Abstract
Factors linked to glucose metabolism are involved in the etiology of several cancers. High glycemic index (GI) or high glycemic load (GL) diets, which chronically raise postprandial blood glucose, may increase cancer risk by affecting insulin-like growth factor. We prospectively investigated cancer risk and dietary GI/GL in the EPIC-Italy cohort. After a median 14.9 years, 5112 incident cancers and 2460 deaths were identified among 45,148 recruited adults. High GI was associated with increased risk of colon and bladder cancer. High GL was associated with: increased risk of colon cancer; increased risk of diabetes-related cancers; and decreased risk of rectal cancer. High intake of carbohydrate from high GI foods was significantly associated with increased risk of colon and diabetes-related cancers, but decreased risk of stomach cancer; whereas high intake of carbohydrates from low GI foods was associated with reduced colon cancer risk. In a Mediterranean population with high and varied carbohydrate intake, carbohydrates that strongly raise postprandial blood glucose may increase colon and bladder cancer risk, while the quantity of carbohydrate consumed may be involved in diabetes-related cancers. Further studies are needed to confirm the opposing effects of high dietary GL on risks of colon and rectal cancers.
Highlights
Factors linked to glucose metabolism seem to be involved in the etiology of several cancers[1,2,3,4]
The main findings of our study are that high dietary glycemic index (GI) was significantly associated with increased risk of colon and bladder cancer; whereas high dietary glycemic load (GL) was significantly associated with increased risk of colon cancer and Diabetes-related cancers (DRCs), but decreased risk of rectal cancer
High carbohydrate intake from high GI foods was significantly associated with increased risk of colon cancer and DRCs, but decreased risk of stomach cancer, whereas high carbohydrate intake from low GI foods was significantly associated with decreased risk of colon cancer
Summary
Factors linked to glucose metabolism seem to be involved in the etiology of several cancers[1,2,3,4]. Consumption of most carbohydrates increases blood glucose and blood insulin, but to varying extents, depending on carbohydrate type and processing, amount consumed, and presence of other nutrients. These variations are captured by the glycemic index (GI)[5], which ranks carbohydrate foods according to their ability to raise blood glucose levels. Several observational studies have investigated associations between dietary GI/GL and risk of different types of cancer, but have produced mixed results. Three meta-analyses − one that investigated only cohort studies[6], and others that considered both case-control and cohort studies7, 8 – found that high GI was associated with increased risk of colorectal cancer. Correspondence and requests for materials should be addressed to V.K.
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