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27 August 2008
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High glycemic load diet not associated with breast cancer
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MedWire News: Consumption of a high glycemic load diet has, at best, a modest influence on breast cancer risk, results of a meta-analysis demonstrate.
Glycemic index (GI) values classify foods according to the 2-hour blood glucose response after consuming a portion of the food containing 50 g of available carbohydrate, compared with the equivalent amount from a standard food, such as glucose or white bread.
The glycemic load (GL) concept was later developed to better reflect the blood glucose response and insulin demand of a food by taking into account the total amount of carbohydrate usually consumed in addition to its GI value.
Habitual consumption of a high GI or GL diet has been postulated to promote carcinogenesis by inducing hyperglycemia and hyperinsulinemia, potentially acting through the insulin-like growth factor (IGF) axis.
Indeed, numerous studies, including two recently reported by MedWire News, have implicated IGF in breast cancer etiology.
In their meta-analysis, H Mulholland (Queens University Belfast, UK) and coworkers identified 14 studies including 17,673 patients with breast cancer who had self-reported dietary information, mostly on the food frequency questionnaire (FFQ).
There was some evidence of an association between the highest versus the lowest category of GI intake and premenopausal (relative risk[RR] 1.14) and postmenopausal (RR=1.11) risk; however, these did not reach statistical significance.
When analysis was restricted to cohort studies that had incorporated a more robust measure of dietary intake, that is, more than 100-items on the FFQ, a significant association emerged between GI intake and premenopausal (RR=1.20) and postmenopausal (RR= 1.10) risk.
It has been hypothesized that chronic hyperinsulinemia induced by a high GI diet may suppress fat oxidation and promote carbohydrate oxidation in the body, resulting in an enhanced appetite and body fat gain, a factor also linked with breast cancer.
However, there was no association between GI/GL intake and breast cancer risk by body mass index categories.
"In conclusion, our systematic review suggests that high dietary GI and GL intakes do not appear to be of etiological importance in breast tumor development," Mulholland and colleagues comment in the British Journal of Cancer.
Br J Cancer 2008; Advance online publication
http://www.nature.com/bjc/index.html
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