title: Aspects of dietary carbohydrate intake are not related to risk of colorectal polyps in the Tennessee Colorectal Polyp Study.
abstract: OBJECTIVE
  High digestible carbohydrate intakes can induce hyperglycemia and hyperinsulinemia and collectively have been implicated in colorectal tumor development. Our aim was to explore the association between aspects of dietary carbohydrate intake and risk of colorectal adenomas and hyperplastic polyps in a large case-control study.
  
  
  METHODS
  Colorectal polyp cases (n = 1,315 adenomas only, n = 566 hyperplastic polyps only and n = 394 both) and controls (n = 3,184) undergoing colonoscopy were recruited between 2003 and 2010 in Nashville, Tennessee, USA. Dietary intakes were estimated by a 108-item food frequency questionnaire. Unconditional logistic regression analysis was applied to determine odds ratios (OR) and corresponding 95 % confidence intervals (CI) for colorectal polyps according to dietary carbohydrate intakes, after adjustment for potential confounders.
  
  
  RESULTS
  No significant associations were detected for risk of colorectal adenomas when comparing the highest versus lowest quartiles of intake for total sugars (OR 1.03; 95 % CI 0.84-1.26), starch (OR 1.01; 95 % CI 0.81-1.26), total or available carbohydrate intakes. Similar null associations were observed between dietary carbohydrate intakes and risk of hyperplastic polyps, or concurrent adenomas and hyperplastic polyps.
  
  
  CONCLUSIONS
  In this US population, digestible carbohydrate intakes were not associated with risk of colorectal polyps, suggesting that dietary carbohydrate does not have an etiological role in the early stages of colorectal carcinogenesis.
authors.affiliation: Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland.
authors.forename: Helen G
authors.initials: HG
authors.lastname: Coleman
authors.forename: Reid M
authors.initials: RM
authors.lastname: Ness
authors.forename: Walter E
authors.initials: WE
authors.lastname: Smalley
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Martha J
authors.initials: MJ
authors.lastname: Shrubsole
mesh_terms: D000236:Adenoma / Q000453:epidemiology*; D000368:Aged; D016022:Case-Control Studies; D003106:Colon / Q000473:pathology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000453:epidemiology; D007417:Intestinal Polyps / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012306:Risk; D012307:Risk Factors; D013714:Tennessee / Q000453:epidemiology
chemical_list: D004040:Dietary Carbohydrates