Stomach Cancer in Korea

The Flipside of Eating Your Kimchi

Written By Jessica Keralis

When my in-laws came to visit in 2013, one of the events they found most entertaining was the annual Kimchi Festival. Though my mother-in-law is not gastronomically adventurous, my father-in-law enthusiastically tried dozens of types of kimchi while the exhibitors explained its powers to fight aging and cure cancer. Indeed, most Koreans are proud of their traditional cuisine and will cheerfully rattle off the many (actual and perceived) benefits of the foods they love.

There are certainly many positive aspects of the typical Korean diet besides simply being delicious (particularly for those who love spicy foods). Korea has some of the lowest rates of obesity and cardiovascular disease in the OECD. The traditional Korean diet has a higher ratio of vegetables to meat or fish, as well as more complex carbohydrates, than the typical Western diet, and it includes many omega fatty acids and vitamins (particularly in fermented foods). However, one caveat has emerged from recent research: higher rates of stomach cancer among Koreans may be linked to their diet.

Cancer etiology is highly complex, so establishing causal links between lifestyle factors and various types of cancer is usually impossible (and bad statistical practice besides). Risk factors for gastric (stomach) cancer are diverse and include certain environmental risks, dietary factors, smoking, alcohol consumption, genetics, and infection with a bacterium called Helicobacter pylori. However, stomach cancer has been the most common cancer diagnosed in Korea since 1999, and the country has also led the world in high rates of gastric cancer by country for years – and this discrepancy persists in Korean-Americans as well.  This has led to some interesting research on what lifestyle factors unique to Koreans might be contributing to higher rates.

Several large research studies have indicated the Korean diet as one possible risk factor. Many experts believe that the diet’s high sodium content, in addition to nitrate and nitrite preservatives, might explain the rates, especially considering the pickled foods, e.g., kimchi, that so many Koreans love. A large cohort study based on cancer registry data published in 2010 showed that preference for a salty diet was associated with cancer risk, and an older case-control study comparing different foods and methods of preparation had similar results.

This is, of course, no reason to stop enjoying your favorite Korean foods. The many vitamins, vegetables, and flavors along with the lower proportions of fats and sugars are reason enough to dig into that bowl of kimchi jjigae with gusto. Stomach cancer rates tend to be much higher among men, and most studies acknowledge that widespread prevalence of smoking and alcohol consumption probably contribute to the risk as well. The best way to take charge of your health is to discuss your diet and any health concerns with your doctor. Also, regular screenings are by far the best way to prevent cancer, and to find it early.

Jessica Keralis has a Master of Public Health degree and four years of experience in the field of public health. She is currently working as an epidemiologist. Feel free to suggest future health article topics by contacting her at jmkeralis@gmail.com. All views expressed here are her own and not those of any employer.