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Nutritional intake and risk of pancreatic cancer - Nutrition
and Cancer
Nutrition Research Newsletter, Dec, 2002 by D. Michaud,
S. Liu, E. Giovannucci
This year, it is estimated that 29,700 individuals will
be diagnosed with pancreatic cancer in the United States
alone. As the five-year survival rate for this type of cancer
is extremely low (4%), means of prevention are necessary.
With the exception of cigarette smoking, few risk factors
for pancreatic cancer have been identified. Recent reviews
do however favor a causal association between diabetes mellitus
and pancreatic cancer. Additionally, in a number of studies,
overweight individuals were consistently at higher risk
of pancreatic cancer when compared with leaner individuals.
The associations between body weight and diabetes suggest
that insulin resistance may play a role in pancreatic carcinogenesis.
Due to these recent suggestions, dietary factors that increase
postprandial plasma glucose levels may have a direct impact
on pancreatic cancer risk. Therefore, investigators examined
glycemic index, glycemic load, sucrose, fructose, and carbohydrate
intakes in relation to the risk of pancreatic cancer in
a large prospective cohort of women with 18 years of follow-up.
The cohort utilized in this investigation was the Nurses'
Health Study (NHS). After excluding participants with incomplete
dietary questonnaires, very high or low caloric intakes
or a cancer diagnosis prior to baseline, 88,802 women were
eligible for analysis. A 61-item food-frequency questionnaire
(FFQ) was mailed to all participants.
Glycemic index is based on the postprandial blood glucose
response compared with the glucose response to a reference
food. Using glycemic index values, investigators calculated
the average dietary glycemic load (GL) during the past year
for each participant by multiplying the carbohydrate content
for each food by its glycemic index value, multiplying that
product by the frequency of consumption, and summing values
for all reported food items.
Height, weight, and smoking history were reported and body
mass index (BMI) was estimated. Physical activity was also
measured. Participants were asked to report specified medical
conditions, including cancers that were diagnosed in the
two-year period between each follow-up questionnaire. When
a subject (or next-of-kin) reported a diagnosis of pancreatic
cancer, the study researchers asked for permission to obtain
related medical records or pathology reports. Nutritional
intake and risk of pancreatic cancer - Nutrition and Cancer
Nutrition Research Newsletter, Dec, 2002 by D. Michaud,
S. Liu, E.
Giovannucci
Results indicate that 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% CI = 0.96 to 2.45)
was seen among women with a high glycemic load intake, and
a similar association was observed for fructose intake (RR
= 1.57, 95% CU = 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
(> 25 kg/[m.sup.2]) or with low physical activity.
This data support previous findings that impaired glucose
metabolism may indeed play a role in the development of
pancreatic cancer. It appears that a diet high in glycemic
load may increase the risk of pancreatic cancer in women
who already have an underlying degree of insulin resistance.
D. Michaud, S. Liu, E. Giovannucci, et al. Dietary sugar,
glycemic load, and pancreatic cancer in risk in a prospective
study. J Natl Cancer Inst; 94:1293-1300 (September 4, 2002).
[Correspondence: Dominique Michaud, Sc.D, National Cancer
Institute, 6120 Executive Blvd., EPS Rm. 3032, Rockville,
MD 20852. E-mail: michaudd@mail.nih.gov].
http://www.findarticles.com/p/
articles/mi_m0887/is_12_21/ai_96070904
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