Glycemic index, glycemic load, and cancer risk: A meta-analysis

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Abstract

Background: Factors linked to glucose metabolism play an important role in the development of cancers, and both glycemic index (GI) and glycemic load (GL) have been investigated as potential etiologic factors. Objective: A meta-analysis was performed to explore the association between GI and GL and cancer risk from published studies. Design: A comprehensive, systematic bibliographic search of the medical literature was conducted to identify relevant studies. Casecontrol and cohort studies published before October 2007 that reported cancer risk estimates for GI and GL were included. Pooled relative risks (RRs) were estimated for breast, colorectal, endometrial, and pancreatic cancer. Results: Thirty-nine studies were included in the meta-analysis. The interquantile ranges of GL were significantly wider in case-control studies, most of which were conducted in European countries, than in cohort studies. Cohort studies that presented lower ranges of GL also reported lower risk estimates. Overall, both GL and GI were significantly associated with a greater risk of colorectal (summary RR = 1.26; 95% CI: 1.11, 1.44 and RR = 1.18; 95% CI: 1.05, 1.34, respectively) and endometrial (RR = 1.36; 95% CI: 1.14, 1.62 and RR = 1.22; 95% CI: 1.01, 1.49) cancer than of breast and pancreatic cancer. There was, however, a significant between-study heterogeneity for colorectal cancer (P <0.0001). The association between GL and breast cancer disappeared when publication bias was taken into account. No association was found for pancreatic cancer. Conclusion: This comprehensive meta-analysis of GI and GL and cancer risk suggested an overall direct association with colorectal and endometrial cancer.

Original languageEnglish
Pages (from-to)1793-1801
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume87
Issue number6
Publication statusPublished - Jun 1 2008

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Glycemic Index
glycemic index
meta-analysis
relative risk
Meta-Analysis
pancreatic neoplasms
neoplasms
cohort studies
Neoplasms
risk estimate
colorectal neoplasms
breast neoplasms
Pancreatic Neoplasms
Breast Neoplasms
Colorectal Neoplasms
Cohort Studies
Endometrial Neoplasms
case-control studies
breasts
Glycemic Load

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

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Glycemic index, glycemic load, and cancer risk : A meta-analysis. / Gnagnarella, Patrizia; Gandini, Sara; La Vecchia, Carlo; Maisonneuve, Patrick.

In: American Journal of Clinical Nutrition, Vol. 87, No. 6, 01.06.2008, p. 1793-1801.

Research output: Contribution to journalArticle

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abstract = "Background: Factors linked to glucose metabolism play an important role in the development of cancers, and both glycemic index (GI) and glycemic load (GL) have been investigated as potential etiologic factors. Objective: A meta-analysis was performed to explore the association between GI and GL and cancer risk from published studies. Design: A comprehensive, systematic bibliographic search of the medical literature was conducted to identify relevant studies. Casecontrol and cohort studies published before October 2007 that reported cancer risk estimates for GI and GL were included. Pooled relative risks (RRs) were estimated for breast, colorectal, endometrial, and pancreatic cancer. Results: Thirty-nine studies were included in the meta-analysis. The interquantile ranges of GL were significantly wider in case-control studies, most of which were conducted in European countries, than in cohort studies. Cohort studies that presented lower ranges of GL also reported lower risk estimates. Overall, both GL and GI were significantly associated with a greater risk of colorectal (summary RR = 1.26; 95{\%} CI: 1.11, 1.44 and RR = 1.18; 95{\%} CI: 1.05, 1.34, respectively) and endometrial (RR = 1.36; 95{\%} CI: 1.14, 1.62 and RR = 1.22; 95{\%} CI: 1.01, 1.49) cancer than of breast and pancreatic cancer. There was, however, a significant between-study heterogeneity for colorectal cancer (P <0.0001). The association between GL and breast cancer disappeared when publication bias was taken into account. No association was found for pancreatic cancer. Conclusion: This comprehensive meta-analysis of GI and GL and cancer risk suggested an overall direct association with colorectal and endometrial cancer.",
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N2 - Background: Factors linked to glucose metabolism play an important role in the development of cancers, and both glycemic index (GI) and glycemic load (GL) have been investigated as potential etiologic factors. Objective: A meta-analysis was performed to explore the association between GI and GL and cancer risk from published studies. Design: A comprehensive, systematic bibliographic search of the medical literature was conducted to identify relevant studies. Casecontrol and cohort studies published before October 2007 that reported cancer risk estimates for GI and GL were included. Pooled relative risks (RRs) were estimated for breast, colorectal, endometrial, and pancreatic cancer. Results: Thirty-nine studies were included in the meta-analysis. The interquantile ranges of GL were significantly wider in case-control studies, most of which were conducted in European countries, than in cohort studies. Cohort studies that presented lower ranges of GL also reported lower risk estimates. Overall, both GL and GI were significantly associated with a greater risk of colorectal (summary RR = 1.26; 95% CI: 1.11, 1.44 and RR = 1.18; 95% CI: 1.05, 1.34, respectively) and endometrial (RR = 1.36; 95% CI: 1.14, 1.62 and RR = 1.22; 95% CI: 1.01, 1.49) cancer than of breast and pancreatic cancer. There was, however, a significant between-study heterogeneity for colorectal cancer (P <0.0001). The association between GL and breast cancer disappeared when publication bias was taken into account. No association was found for pancreatic cancer. Conclusion: This comprehensive meta-analysis of GI and GL and cancer risk suggested an overall direct association with colorectal and endometrial cancer.

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