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Stomach cancer (also known as gastric cancer or carcinoma of the stomach) is one of the most common cancers, affecting roughly twice as many men as women. More than 8 out of 10 cases are diagnosed in people over the age of 60. The success of treatment depends on how early the diagnosis is made.
Most stomach cancers form a tumor or an ulcer in the inner lining of the stomach. Less commonly, the cancer spreads along the stomach wall without forming a discrete lump. This is known as a diffuse tumor.
Incidence; Causes & Development; Risk Factors
There is wide variation from country to country in the numbers of people affected. Less industrialised countries generally have the highest rates. Poorer people in Western countries are also more likely to be affected than the better-off.
The exact causes of stomach cancer are not yet fully understood.
In addition to affecting more men than women, and occurring most in older people (the cancer is uncommon in people under 50) other factors that appear to increase the risk of stomach cancer include:- Helicobacter pylori (H. pylori) infection - these bacteria live in the stomach lining of many people, usually without any symptoms. It causes inflammation of the stomach lining (gastritis), ulcers and also increases the risk of stomach cancer.
- Pernicious anemia - this affects the lining of the stomach.
- Diet - a diet high in salt and foods that are smoked or cured may increase the risk of stomach cancer. In particular, certain food preservative chemicals known as nitrosamines, which are found meats such as bacon and ham, may lead to an increased risk of stomach cancer. In contrast, a diet rich in antioxidant vitamins (A, C and E), available in fresh fruit and vegetables, is thought to be protective against stomach cancer.
- Family history - some people inherit an increased risk of developing stomach cancer.
- Type A blood group - people who have this blood group are at higher risk.
- Smoking - certain types of stomach cancer are four times more likely in smokers than non-smokers.
- Atrophic gastritis - people who have a stomach disorder called atrophic gastritis, where the lining of the stomach wastes away, are at higher risk.
Signs & Symptoms
Early stomach cancer can have very mild symptoms, similar to indigestion symptoms. This includes feeling full after eating only a small meal, heartburn, stomach pain, nausea, vomiting and difficulty swallowing.
As the cancer advances, there may be additional symptoms such as:- Unexplained or sudden weight loss.
- Vomiting blood (it may have the appearance of coffee grounds). See a doctor if vomiting persists for more than a few days, or if it contains blood.
- Passing blood in the stools. This is not usually fresh, red blood, but dark blood.
- The blood loss (through vomiting or passing out via stools) may go unnoticed, but over a period of time, can cause anemia.
- Persistent abdominal pain.
Diagnosis & Tests
If suspected, a doctor should order further investigation. This includes the following:The process of investigating how far the cancer has spread is known as staging. It is based on how deeply the tumor has invaded the stomach wall, whether or not the nearby lymph glands are affected, and whether the cancer has spread to other organs such as the liver or lungs. The stage a cancer is at helps to determine what treatment is possible and what the likely outcome will be.
Laboratory Findings:Gastroscopic biopsy and cytology - essential for diagnosisHypochromic, microcytic anaemia due to chronic blood lossOccult blood in stoolBlood in gastric contentsGastric analysis - 50% of patients have no gastric acid, even following stimulation; 50% have normal or decreased gastric acidIncreased serum gastrin due to hypochlorhydriaPrognosis; Seek medical attention if
If discovered early, stomach cancer can be contained within the stomach lining or stomach wall. However, cancer cells can also invade neighboring organs, and break away and travel to distant parts of the body via the blood stream and lymph channels.
In general, the further that stomach cancer has spread from the original site, the less likely it is that the condition will be cured. This is why recognizing the signs, early diagnosis and treatment are crucial.
It is important to seek medical advice if any symptoms persist despite alterations to lifestyle, such as stopping smoking and eating more healthily, or if they start in someone aged 40 or over.
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Signs, symptoms & indicators of Stomach Cancer:
Conditions that suggest Stomach Cancer:
Risk factors for Stomach Cancer: | | | | | Addictions |  Cigarette Smoke Damage | About 20% of the mortality from stomach cancer is attributable to smoking. There is approximately a 50% increase in the risk of stomach cancer in smokers compared to never-smokers. |
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Digestion |
Atrophic Gastritis |
Infections |
Helicobacter Pylori Infection |
Symptoms - Cancer |
 History of stomach cancer |
Symptoms - Food - Intake |
(High) luncheon meat consumption| | Nitrates and nitrites, such as those in hot dogs, lunch meats, and other cured meats, increase food levels of nitrates, which can lead to the formation of carcinogenic nitrosamines in the stomach.
Processed meats are often salted or smoked, or nitrites may be added to them, in order to prolong their shelf-life. It may be the case that these treatments increase the risk of developing stomach cancer, but previous studies have given contradictory results.
Said Susanna Larsson, research student at The Institute of Environmental Medicine at Karolinska Institutet in Sweden, "We decided to carry out a meta-analysis. This is an analysis in which we collated all research into processed meats and stomach cancer that we could find".
They found 15 studies, covering 4,704 subjects in the period 1966 to 2006, and the results are unequivocal: the risk of developing stomach cancer increases by between 15% and 38% when consumption of processed meat products increases by 30gm (approximately a half-portion) per day.
["Processed Meat Consumption and Stomach Cancer Risk: A Meta-Analysis"; Susanna C. Larsson, Nicola Orsini and Alicja Wolk; Journal of the National Cancer Institute, Volym 98, Nummer 15, Augusti 2006] |
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Symptoms - Food - Preferences |
(Partial) vegetarian diet or omnivorous diet| | An October, 2001 study by Yale School of Medicine researchers has found that a diet high in cholesterol, animal protein and vitamin B12 is linked to increased risk of a specific type of esophageal and stomach cancer, known as adenocarcinoma of the esophagus and gastric cardia, cases of which increased by 300% between the mid-1970s and 2000. |
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Stomach Cancer suggests the following may be present:
Recommendations and treatments for Stomach Cancer: | | | | | Drug |  Chemotherapy| | Chemotherapy may be used after surgery to try to reduce the chances of the cancer coming back. The additional treatment is known as adjuvant chemotherapy. |
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Environmental |
 Radiation Therapy (Radio Therapy)| | Radiotherapy is not usually used to try and cure stomach cancer, but is sometimes used to relieve symptoms if cancer has spread outside the stomach. |
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Surgery/Invasive |
 Surgery| | The only way to cure stomach cancer is to find it early and remove the tumor through surgery. If it has not spread outside the stomach, then an operation to remove either the whole stomach or just the affected part of it may be done. In advanced cases, surgery will not cure the cancer but may be needed to treat symptoms such as vomiting, pain or bleeding. |
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Preventive measures against Stomach Cancer: | | | | | Botanical | Green Tea| | Regular and substantial consumption of green tea may provide protective effect against this type of cancer. |
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Diet |
Increased Fruit/Vegetable Consumption| | Eating a diet rich in fruit and vegetables (which contain antioxidant vitamins) will reduce the risk of stomach problems, including cancer. |
Alcohol Avoidance
Plant-Based Nutrition| | An October, 2001 study by Yale School of Medicine researchers has found that a diet high in cholesterol, animal protein and vitamin B12 is linked to increased risk of a specific type of esophageal and stomach cancer, known as adenocarcinoma of the esophagus and gastric cardia, that has been increasing rapidly. The number of cases increased by 300% between the mid-1970s and 2000, according to lead author Susan Mayne, associate professor in the Department of Epidemiology and Public Health at Yale School of Medicine, and associate director of the Yale Cancer Center.
The researchers found that plant-based nutrients such as dietary fiber, dietary beta-carotene, folic acid, vitamin C and vitamin B6 were associated with lower risk of these kinds of cancers.
"We found that many animal-based nutrients found in foods of animal origin are strongly associated with risk of developing these types of cancers and we were able to identify nutrients that presumably would be protective," said Mayne. "We also found that regular users of vitamin C supplements were at significantly lower risk of stomach cancer."
"Our results suggest that prevention strategies for these cancers should emphasize increased consumption of plant foods, decreased consumption of foods of animal origin with the possible exception of dairy products, and control of obesity." |
Processed Foods Avoidance| | Watch out for cured/smoked foods. Foods such as pickles, ham and bacon should be consumed less. The high rate of stomach cancer in Japan has been traced to the large amount of smoked fish in the Japanese diet. Also, Asians who eat a traditional diet - with lots of salt-cured, pickled and smoked foods - have a high rate of stomach and esophageal cancer. Use herbs and spices to season foods instead. |
Weight Loss| | During analysis of the data from a Yale study (see link between Increased Risk of Stomach Cancer and treatment Vegetarian/Vegan Diet) the research team found that obesity is strongly linked with risk of these cancers. "The increase in the prevalence of obesity in the United States certainly contributes to the time trends... Our results suggest that prevention strategies for these cancers should emphasize increased consumption of plant foods, decreased consumption of foods of animal origin with the possible exception of dairy products, and control of obesity." |
Increased Fish Consumption| | Study subjects who ate two or more servings of fish weekly had a much lower risk for esophageal, stomach, colon, rectum, and pancreatic cancers than those who avoided fish. In fact, the rates of these types of cancer were 30 to 50 percent lower among fish eaters. High fish consumption was also associated with lower risks for cancers of the larynx (30 percent lower risk), endometrial cancer (20 percent lower risk), and ovarian cancer (30 percent lower risk). |
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Habits |
Tobacco Avoidance| | Non-smokers have a significantly lower risk of developing stomach cancer. |
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Mineral |
Selenium |
Vitamins |
Vitamin C (Ascorbic Acid) |
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KEY | | Weak or unproven link | | | Strong or generally accepted link |  | | Proven definite or direct link |  | | Weakly counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended |
GLOSSARY
Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.
Adjuvant
A substance added to a drug that affects the action of the active ingredient in a predictable way.
Anemia (Anaemia, Anemias)
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Antioxidant (Antioxidants)
A chemical compound that slows or prevents oxygen from reacting with other compounds. Some antioxidants have been shown to have cancer-protecting potential because they neutralize free radicals. Examples include vitamins C and E, beta carotene, the minerals selenium and germanium, superoxide dismutase (SOD), coenzyme Q10, catalase, and some amino acids.
Ascorbate
A mineral salt of ascorbic acid (i.e., vitamin C) that aids in the absorption of both vitamin C and the mineral.
Atrophic Gastritis
Chronic inflammation of the stomach that causes the breakdown of the mucous membranes and a reduction in the number of functioning stomach cells. Seen mainly in the elderly.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Barium Meal
An X-ray test that involves drinking a fluid containing barium (a substance that shows up on X-rays) to show the stomach.
Beta-Carotene (Beta Carotene)
The most abundant of the carotenoids, beta-carotene has strong provitamin A activity and is a stronger antioxidant than vitamin A. It is widely accepted today as a cancer preventative. It is found in leafy green and yellow vegetables, often missing in children's diets. Beta-Carotene is believed to be a superior source of Vitamin A because it is readily converted into a more active form of the substance: your body converts it to Vitamin A as needed.
Biopsy
Removal of a sample of tissue from a living being for diagnosis. A pathologist later uses a microscope to look for certain features, such as cancer cells, in the sample. A fine-needle aspiration biopsy involves inserting a thin needle to remove a small amount of tissue, sometimes using CT or ultrasound to guide the needle. A core biopsy involves obtaining a sample of tissue with a thick needle or by inserting a thin, lighted tube (laparoscope) into a small incision in the abdomen. Another biopsy method is to remove tissue during an operation.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Carcinogen (Carcinogenic, Carcinogenicity)
Any agent that is cancer-causing.
Carcinoma
Malignant growth of epithelial cells tending to infiltrate the surrounding tissue and giving rise to metastasis: An invasive malignant tumor derived from epithelial tissue that tends to metastasize to other areas of the body.
Chemotherapy
A treatment of disease by any chemicals. Used most often to refer to the chemical treatments used to combat cancer cells. Chemotherapy is usually given in cycles: a treatment period followed by a recovery period, then another treatment period, and so on. Most anticancer drugs are given by injection into a blood vessel (IV); some are given by mouth. Chemotherapy is a systemic therapy, meaning that the drugs enter the bloodstream and travel throughout the body. Usually, a patient has chemotherapy as an outpatient (at the hospital, at the doctor's office, or at home). However, depending on which drugs are given and the patient's general health, a short hospital stay may be needed.
Cholesterol
A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Cobalamin (B12, B-12, Cobalamine, Vitamin B12)
Essential for normal growth and functioning of all body cells, especially those of bone marrow (red blood cell formation), gastrointestinal tract and nervous system, it prevents pernicious anemia and plays a crucial part in the reproduction of every cell of the body i.e. synthesis of genetic material (DNA).
Colon (Colonic)
The part of the large intestine that extends to the rectum. The colon takes the contents of the small intestine, moving them to the rectum by contracting.
Dietary Fiber (Insoluble Fiber, Insoluble Fibers, Soluble Fiber, Soluble Fibers)
There are two types of dietary fiber - soluble and insoluble. Insoluble fiber acts like a sponge; it absorbs water and moves solid waste out of the intestines. It is found mainly in whole grains and on the outside of seeds, fruits, and legumes. Soluble fiber is found in fruits, vegetables, seeds, brown rice, barley, oats and oat bran. It forms a gel when mixed with liquid producing a softer stool. It also prevents and reduces the absorption of certain substances from the intestines into the bloodstream.
DNA
Deoxyribonucleic acid, the large molecule that is the main carrier of genetic information in cells. DNA is found mainly in the chromosomes of cells.
Epidemiology
The study of the causes and distribution of disease in human populations.
Esophagus (Esophageal)
Commonly called the "food pipe", it is a narrow muscular tube, about nine and a half inches long, that begins below the tongue and ends at the stomach. It consists of an outer layer of fibrous tissue, a middle layer containing smoother muscle, and an inner membrane, which contains numerous tiny glands. It has muscular sphincters at both its upper and lower ends. The upper sphincter relaxes to allow passage of swallowed food that is then propelled down the esophagus into the stomach by the wave-like peristaltic contractions of the esophageal muscles. There is no protective mucosal layer, so problems can arise when digestive acids reflux into the esophagus from the stomach.
Folic Acid
A B-complex vitamin that functions along with vitamin B-12 and vitamin C in the utilization of proteins. It has an essential role in the formation of heme (the iron containing protein in hemoglobin necessary for the formation of red blood cells) and DNA. Folic acid is essential during pregnancy to prevent neural tubular defects in the developing fetus.
Gastric
Of, relating to, or associated with the stomach.
Gastritis
Inflammation of the stomach lining. White blood cells move into the wall of the stomach as a response to some type of injury; this does not mean that there is an ulcer or cancer - it is simply inflammation, either acute or chronic. Symptoms depend on how acute it is and how long it has been present. In the acute phase, there may be pain in the upper abdomen, nausea and vomiting. In the chronic phase, the pain may be dull and there may be loss of appetite with a feeling of fullness after only a few bites of food. Very often, there are no symptoms at all. If the pain is severe, there may be an ulcer as well as gastritis.
Gastroscopy
An investigation using a long thin telescope (an endoscope) that is passed through the mouth, down the gullet and into the stomach, so a doctor can inspect the lining of stomach. The same instrument can be used to take a sample from any areas that look suspicious (biopsy) which are sent for examination in a laboratory.
Gram (gm, gms, Gramme, Grammes, Grams)
A metric unit of weight, there being approximately 28 grams in one ounce.
Helicobacter Pylori (Pylori)
H. pylori is a bacterium that is found in the stomach which, along with acid secretion, damages stomach and duodenal tissue, causing inflammation and peptic ulcers. Although most people will never have symptoms or problems related to the infection, they may include: dull, 'gnawing' pain which may occur 2-3 hours after a meal, come and go for several days or weeks, occur in the middle of the night when the stomach is empty and be relieved by eating; loss of weight; loss of appetite; bloating; burping; nausea; vomiting.
Herbs (Herb, Herbal)
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.
Hypochlorhydria (Hypochlorhydric)
The condition of having low hydrochloric acid levels in the stomach, often the cause of digestive disorders.
Larynx (Laryngeal, Voice Box)
The short passageway shaped like a triangle that is just below the pharyx in the neck.
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.
Lung (Lungs, Pulmonary)
Organ of the body, located in the chest cavity which is designed to bring oxygen from the air into the blood stream, while also expelling carbon dioxide and other waste gases out of the body. Pulmonary: Related to the lungs.
Lymph
A clear fluid that flows through lymph vessels and is collected from the tissues throughout the body. Its function is to nourish tissue cells and return waste matter to the bloodstream. The lymph system eventually connects with and adds to venous circulation.
Lymph Nodes (Axillary Nodes, Inguinal Nodes, Lymph Gland, Lymph Glands, Lymph Node, Lymphatic)
Small, bean-shaped nodes at various points throughout the body that function to filter the lymph fluid and attempt to destroy the microorganisms and abnormal cells which collect there. The most common locations are the neck (both sides and front), armpit (axillary) and groin (inguinal), but also under the jaw and behind the ears. Swollen or painful lymph nodes generally result from localized or systemic infection, abscess formation, or malignancy. Other causes of enlarged lymph nodes are extremely rare. Physical examination for lymph nodes includes pressing on them to check for size, texture, warmth, tenderness and mobility. Most lymph nodes can not be felt until they become swollen, and then will only be tender when pressed or massaged. A lymph node that is painful even without touching indicates greater swelling. Lymph nodes can usually be distinguished from other growths because they generally feel small, smooth, round or oval-shaped and somewhat mobile when attempts are made to push them sideways. Because less fat covers the lymph nodes in children, they are easier to feel, even when they are not busy filtering germs or making antibodies. Childrens' nodes enlarge faster, get bigger in response to an infection and stay swollen longer than an adult's. Also known (incorrectly) as lymph glands.
Magnetic Resonance Imaging (MRI)
A technique used in diagnosis that combines radio waves and magnetic forces to produce detailed images of the internal structures of the body.
Nausea
Symptoms resulting from an inclination to vomit.
Nitrosamine (Nitrosamines)
A chemical that may be formed from the metabolism of nitrates which are common preservatives used in processed foods.
Occult Blood
Usually detected through an occult blood test: A test used in screening for blood found in the stool, sputum or urine. The most common test is for hidden blood in the stool, also known as a stool guaiac or hemoccult test, which usually indicates the presence of ulceration or cancer.
Pancreas (Pancreatic)
Opposite the liver and behind the stomach, the pancreas has two main functions - to manufacture various enzymes for digestion, and to release hormones to help control the body's use of carbohydrates. It releases insulin to help each cell absorb glucose to burn as energy. In this way, insulin controls the amount of sugar (glucose) in the blood. Proper pancreatic function is very important: too much, too little, or no insulin production can be life-threatening. Some of the chemicals released by the pancreas are not hormones, but stimulate other glands to make hormones. Once again, balance is necessary. Nutritional requirements for the pancreas are many. Research indicates that chromium vitamins C, E, B-complex, calcium, magnesium and potassium are especially important.
Pernicious Anemia
Anemia caused by a vitamin B12 deficiency.
Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Radiation Therapy (Radiotherapy)
The use of high-energy rays to kill cancer cells. Depending on the stage of the disease, treatment with radiation may be given alone or with chemotherapy. Radiation therapy is local therapy; it affects cancer cells only in the treated area. External radiation does not cause the body to become radioactive. Most often, treatment is given on an outpatient basis in a hospital or clinic.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Staging
Although grading and the identification of cancer cell types help determine a patient's prognosis, most doctors believe that the cancer's stage is a better indicator of a patient's survivability. The grade of a cancer cell is an assessment of its appearance compared to that of a normal, healthy cell. Grading is done on a scale (such as 1 to 4) with grade 1 cells differing little from normal cells, typically spreading slowly, and having a good prognosis for treatment. The highest grade cells look extremely different and indicate an aggressive cancer with poor prognosis. Staging allows a physician to gauge the size and location of tumors by using information gathered from imaging studies such as CT scans and MRIs, and from pathology tests and physical examinations. Staging factors that influence a patient's prognosis are:- Spread to tissues surrounding the kidney
- Spread to contiguous organs
- Spread to nearby lymph nodes
- Distant metastasis.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Tumor (Tumors, Tumour, Tumours)
An abnormal growth of tissue resulting from uncontrolled, progressive multiplication of cells and serving no physiological function; a neoplasm. Literally, a swelling; in the past the term has been used in reference to any swelling of the body, no matter what the cause. However, the word is now being used almost exclusively to refer to a neoplastic mass, and the more general usage is being discarded.
Ulcer (Ulceration, Ulcers)
Lesion on the skin or mucous membrane.
Ultrasound
Ultrasound testing uses sound waves projected into the body to produce an image of internal organs, structures, tumors, etc. In this procedure, a gel is applied to the patient's skin, and a small device that emits ultrasonic pulses is slowly passed over the area. The sonic image produced is viewed on a monitor.
Vegan (Veganism, Vegans)
A person who consumes no animal products of any kind. In other words, vegans do not consume meat, fish, fowl, dairy products, eggs, honey, or products containing gelatin or any other animal-derived ingredients such as whey powder or food colorings.
Vegetarian (Lacto-Ovo-Vegetarian, Vegetarianism, Vegetarians)
A person who consumes no meat, fish or fowl (chicken, turkey, etc.), but who may consume animal products such as dairy products (milk, cheese, butter, etc.), eggs or honey.
Vitamin B6 (B6, B-6)
Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.
Vitamin C (Ascorbic Acid)
A water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.
Last updated: Apr 13, 2008
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