Written by Greg Arnold, DC, CSCS. Intakes of vegetables and fruits are associated with lowering the risk of Barrett’s Esophagus by 61% in the highest intake group compared to the lowest intake group. (Barrett’s Esophagus is a condition where the cells of the esophagus change and resemble those lining the intestine.

Barrett’s Esophagus is a condition where the cells of the esophagus, the muscular tube that connects the mouth to the stomach, change their form and resemble cells that are in the lining of the intestine by a process called “metaplasia” (1).  Barrett’s Esophagus is estimated to affect 1% of Americans (2) and is a significant health concern because it can lead to cancer of the esophagus, called esophageal adenocarcinoma (EA). This is the most rapidly increasing cancer in the United States (3), costing our healthcare system over $260 million per year (4).

One of the biggest risk factors for Barrett’s Esophagus is Gastroesophageal Reflux Disease (GERD), which is defined as having persistent acid reflux more than two times per week. Gastroesophageal Reflux Disease affects as many as one in five Americans (5) and costs our healthcare system $24 billion per year (6). Now a new study (8) has found that increasing your fruit and vegetable intake may be a preventive treatment for Barrett’s Esophagus.

Previous research has suggested that decreased fruit and vegetable intake may be a risk factor for Barrett’s Esophagus (9). In the current study, 170 patients recently diagnosed with Barrett’s Esophagus were compared with 182 patients without Barrett’s Esophagus. All of the patients completed a 131-item food frequency questionnaire (10) that classified their fruit and vegetable intake into “never, or less than once per month” to “2 or more servings per day.”

The researchers found that, compared to those with the lowest vegetable intake (0.67 servings per 1000 calories), those with the highest intake (> 1.24 servings per 1000 calories) had a 67% reduced risk of Barrett’s Esophagus. Even those in the next level of vegetable consumption (0.67-1.23 servings per 1000 calories) had a 40% reduced risk. When the researchers looked at both fruit and vegetable intake, there was a 61% decreased risk with the highest intakes (> 2.31 servings of fruits and vegetables per 1000 calories) and 51% reduced risk for the next highest intake (1.24-2.30 servings per 1000 calories) compared to the lowest intake (< 1.24 servings per 1000 calories).

For the researchers, “increased intakes of vegetables and fruit are associated with a lower risk of Barrett’s Esophagus in men and women. Prospective data that examine relations between diet and Barrett’s Esophagus are needed.

Source: Thompson, Olivia M., Shirley AA Beresford, Elizabeth A. Kirk, and Thomas L. Vaughan. “Vegetable and fruit intakes and risk of Barrett’s esophagus in men and women.” The American journal of clinical nutrition 89, no. 3 (2009): 890-896.

© 2009 American Society for Nutrition

Posted March 18, 2009.

References:

  1. “Barrett’s Esophagus” posted on the National Digestive Diseases Information Clearinghouse website.
  2. Cameron AJ. Epidemiology of Barrett’s esophagus and adenocarcinoma. Diseases of the Esophagus. 2002;15:106–108.
  3. Pohl, H & Welch, HG. The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst 2005;97:142–6.
  4. Wei WT.  Dollars and sense in preventing esophageal cancer.  Gastroenterology 2003; 125(4): 1268-1270.
  5. El-Serag HB. Time trends of gastroesophageal reflux disease: a systematic review. Clinical Gastroenterology and Hepatology. 2007;5(1):17–26.
  6. Brooks RA.  Cost of gastro-oesophageal reflux disease to the employer: a perspective from the United States. Aliment Pharmacol Ther 2007;26(6):889-98.
  7. Hur C.  Cost-effectiveness of aspirin chemoprevention for Barrett’s esophagus .  J Natl Cancer Inst 2004 Feb 18;96(4):316-25.
  8. Thompson OM.  Vegetable and fruit intakes and risk of Barrett’s esophagus in men and women.  Am J Clin Nutr 2009 89: 890-896. First published online January 14, 2009; doi:10.3945/ajcn.2008.26497.
  9. Kubo, A, Levin, TR, Block, G, et al.. Dietary antioxidants, fruits, and vegetables and the risk of Barrett’s esophagus. Am J Gastroenterol 2008;103:1614–23.
  10. See the Fred Hutchinson Cancer Research Center.