HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Howarth, N. C Articles by Kolonel, L. N PubMed PubMed Citation Articles by Howarth, N. C Articles by Kolonel, L. N Agricola Articles by Howarth, N. C Articles by Kolonel, L. N

The association of glycemic load and carbohydrate intake with colorectal cancer risk in the Multiethnic Cohort Study^1,2,3

¹ From the Cancer Epidemiology Program, Cancer Research Center of Hawai‘i, University of Hawai‘i, Honolulu, HI (NCH, SPM, LRW, and LNK), and the University of Southern California, Los Angeles, CA (BEH)

Background:High-glycemic-load diets may increase colorectal cancer risk through hyperinsulinemic effects.

Objective:We analyzed data for 191 004 participants in the Multiethnic Cohort Study to determine the risk of colorectal cancer associated with glycemic load (GL), carbohydrate, and sucrose and to ascertain whether this risk was modified by sex and ethnicity.

Design:During 8 y of follow-up, 2379 incident cases of colorectal adenocarcinoma occurred. We used baseline quantitative food-frequency questionnaire data to assess usual dietary intake over the preceding year. Using Cox regression, we calculated adjusted relative risks (RRs) and 95% CIs for colorectal cancer associated with quintiles of GL, carbohydrate, and sucrose.

Results:For both men and women in this cohort, white rice was the major contributor to GL. In multivariate models, RRs for colorectal cancer decreased significantly with increasing GL in women (RR for the highest quintile versus the lowest: 0.75; 95% CI: 0.57, 0.97; P for trend = 0.02) but not in men (RR: 1.15; 95% CI: 0.89, 1.48; P for trend = 0.19). Results for carbohydrate and sucrose were similar. The inverse association with GL was found in women of all ethnic groups (P for interaction = 0.58). In men, an interaction was found between ethnicity and GL (P < 0.01): white men had a positive association with increasing GL (RR: 1.69; 95% CI: 0.98, 2.92; P for trend < 0.01), but men of other ethnic groups did not.

Conclusion:GL and carbohydrate intake appear to protect against colorectal cancer in women in the Multiethnic Cohort, perhaps because a major source of GL is white rice.