Dietary sugar, glycemic load, and pancreatic cancer risk in a prospective study.
ABSTRACT Evidence from both animal and human studies suggests that abnormal glucose metabolism plays an important role in pancreatic carcinogenesis. We investigated whether diets high in foods that increase postprandial glucose levels are associated with an increased risk of pancreatic cancer.
In a cohort of U.S. women (n = 88 802) participating in the Nurses' Health Study, 180 case subjects with pancreatic cancer were diagnosed during 18 years of follow-up. We used frequency of intake of individual foods as reported on a food-frequency questionnaire in 1980 to calculate sucrose, fructose, and carbohydrate intakes; glycemic index (postprandial blood glucose response as compared with a reference food); and glycemic load (glycemic index multiplied by carbohydrate content). Analyses of relative risk (RR) were performed by using multivariable Cox proportional hazards models to adjust for potential confounders. All statistical tests were two-sided.
Carbohydrate and sucrose intake were not associated with overall pancreatic cancer risk in this cohort. A statistically nonsignificant 53% increase in risk of pancreatic cancer (RR = 1.53, 95% confidence interval [CI] = 0.96 to 2.45) was observed among women with a high glycemic load intake, and a similar association was observed for fructose intake (RR = 1.57, 95% CI = 0.95 to 2.57). The associations of glycemic load and fructose intakes with pancreatic cancer risk were most apparent among women with elevated body mass index (>or=25 kg/m(2)) or with low physical activity. Among women who were both overweight and sedentary, a high glycemic load was associated with an RR of 2.67 (95% CI = 1.02 to 6.99; highest versus lowest quartile of intake; P for trend =.03), and high fructose was associated with an RR of 3.17 (95% CI = 1.13 to 8.91; P for trend =.04).
Our data support other findings that impaired glucose metabolism may play a role in pancreatic cancer etiology. A diet high in glycemic load may increase the risk of pancreatic cancer in women who already have an underlying degree of insulin resistance.
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ABSTRACT: Background This study aims to determine cancer risks among patients with type 2 diabetes through a follow-up study on a nationwide population-based cohort that included Taiwanese diabetic patients and general population in Taiwan as well as to estimate the population attributable fraction (PAF) of site-specific cancer risks that can be attributed to type 2 diabetes in Taiwanese population by using standardized incidence ratios (SIRs, 95% CI). Methods Subjects with type 2 diabetes consisted of 472,979 patients aged ≥20 years, whereas general population consisted of 9,411,249 individuals of the same age limit but are not diabetic. Subjects were identified from 1997 to 1998 and followed up until December 31, 2007 or until the first manifestation of any cancer. Results Cancer sites with increased risks in men, which were consistent with the main and sensitivity analyses, included pancreas (SIR = 1.62; 95% CI = 1.53 to 1.72), liver (1.61; 1.57 to 1.64), kidney (1.32; 1.25 to 1.40), oral (1.16, 1.12 to 1.21), and colorectal (1.19, 1.15 to 1.22). Cancer sites with increased risks in women included liver (1.55; 1.51 to 1.60), pancreas (1.44; 1.34 to 1.55), kidney (1.38; 1.30 to 1.46), endometrium (1.36; 1.26 to 1.47), bladder (1.19; 1.11 to 1.27), colorectal (1.16; 1.13 to 1.20), and breast (1.14; 1.09 to 1.18). Overall, PAFs were highest for liver cancer in men (4.0%) and women (3.7%), followed by pancreas (3.4%) and kidney (1.6%) cancers in men, and then for endometrium (1.8%) and kidney (1.8%) cancers in women. Conclusion Our data suggested that increased cancer risks are associated with type 2 diabetes.BMC Cancer 05/2014; 14(1):381. DOI:10.1186/1471-2407-14-381 · 3.32 Impact Factor
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ABSTRACT: The main purpose of the paper is to introduce a mixed-integer programming model for the diet problem with glycemic load (GL) values of foods as objective function parameters. It is assumed that the glycemic load values are subject to uncertainty. The diet problem with minimum cost function is well-known in the literature. However, the diet problem with minimum total daily GL values of foods that satisfies the daily nutritional and serving size requirements has not been proposed. Robust optimization approach is used to account for uncertainty in the GL values of foods. The decision maker is flexible to tune the degree of uncertainty rather than assuming a worst-case scenario. An experimental analysis with a total of 177 foods is performed based on the nutritional and serving size requirements and the basic food groups recommended by the U.S. Department of Health and Human Services & U.S. Department of Agriculture (USDA). The results of the experimental analysis with different scenarios give different solutions for different degrees of uncertainty. However, some foods are frequently found to be in the optimum solutions. These foods are in good agreement with the literature advising them as a part of a daily diet for attaining low level of blood glucose levels. Although we believe that the proposed diet problem with minimum total GL has contributions for satisfying the daily nutritional and serving size requirements with a minimum level of effect on blood glucose levels, it has several limitations. It is a basic diet problem, and assumes that the overall GL is a linear combination of number of serving sizes with the GL values of foods. It also does not consider any other factors such as several combinations of foods and their varying effects on blood glucose levels. These factors should be considered for the next research.Applied Mathematical Modelling 10/2014; DOI:10.1016/j.apm.2014.03.049 · 2.16 Impact Factor