Daily dietary patterns associated with Helicobacter pylori infection and eradication-related adverse events, but not eradication rate: a cross-sectional and prospective cohort study.

BACKGROUND

Daily dietary patterns are associated with Helicobacter pylori (Hp) infection, though with notable regional differences. However, their impact on Hp eradication efficacy and treatment-related adverse events remains unclear.

METHODS

This two-part observational study assessed the link between diet and Hp. A cross-sectional analysis (n = 464 after matching) identified dietary patterns associated with infection, and a prospective cohort (n = 476) evaluated how these patterns influenced eradication rates and adverse events. Dietary patterns were derived via exploratory factor analysis (EFA), with logistic regression and restricted cubic splines used to analyze associations.

RESULTS

In the cross-sectional phase, a "traditional northwest" pattern increased infection risk (OR = 3.776, 95% CI 2.099-6.792), while a "plant-based" pattern reduced it (OR = 0.479, 95% CI 0.268-0.856). In the prospective cohort, the overall eradication rate was 88.7%. None of the identified dietary patterns (high-protein, traditional northwest, or healthy) showed a significant association with eradication rates. However, adverse events occurred in 20.4% of participants during eradication therapy, with bitter taste being most common (32.0%). The traditional northwest pattern, characterized by high-salt diet, was associated with a reduced risk of these events (OR = 0.396, 95% CI 0.188-0.837).

CONCLUSION

Daily dietary patterns were associated with Hp infection and eradication-related adverse events, but not eradication rate. These findings suggest that dietary patterns may be applicable to Hp prevention and management strategies, independent of their influence on eradication efficacy.