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00925njm 22002777a 4500 dc Castelló Pastor, Adela author Fernandez de Larrea-Baz, Nerea author Martín, Vicente author Dávila-Batista, Verónica author Boldo, Elena author Guevara, Marcela author Moreno, Victor author Castaño-Vinyals, Gemma author Gómez-Acebo, Inés author Fernández-Tardón, Guillermo author Peiró, Rosana author Olmedo-Requena, Rocío author Capelo, Rocío author Navarro, Carmen author Pacho-Valbuena, Silvino author Perez-Gomez, Beatriz author Kogevinas, Manolis author Pollan-Santamaria, Marina author Aragones, Nuria author 2018-05 BACKGROUND: The influence of dietary habits on the development of gastric adenocarcinoma is not clear. The objective of the present study was to explore the association of three previously identified dietary patterns with gastric adenocarcinoma by sex, age, cancer site, and morphology. METHODS: MCC-Spain is a multicase-control study that included 295 incident cases of gastric adenocarcinoma and 3040 controls. The association of the Western, Prudent, and Mediterranean dietary patterns-derived in another Spanish case-control study-with gastric adenocarcinoma was assessed using multivariable logistic regression models with random province-specific intercepts and considering a possible interaction with sex and age. Risk according to tumor site (cardia, non-cardia) and morphology (intestinal/diffuse) was evaluated using multinomial regression models. RESULTS: A high adherence to the Western pattern increased gastric adenocarcinoma risk [odds ratiofourth_vs._first_quartile (95% confidence interval), 2.09 (1.31; 3.33)] even at low levels [odds ratiosecond_vs._first_quartile (95% confidence interval), 1.63 (1.05; 2.52)]. High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma [odds ratiofourth_vs._first_quartile (95% confidence interval), 0.53 (0.34; 0.82)]. Although no significant heterogeneity of effects was observed, the harmful effect of the Western pattern was stronger among older participants and for non-cardia adenocarcinomas, whereas the protective effect of the Mediterranean pattern was only observed among younger participants and for non-cardia tumors. CONCLUSION: Decreasing the consumption of fatty and sugary products and of red and processed meat in favor of an increase in the intake of fruits, vegetables, legumes, olive oil, nuts, and fish might prevent gastric adenocarcinoma. Gastric Cancer. 2018 May;21(3):372-382. 10.1007/s10120-017-0774-x 1436-3305 1436-3291 Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 29139048 http://hdl.handle.net/20.500.12105/8547 Adenocarcinoma Diet, Mediterranean Diet, Western Population attributable fraction Prevention and control Principal component analysis Stomach neoplasms High adherence to the Western, Prudent, and Mediterranean dietary patterns and risk of gastric adenocarcinoma: MCC-Spain study