Journal
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
Volume 51, Issue 1, Pages 250-264Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyab169
Keywords
glycaemic index; glycaemic load; cancer risk; breast cancer; prospective cohort
Categories
Funding
- Ministere de la Sante, Sante Publique France
- Institut National de la Sante et de la Recherche Medicale (Inserm)
- Institut national de recherche pour l'agriculture, l'alimentation et l'environnement (INRAE)
- Conservatoire National des Arts et Metiers (CNAM)
- Universite Sorbonne Paris Nord (Universite Paris 13)
- French National Cancer Institute (INCa)
- Universite Paris 13-Galilee Doctoral School
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This study found that a high dietary glycemic load (GL) was associated with an increased overall cancer risk, especially postmenopausal breast cancer. A higher contribution of low glycemic index (GI) foods was associated with a lower cancer risk, while a higher contribution of medium/high GI foods was associated with an increased risk of overall, breast, and postmenopausal breast cancers.
Background Evidence is accumulating that high dietary glycaemic index (GI) and glycaemic load (GL) are potential risk factors for several metabolic disorders (e.g. type-2 diabetes, cardiovascular diseases), but remains limited concerning cancer risk. Although, mechanistic data suggest that consuming high-GI foods may contribute to carcinogenesis through elevated blood glucose levels, insulin resistance or obesity-related mechanisms. Our objective was to study the associations between dietary GI/GL and cancer. Methods In total, 103 020 French adults (median age = 40.2 years) from the NutriNet-Sante cohort (2009-2020) with no cancer or diabetes at baseline were included (705 137 person-years, median follow-up time = 7.7 years). Repeated 24-h dietary records linked with a detailed food-composition table (>3500 food/beverage items). We computed the average dietary GI and GL at the individual level. Associations between GI, GL, contribution of low- and medium/high-GI foods to energy and carbohydrate intake and cancer risk (overall, breast, prostate and colorectal) were assessed using multivariable Cox proportional-hazard models. Results Higher dietary GL was associated with higher overall cancer risk [n = 3131 cases, hazard ratios (HRs) for sex-specific quintile 5 vs 1 = 1.25, 95% confidence interval (CI) = 1.03-1.52; P-trend = 0.008] and specifically postmenopausal breast cancer (n = 924, HRQ5vs.Q1 = 1.64, 95% CI = 1.06-2.55; P-trend = 0.03). A higher contribution of low-GI food/beverages to energy intake was associated with lower cancer risk whereas a higher contribution of medium/high-GI items to energy intake was positively associated with higher risk of overall, breast and postmenopausal breast cancers (P-trend <= 0.02). Conclusions These results support a possible impact of GI/GL on cancer risk. If confirmed in other populations and settings, dietary GI/GL could be considered as modifiable risk factors for primary cancer prevention.
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