stomach cancer.

The DASH diet's components, such as excessive salt intake, red meat consumption, and fruits, have been linked to an increased risk of stomach cancer.

A Markov cohort state-transition model projected that a low sodium-DASH diet reduced stomach cancer risk by 25% in men and 21% in women.

Meta-analyses indicate that Mediterranean diet (MD) followers are less likely to develop stomach cancer.

MD vitamins and fibers reduce H. pylori colonization, whereas polyphenol-rich foods and extra-virgin olive oil (EVOO) reduce inflammation by inhibiting free radicals and lowering oxidative stress.

Omega-3 fatty acids reduce triglyceride levels and inflammation, methionine reduces body weight and insulin resistance, branched-chain amino acids improve insulin sensitivity, and short-chain fatty acids reduce trimethylamine N-oxide (TMAO) and inflammation and regulate autoimmunity factors. Patterns based on biological markers

Inflammation increases gastric cancer risk, particularly among men. Pro-inflammatory foods increase the incidence of intestinal and diffuse cancer subtypes.

The upregulation of cytokines and chemokines, which recruit several hematopoietic and progenitor cell types to inflamed stomach tissues, may cause chronic inflammation.

Gastric cancer-related inflammation includes inflammatory cytokines such as interleukin-1 (IL-1), IL-6, and tumor necrosis factor-alpha (TNF-α). IL-1 has an anti-tumor impact, whereas IL-6 is associated with tumor progression, invasion, and metastasis.

The ketogenic diet (KD) is associated with anti-cancer treatment in advanced gastric cancer patients. The KD alters glucose metabolism and inhibits insulin signaling and insulin-like growth factor 1 (IGF-1), the primary energy source for tumor cells. KD reduces nicotinamide adenine dinucleotide phosphate (NADPH) generation to increase oxidative stress in tumor cells.

Ad libitum KD therapy inhibits hypoxia-related and growth-driven proteins, influencing tumor progression.

Ketones enter cancer cells by monocarboxylate transporters (MCTs), limit lactate export, reduce cancer survival time, and prevent the activation of NLR family pyrin domain containing 3 (NLRP3), nuclear factor kappa B (NF-kB) and Signal transducer and activator of transcription 3 (STAT3) activation, lowering IL-1β expression.

The review findings indicate that dietary patterns can influence gastric cancer risk by influencing metabolites, gut microbiota, inflammation, and immune function.

Inconsistency in results might be owing to various factors such as meal types, recollection bias, overall energy consumption, and other confounders. Large-scale prospective cohort studies could improve the validity of the findings. Journal reference:

Pu K, Feng Y, Tang Q, Yang G, and Xu C (2024) Review of dietary patterns and gastric cancer risk: epidemiology and biological evidence. Front. Oncol. 14:1333623. doi: 10.3389/fonc.2024.1333623. https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2024.1333623/full?utm_source=S-TWT

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Israel attacks Syrian military HQ – and disrupts live TV broadcast

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Israel attacks Syrian military HQ - and disrupts live TV broadcast

Israeli airstrikes have targeted the Syrian military headquarters in Damascus amid renewed clashes in the country.

The gate of the Ministry of Defence in the Syrian capital was targeted by two warning missiles from an Israeli reconnaissance aircraft.

State-owned Elekhbariya TV said the Israeli strike had wounded two civilians, the Reuters news agency reported.

Smoke rises after strikes on Syria's defence ministry in Damascus, Syria.
Pic: Reuters
Image:
Smoke rises from Syria’s defence ministry building in Damascus. Pic: Reuters

It came as Israeli airstrikes targeted security and army vehicles in the southern city of Sweida, where the Druze faith is one of the major religious groups – marking the third consecutive day Israel has struck Syrian forces.

The Israeli military confirmed it had “struck the entrance gate” in Damascus – and that it would be monitoring “actions being taken against Druze civilians in southern Syria”.

Smoke rises from an Israeli airstrike that hit the Syrian Defence Ministry in Damascus.
Pic: AP
Image:
The Israeli airstrike targeted Syria’s military headquarters. Pic: AP

Why Israel is getting involved in Syria’s internal fighting


Dominic Waghorn

Dominic Waghorn

International affairs editor

@DominicWaghorn

Israel has shown little respect for international borders since becoming the unrivalled military hegemon of the Middle East. Today that meant an Israeli airstrike on a government building in Damascus.

Israel says its attack on a Syrian defence ministry facility was intended as a warning to the new government: stay out of the part of southern Syria we have occupied or else.

Israel has moved into parts of the south of the country, built military bases and declared a line of control.

On Monday, Syrian tanks heading south to try and restore order following an outbreak of factional fighting were attacked by Israeli warplanes.

“The presence of such vehicles in southern Syria could pose a threat to Israel,” stated the Israel Defence Forces.

In reality, Syria’s ageing tanks pose minimal threat to Israel’s state-of-the art military.

Read the full analysis

Local media said Sweida and nearby villages were coming under heavy artillery and mortar fire on Wednesday, according to Reuters.

The clashes marked the collapse of a ceasefire between Syrian government forces and Druze armed groups, with Israel also warning it would increase its involvement.

Syrian security forces walk together along a street in the southern Druze city of Sweida.
Pic: Reuters
Image:
Syria said its forces had responded to being fired upon. Pic: Reuters

Israel said it was acting to protect the Druze groups through its attacks on convoys of Syrian forces.

Syria blamed militias in Sweida for violating a ceasefire agreement which had only been reached on Tuesday.

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A statement from its defence ministry said: “Military forces continue to respond to the source of fire inside the city of Sweida, while adhering to rules of engagement to protect residents, prevent harm, and ensure the safe return of those who left the city back to their homes.”

Israel’s defence minister Israel Katz said the military will continue to strike Syrian forces until they withdraw and should “leave Druze alone”, according to local reports.

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Why Israel is getting involved in Syria’s internal fighting

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Why Israel is getting involved in Syria's internal fighting

Israel has shown little respect for international borders since becoming the unrivalled military hegemon of the Middle East.  Today that meant an Israeli airstrike on a government building in Damascus.

Israel says its attack on a Syrian defence ministry facility was intended as a warning to the new government: stay out of the part of southern Syria we have occupied or else.

Israel has moved into parts of the south of the country, built military bases and declared a line of control.

Smoke rises from an Israeli airstrike that hit the Syrian Defence Ministry in Damascus.
Pic: AP
Image:
Smoke rises from an Israeli airstrike that hit the Syrian Defence Ministry in Damascus. Pic: AP

On Monday, Syrian tanks heading south to try and restore order following an outbreak of factional fighting were attacked by Israeli warplanes.

“The presence of such vehicles in southern Syria could pose a threat to Israel,” stated the Israel Defence Forces.

In reality, Syria’s ageing tanks pose minimal threat to Israel’s state-of-the art military.

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Syrian presenter interrupted by Israeli airstrike

The Syrian armour was attacked as it entered the area around Sweida in the Druze heartland of southern Syria following factional fighting there.

More on Israel

The flare-up reportedly began with clashes between Bedouin and Druze groups that ended in scores killed.

The background to the escalation is complicated.

At least three Druze militia groups are divided in their loyalties to different religious leaders and differ over how they should respond to calls to assimilate into the new post-revolutionary Syria.

Druze from Syria and Israel protest on the Israeli-Syrian border, in Majdal Shams in the Israeli-controlled Golan Heights.
Pic: AP
Image:
Druze from Syria and Israel protest on the Israeli-Syrian border.
Pic: AP

Read more:
30 dead as armed groups clash in Syria
UK restores diplomatic ties with Syria

Israel is becoming more and more involved in Syria’s internecine war and says it will remain there indefinitely “to protect our communities and thwart any threat”.

Its critics say Israel is operating a policy of divide and rule in Syria, weakening the fledgling government and creating a buffer zone to protect the border with the Golan Heights – originally Syrian territory that it has occupied and annexed for almost half a century.

Since the fall of the Assad regime, Israel has used airstrikes to destroy of much of Syria’s military capability weakening its ability to impose control on outlying regions. This makes it more not less likely Israel will have a volatile unstable state on its northern border.

Syrian security forces walk together along a street in the southern Druze city of Sweida.
Pic: Reuters
Image:
Syrian security forces walk along a street in the southern Druze city of Sweida. Pic: Reuters

America and European powers have chosen to normalise relations with the new government in Damascus and lift sanctions.

In contrast Israel has occupied its territory, bombed its military and today hit one of its government buildings in the capital with an airstrike.

Since its crushing military campaigns against Hamas, Hezbollah and Iran, Israel has emerged as the unchallenged military power of the region.

There is however a limit to what blunt force can achieve alone. It requires diplomacy to achieve lasting gains and Israel’s repeated assaults on multiple neighbours combined with its relentless campaign in Gaza are winning it few friends in the region.

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Gaza: At least 19 killed in crowd crush near distribution site, says Israel-backed aid group

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Gaza: At least 19 killed in crowd crush near distribution site, says Israel-backed aid group

At least 20 people have been killed in an incident in Khan Younis, according to the Gaza Humanitarian Foundation (GHF), an Israel and US-backed organisation.

In a statement, it said 19 people were trampled and one was stabbed in a surge “driven by agitators in the crowd”.

“We have credible reason to believe that elements within the crowd – armed and affiliated with Hamas – deliberately fomented the unrest,” it said.

“For the first time since operations began, GHF personnel identified multiple firearms in the crowd, one of which was confiscated. An American worker was also threatened with a firearm by a member of the crowd during the incident.”

It provided no evidence to support the claim.

The Hamas-run Gaza health ministry claimed 21 Palestinians were killed, “including 15 who died of suffocation as a result of tear gas fired at the starving people and the subsequent stampede” at the GHF site.

Read analysis: Deaths go up when aid sites open

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Gaza deaths increase when aid sites open

The statement is unusual for the GHF, as the controversial group, which has been rejected by the United Nations and other aid groups, rarely acknowledges trouble at its distribution sites.

The GHF began distributing food packages in Gaza at the end of May, after Israel eased its 11-week blockade of aid into the territory.

It has four distribution centres, three of which are in the southern Gaza Strip. The sites, kept off-limits to independent media, are guarded by private security contractors and located in zones where the Israeli military operates.

Analysis: Gazans face unbearable choice of risking their lives for supplies or going hungry

by Lisa Holland, Sky News correspondent in Jerusalem

The United Nations has already condemned the aid centres run by the Gaza Humanitarian Foundation as “death traps” – and that was before the latest loss of life, seemingly mostly from suffocation.

It’s the first and only time we know of people dying in this way, waiting to get food.  Although the Gaza health ministry and the GHF dispute exactly what happened.

But how much longer can this Israeli and American-backed way to supply aid continue when people are dying on a near-daily basis?

However it happened, Gaza’s overcrowded hospitals are once again overwhelmed.

And there are serious questions to answer about the organisation of a system which is supposed to be providing humanitarian aid to desperately hungry people, but instead is a place where there is so much loss of life.

It leaves people with an unbearable choice between risking their lives to get supplies or going hungry.

Palestinian witnesses say Israeli forces have repeatedly opened fire towards crowds of people going to receive aid.

The Israeli military says it has fired warning shots at people who have behaved in what it says is a suspicious manner. It says its forces operate near the aid sites to stop supplies from falling into the hands of militants.

After the deaths of hundreds of Palestinians trying to reach the aid hubs, the UN has called the GHF’s aid model “inherently unsafe” and a violation of humanitarian impartiality standards.

In response, a GHF spokesperson said: “The fact is the most deadly attacks on aid sites have been linked to UN convoys.”

People carry distributed aid supplies in Khan Yunis, southern Gaza, on July 1, 2025. Pic: AP
Image:
People carry distributed aid supplies in Khan Yunis, southern Gaza. File pic: AP

The GHF says it has delivered more than 70 million meals to Gazans in five weeks and claims other humanitarian groups – which refuse to work with the GHF – had “nearly all of their aid looted” by Hamas or criminal gangs.

Read more:
Medical charity warns acute malnutrition at all-time high

UN data on Gaza deaths ‘disinformation’, claims GHF chief

Since the GHF sites began operating, more than 875 people have been killed while receiving aid, both at GHF distribution points or elsewhere, according to the UN human rights office and the Hamas-run Gaza health ministry.

At least 674 of those have been killed in the vicinity of aid distribution sites run by the GHF.

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