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April 7, 2004

Dietary Risk Factors for Gastric Carcinoma

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(13):1564. doi:10.1001/jama.291.13.1564-a

To the Editor: In their Editorial about the relationship between Helicobacter pylori and gastric carcinoma, Drs Parsonnet and Forman1 did not discuss the dramatic decline in the use of salting and pickling food for preservation, which has mirrored the decline in US cases of gastric cancer during this period.2 Worldwide, there has been an ongoing reduction in salt intake.3,4 There is some evidence that the relevant carcinogens are produced from specific food items, such as those in fish, by salting and pickling, which involves the use of large amounts of salt and nitrates.5 Reducing salt intake may decrease the risk of gastric cancer, irrespective of the presence of H pylori.