Background: We report on the associations between the intake of certain foods and beverages and the incidence of gastric cancer in a cohort of 11,907 randomly selected Japanese residents of Hawaii (6297 women and 5610 men).

Methods: The daily intake of six beverages, cigarettes and alcohol and the weekly frequency of intake of 13 foods and food groups was estimated with a short food frequency questionnaire. Over an average follow-up period of 14.8 years, 108 cases of gastric cancer (44 women, 64 men) were identified via linkage to the Hawaii Tumor Registry.

Results: In gender-combined proportional hazards analyses, the consumption of fresh fruit seven or more times per week was associated with a significantly reduced risk of gastric cancer, compared to lower levels of consumption (relative hazard (RH): 0.6, 95% confidence interval (CI): 0.4-1.0, P = 0.03). The combined intake of fresh fruit and raw vegetables was inversely associated with the risk of gastric cancer in the total cohort, and among the men (P < 0.05). No significant relationships were found between gastric cancer incidence and the intake of pickled vegetables, miso soup, dried or salted fish, or processed meats among either gender. Compared to non-drinkers, men who drank one cup of coffee per day had a significantly elevated risk of gastric cancer (RH: 2.5, 95% CI: 1.0-6.1, P = 0.05), but there was no evidence of a dose-response relationship. Cigarette smoking and consumption of alcohol were not related to gastric cancer, in analyses restricted to the men.

Conclusions: The results related to fruit and vegetable intake are consistent with an anti-nitrosating effect of these foods, while the unexpected association between coffee consumption and gastric cancer is difficult to explain and may represent a chance finding.