Dietary Glycemic Load Research Articles

Simple Carbohydrate Intake and Higher Risk for Physical Frailty Over 15 Years in Community-Dwelling Older Adults.

Insulin resistance is a major mechanism involved in the onset of physical frailty (PF). Although rich carbohydrate diets may promote insulin resistance, few studies have examined their association with PF risk. This study aimed to investigate the spectrum of carbohydrate exposure, including carbohydrate intake (simple, complex, and total), glycemic load (a measure of the diet-related insulin demand), and adherence to a low-carbohydrate diet with the incident risk of PF in community-dwelling older adults. Baseline carbohydrate exposure was assessed in nonfrail participants of the Three-City Bordeaux cohort using a 24-hour dietary recall. Over 15 years of follow-up, participants were screened for PF, defined by the FRAIL scale (≥3 criteria out of Fatigue, Resistance, Ambulation, Illnesses, and weight Loss). Associations were estimated using mixed-effects logistic models adjusted for sex, age, education, smoking status, alcohol consumption, depressive symptomatology, global cognitive performances, and protein and energy intakes. The sample included 1 210 participants (62% females, mean age 76 years). Over the follow-up, 295 (24%) incident cases of PF were documented (28% in females, 18% in males). Higher intake of simple carbohydrates was significantly associated with greater odds of incident PF (per 1-SD increased: OR = 1.29; 95% CI = 1.02-1.62), specifically among males (OR = 1.52; 95% CI = 1.04-2.22). No association was observed with complex or total carbohydrate intake, glycemic load, or low-carbohydrate diet. Among the whole carbohydrate exposure, only higher consumption of simple carbohydrates in older age was associated with a higher risk of developing PF. Further studies are required to explore underlying mechanisms.

Dietary glycemic index, glycemic load, and endometrial cancer risk: The Japan Public Health Center-based Prospective Study.

Evidence supporting the association of glycemic index (GI) and glycemic load (GL) with the risk of endometrial cancer is controversial and reports from Asia were limited. Therefore, we aimed to investigate the association in Japanese women. We evaluated 52 460 women in the Japan Public Health Center‐based Prospective Study aged 45‐74 years who responded to the 5‐year follow‐up survey. GI and GL were calculated from a validated food frequency questionnaire, and the participants were divided into three groups by GI and GL. The hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with the Cox proportional hazard model adjusted for potential confounding factors. As a result, within 15.5 years of follow‐up, 166 new cases of endometrial cancer were identified. Compared with the lowest GI and GL tertile groups, the HR of the risk of endometrial cancer in the highest GI tertile group was 0.80 (95% CI, 0.53‐1.20; Ptrend = .33), and that of the highest GL tertile group was 0.79 (95% CI, 0.52‐1.19; Ptrend = .82). The results were unchanged after stratification by body mass index, coffee consumption, and history of diabetes. In conclusion, we did not find any significant association between GI and GL with the risk of endometrial cancer. Further research is required to clarify the association.

Effect of diabetes nutrition education on the dietary feeding practices and lifestyle of type 2 diabetic patients.

Type 2 diabetes mellitus (T2DM) is one of the most common global diseases of public concern. In developing countries like Uganda, dietary habits and sedentary lifestyle are the major factors for rapidly rising incidence of DM. Therefore, awareness about diabetes dietary practices and life style are paramount in the control of the disease. One hundred type 2 diabetic patients were randomly selected and divided into two groups of intervention and control (50 patients in each group) to participate in the study. The intervention consisted of two educational sessions each for 30 min with various learning segments. A conversation map for type 2 diabetes, 24-h dietary recall and glycemic load tables were used. Data were collected using a pre-tested questionnaire before intervention and on monthly basis for a period of four months of intervention. Data were entered and analyzed using SPSS software version 21. There was a significant (p < 0.001) increase in water, vegetables, fruits, and number of meals intake per day coupled with quitting alcohol, soda, and beer among the intervention group. On the other hand, it was revealed that meat and milk consumption significantly reduced by 81.6 and 82.4% respectively among the intervention group. At the end of study period, milk, meat, vegetable, beer, soda, cigarettes intake, and duration of physical activity increased among the control group. Nutrition education improves dietary feeding practices and lifestyle among type 2 diabetes patients within four months of intervention.

Dietary glycemic index, glycemic load and mortality: Japan Public Health Center-based prospective study.

Long-term associations of dietary glycemic index (GI) and glycemic load (GL) with mortality outcomes remain unclear. The present analysis included 72,783 participants of the Japan Public Health Center-based Prospective Study. Participants who responded to the 5-year follow-up questionnaire in 1995-1999 were followed-up until December 2015. We estimated the risk of total and cause-specific mortality associated with GI and GL using Cox proportional hazards regression models. During 1,244,553 person years of follow-up, 7535 men and 4913 women died. GI was positively associated with all-cause mortality. As compared with the lowest quartile, the multivariable HR for those who had the highest quartile of GI was 1.14 (95% CI 1.08-1.20). The HRs for death comparing the highest with the lowest quartile were 1.28 (95% CI 1.14-1.42) for circulatory system diseases, 1.33 (95% CI 1.14-1.55) for heart disease, 1.32 (95% CI 1.11-1.57) for cerebrovascular disease, and 1.45 (95% CI 1.18-1.78) for respiratory diseases. GI was not associated with mortality risks of cancer and digestive diseases. GL showed a null association with all-cause mortality (highest vs lowest quartile; HR 1.04; 95% CI 0.96-1.12). However, among those who had the highest quartile of GL, the HRs for death from circulatory system diseases was 1.24 (95% CI 1.05-1.46), cerebrovascular disease was 1.34 (95% CI 1.03-1.74), and respiratory diseases was 1.35 (95% CI 1.00-1.82), as compared with the lowest quartile. In this large prospective cohort study, dietary GI and GL were associated with mortality risks.

Dietary Carbohydrate Quality and Quantity and Risk of Breast Cancer among Iranian Women

Objective This study investigated the association between quality and quantity of carbohydrate by assessing low carbohydrates diet score (LCDS), carbohydrate quality score (CQI), glycemic index (GI), dietary glycemic load (GL), and dietary carbohydrate intake, and risk of breast cancer (BrCa) among Iranian women. Methods This hospital-based case-control study was carried out in the Cancer Research Center of Imam Khomeini hospital, Iran. We included One hundred and fifty newly diagnosed BrCa cases and one hundred and fifty healthy controls in this study. Socio-demographic and dietary data and anthropometric measures were recorded. Results We found that a higher CQI than a lower score was associated with a decrease in odds of BrCa (P = 0.04). After adjusting for potential confounders, we observed that CQI was not associated with BrCa development (P = 0.05). An increase in odds of BrCa among women in the highest tertiles of GL (P = 0.12), GI (P = 0.48), and dietary carbohydrate intake (P = 0.06) was seen, which was not statistically significant. There was also a non-significant lower chance of having BrCa with adherence to the LCDS (P = 0.09). Conclusion Our findings suggest that CQI was not related to BrCa risk among Iranian women. This relation deserves to be investigated in prospective studies.

A pilot study of a low glycemic load diet in patients with stage I-III colorectal cancer.

Consumption of a diet with high glycemic indices has been associated with inferior cancer-specific outcomes in patients with early-stage colorectal cancer, but there is limited prospective evidence that alterations in dietary habits improves cancer outcomes. This study aimed to determine the feasibility and acceptability of following a low glycemic load (GL) diet in patients with stage I-III colorectal cancer. Patients with stage I-III colorectal cancer, who completed definitive therapy, and consumed an average daily GL >150 participated in a 12-week tailored face-to-face dietary intervention with a target GL. This study followed a 2-stage design, with 4 planned cohorts, each with an assigned GL target and dietary intervention intensity. The primary endpoint of feasibility was determined by participant compliance, defined as an individual following the assigned GL ≥75% of the time. Compliance was determined using 24-hour telephone recalls. A cohort was deemed feasible if at least 67% of participants were compliant. Secondary endpoints included acceptability of the diet, nutritional support resources necessary to follow the diet, and evaluation of the effect of the diet on physical measures and correlative laboratories. Only cohort 1 was required as the primary endpoint of feasibility was met (stringent GL target, low intensity dietary support). The majority of participants experienced a decrease in body mass index (BMI) and waist circumference, 29% experiencing meaningful weight loss (≥5%). The dietitian spent an average of 6.97 hours (SD 2.18) face-to-face time and 1.58 hours (SD 0.68) by phone with each participant. Significant decreases were seen in total cholesterol, very-low-density lipoprotein (VLDL) and triglycerides (all P<0.05). All participants liked the foods and were satisfied with the diet. All participants felt the in-person meetings were helpful, and 62% did not feel a virtual meeting (e.g., Skype, etc.) could replace in-person meetings. Patients with stage I-III colorectal cancer can follow a low GL diet with a 12-week in-person dietary intervention. Significant changes in physical and laboratory measures suggest relevant biologic effects of the dietary intervention. This study establishes feasibility, and warrants a larger scale prospective intervention trial to evaluate the impact of a low GL diet on cancer outcomes.

Dose-Dependent Associations of Dietary Glycemic Index, Glycemic Load, and Fiber With 3-Year Weight Loss Maintenance and Glycemic Status in a High-Risk Population: A Secondary Analysis of the Diabetes Prevention Study PREVIEW.

To examine longitudinal and dose-dependent associations of dietary glycemic index (GI), glycemic load (GL), and fiber with body weight and glycemic status during 3-year weight loss maintenance (WLM) in adults at high risk of type 2 diabetes. In this secondary analysis we used pooled data from the PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World (PREVIEW) randomized controlled trial, which was designed to test the effects of four diet and physical activity interventions. A total of 1,279 participants with overweight or obesity (age 25-70 years and BMI ≥25 kg ⋅ m-2) and prediabetes at baseline were included. We used multiadjusted linear mixed models with repeated measurements to assess longitudinal and dose-dependent associations by merging the participants into one group and dividing them into GI, GL, and fiber tertiles, respectively. In the available-case analysis, each 10-unit increment in GI was associated with a greater regain of weight (0.46 kg ⋅ year-1; 95% CI 0.23, 0.68; P < 0.001) and increase in HbA1c. Each 20-unit increment in GL was associated with a greater regain of weight (0.49 kg ⋅ year-1; 0.24, 0.75; P < 0.001) and increase in HbA1c. The associations of GI and GL with HbA1c were independent of weight change. Compared with those in the lowest tertiles, participants in the highest GI and GL tertiles had significantly greater weight regain and increases in HbA1c. Fiber was inversely associated with increases in waist circumference, but the associations with weight regain and glycemic status did not remain robust in different analyses. Dietary GI and GL were positively associated with weight regain and deteriorating glycemic status. Stronger evidence on the role of fiber is needed.

Dietary Carbohydrate Intake Glycemic Index and Glycemic Load and the Risk of Prostate Cancer among Iranian Men: A Case-Control Study

Previous studies have presented a few evidences on the relationship between dietary carbohydrate intake, glycemic index (GI), glycemic load (GL), with the prostate cancer risk. We performed a case-control study to evaluate these associations in 50 men with histologically confirmed prostate cancer and 100 control men. Odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were derived using logistic regression. The fully adjusted ORs for the top vs. the bottom quartile were 15.02 (P trend = 0.004), 1.04 (P trend = 0.003), and 10.35 (P trend = 0.002) for carbohydrate intake, GI and GL, respectively. Significant associations with prostate cancer remained only among men with reduced fiber intake for carbohydrate intake, GI and GL and among those had increased fiber intake for GI. These findings support the hypothesis that diet with high carbohydrate, GI and GL enhance risk of prostate cancer.

Kadar gula darah atlet sepak bola remaja setelah pemberian diet beban glikemik

Effect of diets with glycemic load arrangement on blood glucose levels in young soccer athletes Background: Carbohydrate arrangement considering the glycemic index (GI) and glycemic load (BG) are important to support the performance of athletes.Objective: To examine the effect of diets with glycemic load arrangement on blood glucose levels in young soccer athletes.Methods: Quasi-experimental study on 14 male young soccer players aged 15-18 years old at Terang Bangsa Soccer School. Each subject completed 4 trials separated by at least 7 days as a washout period. Diets provided consist of high GI with high GL diet (H-H), low GI with high GL diet (L-H), high GI with low GL (H-L), and low GI with low GL diet (L-L). Collected data were fasting blood glucose level (BGL 0), blood glucose level one hour after intervention (BGL 1), blood glucose level two hours after intervention (BGL 2), and blood glucose level after exercise (BGL 3).Results: The results of paired t-test analysis showed that there were differences between fasting blood glucose level and blood glucose level one hour after intervention, blood glucose level one hour after intervention and blood glucose level two hours after intervention, blood glucose level two hours after intervention and blood glucose level after exercise in the H-H and L-H diet group. In the L-L diet group, there were differences between BGL 2 and BGL 3. One-Way ANOVA analysis showed that there were no significant differences in blood glucose levels one hour after the intervention, blood glucose level two hours after intervention, and blood glucose level after exercise between groups.Conclusions: High glycemic load diets influence the increase in blood glucose levels at 1 hour postprandial and after exercise. Low glycemic load diets influence the increase in blood glucose levels after exercise. Diets with the arrangement of glycemic index and glycemic load did not affect blood glucose levels between diet groups.

Relevance of dietary glycemic index, glycemic load and fiber intake before and during pregnancy for the risk of gestational diabetes mellitus and maternal glucose homeostasis

To date, the prevalence of Gestational diabetes mellitus (GDM) in China was 17.5%. Given the substantial relevance of GDM for medium- and long-term health of both mother and offspring and the paucity of existing data on the link between maternal diet and glucose homeostasis during pregnancy in Asian population, additional studies are needed. To examine the relevance of dietary glycemic index (GI), glycemic load (GL) and fiber intake before and during pregnancy for the development of GDM and glucose homeostasis over the course of pregnancy. Cox proportional hazards analysis and linear mixed effects regressions were performed on data from 9317 women for whom three food frequency questionnaires (pre-pregnancy, 1st and 2nd trimesters) and biochemical measures during pregnancy were available. Investigated outcome variables included GDM risk, fasting plasma glucose (FPG), glycated hemoglobin (HbA1C), and homeostasis model assessment insulin resistance (HOMA-IR) in the 1st, 2nd and 3rd trimesters. Women in the highest tertile of dietary GI (or GL) before pregnancy, in the 1st, or the 2nd trimester respectively had a 12% (15%), 25% (23%) or 29% (25%) higher risk of developing GDM than those in the lowest tertile (all p for trend≤0.02). Women with the highest dietary fiber intake before pregnancy, in the 1st or 2nd trimester had a 11%, 17% or 18% lower GDM risk (all p for trend≤0.03). Moreover, increases in GI or GL and decreases in fiber intake over the course of pregnancy (1st to 3rd trimesters) were independently associated with adverse concurrent developments in FPG, HbA1C and HOMA-IR (p≤0.03). Our study indicates that dietary GI, GL and fiber intake before and during pregnancy affects glucose homeostasis of pregnant Chinese women.

Glycaemic index and glycaemic load of foods and food products in Malaysia: a review

Glycaemic index (GI) is a method used to classify the type of carbohydrate-rich foods according to their effect on postprandial glycaemic responses. While the GI concept provides a measure of carbohydrate quality, glycaemic load (GL) quantifies the overall glycaemic effects by considering both the quality and quantity of carbohydrate-rich foods. The higher the GI and GL of the foods, the greater the elevation of blood glucose and insulin demand. Reduction in dietary GI and GL are associated with the prevention and control of chronic diseases, including type 2 diabetes. Although the GI concept has been applied in various nutrition-related interventions in Malaysia, a reliable database on Malaysian foods and food products are scarce. This review attempts to determine and compile reliable data of GI and GL values of Malaysian foods and food products. A literature search was performed using predefined terms and criteria not only limited to web-based databases (n = 20), but included abstracts (n = 6) and manufacturer (n = 1). The GL value for each food was calculated. A total of 83 foods was identified with the most common being rice (25.3%) and bread (16.9%), either eaten alone or in mixed meals. Food with the highest GI value was sago (GI = 156; GL = 59), while food with the lowest GI value was spaghetti with chicken soup (GI = 35; GL = 4). This review shows that the number of foods and food products with the assigned GI and GL values in Malaysia is still limited, which warrants for more studies in this area.

Low and High Glycemic Load Diet on Immune Responses of Adolescent Football Athletes

High-intensity physical exercise causes physical stress that will suppress immune system in athlete’s body. Decreased immune system function can cause physiological and pathological changes such as fatigue, reduce athlete performance, and increase risk of infection. Regulation diets of glycemic index (GI) and glycemic load (GL) are known to help control blood glucose during exercise so the immune system can be maintained.The purpose of this study was to determine differences effects of low and high glycemic load diets on immune responses in adolescent football athletes. This study was a quasi experimental with multiple time series design, conducted on 22 adolescent football athletes aged 15-17 years old. The subjects were divided into two groups, low GL diet group was given carbohydrate-source foods with GL 9.15, high GL diet group was given foods with GL 27.29. Diet was given once in the morning and 2 hours later subjects doing RAST (Running-based Anaerobic Sprint Test) to trigger physical stress. Immune response was measure using total leukocytes and leukocytes differential count. There were no significant differences in blood glucose levels, leukocyte counts, and leukocytes differential count between low GL and high GL groups (p0.05). Low GL diet causes an increase in blood glucose and total leukocytes smaller than high GL diet.Â

Role of dietary carbohydrates on risk of lung cancer

ObjectivesInconsistent findings have been reported on the link between dietary carbohydrates and lung cancer. This study aims to comprehensively evaluate the role of dietary carbohydrates on lung cancer risk. Materials and methodsThe prospective study is based on the PLCO trial, which recruited 113,096 eligible participants across the United States. Participants had to have completed baseline and diet history questionnaires. The incidence of lung cancer was acquired through self-report and medical record follow-up. A multivariable logistic model adjusted for confounders was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) of dietary carbohydrates, fiber, whole grains, glycemic index (GI) and glycemic load (GL) for lung cancer. Similar methods were applied in analyzing the carbohydrates and fiber from different food sources. Multinomial logistic models were used for sensitivity analysis with lung cancer subtypes as outcomes. ResultsDietary carbohydrates and GL were inversely associated with lung cancer incidence in the PLCO population. Among various carbohydrates, 30-g daily consumption of dietary fiber was related to a lower risk of lung cancer (fourth vs first quartile OR: 0.62, 95 % CI: 0.54−0.72) compared with 8.8-g. Furthermore, consuming whole grains 2.3 servings per day as opposed to 0.3 servings per day was associated with a lower risk of lung cancer (OR: 0.73, 95 % CI: 0.64−0.83). A higher risk of lung cancer was seen for the consumption of high-GI food (OR: 1.19, 95 % CI: 1.05–1.35) and refined carbohydrates from soft drinks (OR: 1.23, 95 % CI: 1.04–1.46). ConclusionCarbohydrates and fiber from fruits, vegetables and whole grains are associated with lower lung cancer risk. Refined carbohydrates from processed food, such as soft drinks, appear to increase risk.

Effect of a Low-Glycemic Load Diet Intervention on Maternal and Pregnancy Outcomes in Obese Pregnant Women.

The increased prevalence of obese, pregnant women who have a higher risk of glucose intolerance warrants the need for nutritional interventions to improve maternal glucose homeostasis. In this study, the effect of a low-glycemic load (GL) (n = 28) was compared to a high-GL (n = 34) dietary intervention during the second half of pregnancy in obese women (body mass index (BMI) > 30 or a body fat >35%). Anthropometric and metabolic parameters were assessed at baseline (20 week) and at 28 and 34 weeks gestation. For the primary outcome 3h-glucose-iAUC (3h-incremental area under the curve), mean between-group differences were non-significant at every study timepoint (p = 0.6, 0.3, and 0.8 at 20, 28, and 34 weeks, respectively) and also assessing the mean change over the study period (p = 0.6). Furthermore, there was no statistically significant difference between the two intervention groups for any of the other examined outcomes (p ≥ 0.07). In the pooled cohort, there was no significant effect of dietary GL on any metabolic or anthropometric outcome (p ≥ 0.2). A post hoc analysis comparing the study women to a cohort of overweight or obese pregnant women who received only routine care showed that the non-study women were more likely to gain excess weight (p = 0.046) and to deliver large-for-gestational-age (LGA) (p = 0.01) or macrosomic (p = 0.006) infants. Thus, a low-GL diet consumed during the last half of pregnancy did not improve pregnancy outcomes in obese women, but in comparison to non-study women, dietary counseling reduced the risk of adverse outcomes.

Dietary glycemic index, glycemic load, insulin index, insulin load and risk of diabetes-related cancers: A systematic review of cohort studies

It is believed that diets high in glycemic index (GI), glycemic load (GL), Insulin index (II), and Insulin load (IL) are associated with the increased risks of certain cancers through increasing serum glucose or insulin levels. We conducted this systematic review of cohort studies to evaluate the possible relation between GI, GL, II, and IL with diabetes-related cancers, including colorectal, bladder, breast, endometrium, liver, pancreas, and prostate cancers. Two separate investigators conducted a literature search through PubMed/Medline, Scopus, and Web of Science databases up to February 2020, plus reference lists of relevant articles. Fifty-three cohort studies with a total of 100098 cancer cases were included in this systematic review. Fifteen out of eighteen studies among breast cancer cases reported no significant association between GI/GL and cancer risk. These numbers were 4 out of 13 for colorectal cancer, 7 out of 9 for endometrial cancer, 2 out of 3 for liver cancer, 8 out of 10 for pancreatic cancer, and 3 out of 3 for prostate cancer. Only one cohort investigated this association in terms of bladder cancer and reported a significant association. Also, five studies reported this relation in terms of II/IL, and only one cohort among endometrial cancer patients observed a significant positive association between the risk of cancer and IL. We concluded a weak association between dietary GI/GL and no association between II/IL with diabetes-related cancer risk. More cohort studies are required to be performed regarding II/IL and the risk of cancer.

Abstract GS2-07: Glycemic index, glycemic load and breast cancer risk: Results from the prospective NutriNet-Santé cohort

Abstract Background: Evidence is accumulating that high dietary glycemic index (GI) and glycemic load (GL) are risk factors for several metabolic disorders, e.g. diabetes or cardiovascular diseases, but evidence on GI/GL and cancer is less consistent. However, mechanistic data suggest that food with high-GI may contribute to carcinogenesis through the insulin resistance pathway.Objective: The objective was to study the associations between dietary GI/GL and breast cancer risk.Design: Population based prospective cohort study.Setting and Participants: 81,526 women aged ≥18y (mean age: 40.8±14.0y), free of cancer at baseline and with no prevalence or incidence of diabetes, from the French NutriNet-Santé cohort (2009-2019) were included in the analyses. 24-hour dietary records linked with a nutritional composition table for &amp;gt;3,500 food/beverage items containing GI values and carbohydrate content enabled us to compute average dietary GI and GL.Main outcome measures: Associations between GI; GL; proportion of energy and proportion of carbohydrates from low-GI (GI≤55) and from medium/high-GI (GI&amp;gt;55) foods and risk of breast cancer were assessed by Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors).Results: A higher dietary GL was associated with higer postmenopausal breast cancer risk (n=572, hazard ratio for quintile 5 versus quintile 1: 1.64 confidence interval 1.06-2.55 Ptrend=0.03). Percentage of energy intake from medium/high-GI foods was associated with higher breast cancer risk (HRQ5vs.Q1=1.34 (1.05-1.71), Ptrend=0.04), more specifically postmenopausal breast cancer (HRQ5vs.Q1=1.36 (1.00-1.84), Ptrend=0.02). Carbohydrates intake from medium/high-GI foods was also associated with higher breast cancer risk (HRQ5vs.Q1=1.34 (1.05-1.71), Ptrend=0.04) in both premenopausal (HRQ5vs.Q1=1.49 (1.03-2.17), Ptrend=0.04) and postmenopausal (HRQ5vs.Q1=1.44 (1.08-1.93), Ptrend=0.03) women, whereas carbohydrates from low-GI foods was associated with lower breast cancer risk (HRQ5vs.Q1=0.74 (0.59-0.92), Ptrend=0.04), only among postmenopausal women (HRQ5vs.Q1=0.69 (0.52-0.92), Ptrend=0.03). Conclusion: The consumption of foods with high-GI was associated increased breast cancer risk. If these results are confirmed dietary GI and GL should be considered as modifiable risk factor for primary breast cancer prevention. Citation Format: Charlotte Debras, Eloi Chazelas, Bernard Srour, Chantal Julia, Emmanuelle Kesse-Guyot, Laurent Zelek, Cédric Agaësse, Nathalie Druesne-Pecollo, Pilar Galan, Serge Hercberg, Paule Latino-Martel, Mélanie Deschasaux, Mathilde Touvier. Glycemic index, glycemic load and breast cancer risk: Results from the prospective NutriNet-Santé cohort [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr GS2-07.

Postdiagnostic Dietary Glycemic Index, Glycemic Load, Dietary Insulin Index, and Insulin Load and Breast Cancer Survival.

We investigated the associations of postdiagnostic dietary glycemic index (GI), glycemic load (GL), insulin index (II), and insulin load (IL) with breast cancer-specific and all-cause mortality. Among 8,932 women with stage I-III breast cancer identified in the Nurses' Health Study (NHS; 1980-2010) and NHSII (1991-2011), we prospectively evaluated the associations between postdiagnostic GI, GL, II, and IL, and breast cancer-specific and all-cause mortality. Participants completed a validated food frequency questionnaire every 4 years after diagnosis. During follow-up by 2014 in the NHS and 2015 in the NHSII, 2,523 deaths, including 1,071 from breast cancer, were documented. Higher postdiagnostic GL was associated with higher risk of both breast cancer-specific mortality [HRQ5vsQ1 = 1.33; 95% confidence interval (CI) = 1.09-1.63; P trend = 0.008] and all-cause mortality (HRQ5vsQ1 = 1.26; 95% CI = 1.10-1.45; P trend = 0.0006). Higher all-cause mortality was also observed with higher postdiagnostic GI (HRQ5vsQ1 = 1.23; 95% CI = 1.08-1.40; P trend = 0.001), II (HRQ5vsQ1 = 1.20; 95% CI = 1.04-1.38; P trend = 0.005), and IL (HRQ5vsQ1 = 1.23; 95% CI = 1.07-1.42; P trend = 0.0003). The associations were not modified by insulin receptor or estrogen receptor status of the tumor, or body mass index. We found that higher dietary GL, reflecting postprandial glucose response, after a breast cancer diagnosis was associated with higher risk of breast cancer-specific mortality. Higher dietary GI, GL, II, and IL after a breast cancer diagnosis were associated with higher risk of death from any cause. These results suggest that carbohydrate quantity and quality may be important in breast cancer prognosis.See related commentary by McTiernan, p. 252.

Diet and Prognosis in Women with Breast Cancer.

Women who have obesity or who have metabolic abnormalities, including diabetes, prediabetes, or hyperglycemia/insulinemia, have poorer survival compared with other women with breast cancer. Data are lacking on specific lifestyle modifications to prevent or treat these conditions to improve women's chances of survival from breast cancer. The Nurses' Health Study cohorts provide new evidence that diets with the potential to elevate circulating insulin or glucose are associated with breast cancer prognosis. The researchers found statistically significant evidence that women in the highest quintile of glycemic load had a 31% higher risk of breast cancer-specific mortality and a 26% higher risk of all-cause mortality. While a randomized controlled clinical trial testing if a reduced glycemic load diet reduces recurrence or death would be optimal, evidence from this observational study suggests that diet matters in survival from breast cancer. The dietary guidelines provided by the World Cancer Research Fund/American Institute for Cancer Research, the American Cancer Society, and the American Society for Clinical Oncology, which collectively emphasize increased intake of vegetables, fruits, whole grains, and legumes, and reduced intake of sugar, calorie-dense foods, and sugary drinks, are reasonable for most breast cancer survivors to follow for optimal health.See related article by Farvid et al., p. 335.

Changes in Ghrelin and Glucagon following a Low Glycemic Load Diet in Women with PCOS.

Altered satiety hormones in women with polycystic ovarian syndrome (PCOS) may contribute to obesity. Diets with a low glycemic load (GL) may influence appetite-regulating hormones including glucagon and ghrelin. To test the hypothesis that following a 4-week, eucaloric low vs high GL diet habituation, a low vs high GL meal will increase glucagon and decrease ghrelin to reflect greater satiety and improve self-reported fullness. Secondary analysis of a randomized crossover trial. Thirty women diagnosed with PCOS. Participants were provided low (41:19:40% energy from carbohydrate:protein:fat) and high (55:18:27) GL diets for 8 weeks each. At each diet midpoint, a solid meal test was administered to examine postprandial ghrelin, glucagon, glucose, insulin, and self-reported appetite scores. After 4 weeks, fasting glucagon was greater with the low vs high GL diet (P = .035), and higher fasting glucagon was associated with lesser feelings of hunger (P = .009). Significant diet effects indicate 4-hour glucagon was higher (P < .001) and ghrelin was lower (P = .009) after the low vs high GL meal. A trending time × diet interaction (P = .077) indicates feelings of fullness were greater in the early postprandial phase after the high GL meal, but no differences were observed the late postprandial phase. These findings suggest after low GL diet habituation, a low GL meal reduces ghrelin and increases glucagon in women with PCOS. Further research is needed to determine the influence of diet composition on ad libitum intake in women with PCOS.

Validation of estimated glycaemic index and glycaemic load, stratified by race, in the Adventist Health Study-2 (AHS-2).

Few studies have validated FFQ estimates of dietary glycaemic index (GI) and load (GL). We investigated how well our estimates of overall GI and GL from FFQs correlate with estimates from repeated 24 h recall data to validate overall GI and GL in the Adventist Health Study-2 (AHS-2). The AHS-2 is a prospective population-based cohort of 95 873 Seventh-day Adventist adult church members enrolled from 2002 to 2007 to investigate diet, cancer and mortality. A 204-item FFQ was used to assess race- and gender-specific validity of GI and GL and 24 h recall data, from the calibration sub-study, were used as the reference. The 734 calibration study participants were randomly selected by church and included approximately equal numbers of blacks and whites but were otherwise similar to the whole cohort with respect to gender, age, education and vegetarian status. The deattenuated correlation coefficients for overall GI ranged from 0·19 (95 % CI -0·06, 0·53) in black men to 0·46 (95 % CI 0·40, 0·60) in black women, with both non-black men and women falling between those values (0·45 (95 % CI 0·35, 0·65) and 0·38 (95 % CI 0·27, 0·57), respectively). GL correlations were somewhat higher for all study participants. When looking at the entire cohort, the deattenuated validity correlation value for overall GI was (r 0·38, 95 % CI 0·36, 0·47) and GL was (r 0·39, 95 % CI 0·34, 0·49). Our findings support the cautious use of our FFQ in epidemiological studies when assessing associations of overall GI and GL with disease risk. However, observed differences by race should be considered when interpreting results.