Glycemic index, glycemic load, dietary carbohydrate, and dietary fiber intake and risk of liver and biliary tract cancers in Western Europeans
- 2 November 2012
- journal article
- research article
- Published by Elsevier BV in Annals of Oncology
- Vol. 24 (2), 543-553
- https://doi.org/10.1093/annonc/mds434
Abstract
The type and quantity of dietary carbohydrate as quantified by glycemic index (GI) and glycemic load (GL), and dietary fiber may influence the risk of liver and biliary tract cancers, but convincing evidence is lacking. The association between dietary GI/GL and carbohydrate intake with hepatocellular carcinoma (HCC; N = 191), intrahepatic bile duct (IBD; N = 66), and biliary tract (N = 236) cancer risk was investigated in 477 206 participants of the European Prospective Investigation into Cancer and Nutrition cohort. Dietary intake was assessed by country-specific, validated dietary questionnaires. Hazard ratios and 95% confidence intervals were estimated from proportional hazard models. HBV/HCV status was measured in a nested case–control subset. Higher dietary GI, GL, or increased intake of total carbohydrate was not associated with liver or biliary tract cancer risk. For HCC, divergent risk estimates were observed for total sugar = 1.43 (1.17–1.74) per 50 g/day, total starch = 0.70 (0.55–0.90) per 50 g/day, and total dietary fiber = 0.70 (0.52–0.93) per 10 g/day. The findings for dietary fiber were confirmed among HBV/HCV-free participants [0.48 (0.23–1.01)]. Similar associations were observed for IBD [dietary fiber = 0.59 (0.37–0.99) per 10 g/day], but not biliary tract cancer. Findings suggest that higher consumption of dietary fiber and lower consumption of total sugars are associated with lower HCC risk. In addition, high dietary fiber intake could be associated with lower IBD cancer risk.Keywords
Funding Information
- French National Cancer Institute
- L'Institut National du Cancer; INCA (2009-139)
- European Commission
- International Agency for Research on Cancer
- Danish Cancer Society
- Ligue Contre le Cancer
- Institut Gustave Roussy
- Mutuelle Générale de l'Education Nationale
- Institut National de la Sante et de la Recherche Medicale (INSERM)
- Deutsche Krebshilfe, Deutsches Krebsforschungszentrum
- Federal Ministry of Education and Research
- Stavros Niarchos Foundation
- Hellenic Health Foundation
- Ministry of Health and Social Solidarity
- Italian Association for Research on Cancer
- National Research Council
- AIRE-ONLUS Ragusa
- AVIS Ragusa, Sicilian Government
- Dutch Ministry of Public Health, Welfare and Sports
- Netherlands Cancer Registry
- LK Research Funds
- Dutch Prevention Funds
- Dutch ZON
- World Cancer Research Fund
- Statistics Netherlands
- European Research Council (ERC-2009-AdG 232997)
- Nordforsk; and Nordic Center of Excellence Programme on Food, Nutrition and Health
- Health Research Fund
- Regional Governments of Andalucía, Asturias, Basque Country, Murcia (6236)
- Navarra (RD06/0020)
- Swedish Cancer Society
- Swedish Scientific Council
- Regional Government of Skåne and Västerbotten
- Cancer Research UK
- Medical Research Council; Stroke Association
- British Heart Foundation
- Department of Health; Food Standards Agency; and Wellcome Trust
This publication has 56 references indexed in Scilit:
- Abdominal obesity, weight gain during adulthood and risk of liver and biliary tract cancer in a European cohortInternational Journal of Cancer, 2012
- Hepatocellular Carcinoma Risk Factors and Disease Burden in a European Cohort: A Nested Case-Control StudyJNCI Journal of the National Cancer Institute, 2011
- Diabetes and CancerDiabetes Care, 2010
- Global Burden of Aflatoxin-Induced Hepatocellular Carcinoma: A Risk AssessmentEnvironmental Health Perspectives, 2010
- Hepatocellular Carcinoma Incidence, Mortality, and Survival Trends in the United States From 1975 to 2005Journal of Clinical Oncology, 2009
- Fruit and vegetable intake and risk of cancer: a prospective cohort studyThe American Journal of Clinical Nutrition, 2009
- Dietary Glycemic Index, Glycemic Load, and Risk of Cancer: A Prospective Cohort StudyAmerican Journal of Epidemiology, 2008
- The evaluation of the diet/disease relation in the EPIC study: considerations for the calibration and the disease modelsInternational Journal of Epidemiology, 2008
- Overweight, obesity and risk of liver cancer: a meta-analysis of cohort studiesBritish Journal of Cancer, 2007