Stomach cancer was the top cancer killer of Americans for the first half of the 20th century. Its incidence started to decline rapidly in the 1940s due to the increased reliance on refrigerators rather than salting, pickling and smoking to preserve foods. Today stomach cancer still kills nearly 15,000 Americans each year. In the northern part of Japan, people eat a lot of salty foods and stomach cancer remains the top cancer killer in Japan.A new study examined the eating, smoking and drinking habits of about 40,000 middle-aged people in Japan. During 11 years of follow up, researchers determined what diet and lifestyle factors correlated with the development of stomach cancer. For Japanese men, those who ate the most salt doubled their risk of developing stomach cancer. For women the stomach cancer rate was 54% higher among those who ate the most salt compared to those who ate the least.1 Of course, using a diet questionnaire to assess dietary salt intake is not very precise. Also the variability in salt intake between the top 20% and bottom 20% of Japanese men and women is not that great. What if everyone smoked between 1 and 2 packs of cigarettes a day and you wanted to see if the amount of cigarettes smoked daily increased the risk of getting lung cancer over 11 years? Perhaps the risk would be twice as high in the 2-packs-a-day smokers vs. the 1-pack-a-day smokers. This means that the rather strong correlation between the intake of salt and the development of stomach cancer in this study probably grossly underestimates the true role of consuming salty food in the promotion of stomach cancer.Bottom Line:To avoid stomach cancer, it is important to limit your intake of salty foods and eat more fresh fruits and vegetables. Ideally, those older Americans with atrophic gastritis should avoid all highly salted, pickled and smoked foods.By James J. Kenney, PhD, RD, LD, FACN.Reference:1. Tsugane S, Sasazuki S, Kobayashi M, Sasaki S. Br J Cancer 2004;90:128-34