Dietary carbohydrate, glycemic index, and glycemic load and the risk of colorectal cancer in the BCDDP cohort

Lori S Strayer, David R Jacobs Jr, Catherine Schairer, Arthur Schatzkin, Andrew Flood

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Background: There is considerable support for associations between insulin and IGF-I levels and colorectal cancer. Diet may relate to colorectal cancer through this mechanism, for example, diets high in glycemic index, glycemic load and/or carbohydrate are hypothesized to increase insulin load and the risk of insulin resistance, hyperinsulinemia. Case-control studies support this hypothesis, but prospective cohorts have had mixed results. Methods: In the Breast Cancer Detection Demonstration Project (BCDDP) follow-up cohort of 45,561 women, we used Cox proportional hazards regression to assess the distribution of 490 incident cases of colorectal cancer ascertained during 8.5 years of follow-up across quintiles of carbohydrate intake, glycemic index, and glycemic load. We also stratified by combined BMI and physical activity levels. Results: We found reductions in colorectal cancer risk for diets high in carbohydrate (RR for Q5 vs. Q1 = 0.70, 95% CI: 0.50-0.97) and glycemic index (0.75, 95% CI: 0.56-1.00), and no significant association for glycemic load (0.91, 95% CI: 0.70-1.20). Inverse associations were weakest in normal weight active persons. The inverse association for glycemic index was strongest for the portion from dairy food. Conclusions: These results do not support an association between diets high in carbohydrate, glycemic index or glycemic load and colorectal cancer.

Original languageEnglish (US)
Pages (from-to)853-863
Number of pages11
JournalCancer Causes and Control
Volume18
Issue number8
DOIs
StatePublished - Oct 1 2007

Keywords

  • Colorectal cancer
  • Dietary carbohydrate
  • Glycemic index
  • Glycemic load
  • Insulin resistance

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