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Glycemic index, carbohydrate and fiber intakes and risk of reflux esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma

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Abstract

Objective

To examine the association between dietary glycemic index (GI), glycemic load (GL), total carbohydrate, sugars, starch, and fiber intakes and the risk of reflux esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma.

Methods

In an all-Ireland study, dietary information was collected from patients with esophageal adenocarcinoma (n = 224), long-segment Barrett’s esophagus (n = 220), reflux esophagitis (n = 219), and population-based controls (n = 256). Multiple logistic regression analysis examined the association between dietary variables and disease risk by tertiles of intake and as continuous variables, while adjusting for potential confounders.

Results

Reflux esophagitis risk was positively associated with starch intake and negatively associated with sugar intake. Barrett’s esophagus risk was significantly reduced in people in the highest versus the lowest tertile of fiber intake (OR 0.44 95%CI 0.25–0.80). Fiber intake was also associated with a reduced risk of esophageal adenocarcinoma, as was total carbohydrate intake (OR 0.45 95%CI 0.33–0.61 per 50 g/d increase). However, an increased esophageal adenocarcinoma risk was detected per 10 unit increase in GI intake (OR 1.42 95%CI 1.07–1.89).

Conclusions

Our findings suggest that fiber intake is inversely associated with Barrett’s esophagus and esophageal adenocarcinoma risk. Esophageal adenocarcinoma risk is inversely associated with total carbohydrate consumption but positively associated with high GI intakes.

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Author information

Authors and Affiliations

  1. Cancer Epidemiology & Prevention Research Group, Centre for Clinical & Population Sciences, Queens University Belfast, Room 02040 Mulhouse Building, RVH Site, Grosvenor Road, Belfast, BT12 6BJ, Northern Ireland, UK

    Helen G. Mulholland, Marie M. Cantwell, Lesley A. Anderson & Liam J. Murray

  2. Belfast Health & Social Care Trust, Belfast, Northern Ireland, UK

    Brian T. Johnston, R. G. Peter Watson & Jim McGuigan

  3. Daisy Hill Hospital, Newry, Northern Ireland, UK

    Seamus J. Murphy

  4. Craigavon Area Hospital, Craigavon, Northern Ireland, UK

    Heather R. Ferguson

  5. St James’s Hospital, Dublin, Republic of Ireland

    John V. Reynolds

  6. National Cancer Registry, Cork, Republic of Ireland

    Harry Comber

Authors
  1. Helen G. Mulholland
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  2. Marie M. Cantwell
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  3. Lesley A. Anderson
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  4. Brian T. Johnston
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  6. Seamus J. Murphy
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  7. Heather R. Ferguson
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  8. Jim McGuigan
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  11. Liam J. Murray
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Correspondence to Helen G. Mulholland.

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Mulholland, H.G., Cantwell, M.M., Anderson, L.A. et al. Glycemic index, carbohydrate and fiber intakes and risk of reflux esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma. Cancer Causes Control 20, 279–288 (2009). https://doi.org/10.1007/s10552-008-9242-6

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  • DOI: https://doi.org/10.1007/s10552-008-9242-6

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