title: Dietary fructose, carbohydrates, glycemic indices and pancreatic cancer risk: a systematic review and meta-analysis of cohort studies.
abstract: BACKGROUND
  Dietary carbohydrates, glycemic load and glycemic index have been hypothesized to influence pancreatic cancer risk, but epidemiological studies have been inconsistent. We conducted a systematic review and meta-analysis of prospective studies to clarify these results.
  
  
  METHODS
  PubMed and several other databases were searched for prospective studies of intake of carbohydrates, glycemic index and glycemic load and pancreatic cancer up to September 2011. Summary relative risks were estimated using a random effects model.
  
  
  RESULTS
  Ten cohort studies (13 publications) were included in the meta-analysis. The summary relative risk (RR) per 10 glycemic index units was 1.02 [95% confidence interval (CI): 0.93-1.12, I(2) = 0%], per 50 glycemic load units was 1.03 (95% CI: 0.93-1.14, I(2) = 10%), per 100 g/day of total carbohydrates was 0.97 (95% CI: 0.81-1.16, I(2) = 35%), and per 25 g/day of sucrose intake was 1.05 (95% CI: 0.85-1.23, I(2) = 53%). A positive association was observed with fructose intake, summary RR = 1.22 (95% CI: 1.08-1.37, I(2) = 0%) per 25 g/day.
  
  
  CONCLUSIONS
  This meta-analysis does not support an association between diets high in glycemic index, glycemic load, total carbohydrates or sucrose and pancreatic cancer risk. The finding of an increased risk with fructose intake warrants further investigation in studies with better adjustment for confounding and in non-American populations.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London. Electronic address: d.aune@imperial.ac.uk.
authors.forename: D
authors.initials: D
authors.lastname: Aune
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London.
authors.forename: D S M
authors.initials: DSM
authors.lastname: Chan
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London.
authors.forename: A R
authors.initials: AR
authors.lastname: Vieira
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London.
authors.forename: D A
authors.initials: DA
authors.lastname: Navarro Rosenblatt
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London.
authors.forename: R
authors.initials: R
authors.lastname: Vieira
authors.affiliation: Biostatistics Unit, Centre for Epidemiology and Biostatistics.
authors.forename: D C
authors.initials: DC
authors.lastname: Greenwood
authors.affiliation: School of Food Science and Nutrition, University of Leeds, Leeds, UK.
authors.forename: J E
authors.initials: JE
authors.lastname: Cade
authors.affiliation: School of Food Science and Nutrition, University of Leeds, Leeds, UK.
authors.forename: V J
authors.initials: VJ
authors.lastname: Burley
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London.
authors.forename: T
authors.initials: T
authors.lastname: Norat
mesh_terms: D000328:Adult; D000368:Aged; D002241:Carbohydrates / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D005632:Fructose / Q000008:administration & dosage*; D038321:Glycemic Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology*
chemical_list: D002241:Carbohydrates; D005632:Fructose