Carbohydrate, glycemic index, and glycemic load and colorectal adenomas in the Prostate, Lung, Colorectal, and Ovarian Screening Study

Andrew Flood, Ulrike Peters, David J A Jenkins, Nilanjan Chatterjee, Amy F. Subar, Timothy R. Church, Robert Bresalier, Joel L. Weissfeld, Richard B. Hayes, Arthur Schatzkin

Research output: Contribution to journalArticle

Abstract

Background: It is possible that high-glycemic-load diets, through their hyperinsulinemic effects, can increase the risk of colorectal cancer. Objective: We analyzed data from a cancer screening study to determine whether persons with high-glycemic-load diets would be at an increased risk of distal adenomas. Design:Weincluded subjects with no prior adenoma or cancer from the Prostate, Lung, Colorectal, and Ovarian screening trial and whose results from flexible sigmoidoscopy exams indicated either no lesions (n = 34 817) or ≥ 1 distal adenoma (n = 3696). We used a 137-item food-frequency questionnaire to assess usual dietary intake over the preceding 12 mo. Using logistic regression analysis, we calculated, separately for men and women, prevalence odds ratios (ORs) and 95% CIs of sigmoidoscopy-detected, distal adenomas for quintiles of energy-adjusted dietary carbohydrate, glycemic index, and glycemic load. Results: ORs decreased with increasing intakes of carbohydrate for both the men and the women in unadjusted models, but these associations were attenuated in multivariate-adjusted models. Among the men, the association remained significant after adjustment (OR: 0.71; 95% CI 0.60, 0.84; P for trend <0.0001), but in the women it did not (OR: 0.89; 95% CI: 0.73, 1.10; P for trend = 0.30). The results for glycemic index showed no associations in either men or women. Results for glycemic load closely mirrored those for carbohydrate. Conclusion: Despite expectations that increasing glycemic load and glycemic index would increase the risk of adenoma, we observed no association in women and even an inverse association in men.

Original languageEnglish (US)
Pages (from-to)1184-1192
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume84
Issue number5
StatePublished - Nov 1 2006
Externally publishedYes

Fingerprint

Glycemic Index
glycemic index
adenoma
Adenoma
Prostate
odds ratio
lungs
Carbohydrates
sigmoidoscopy
screening
carbohydrates
Lung
Odds Ratio
Sigmoidoscopy
Diet
Dietary Carbohydrates
neoplasms
carbohydrate intake
dietary carbohydrate
food frequency questionnaires

Keywords

  • Carbohydrate
  • Colorectal adenoma
  • Fiber
  • Glycemic index
  • Glycemic load
  • Insulin resistance

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Carbohydrate, glycemic index, and glycemic load and colorectal adenomas in the Prostate, Lung, Colorectal, and Ovarian Screening Study. / Flood, Andrew; Peters, Ulrike; Jenkins, David J A; Chatterjee, Nilanjan; Subar, Amy F.; Church, Timothy R.; Bresalier, Robert; Weissfeld, Joel L.; Hayes, Richard B.; Schatzkin, Arthur.

In: American Journal of Clinical Nutrition, Vol. 84, No. 5, 01.11.2006, p. 1184-1192.

Research output: Contribution to journalArticle

Flood, A, Peters, U, Jenkins, DJA, Chatterjee, N, Subar, AF, Church, TR, Bresalier, R, Weissfeld, JL, Hayes, RB & Schatzkin, A 2006, 'Carbohydrate, glycemic index, and glycemic load and colorectal adenomas in the Prostate, Lung, Colorectal, and Ovarian Screening Study', American Journal of Clinical Nutrition, vol. 84, no. 5, pp. 1184-1192.
Flood, Andrew ; Peters, Ulrike ; Jenkins, David J A ; Chatterjee, Nilanjan ; Subar, Amy F. ; Church, Timothy R. ; Bresalier, Robert ; Weissfeld, Joel L. ; Hayes, Richard B. ; Schatzkin, Arthur. / Carbohydrate, glycemic index, and glycemic load and colorectal adenomas in the Prostate, Lung, Colorectal, and Ovarian Screening Study. In: American Journal of Clinical Nutrition. 2006 ; Vol. 84, No. 5. pp. 1184-1192.
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abstract = "Background: It is possible that high-glycemic-load diets, through their hyperinsulinemic effects, can increase the risk of colorectal cancer. Objective: We analyzed data from a cancer screening study to determine whether persons with high-glycemic-load diets would be at an increased risk of distal adenomas. Design:Weincluded subjects with no prior adenoma or cancer from the Prostate, Lung, Colorectal, and Ovarian screening trial and whose results from flexible sigmoidoscopy exams indicated either no lesions (n = 34 817) or ≥ 1 distal adenoma (n = 3696). We used a 137-item food-frequency questionnaire to assess usual dietary intake over the preceding 12 mo. Using logistic regression analysis, we calculated, separately for men and women, prevalence odds ratios (ORs) and 95{\%} CIs of sigmoidoscopy-detected, distal adenomas for quintiles of energy-adjusted dietary carbohydrate, glycemic index, and glycemic load. Results: ORs decreased with increasing intakes of carbohydrate for both the men and the women in unadjusted models, but these associations were attenuated in multivariate-adjusted models. Among the men, the association remained significant after adjustment (OR: 0.71; 95{\%} CI 0.60, 0.84; P for trend <0.0001), but in the women it did not (OR: 0.89; 95{\%} CI: 0.73, 1.10; P for trend = 0.30). The results for glycemic index showed no associations in either men or women. Results for glycemic load closely mirrored those for carbohydrate. Conclusion: Despite expectations that increasing glycemic load and glycemic index would increase the risk of adenoma, we observed no association in women and even an inverse association in men.",
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AU - Chatterjee, Nilanjan

AU - Subar, Amy F.

AU - Church, Timothy R.

AU - Bresalier, Robert

AU - Weissfeld, Joel L.

AU - Hayes, Richard B.

AU - Schatzkin, Arthur

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N2 - Background: It is possible that high-glycemic-load diets, through their hyperinsulinemic effects, can increase the risk of colorectal cancer. Objective: We analyzed data from a cancer screening study to determine whether persons with high-glycemic-load diets would be at an increased risk of distal adenomas. Design:Weincluded subjects with no prior adenoma or cancer from the Prostate, Lung, Colorectal, and Ovarian screening trial and whose results from flexible sigmoidoscopy exams indicated either no lesions (n = 34 817) or ≥ 1 distal adenoma (n = 3696). We used a 137-item food-frequency questionnaire to assess usual dietary intake over the preceding 12 mo. Using logistic regression analysis, we calculated, separately for men and women, prevalence odds ratios (ORs) and 95% CIs of sigmoidoscopy-detected, distal adenomas for quintiles of energy-adjusted dietary carbohydrate, glycemic index, and glycemic load. Results: ORs decreased with increasing intakes of carbohydrate for both the men and the women in unadjusted models, but these associations were attenuated in multivariate-adjusted models. Among the men, the association remained significant after adjustment (OR: 0.71; 95% CI 0.60, 0.84; P for trend <0.0001), but in the women it did not (OR: 0.89; 95% CI: 0.73, 1.10; P for trend = 0.30). The results for glycemic index showed no associations in either men or women. Results for glycemic load closely mirrored those for carbohydrate. Conclusion: Despite expectations that increasing glycemic load and glycemic index would increase the risk of adenoma, we observed no association in women and even an inverse association in men.

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