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.
Mulholland
Helen G
HG
Cancer Epidemiology & Prevention Research Group, Centre for Clinical & Population Sciences, Queens University Belfast, Grosvenor Road, Belfast, Northern Ireland, UK. hmulholland04@qub.ac.uk
Cantwell
Marie M
MM
Anderson
Lesley A
LA
Johnston
Brian T
BT
Watson
R G Peter
RG
Murphy
Seamus J
SJ
Ferguson
Heather R
HR
McGuigan
Jim
J
Reynolds
John V
JV
Comber
Harry
H
Murray
Liam J
LJ
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