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Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Romieu, Isabelle; Ferrari, Pietro; Rinaldi, Sabina; Slimani, Nadia; Jenab, Mazda; Olsen, Anja; Tjonneland, Anne; Overvad, Kim; Boutron-Ruault, Marie-Christine and Lajous, Martin, et al. (2012) In American Journal of Clinical Nutrition 96(2). p.345-355
Abstract
Background: The glycemic potential of a diet is associated with chronically elevated insulin concentrations, which may augment breast cancer (BC) risk by stimulating insulin receptor or by affecting insulin-like growth factor I (IGF-I)-mediated mitogenesis. It is unclear whether this effect differs by BC phenotype. Objective: The objective was to investigate the relation between glycemic index (GI), glycemic load (GL), and total carbohydrate intake with BC by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Design: We identified 11,576 women with invasive BC among 334,849 EPIC women aged 34-66 y (5th to 95th percentiles) at baseline over a median follow-up of 11.5 y. Dietary GI and GL were calculated... (More)
Background: The glycemic potential of a diet is associated with chronically elevated insulin concentrations, which may augment breast cancer (BC) risk by stimulating insulin receptor or by affecting insulin-like growth factor I (IGF-I)-mediated mitogenesis. It is unclear whether this effect differs by BC phenotype. Objective: The objective was to investigate the relation between glycemic index (GI), glycemic load (GL), and total carbohydrate intake with BC by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Design: We identified 11,576 women with invasive BC among 334,849 EPIC women aged 34-66 y (5th to 95th percentiles) at baseline over a median follow-up of 11.5 y. Dietary GI and GL were calculated from country-specific dietary questionnaires. We used multivariable Cox proportional hazards models to quantify the association between GI. GL, and carbohydrate intake and BC risk. BC tumors were classified by receptor status. Results: Overall GI, GL, and carbohydrates were not related to BC. Among postmenopausal women, GL and carbohydate intake were significantly associated with an increased risk of estrogen receptor negative (ER-) BC when extreme quintiles (Q) were compared [multivariable HRQ5-Q1 (95% CI) = 1.36 (1.02, 1.82; P-trend = 0.010) and HRQ5-Q1 = 1.41 (1.05, 1.89; P-trend = 0.009), respectively]. Further stratification by progesterone receptor (PR) status showed slightly stronger associations with ER (-)/PR- BC [HRQ5-Q1 (95% CI) = 1.48 (1.07, 2.05; P-trend = 0.010) for GL and HRQ5-Q1 = 1.62 (1.15, 2.30; P-trend = 0.005) for carbohydrates]. No significant association with ER-positive BC was observed. Conclusion: Our results indicate that a diet with a high GL and carbohydrate intake is positively associated with an increased risk of developing ER- and ER-/PR- BC among postmenopausal women. Am J Clin Nutr 2012;96:345-55. (Less)
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American Journal of Clinical Nutrition
volume
96
issue
2
pages
345 - 355
publisher
American Society for Clinical Nutrition
external identifiers
  • wos:000306769700018
  • scopus:84864353220
ISSN
1938-3207
DOI
10.3945/ajcn.111.026724
language
English
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yes
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ff589243-d10a-411d-a9fa-c810ebf54963 (old id 3069672)
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2012-10-05 06:58:16
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2017-09-17 06:56:30
@article{ff589243-d10a-411d-a9fa-c810ebf54963,
  abstract     = {Background: The glycemic potential of a diet is associated with chronically elevated insulin concentrations, which may augment breast cancer (BC) risk by stimulating insulin receptor or by affecting insulin-like growth factor I (IGF-I)-mediated mitogenesis. It is unclear whether this effect differs by BC phenotype. Objective: The objective was to investigate the relation between glycemic index (GI), glycemic load (GL), and total carbohydrate intake with BC by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Design: We identified 11,576 women with invasive BC among 334,849 EPIC women aged 34-66 y (5th to 95th percentiles) at baseline over a median follow-up of 11.5 y. Dietary GI and GL were calculated from country-specific dietary questionnaires. We used multivariable Cox proportional hazards models to quantify the association between GI. GL, and carbohydrate intake and BC risk. BC tumors were classified by receptor status. Results: Overall GI, GL, and carbohydrates were not related to BC. Among postmenopausal women, GL and carbohydate intake were significantly associated with an increased risk of estrogen receptor negative (ER-) BC when extreme quintiles (Q) were compared [multivariable HRQ5-Q1 (95% CI) = 1.36 (1.02, 1.82; P-trend = 0.010) and HRQ5-Q1 = 1.41 (1.05, 1.89; P-trend = 0.009), respectively]. Further stratification by progesterone receptor (PR) status showed slightly stronger associations with ER (-)/PR- BC [HRQ5-Q1 (95% CI) = 1.48 (1.07, 2.05; P-trend = 0.010) for GL and HRQ5-Q1 = 1.62 (1.15, 2.30; P-trend = 0.005) for carbohydrates]. No significant association with ER-positive BC was observed. Conclusion: Our results indicate that a diet with a high GL and carbohydrate intake is positively associated with an increased risk of developing ER- and ER-/PR- BC among postmenopausal women. Am J Clin Nutr 2012;96:345-55.},
  author       = {Romieu, Isabelle and Ferrari, Pietro and Rinaldi, Sabina and Slimani, Nadia and Jenab, Mazda and Olsen, Anja and Tjonneland, Anne and Overvad, Kim and Boutron-Ruault, Marie-Christine and Lajous, Martin and Kaaks, Rudolf and Teucher, Birgit and Boeing, Heiner and Trichopoulou, Antonia and Naska, Androniki and Vasilopoulo, Effie and Sacerdote, Carlotta and Tumino, Rosario and Masala, Giovanna and Sieri, Sabina and Panico, Salvatore and Bueno-de-Mesquita, H. Bas and Van-der-A, Daphne and van Gils, Carla H. and Peeters, Petra H. M. and Lund, Eiliv and Skeie, Guri and Asli, Lene Angell and Rodriguez, Laudina and Navarro, Carmen and Amiano, Pilar and Sanchez, Maria-Jose and Barricarte, Aurelio and Buckland, Genevieve and Sonestedt, Emily and Wirfält, Elisabet and Hallmans, Goran and Johansson, Ingegerd and Key, Timothy J. and Allen, Naomi E. and Khaw, Kay-Tee and Wareham, Nicholas J. and Norat, Teresa and Riboli, Elio and Clavel-Chapelon, Francoise},
  issn         = {1938-3207},
  language     = {eng},
  number       = {2},
  pages        = {345--355},
  publisher    = {American Society for Clinical Nutrition},
  series       = {American Journal of Clinical Nutrition},
  title        = {Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)},
  url          = {http://dx.doi.org/10.3945/ajcn.111.026724},
  volume       = {96},
  year         = {2012},
}