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Scripta Scientifica Pharmaceutica


Krasimira Aleksandrova


Despite years of intensive research, cancer incidence is projected to rise over the next decades reaching 24 million new cases by 2035. According to authoritative reports by leading cancer prevention organizations such as the World Cancer Research Fund and the American Institute for Cancer Research, about one third of cancer cases can be prevented by adopting healthy nutrition and lifestyle. Among different cancers, those arising in the gastrointestinal system have been most commonly associated with nutritional exposures; however the recent accumulating evidence from human studies has not been summarized. We have reviewed the latest epidemiological evidence on the role of nutrition on the risk and development of gastrointestinal tumors: colorectal, stomach, liver, esophagial and pancreatic. A meta-epidemiological approach was used to identify and summarize the most recently published reviews and meta-analyses (up to June 2017). Existing research highlighted the importance of body fat as a major risk factor for the most common gastrointestinal cancers. Body fat distribution, particularly in the abdominal area, poses a higher risk for colorectal, liver and pancreatic cancer. Additional risk factors include high alcohol consumption and high intakes of processed meat and salted foods. Potentially protective role has been suggested for whole grain intake, dairy products and citrus fruits. The data revealed chemopreventive potential of optimizing micronutrient intakes, i.e. calcium, vitamin D, vitamin B6 and B12, and trace elements – i.e. zinc and selenium. However, having the observational nature of published research, data from randomized control trials is needed to prove the preventive role of these nutrients. Further research focus should be put on the evaluation of complex dietary patterns and assessment of life-course nutritional exposures. From a prevention perspective, concerted actions should be taken for the establishment of complex lifestyle recommendations, patient education about nutritional risks and benefits (i.e. salt, processed meat, aflatoxin exposure) and development of targeted nutritional interventions.


nutrition, gastrointestinal cancer, meta-epidemiological analysis, prevention



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Krasimira Aleksandrova

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