Skip to main content
×
×
Home

Carbohydrate nutrition and risk of adiposity-related cancers: results from the Framingham Offspring cohort (1991–2013)

  • Nour Makarem (a1), Elisa V. Bandera (a2) (a3), Yong Lin (a2) (a3), Paul F. Jacques (a4), Richard B. Hayes (a5) and Niyati Parekh (a5) (a6)...
Abstract

Higher carbohydrate intake, glycaemic index (GI), and glycaemic load (GL) are hypothesised to increase cancer risk through metabolic dysregulation of the glucose-insulin axis and adiposity-related mechanisms, but epidemiological evidence is inconsistent. This prospective cohort study investigates carbohydrate quantity and quality in relation to risk of adiposity-related cancers, which represent the most commonly diagnosed preventable cancers in the USA. In exploratory analyses, associations with three site-specific cancers: breast, prostate and colorectal cancers were also examined. The study sample consisted of 3184 adults from the Framingham Offspring cohort. Dietary data were collected in 1991–1995 using a FFQ along with lifestyle and medical information. From 1991 to 2013, 565 incident adiposity-related cancers, including 124 breast, 157 prostate and sixty-eight colorectal cancers, were identified. Cox proportional hazards models were used to evaluate the role of carbohydrate nutrition in cancer risk. GI and GL were not associated with risk of adiposity-related cancers or any of the site-specific cancers. Total carbohydrate intake was not associated with risk of adiposity-related cancers combined or prostate and colorectal cancers. However, carbohydrate consumption in the highest v. lowest quintile was associated with 41 % lower breast cancer risk (hazard ratio (HR) 0·59; 95 % CI 0·36, 0·97). High-, medium- and low-GI foods were not associated with risk of adiposity-related cancers or prostate and colorectal cancers. In exploratory analyses, low-GI foods, were associated with 49 % lower breast cancer risk (HR 0·51; 95 % CI 0·32, 0·83). In this cohort of Caucasian American adults, associations between carbohydrate nutrition and cancer varied by cancer site. Healthier low-GI carbohydrate foods may prevent adiposity-related cancers among women, but these findings require confirmation in a larger sample.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Carbohydrate nutrition and risk of adiposity-related cancers: results from the Framingham Offspring cohort (1991–2013)
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Carbohydrate nutrition and risk of adiposity-related cancers: results from the Framingham Offspring cohort (1991–2013)
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Carbohydrate nutrition and risk of adiposity-related cancers: results from the Framingham Offspring cohort (1991–2013)
      Available formats
      ×
Copyright
Corresponding author
* Corresponding author: N. Parekh, fax +1 212 998 4194, email niyati.parekh@nyu.edu
References
Hide All
1. Siegel, RL, Miller, KD & Jemal, A (2017) Cancer statistics, 2017. CA Cancer J Clin 67, 730.
2. National Cancer Institute (2014) Obesity and cancer risk. http://www.cancer.gov/cancertopics/factsheet/Risk/obesity (accessed April 2017).
3. American Cancer Society (2013) Body weight and cancer risk. http://www.cancer.org/cancer/cancercauses/dietandphysicalactivity/bodyweightandcancerrisk/body-weight-and-cancer-risk-effects (accessed April 2017).
4. Yabroff, KR, Lund, J, Kepka, D, et al. (2011) Economic burden of cancer in the United States: estimates, projections, and future research. Cancer Epidemiol Biomarkers Prev 20, 20062014.
5. Parekh, N, Lin, Y, Vadiveloo, M, et al. (2013) Metabolic dysregulation of the insulin-glucose axis and risk of obesity-related cancers in the Framingham heart study-offspring cohort (1971–2008). Cancer Epidemiol Biomarkers Prev 22, 18251836.
6. Roberts, DL, Dive, C & Renehan, AG (2010) Biological mechanisms linking obesity and cancer risk: new perspectives. Annu Rev Med 61, 301316.
7. Doyle, SL, Donohoe, CL, Lysaght, J, et al. (2012) Visceral obesity, metabolic syndrome, insulin resistance and cancer. Proc Nutr Soc 7, 181189.
8. Shikata, K, Ninomiya, T & Kiyohara, Y (2013) Diabetes mellitus and cancer risk: review of the epidemiological evidence. Cancer Sci 104, 914.
9. Te Morenga, L, Mallard, S & Mann, J (2013) Dietary sugars and body weight: systematic review and meta-analyses of randomized controlled trials and cohort studies. BMJ 346, e7492.
10. Santos, F, Esteves, S, da Costa Pereira, A, et al. (2012) Systematic review and meta‐analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obes Rev 13, 10481066.
11. Jenkins, DJ, Wolever, TM, Taylor, RH, et al. (1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr 34, 362366.
12. Jenkins, DA, Jenkins, A, Wolever, TS, et al. (1984) The glycaemic response to carbohydrate foods. Lancet 324, 388391.
13. Atkinson, FS, Foster-Powell, K & Brand-Miller, JC (2008) International tables of glycemic index and glycemic load values: 2008. Diabetes Care 31, 22812283.
14. American Institute for Cancer Research & World Cancer Research Fund (2007) Food, Nutrition, and Physical Activity and the Prevention of Cancer: A Global Perspective. Washington, DC: American Institute for Cancer Research.
15. Dong, J & Qin, L (2011) Dietary glycemic index, glycemic load, and risk of breast cancer: meta-analysis of prospective cohort studies. Breast Cancer Res Treat 126, 287294.
16. Gnagnarella, P, Gandini, S, La Vecchia, C, et al. (2008) Glycemic index, glycemic load, and cancer risk: a meta-analysis. Am J Clin Nutr 87, 17931801.
17. Mulholland, HG, Murray, LJ, Cardwell, CR, et al. (2009) Glycemic index, glycemic load, and risk of digestive tract neoplasms: a systematic review and meta-analysis. Am J Clin Nutr 89, 568576.
18. Nagle, CM, Olsen, CM, Ibiebele, TI, et al. (2012) Glycemic index, glycemic load and endometrial cancer risk: results from the Australian National Endometrial Cancer study and an updated systematic review and meta-analysis. Eur J Nutr 52, 111.
19. Aune, D, Chan, D, Lau, R, et al. (2012) Carbohydrates, glycemic index, glycemic load, and colorectal cancer risk: a systematic review and meta-analysis of cohort studies. Cancer Cause Control 23, 521535.
20. Aune, D, Chan, D, Vieira, A, et al. (2012) Dietary fructose, carbohydrates, glycemic indices and pancreatic cancer risk: a systematic review and meta-analysis of cohort studies. Ann Oncol 23, 25362546.
21. Dawber, TR, Meadors, GF & Moore, FE Jr (1951) Epidemiological approaches to heart disease: the Framingham Study. Am J Public Health 41, 279281.
22. Feinleib, M, Kannel, WB, Garrison, RJ, et al. (1975) The Framingham offspring study. Design and preliminary data. Prev Med 4, 518525.
23. Makarem, N, Scott, M, Quatromoni, P, et al. (2014) Trends in dietary carbohydrate consumption from 1991 to 2008 in the Framingham Heart Study Offspring Cohort. Br J Nutr 27, 114.
24. McKeown, NM, Meigs, JB, Liu, S, et al. (2004) Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care 27, 538546.
25. Rimm, EB, Giovannucci, EL, Stampfer, MJ, et al. (1992) Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol 135, 11141126.
26. Willett, WC, Sampson, L, Stampfer, MJ, et al. (1985) Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122, 5165.
27. Liu, S, Manson, JE, Stampfer, MJ, et al. (2001) Dietary glycemic load assessed by food-frequency questionnaire in relation to plasma high-density-lipoprotein cholesterol and fasting plasma triacylglycerols in postmenopausal women. Am J Clin Nutr 73, 560566.
28. McKeown, NM, Meigs, JB, Liu, S, et al. (2009) Dietary carbohydrates and cardiovascular disease risk factors in the Framingham offspring cohort. J Am Coll Nutr 28, 150158.
29. American Diabetes Association (2014) Glycemic index and diabetes. http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/understanding-carbohydrates/glycemic-index-and-diabetes.html (accessed April 2017).
30. Block, G (2004) Foods contributing to energy intake in the US: data from NHANES III and NHANES 1999–2000. J Food Comp Anal 17, 439447.
31. Kannel, WB & Sorlie, P (1979) Some health benefits of physical activity: the Framingham Study. Arch Intern Med 139, 857.
32. World Health Organization (2016) BMI classification. http://apps.who.int/bmi/index.jsp?introPage=intro_3.html (accessed April 2017).
33. National Heart, Lung, and Blood Institute (2016) Guidelines on overweight and obesity: according to waist circumference. http://www.nhlbi.nih.gov/health-pro/guidelines/current/obesity-guidelines/e_textbook/txgd/4142.htm (accessed April 2017).
34. Hubert, HB, Feinleib, M, McNamara, PM, et al. (1983) Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 67, 968977.
35. Nagle, CM, Kolahdooz, F, Ibiebele, TI, et al. (2011) Carbohydrate intake, glycemic load, glycemic index, and risk of ovarian cancer. Ann Oncol 22, 13321338.
36. Zhai, L, Cheng, S & Zhang, D (2015) Dietary carbohydrate and prostate cancer risk: a meta-analysis. Nutr Cancer 67, 594602.
37. Messina, MJ (1999) Legumes and soybeans: overview of their nutritional profiles and health effects. Am J Clin Nutr 70, 439S450SS.
38. Farvid, MS, Cho, E, Chen, WY, et al. (2014) Dietary protein sources in early adulthood and breast cancer incidence: prospective cohort study. BMJ 348, g3437.
39. Hardin, J, Cheng, I & Witte, JS (2011) Impact of consumption of vegetable, fruit, grain, and high glycemic index foods on aggressive prostate cancer risk. Nutr Cancer 63, 860872.
40. Drake, I, Sonestedt, E, Gullberg, B, et al. (2012) Dietary intakes of carbohydrates in relation to prostate cancer risk: a prospective study in the Malmö Diet and Cancer cohort. Am J Clin Nutr 96, 14091418.
41. Mullie, P, Koechlin, A, Boniol, M, et al. (2016) Relation between Breast cancer and high glycemic index or glycemic load: a meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr 56, 152159.
42. Michels, KB, Mohllajee, AP, Roset‐Bahmanyar, E, et al. (2007) Diet and breast cancer. Cancer 109, 27122749.
43. Wen, W, Shu, XO, Li, H, et al. (2009) Dietary carbohydrates, fiber, and breast cancer risk in Chinese women. Am J Clin Nutr 89, 283289.
44. Romieu, I, Lazcano-Ponce, E, Sanchez-Zamorano, LM, et al. (2004) Carbohydrates and the risk of breast cancer among Mexican women. Cancer Epidemiol Biomarkers Prev 13, 12831289.
45. Cho, E, Spiegelman, D, Hunter, DJ, et al. (2003) Premenopausal dietary carbohydrate, glycemic index, glycemic load, and fiber in relation to risk of breast cancer. Cancer Epidemiol Biomarkers Prev 12, 11531158.
46. Albuquerque, RC, Baltar, VT & Marchioni, DM (2014) Breast cancer and dietary patterns: a systematic review. Nutr Rev 72, 117.
47. Guo, J, Wei, W & Zhan, L (2015) Red and processed meat intake and risk of breast cancer: a meta-analysis of prospective studies. Breast Cancer Res Treat 151, 191198.
48. Seitz, HK, Pelucchi, C, Bagnardi, V, et al. (2012) Epidemiology and pathophysiology of alcohol and breast cancer: update 2012. Alcohol Alcohol 47, 204212.
49. Schatzkin, A, Kipnis, V, Carroll, RJ, et al. (2003) A comparison of a food frequency questionnaire with a 24-hour recall for use in an epidemiological cohort study: results from the biomarker-based Observing Protein and Energy Nutrition (OPEN) study. Int J Epidemiol 32, 10541062.
50. Holt, SH, Miller, JC & Petocz, P (1997) An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods. Am J Clin Nutr 66, 12641276.
51. Mayer-Davis, EJ, Dhawan, A, Liese, AD, et al. (2006) Towards understanding of glycemic index and glycemic load in habitual diet: associations with measures of glycaemia in the Insulin Resistance Atherosclerosis Study. Br J Nutr 95, 397405.
52. American Institute for Cancer Research (2016) The glycemic index: what it is and what it is not. http://preventcancer.aicr.org/site/DocServer/Glycemic_Index.pdf?docID=341 (accessed April 2017).
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
WORD
Supplementary materials

Makarem supplementary material
Table S1

 Word (15 KB)
15 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed