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Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).
Am J Clin Nutr 2012; 96(2):345-55AJ

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 HR(Q5-Q1) (95% CI) = 1.36 (1.02, 1.82; P-trend = 0.010) and HR(Q5-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 [HR(Q5-Q1) (95% CI) = 1.48 (1.07, 2.05; P-trend = 0.010) for GL and HR(Q5-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.

Authors+Show Affiliations

Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France, Barcelona, Spain. romieui@iarc.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22760570

Citation

Romieu, Isabelle, et al. "Dietary Glycemic Index and Glycemic Load and Breast Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC)." The American Journal of Clinical Nutrition, vol. 96, no. 2, 2012, pp. 345-55.
Romieu I, Ferrari P, Rinaldi S, et al. Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr. 2012;96(2):345-55.
Romieu, I., Ferrari, P., Rinaldi, S., Slimani, N., Jenab, M., Olsen, A., ... Clavel-Chapelon, F. (2012). Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). The American Journal of Clinical Nutrition, 96(2), pp. 345-55. doi:10.3945/ajcn.111.026724.
Romieu I, et al. Dietary Glycemic Index and Glycemic Load and Breast Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC). Am J Clin Nutr. 2012;96(2):345-55. PubMed PMID: 22760570.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). AU - Romieu,Isabelle, AU - Ferrari,Pietro, AU - Rinaldi,Sabina, AU - Slimani,Nadia, AU - Jenab,Mazda, AU - Olsen,Anja, AU - Tjonneland,Anne, AU - Overvad,Kim, AU - Boutron-Ruault,Marie-Christine, AU - Lajous,Martin, AU - Kaaks,Rudolf, AU - Teucher,Birgit, AU - Boeing,Heiner, AU - Trichopoulou,Antonia, AU - Naska,Androniki, AU - Vasilopoulo,Effie, AU - Sacerdote,Carlotta, AU - Tumino,Rosario, AU - Masala,Giovanna, AU - Sieri,Sabina, AU - Panico,Salvatore, AU - Bueno-de-Mesquita,H Bas, AU - Van-der-A,Daphne, AU - van Gils,Carla H, AU - Peeters,Petra H M, AU - Lund,Eiliv, AU - Skeie,Guri, AU - Asli,Lene Angell, AU - Rodriguez,Laudina, AU - Navarro,Carmen, AU - Amiano,Pilar, AU - Sanchez,Maria-José, AU - Barricarte,Aurelio, AU - Buckland,Genevieve, AU - Sonestedt,Emily, AU - Wirfält,Elisabet, AU - Hallmans,Göran, AU - Johansson,Ingegerd, AU - Key,Timothy J, AU - Allen,Naomi E, AU - Khaw,Kay-Tee, AU - Wareham,Nicholas J, AU - Norat,Teresa, AU - Riboli,Elio, AU - Clavel-Chapelon,Françoise, Y1 - 2012/07/03/ PY - 2012/7/5/entrez PY - 2012/7/5/pubmed PY - 2012/10/2/medline SP - 345 EP - 55 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 96 IS - 2 N2 - 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 HR(Q5-Q1) (95% CI) = 1.36 (1.02, 1.82; P-trend = 0.010) and HR(Q5-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 [HR(Q5-Q1) (95% CI) = 1.48 (1.07, 2.05; P-trend = 0.010) for GL and HR(Q5-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. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/22760570/Dietary_glycemic_index_and_glycemic_load_and_breast_cancer_risk_in_the_European_Prospective_Investigation_into_Cancer_and_Nutrition__EPIC__ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.111.026724 DB - PRIME DP - Unbound Medicine ER -