title: Dietary intakes of carbohydrates in relation to prostate cancer risk: a prospective study in the Malmö Diet and Cancer cohort.
abstract: BACKGROUND
  Dietary carbohydrates have been implicated in relation to prostate cancer.
  
  
  OBJECTIVE
  Our objective was to examine the associations between dietary intakes of carbohydrates, fiber, and their food sources and risk of prostate cancer, overall and by case severity, in the Malmö Diet and Cancer cohort.
  
  
  METHODS
  The analysis included 8128 men aged 45-73 y without a history of cancer, cardiovascular disease, or diabetes and who were classified as adequate energy reporters. After a median follow-up time of 15 y, prostate cancer was diagnosed in 817 men. We used Cox proportional hazards regression to model associations between energy-adjusted nutrient and food intakes with risk of incident prostate cancer, with competing risk of death from non-prostate cancer causes taken into account.
  
  
  RESULTS
  After adjustment for age and other known or potential risk factors, we observed no associations between total carbohydrates or dietary fiber and prostate cancer. We observed positive associations between the intake of low-fiber cereals with overall and low-risk prostate cancer and between intakes of cake and biscuits and rice and pasta with low-risk prostate cancer (all P-trend < 0.05). A high intake compared with zero consumption of sugar-sweetened beverages was associated with increased risk of symptomatic prostate cancer (HR: 1.38; 95% CI: 1.04, 1.84).
  
  
  CONCLUSIONS
  Results from this large study with high-validity dietary data suggest that a high intake of refined carbohydrates may be associated with increased risk of prostate cancer. However we observed no significant associations with high-risk prostate cancer, and not all foods that are typically high in refined carbohydrates were associated with prostate cancer.
authors.affiliation: Research Group in Nutritional Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden. isabel.drake@med.lu.se
authors.forename: Isabel
authors.initials: I
authors.lastname: Drake
authors.forename: Emily
authors.initials: E
authors.lastname: Sonestedt
authors.forename: Bo
authors.initials: B
authors.lastname: Gullberg
authors.forename: Göran
authors.initials: G
authors.lastname: Ahlgren
authors.forename: Anders
authors.initials: A
authors.lastname: Bjartell
authors.forename: Peter
authors.initials: P
authors.lastname: Wallström
authors.forename: Elisabet
authors.initials: E
authors.lastname: Wirfält
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000009:adverse effects*; D004043:Dietary Fiber / Q000008:administration & dosage; D019422:Dietary Sucrose / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D012306:Risk; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
chemical_list: D004040:Dietary Carbohydrates; D004043:Dietary Fiber; D019422:Dietary Sucrose; D017430:Prostate-Specific Antigen