Available carbohydrates, glycemic load, and pancreatic cancer: is there a link?
High-carbohydrate diets have been linked to pancreatic cancer risk in case-control studies, but prospective studies have shown mostly null results. The authors investigated the associations of glycemic load, glycemic index, and carbohydrate intake with pancreatic cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary intake was assessed by using a self-administered questionnaire. Between 1998 and 2006 (median follow-up = 6.5 years), 266 incident, confirmed pancreatic cancers were identified among 109,175 participants. Hazards ratios and 95% confidence intervals were adjusted for sex, smoking, body mass index, and total energy. Overall, elevated risks for pancreatic cancer were observed in the 90th versus 10th percentile of glycemic load (hazards ratio (HR) = 1.45, 95% confidence interval (CI): 1.05, 2.00), available carbohydrate (HR = 1.47, 95% CI: 1.05, 2.06), and sucrose (HR = 1.37, 95% CI: 0.99, 1.89) intake. The positive association for available carbohydrate intake was observed during the first 4 years of follow-up (HR(<2 years) = 2.60, 95% CI: 1.34, 5.06; HR(2-<4 years) = 1.94, 95% CI: 1.06, 3.55) but not subsequently (HR = 0.86, 95% CI: 0.52, 1.44); the opposite pattern was observed for total fat and saturated fat intake. Rather than being causal, the short-term increase in pancreatic cancer risk associated with high available carbohydrate and low fat intake may be capturing dietary changes associated with subclinical disease.
Meinhold
Cari L
CL
National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland 20852, USA.
Dodd
Kevin W
KW
Jiao
Li
L
Flood
Andrew
A
Shikany
James M
JM
Genkinger
Jeanine M
JM
Hayes
Richard B
RB
Stolzenberg-Solomon
Rachael Z
RZ
D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D016001:Confidence Intervals; D004032:Diet / Q000009:adverse effects; D004040:Dietary Carbohydrates / Q000009:adverse effects*; D004041:Dietary Fats / Q000009:adverse effects; D004435:Eating; D005260:Female; D038321:Glycemic Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000209:etiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats
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