title: Associations of bread and pasta with the risk of cancer of the breast and colorectum.
abstract: BACKGROUND
  Carbohydrate foods with high glycemic and insulinemic potential may influence cancer risk possibly through the insulin/growth-factor axis. Two staple carbohydrate foods of the Mediterranean diet, bread and pasta, have different glycemic and insulinemic responses and hence may affect cancer risk differently.
  
  
  METHODS
  We studied the association of bread and pasta with breast and colorectal cancer risk using data from two Italian case-control studies. These studies included 2569 women with histologically confirmed breast cancer and 1953 men and women with colorectal cancer. Controls were 2588 and 4154, respectively, admitted to the same hospitals as cases for acute, non-neoplastic conditions. Multivariate odds ratios (ORs) were obtained after allowance for relevant confounding factors.
  
  
  RESULTS
  The ORs of breast cancer for the highest versus the lowest quintile were 1.28 (95% confidence interval, CI: 1.03-1.58, P-trend = 0.0342) for bread and 1.07 (95% CI: 0.88-1.31, P-trend = 0.7072) for pasta. The association with bread remained virtually unchanged with postmenopause and overweight. The ORs of colorectal cancer in women for the highest versus the lowest quintile were 2.02 (95% CI: 1.46-2.80, P-trend = 0.0002) for bread and 1.37 (95% CI: 1.00-1.88, P-trend = 0.0164) for pasta. The associations remained significant only for bread in strata of menopausal status and in women with overweight. No significant associations were seen in men for either bread or pasta.
  
  
  CONCLUSIONS
  Overall, these two cancer case-control studies showed stronger positive associations with bread than pasta in women, particularly if overweight, suggesting possible hormonal-related mechanisms.
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto and Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Canada.
authors.forename: L S A
authors.initials: LS
authors.lastname: Augustin
authors.forename: S
authors.initials: S
authors.lastname: Malerba
authors.forename: A
authors.initials: A
authors.lastname: Lugo
authors.forename: S
authors.initials: S
authors.lastname: Franceschi
authors.forename: R
authors.initials: R
authors.lastname: Talamini
authors.forename: D
authors.initials: D
authors.lastname: Serraino
authors.forename: D J A
authors.initials: DJ
authors.lastname: Jenkins
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
mesh_terms: D000368:Aged; D015992:Body Mass Index; D001939:Bread / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000209:etiology*; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000209:etiology*; D038441:Diet, Mediterranean; D004040:Dietary Carbohydrates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors
chemical_list: D004040:Dietary Carbohydrates
keywords: cancer risk; colorectal and breast cancer; diet