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Effects of Carbohydrates and Dietary Salt on the Risk of Esophageal Cancer: A Meta-Analysis
Other Title
Effects of Carbohydrates and Dietary Salt on the Risk of Esophageal Cancer: A Meta-Analysis
Type
thesis
Date Issued
2018-06-04
Author(s)
Kondwani Joseph Banda
Advisor
Hui-Chuan Huang
Subjects
系所名稱：護理學系碩士暨碩士在職專班
Description
學位別：碩士
語文別：英文
指導教授：Hui-Chuan Huang
口試委員：Hsiao-Yean Chiu;Huey-Lan Hu
中文關鍵字：carbohydrates, dietary salt, esophageal cancer, meta-analysis
英文關鍵字：carbohydrates, dietary salt, esophageal cancer, meta-analysis
語文別：英文
指導教授：Hui-Chuan Huang
口試委員：Hsiao-Yean Chiu;Huey-Lan Hu
中文關鍵字：carbohydrates, dietary salt, esophageal cancer, meta-analysis
英文關鍵字：carbohydrates, dietary salt, esophageal cancer, meta-analysis
Abstract
Thesis title: Effects of Carbohydrates and Dietary Salt on the Risk of Esophageal Cancer: A Meta-Analysis
Institution: School of Nursing, Taipei Medical University
Author: Kondwani Joseph Banda
Thesis Advisor: Hui-Chuang Huang, Assistant Professor.
Background: Esophageal cancer (EC) is the 8th most common cancer and the 6th cause of cancer deaths in the world with two main histological types: esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). Carbohydrates and dietary salt are essential components of the human diet responsible for energy metabolism and blood pressure control respectively. The role of carbohydrates and dietary salt on the risk of EC has not been well understood. Available evidence from epidemiological studies is inconclusive with conflicting results. The aim of this study was to evaluate the effect of carbohydrates and dietary salt on the risk of EC by conducting a meta-analysis.
Methods: A systematic literature search was done from PubMed, Medline, Embase, Google Scholar, Cochrane library and reference lists to identify potential relevant studies. Data extraction was done by 2 reviewers. Newcastle-Ottawa Scale (NOS) was used for quality assessment of the included studies. Pooled OR for the highest intake versus lowest intake categories and 95% Confidence Interval (CI) were calculated and the random-effects model was adopted for statistically significant heterogeneity. A X^2-based test using Cochran's Q statistic and I^2 Statistic were used to identify and quantify heterogeneity. Sub-group analysis and meta-regression were used to identify potential sources of heterogeneity. Publication bias was assesed using Begg’s adjusted rank correction and the trim and fill methods.
Results: 21 case-control and 3 cohort studies investigating the effect of carbohydrates and dietary salt on the risk of EC were included in the meta-analysis. The results of the included case-control studies for carbohydrate on the risk of EC suggested an inverse association with pooled OR in the highest category compared with those in the lowest category being 0.63 (95% CI, 0.51 – 0.78). However, analysis of the included cohort studies for effect of carbohydrates on the risk of EC was not performed due to insufficient number of studies. The results of the included case-control and cohort studies for effect of dietary salt on the risk of EC suggested a positive association with pooled OR in the highest category compared with those in the lowest category being 1.83 (95% CI, 1.47 – 2.29) and 1.04 (95% CI, 1.00 – 1.08) respectively. Age, gender (male percentage), study location, salted food and adjustment of alcohol and energy intake were found to be significant moderators. No evidence of publication was observed.
Conclusion: The results of this meta-analysis suggest that a high intake of carbohydrate is associated with a reduction of EC and high intake of dietary salt was associated with an increased risk of EC. Our findings suggest that high intake of carbohydrates and low salt intake would be beneficial for reduction in the risk of EC and should be encouraged in the diet of the general population.
Key words: carbohydrates, dietary salt, esophageal cancer, meta-analysis
Institution: School of Nursing, Taipei Medical University
Author: Kondwani Joseph Banda
Thesis Advisor: Hui-Chuang Huang, Assistant Professor.
Background: Esophageal cancer (EC) is the 8th most common cancer and the 6th cause of cancer deaths in the world with two main histological types: esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). Carbohydrates and dietary salt are essential components of the human diet responsible for energy metabolism and blood pressure control respectively. The role of carbohydrates and dietary salt on the risk of EC has not been well understood. Available evidence from epidemiological studies is inconclusive with conflicting results. The aim of this study was to evaluate the effect of carbohydrates and dietary salt on the risk of EC by conducting a meta-analysis.
Methods: A systematic literature search was done from PubMed, Medline, Embase, Google Scholar, Cochrane library and reference lists to identify potential relevant studies. Data extraction was done by 2 reviewers. Newcastle-Ottawa Scale (NOS) was used for quality assessment of the included studies. Pooled OR for the highest intake versus lowest intake categories and 95% Confidence Interval (CI) were calculated and the random-effects model was adopted for statistically significant heterogeneity. A X^2-based test using Cochran's Q statistic and I^2 Statistic were used to identify and quantify heterogeneity. Sub-group analysis and meta-regression were used to identify potential sources of heterogeneity. Publication bias was assesed using Begg’s adjusted rank correction and the trim and fill methods.
Results: 21 case-control and 3 cohort studies investigating the effect of carbohydrates and dietary salt on the risk of EC were included in the meta-analysis. The results of the included case-control studies for carbohydrate on the risk of EC suggested an inverse association with pooled OR in the highest category compared with those in the lowest category being 0.63 (95% CI, 0.51 – 0.78). However, analysis of the included cohort studies for effect of carbohydrates on the risk of EC was not performed due to insufficient number of studies. The results of the included case-control and cohort studies for effect of dietary salt on the risk of EC suggested a positive association with pooled OR in the highest category compared with those in the lowest category being 1.83 (95% CI, 1.47 – 2.29) and 1.04 (95% CI, 1.00 – 1.08) respectively. Age, gender (male percentage), study location, salted food and adjustment of alcohol and energy intake were found to be significant moderators. No evidence of publication was observed.
Conclusion: The results of this meta-analysis suggest that a high intake of carbohydrate is associated with a reduction of EC and high intake of dietary salt was associated with an increased risk of EC. Our findings suggest that high intake of carbohydrates and low salt intake would be beneficial for reduction in the risk of EC and should be encouraged in the diet of the general population.
Key words: carbohydrates, dietary salt, esophageal cancer, meta-analysis