Glycemic index, glycemic load, and the risk of pancreatic cancer among postmenopausal women in the women's health initiative observational study and clinical trial

M. S. Simon, J. M. Shikany, M. L. Neuhouser, Thomas E. Rohan, K. Nirmal, Y. Cui, J. Abrams

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Several reports have suggested that conditions associated with hyperinsulinemia and insulin resistance, such as diets high in carbohydrates, may influence the risk of pancreatic cancer, although results from prior studies have been mixed. Methods: We utilized data from the population-based women's health initiative (WHI) cohort to determine whether dietary factors that are associated with increased postprandial blood glucose levels are also associated with an increased risk of pancreatic cancer. The WHI included 161,809 postmenopausal women of ages 50-79, in which 332 cases of pancreatic cancer were identified over a median of 8 years of follow-up; 287 of these cases met the criteria for analysis. A validated 122-item food frequency questionnaire was used to estimate dietary glycemic load (GL), glycemic index (GI), total and available carbohydrates, fructose and sucrose. Baseline questionnaires and physical exams provided information on demographic, medical, lifestyle, and anthropometric characteristics. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between the exposures of interest and pancreatic cancer risk, with adjustment for potential confounders. Results: Dietary GL, GI, carbohydrates, fructose, and sucrose were not associated with increased risk of pancreatic cancer. The multivariable adjusted HR for the highest vs. the lowest quartile of GL was 0.80 (95% CI = 0.55-1.15, trend p = 0.31) and 1.13 (95% CI = 0.78-1.63, trend p = 0.94) for GI. The results remained negative when individuals with a history of diabetes were excluded. Conclusions: Our results do not support the hypothesis that dietary intake of carbohydrates is associated with increased risk of pancreatic cancer.

Original languageEnglish (US)
Pages (from-to)2129-2136
Number of pages8
JournalCancer Causes and Control
Volume21
Issue number12
DOIs
StatePublished - Dec 2010

Fingerprint

Glycemic Index
Women's Health
Pancreatic Neoplasms
Observational Studies
Clinical Trials
Carbohydrates
Confidence Intervals
Fructose
Sucrose
Dietary Carbohydrates
Risk Adjustment
Hyperinsulinism
Proportional Hazards Models
Insulin Resistance
Blood Glucose
Glycemic Load
Life Style
Demography
Diet
Food

Keywords

  • Glycemic index
  • Glycemic load
  • Pancreatic neoplasms
  • Prospective cohort

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Glycemic index, glycemic load, and the risk of pancreatic cancer among postmenopausal women in the women's health initiative observational study and clinical trial. / Simon, M. S.; Shikany, J. M.; Neuhouser, M. L.; Rohan, Thomas E.; Nirmal, K.; Cui, Y.; Abrams, J.

In: Cancer Causes and Control, Vol. 21, No. 12, 12.2010, p. 2129-2136.

Research output: Contribution to journalArticle

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abstract = "Background: Several reports have suggested that conditions associated with hyperinsulinemia and insulin resistance, such as diets high in carbohydrates, may influence the risk of pancreatic cancer, although results from prior studies have been mixed. Methods: We utilized data from the population-based women's health initiative (WHI) cohort to determine whether dietary factors that are associated with increased postprandial blood glucose levels are also associated with an increased risk of pancreatic cancer. The WHI included 161,809 postmenopausal women of ages 50-79, in which 332 cases of pancreatic cancer were identified over a median of 8 years of follow-up; 287 of these cases met the criteria for analysis. A validated 122-item food frequency questionnaire was used to estimate dietary glycemic load (GL), glycemic index (GI), total and available carbohydrates, fructose and sucrose. Baseline questionnaires and physical exams provided information on demographic, medical, lifestyle, and anthropometric characteristics. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95{\%} confidence intervals (CI) for the association between the exposures of interest and pancreatic cancer risk, with adjustment for potential confounders. Results: Dietary GL, GI, carbohydrates, fructose, and sucrose were not associated with increased risk of pancreatic cancer. The multivariable adjusted HR for the highest vs. the lowest quartile of GL was 0.80 (95{\%} CI = 0.55-1.15, trend p = 0.31) and 1.13 (95{\%} CI = 0.78-1.63, trend p = 0.94) for GI. The results remained negative when individuals with a history of diabetes were excluded. Conclusions: Our results do not support the hypothesis that dietary intake of carbohydrates is associated with increased risk of pancreatic cancer.",
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