Cancer of the stomach occurs only about half as commonly today in the United States as it did 30 years ago, but it remains one of the “bad actor cancers that are associated with a high likelihood of death. On a global scale, stomach cancer remains the #2 cause of cancer-associated death, while in the United States, gastric cancer is currently the #7 cause of cancer-associated death.
Known risk factors for stomach cancer include chronic infection with the Helicobacter pylori bacterium (and other causes of chronic gastric inflammation), smoking, obesity, decreased acid secretion within the stomach, stomach ulcers, pernicious anemia, a family history of stomach cancer, certain inherited cancer syndromes, and other less common risk factors. As with other GI tract cancers, diet also appears to play an important role in gastric cancer risk. For example, gastric cancer is more common among people who eat a lot of processed meat and red meat, smoked foods, and salt-cured or pickled foods. On the other hand, stomach cancer is less common among people who consume a large amount of fresh fruits and vegetables.
The role of salt in gastric cancer risk has been a subject of some debate, as clinical research studies have come to varying and contradictory conclusions regarding this issue. However, a newly published public health study, which appears in the current issue of the British Journal of Cancer, appears to strongly link excess salt consumption with an increased risk of developing stomach cancer. In this case-control study, 442 patients with stomach cancer, and 649 healthy patients without any clinical evidence of cancer, were evaluated. Multiple previously validated dietary questionnaires were administered to all of the study volunteers, with particular attention to dietary salt intake.
The results of this public health study indicated that the risk of stomach cancer was twice as common among patients who regularly consumed the highest amounts of salt, when compared to patients with the smallest amount of regular salt intake. After adjusting for other risk factors known to be associated with gastric cancer risk (including Helicobacter pylori status, smoking history, and other known gastric cancer risk factors), increased salt intake was still associated with a doubling of gastric cancer risk.
While case-control studies, such as this one, do not offer high-level clinical research evidence (unlike the “gold standard prospective, randomized, blinded clinical research trials that provide “Level 1 clinical research data), the findings of this observational study nonetheless add to an increasing volume of data linking increased salt intake with gastric cancer risk.
Excessive salt intake has also been clearly linked to a significant increase in the risk of high blood pressure, stroke, and cardiovascular disease. Most hypertension experts are currently recommending that we lower our average daily intake of sodium, from the current 3,500 to 4,000 milligram (mg) per day level in the United States, to somewhere around 1,500 mg per day. At this level of sodium intake reduction, significant improvements in high blood pressure, and in the risk of stroke and cardiovascular disease, have been demonstrated by multiple high-quality clinical research studies. (An excellent pamphlet on the topic of dietary sodium reduction, as part of a heart-healthy diet, has been published online by the National Institutes of Health.)
As with many other dietary and lifestyle factors that have been shown to reduce cancer risk, reducing sodium intake, by reducing your dietary salt consumption, can pay big health dividends not only in terms of cancer risk reduction, but also in terms of reducing those other great global killers of mankind, cardiovascular disease and stroke!
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Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity
Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author