Dietary glycemic load and risk of colorectal cancer in Chinese women.

BACKGROUND Mixed results have been reported in recent epidemiologic studies in Western populations that have investigated the hypothesis that high glycemic load may increase the risk of colorectal cancer. This association has not been prospectively evaluated in other populations. OBJECTIVE We examined the association of overall glycemic index and glycemic load with colorectal cancer risk in a prospective cohort of Chinese women. DESIGN A total of 73,061 women aged 40-70 y and free of cancer at enrollment were included in this analysis. Usual dietary intake was assessed at baseline (1997-2000) and reassessed during the first follow-up (2000-2002) through in-person interviews by using a validated food-frequency questionnaire. RESULTS During an average follow-up of 9.1 y, 475 incident colorectal cancer cases were identified. Glycemic load was not associated with colorectal cancer risk (P for trend = 0.84). The multivariable hazard ratio for the highest compared with the lowest quintile of glycemic load was 0.94 (95% CI: 0.71, 1.24). Similar results were also observed for associations with dietary glycemic index and total carbohydrate intake, and results did not vary by excluding individuals with a history of diabetes from the analysis. CONCLUSION This prospective study, conducted in a population with a high intake of carbohydrates, provides no evidence that a high-glycemic index diet or high glycemic load is associated with an increased risk of colorectal cancer.

[1]  A. Jemal,et al.  Cancer Statistics, 2010 , 2010, CA: a cancer journal for clinicians.

[2]  L. Murray,et al.  Glycemic index, glycemic load, and risk of digestive tract neoplasms: a systematic review and meta-analysis. , 2009, The American journal of clinical nutrition.

[3]  B. Henderson,et al.  The association of glycemic load and carbohydrate intake with colorectal cancer risk in the Multiethnic Cohort Study. , 2008, The American journal of clinical nutrition.

[4]  J. Shikany,et al.  Dietary carbohydrate, glycemic index, and glycemic load in relation to colorectal cancer risk in the Women’s Health Initiative , 2008, Cancer Causes & Control.

[5]  C. la Vecchia,et al.  Glycemic index, glycemic load, and cancer risk: a meta-analysis. , 2008, The American journal of clinical nutrition.

[6]  P. Mitchell,et al.  Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies. , 2008, The American journal of clinical nutrition.

[7]  R. Goldbohm,et al.  Dietary glycemic load, glycemic index and colorectal cancer risk: Results from the Netherlands Cohort Study , 2008, International journal of cancer.

[8]  X. Shu,et al.  Prospective study of dietary carbohydrates, glycemic index, glycemic load, and incidence of type 2 diabetes mellitus in middle-aged Chinese women. , 2007, Archives of internal medicine.

[9]  D. Jacobs,et al.  Dietary carbohydrate, glycemic index, and glycemic load and the risk of colorectal cancer in the BCDDP cohort , 2007, Cancer Causes & Control.

[10]  X. Shu,et al.  A Prospective Study of Dietary Patterns and Mortality in Chinese Women , 2007, Epidemiology.

[11]  S. Larsson,et al.  Dietary carbohydrate, glycemic index, and glycemic load in relation to risk of colorectal cancer in women. , 2006, American journal of epidemiology.

[12]  A. Folsom,et al.  Incidence of Colorectal Cancer in Relation to Glycemic Index and Load in a Cohort of Women , 2006, Cancer Epidemiology Biomarkers & Prevention.

[13]  N. Rothman,et al.  The Shanghai Women's Health Study: rationale, study design, and baseline characteristics. , 2005, American journal of epidemiology.

[14]  J. Ferlay,et al.  Global Cancer Statistics, 2002 , 2005, CA: a cancer journal for clinicians.

[15]  W. Willett,et al.  Dietary glycemic load, carbohydrate, sugar, and colorectal cancer risk in men and women. , 2005, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[16]  F Xavier Pi-Sunyer,et al.  Dietary carbohydrate (amount and type) in the prevention and management of diabetes: a statement by the american diabetes association. , 2004, Diabetes care.

[17]  J. Brand-Miller.  Postprandial glycemia, glycemic index, and the prevention of type 2 diabetes. , 2004, The American journal of clinical nutrition.

[18]  N. Cook,et al.  Dietary glycemic load and risk of colorectal cancer in the Women's Health Study. , 2004, Journal of the National Cancer Institute.

[19]  B. Ainsworth,et al.  Reproducibility and validity of the Shanghai Women's Health Study physical activity questionnaire. , 2003, American journal of epidemiology.

[20]  A. Miller,et al.  Glycemic load, carbohydrate intake, and risk of colorectal cancer in women: a prospective cohort study. , 2003, Journal of the National Cancer Institute.

[21]  Edward Giovannucci,et al.  Modifiable risk factors for colon cancer. , 2002, Gastroenterology clinics of North America.

[22]  C. la Vecchia,et al.  Glycaemic index, breast and colorectal cancer. , 2002, Annals of oncology : official journal of the European Society for Medical Oncology.

[23]  E. Giovannucci,et al.  Obesity, gender, and colon cancer , 2002, Gut.

[24]  D. Dunger,et al.  Insulin, insulin-like growth factor-I (IGF-I), IGF binding proteins, their biologic interactions, and colorectal cancer. , 2002, Journal of the National Cancer Institute.

[25]  J. Manson,et al.  Glycemic index, glycemic load, and risk of type 2 diabetes. , 2002, The American journal of clinical nutrition.

[26]  S. Franceschi,et al.  Glycemic index: overview of implications in health and disease. , 2002, The American journal of clinical nutrition.

[27]  D. Pawlak,et al.  Glycemic index and obesity. , 2002, The American journal of clinical nutrition.

[28]  D. Ludwig,et al.  The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. , 2002, JAMA.

[29]  L. Hennighausen,et al.  Circulating insulin-like growth factor-I levels regulate colon cancer growth and metastasis. , 2002, Cancer research.

[30]  Frank B. Hu,et al.  Dietary pattern analysis: a new direction in nutritional epidemiology , 2002, Current opinion in lipidology.

[31]  C. la Vecchia,et al.  Dietary glycemic load and colorectal cancer risk. , 2001, Annals of oncology : official journal of the European Society for Medical Oncology.

[32]  W C Willett,et al.  A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. , 2000, The American journal of clinical nutrition.

[33]  J. Fraumeni,et al.  Cancer incidence trends in urban Shanghai, 1972–1994: An update , 1999, International journal of cancer.

[34]  J. Potter,et al.  Dietary sugar and colon cancer. , 1997, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[35]  W C Willett,et al.  Adjustment for total energy intake in epidemiologic studies. , 1997, The American journal of clinical nutrition.

[36]  G A Colditz,et al.  Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. , 1997, JAMA.

[37]  L. Suardet,et al.  Growth regulation and co-stimulation of human colorectal cancer cell lines by insulin-like growth factor I, II and transforming growth factor alpha. , 1992, British Journal of Cancer.

[38]  A S Whittemore,et al.  Diet, physical activity, and colorectal cancer among Chinese in North America and China. , 1990, Journal of the National Cancer Institute.

[39]  T. Wolever,et al.  Glycemic index of foods: a physiological basis for carbohydrate exchange. , 1981, The American journal of clinical nutrition.

[40]  X. Shu,et al.  Validity and reproducibility of the food frequency questionnaire used in the Shanghai Women's Health Study , 2004, European Journal of Clinical Nutrition.

[41]  Kaye Foster-Powell,et al.  International table of glycemic index and glycemic load values: 2002. , 2002, The American journal of clinical nutrition.

[42]  A. Jemal,et al.  Global cancer statistics , 2011, CA: a cancer journal for clinicians.

[43]  Stampfer,et al.  Prospective study of colorectal cancer risk in men and plasma levels of insulin-like growth factor (IGF)-I and IGF-binding protein-3. , 1999, Journal of the National Cancer Institute.

[44]  J. Potter,et al.  Colon cancer: a review of the epidemiology. , 1993, Epidemiologic reviews.

[45]  N. Dubrawsky.  Cancer statistics , 1989, CA: a cancer journal for clinicians.