Glycemic Index, Glycemic Load, and Lung Cancer Risk in Non-Hispanic Whites

Abstract

Background Postprandial glucose (PPG) and insulin responses play a role in carcinogenesis. We evaluated the association between dietary glycemic index (GI) and glycemic load (GL), markers of carbohydrate intake and PPG, and lung cancer risk in non-Hispanic whites. Methods GL and GI were assessed among 1,905 newly diagnosed lung cancer cases recruited from the University of Texas MD Anderson Cancer Center in Houston, Texas and 2,413 healthy controls recruited at Kelsey-Seybold Clinics in Houston. We assessed associations between quintiles of GI/GL and lung cancer risk and effect modification by various risk factors. Odds ratios (ORs) and 95% confidence intervals (CI) were estimated using multivariable logistic regression. Results We observed a significant association between GI (5th vs 1st quintile (Q)) OR = 1.49, 95% CI: 1.21–1.83, P-trend <0.001) and lung cancer risk and GIac (5th vs 1st Q OR = 1.48, 95% CI: 1.20–1.81, P-trend =0.001) and lung cancer risk. We observed a more pronounced association between GI and lung cancer risk among never smokers, (5th vs 1st Q OR=2.25, 95% CI: 1.42–3.57), squamous cell carcinomas (SCCs) (5th vs 1st Q OR=1.92, 95% CI: 1.30–2.83) and those with less than 12 years of education (5th vs 1st Q OR=1.75, 95% CI: 1.19–2.58, P-interaction = 0.02). Conclusion This study suggests that dietary glycemic index and other lung cancer risk factors may jointly and independently influence lung cancer etiology. Impact Understanding the role of glycemic index in lung cancer could inform prevention strategies and elucidate biological pathways related to lung cancer risk.

Glycemic Index, Glycemic Load and Cancer Risk: An Updated Meta-Analysis

“…Two reports gave results on GI/GL and lung cancer [22,25]. Data from the Shanghai Women’s and Men’s Health Studies, including 649 incident lung cancers among women and 663 among men developed during an average follow-up of about 15 years, indicated no association of GI or GL with lung cancer [25].…”

“…Null findings were also found in strata of BMI, smoking, family history of cancer and menopausal status (in women). In a population-based case-control study from USA based on 1905 incident cases and 2413 controls [22] a significant positive association with lung cancer risk was found for GI (OR for the fifth versus the first quintile 1.49, 95% CI, 1.21–1.83, p for trend < 0.001), but not for GL (OR 1.16, 95% CI, 0.94–1.42). The positive association with GI was more evident among never smokers (OR fifth quintile 2.25, 95% CI, 1.42–3.57) and for the squamous cell carcinoma histologic subtype (OR 1.30, 95% CI, 1.02–1.67) [22].…”

“…After that review, 20 reports [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33] have been published, accounting for 23 distinct original studies and almost 22,000 additional cancer cases. These included the EPIC-Italy cohort investigating multiple cancer sites [26], the Framingham Offspring cohort on adiposity-related cancers [29], a pooled analysis of two studies on esophageal and gastric cardia adenocarcinoma [24], three studies on colorectal cancer [17,30,31], one combined analysis of two North European cohorts on cancer of the biliary tract [19], two studies on lung cancer [22,25] (including a combined analysis of two Asian cohorts [25]), one on melanoma [23], four on breast cancer [14,15,16,32] (including the update to 2011 of the Nurses’ Health Study II (NHSII) [16]), two on endometrial cancer [20,33], one on ovarian cancer [21], one on bladder cancer [28], one on kidney cancer [27], and one on thyroid cancer [18].…”

CIMMYT Series on Carbohydrates, Wheat, Grains, and Health: Carbohydrates, Grains, and Whole Grains and Disease Prevention. Part IV. Cancer Risk: Lung, Prostate, and Stomach

“…However, intake of low-GI cereal foods was greater for the control than for the case subjects, suggesting a beneficial role for these foods. In a Texas cross-sectional study that included non-Hispanic white subjects, GL was not related to lung cancer risk in either smokers or nonsmokers, but GI was (24). There are, however, several caveats to these findings: 1) Diets were assessed at the time of diagnosis, which might not be representative of a lifetime eating pattern.…”

Diet and exercise interventions for pediatric cancer patients during therapy: tipping the scales for better outcomes

“…Whether intake of sugar and fat contributes to poor outcomes in cancer patients independent of obesity is unclear. For example, epidemiological data shows that sugar intake correlates with increased cancer incidence, and mouse models for breast and liver cancer indicate that sucrose-rich diets promote tumor progression and metastasis in normal weight non-obese mice (28–32). Molecular explanations for sugar’s impact on tumor progression have been put forth from patient data and mouse models.…”