title: Dietary glycemic load and colorectal cancer risk.
abstract: BACKGROUND
  Insulin and insulin-like growth factors can stimulate proliferation of colorectal cells. High intake of refined carbohydrates and markers of insulin resistance are associated with colorectal cancer. To test the insulin/colon cancer hypothesis, we determined whether the dietary glycemic index and the glycemic load are associated with colorectal cancer risk.
  
  
  METHODS
  A case-control study on colorectal cancer conducted in Italy. Cases included 1125 men and 828 women with histologically confirmed incident cancer of the colon or rectum. Controls were 2073 men and 2081 women hospitalized for acute conditions. We calculated average daily dietary glycemic index and glycemic load, and fiber intake from a validated food frequency questionnaire.
  
  
  RESULTS
  Direct associations with colorectal cancer risk emerged for glycemic index (odds ratio (OR) in highest vs. lowest quintile = 1.7; 95% confidence interval (CI): 1.4-2.0) and glycemic load (OR = 1.8; 95% CI: 1.5-2.2), after allowance for sociodemographic factors, physical activity, number of daily meals, and intakes of fiber, alcohol and energy. ORs were more elevated for cancer of the colon than rectum. Overweight and low intake of fiber from vegetables and fruit appeared to amplify the adverse consequences of high glycemic load.
  
  
  CONCLUSIONS
  The positive associations of glycemic index and load with colorectal cancer suggest a detrimental role of refined carbohydrates in the etiology of the disease.
authors: Servizio di Epidemiologia, Centro di Riferimento Oncologico, Istituto Nazionale Tumori, Aviano, Italy.
authors: S
authors: S
authors: Franceschi
authors: L
authors: L
authors: Dal Maso
authors: L
authors: L
authors: Augustin
authors: E
authors: E
authors: Negri
authors: M
authors: M
authors: Parpinel
authors: P
authors: P
authors: Boyle
authors: D J
authors: DJ
authors: Jenkins
authors: C
authors: C
authors: La Vecchia
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012004:Rectal Neoplasms / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004043:Dietary Fiber