Association between dietary carbohydrate intake, glycemic index and glycemic load, and risk of gastric cancer
- 599 Downloads
The association between dietary carbohydrate intake, glycemic index (GI) and glycemic load (GL), and risk of gastric cancer (GC) has been investigated by many studies. However, the results of these studies were controversial. The aim of our study was to systematically assess this issue.
PUBMED and EMBASE were searched up to March 2015, and either a fixed- or a random-effects model was adopted to estimate overall relative risks (RRs). Dose–response, meta-regression, subgroup, and publication bias analyses were applied.
Twenty-six studies with approximately 540,000 participants were finally included in this meta-analysis. High level of dietary carbohydrate intake (pooled RR 1.17, 95 % CI 0.91–1.50), GI (pooled RR 1.17, 95 % CI 0.80–1.69), and GL (pooled RR 1.06, 95 % CI 0.90–1.26) were all nonsignificantly associated with incidence of GC. In addition, no significant dose–response relationship was observed between carbohydrate intake, GI and GL, and the risk of GC. However, further subgroup analyses based on gender and geographic region suggested a significant association between higher carbohydrate intake (pooled RR 1.52, 95 % CI 1.10–2.08), GL (pooled RR 1.41, 95 % CI 1.04–1.92), and GC risk in males subgroup, and between higher carbohydrate intake (pooled RR 1.69, 95 % CI 1.36–2.09) and GC risk in Asian studies.
No significant association was found between dietary carbohydrate intake, GI and GL, and risk of GC. However, significantly positive association was observed in the males subgroup and Asian studies.
KeywordsCarbohydrate intake Glycemic index Glycemic load Gastric cancer
The corresponding author (Drs. Yihua Wu and Dajing Xia) have the right to grant on behalf of all authors and do grant on behalf of all authors. Dr. Dajing Xia contributed to conception and design of the study; Drs. Yihua Wu and Yao Ye contributed to conception, statistical analysis, and editing of the manuscript; Dr. Kefeng Ding contributed to statistical analysis and the data acquisition, analysis; Drs. Jinming Xu and Xiaoyun Shan contributed to interpretation of the data. All authors commented on drafts of the paper and have approved the final draft of the manuscript.
The work was funded by the National Natural Science Foundation of China (Grant No. 81172692 and No. 81373036), Zhejiang Provincial Department of Science and Technology (Grant No. 2013C14016), and China Postdoctoral Science Foundation funded project (Grant No. 419000-X91301).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.IARC (2014) Glonocan 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012Google Scholar
- 7.Stocks T, Rapp K, Bjorge T, Manjer J, Ulmer H, Selmer R, Lukanova A, Johansen D, Concin H, Tretli S, Hallmans G, Jonsson H, Stattin P (2009) Blood glucose and risk of incident and fatal cancer in the metabolic syndrome and cancer project (me-can): analysis of six prospective cohorts. PLoS Med 6:e1000201CrossRefGoogle Scholar
- 12.Wolever TM, Mehling C (2003) Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance. Am J Clin Nutr 77:612–621Google Scholar
- 15.Wolever TM, Bolognesi C (1996) Source and amount of carbohydrate affect postprandial glucose and insulin in normal subjects. J Nutr 126:2798–2806Google Scholar
- 16.Jenkins DJ, Wolever TM, Taylor RH, Barker H, Fielden H, Baldwin JM, Bowling AC, Newman HC, Jenkins AL, Goff DV (1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr 34:362–366Google Scholar
- 17.Foster-Powell K, Holt SH, Brand-Miller JC (2002) International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr 76:5–56Google Scholar
- 20.Lazarevic K, Nagorni A, Jeremic M (2009) Carbohydrate intake, glycemic index, glycemic load and risk of gastric cancer. Cent Eur J Public Health 17:75–78Google Scholar
- 25.Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283:2008–2012CrossRefGoogle Scholar
- 35.Mayne ST, Risch HA, Dubrow R, Chow WH, Gammon MD, Vaughan TL, Farrow DC, Schoenberg JB, Stanford JL, Ahsan H, West AB, Rotterdam H, Blot WJ, Fraumeni JF Jr (2001) Nutrient intake and risk of subtypes of esophageal and gastric cancer. Cancer Epidemiol Biomark Prev 10:1055–1062Google Scholar
- 36.Jedrychowski W, Popiela T, Steindorf K, Tobiasz-Adamczyk B, Kulig J, Penar A, Wahrendorf J (2001) Nutrient intake patterns in gastric and colorectal cancers. Int J Occup Med Environ Health 14:391–395Google Scholar
- 40.Li D, Gao X, Xing W (1995) Use of nutrient density in etiologic studies on stomach cancer. Zhonghua Yu Fang Yi Xue Za Zhi 29:339–341Google Scholar
- 45.Nomura A, Grove JS, Stemmermann GN, Severson RK (1990) A prospective study of stomach cancer and its relation to diet, cigarettes, and alcohol consumption. Cancer Res 50:627–631Google Scholar
- 46.Correa P, Fontham E, Pickle LW, Chen V, Lin YP, Haenszel W (1985) Dietary determinants of gastric cancer in south Louisiana inhabitants. J Natl Cancer Inst 75:645–654Google Scholar
- 49.Hunt RH, Xiao SD, Megraud F, Leon-Barua R, Bazzoli F, van der Merwe S, Vaz Coelho LG, Fock M, Fedail S, Cohen H, Malfertheiner P, Vakil N, Hamid S, Goh KL, Wong BC, Krabshuis J, Le Mair A (2011) Helicobacter pylori in developing countries. World Gastroenterology Organisation global guideline. J Gastrointest Liver Dis 20:299–304Google Scholar
- 52.Jenkins D, Axelsen M, Kendall C, Augustin L, Vuksan V, Smith U (2000) Dietary fibre, lente carbohydrates and the insulin-resistant diseases. Br J Nutr 83(Suppl 1):S157–S163Google Scholar
- 55.Kasuga M, Ueki K, Tajima N, Noda M, Ohashi K, Noto H, Goto A, Ogawa W, Sakai R, Tsugane S, Hamajima N, Nakagama H, Tajima K, Miyazono K, Imai K (2013) Report of the Japan Diabetes Society/Japanese Cancer Association Joint Committee on diabetes and cancer. Cancer Sci 104:965–976CrossRefGoogle Scholar
- 56.Giovannucci E (2001) Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr 131:3109s–3120sGoogle Scholar
- 57.Biddinger SB, Ludwig DS (2005) The insulin-like growth factor axis: a potential link between glycemic index and cancer. Am J Clin Nutr 82:277–278Google Scholar
- 60.Pi-Sunyer FX (2002) Glycemic index and disease. Am J Clin Nutr 76:290s–298sGoogle Scholar