Glycemic index, carbohydrate and fiber intakes and risk of reflux esophagitis, Barrett's esophagus, and esophageal adenocarcinoma.
OBJECTIVE
To examine the association between dietary glycemic index (GI), glycemic load (GL), total carbohydrate, sugars, starch, and fiber intakes and the risk of reflux esophagitis, Barrett's esophagus, and esophageal adenocarcinoma.


METHODS
In an all-Ireland study, dietary information was collected from patients with esophageal adenocarcinoma (n = 224), long-segment Barrett's esophagus (n = 220), reflux esophagitis (n = 219), and population-based controls (n = 256). Multiple logistic regression analysis examined the association between dietary variables and disease risk by tertiles of intake and as continuous variables, while adjusting for potential confounders.


RESULTS
Reflux esophagitis risk was positively associated with starch intake and negatively associated with sugar intake. Barrett's esophagus risk was significantly reduced in people in the highest versus the lowest tertile of fiber intake (OR 0.44 95%CI 0.25-0.80). Fiber intake was also associated with a reduced risk of esophageal adenocarcinoma, as was total carbohydrate intake (OR 0.45 95%CI 0.33-0.61 per 50 g/d increase). However, an increased esophageal adenocarcinoma risk was detected per 10 unit increase in GI intake (OR 1.42 95%CI 1.07-1.89).


CONCLUSIONS
Our findings suggest that fiber intake is inversely associated with Barrett's esophagus and esophageal adenocarcinoma risk. Esophageal adenocarcinoma risk is inversely associated with total carbohydrate consumption but positively associated with high GI intakes.
Cancer Epidemiology & Prevention Research Group, Centre for Clinical & Population Sciences, Queens University Belfast, Grosvenor Road, Belfast, Northern Ireland, UK. hmulholland04@qub.ac.uk
Helen G
HG
Mulholland
Marie M
MM
Cantwell
Lesley A
LA
Anderson
Brian T
BT
Johnston
R G Peter
RG
Watson
Seamus J
SJ
Murphy
Heather R
HR
Ferguson
Jim
J
McGuigan
John V
JV
Reynolds
Harry
H
Comber
Liam J
LJ
Murray
D000230:Adenocarcinoma / Q000453:epidemiology* / Q000473:pathology; D000368:Aged; D001471:Barrett Esophagus / Q000453:epidemiology*; D015992:Body Mass Index; D016001:Confidence Intervals; D016208:Databases, Factual; D004040:Dietary Carbohydrates / Q000378:metabolism; D004043:Dietary Fiber / Q000378:metabolism; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D004942:Esophagitis, Peptic / Q000453:epidemiology*; D005260:Female; D038321:Glycemic Index; D006801:Humans; D007407:Interviews as Topic; D007494:Ireland / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014505:Urban Population; D049629:Waist-Hip Ratio
D004040:Dietary Carbohydrates; D004043:Dietary Fiber