Background/Objectives: Plant-based dietary patterns, including provegetarian diets (PVG), may reduce the risk of gastric cancer (GC); although, current evidence remains limited. The aim of this study is to evaluate the association between three PVG patterns -general (gPVG), healthful (hPVG), and unhealthful (uPVG)- and GC risk within the Stomach Cancer Pooling (StoP) Consortium, which includes studies from multiple countries.

Methods: Data from six case-control studies conducted in Italy, Greece, Portugal, Mexico and Spain, and included in the StoP Consortium, were analysed. The final sample included 1,857 histologically confirmed incident GC cases and 5,646 controls. Dietary intake was assessed using country-specific food frequency questionnaires, which allowed the estimation of PVG patterns using standardized methods. Adherence to PVG dietary patterns was categorized into quintiles. Mixed-effects logistic regression models, adjusted for study and other covariates, were used to estimate odds ratios (ORs) and the corresponding 95% confidence intervals (95%CIs).

Results: Higher adherence to the gPVG and hPVG patterns was associated with a lower risk of GC, OR = 0.60 (95%CI: 0.49-0.74) and OR = 0.65 (95%CI: 0.54-0.79), respectively. Conversely, higher adherence to the uPVG pattern was associated with an increased GC risk, OR = 1.28 (95%CI: 1.06-1.56). Similar associations were observed for both intestinal and diffuse GC subtypes.

Conclusions/Recommendations: Greater adherence to gPVG and hPVG dietary patterns, rich in fruits and vegetables, is associated with a lower risk of GC, whereas higher adherence to the uPVG pattern, characterized by consumption of sugary drinks, fried potatoes, and sweets and desserts, is associated with a higher risk. These findings support dietary recommendations aimed at reducing GC risk.