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Determination of Postprandial Glycemic Responses by Continuous Glucose Monitoring in a Real-World Setting
Open AccessArticle

Glycemic Index, Glycemic Load and Cancer Risk: An Updated Meta-Analysis

1
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133 Milan, Italy
2
Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON M5B 1W8, Canada
3
National Cancer Institute, SSD di Epidemiologia, Istituto Nazionale Tumori - IRCCS - “Fondazione G. Pascale”, 80131 Naples, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(10), 2342; https://doi.org/10.3390/nu11102342
Received: 11 September 2019 / Accepted: 30 September 2019 / Published: 2 October 2019
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
Diets high in glycemic index (GI) and glycemic load (GL) have been related to an increased risk of selected cancers, but additional quantification is required. We updated a systematic review and meta-analysis published in 2015 to May 2019 to provide quantitative information on GI/GL and cancer risk. Relative risks (RR) and the corresponding 95 % confidence intervals (CI) for the highest versus the lowest categories of GI and GL were extracted from selected studies and pooled using random-effects models. Twenty reports (>22,000 cancer cases) have become available after January 2015, and 15 were added to the meta-analyses by cancer sites, which considered a total of 88 investigations. The five additional reports were reviewed, but not included in the meta-analyses, since data were inadequate to be pooled. For hormone-related cancers, summary RRs for the highest versus lowest GI and GL intakes were moderately increased. They ranged from 1.04 (breast) to 1.12 (endometrium) for GI and from 1.03 (prostate) to 1.22 (ovary) for GL, of borderline significance. High GI was associated with small increased risks of colorectal (summary RR for GI: 1.20, 95% CI, 1.07–1.34—GL: 1.09, 95% CI, 0.97–1.22, 19 studies), bladder (GI: 1.25, 95% CI, 1.11–1.41—GL: 1.10, 95% CI, 0.85–1.42, four studies) and kidney cancers (GI: 1.16, 95% CI, 1.02–1.32—GL: 1.14, 95% CI, 0.81–1.60, five studies). GL was not significantly related to those cancer sites. Stomach, prostate and lung cancers were not associated with GI and GL. The present analysis, based on an updated comprehensive evaluation of the epidemiological literature, indicates moderate unfavorable effects of high versus low GI on colorectal, and possibly bladder and kidney cancers, and a possible moderate positive association between GL and endometrial cancer. View Full-Text
Keywords: cancer; glycemic index; glycemic load; review; risk cancer; glycemic index; glycemic load; review; risk
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Turati, F.; Galeone, C.; Augustin, L.S.A.; La Vecchia, C. Glycemic Index, Glycemic Load and Cancer Risk: An Updated Meta-Analysis. Nutrients 2019, 11, 2342.

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