Dietary glycemic index,glycemic load and cancer: An overview of the literature

Aims

The aim of this paper is to provide an overview of the current evidence for associations between dietary glycemic index (GI) and dietary glycemic load (GL), and the risk of various types of cancer, and to summarize mechanisms proposed to explain the associations found.

Data synthesis

Medline was searched for cohort studies, case-control studies, and meta-analyses, published up to February 2016, that examined associations between dietary GI/GL and cancer. Findings from the main meta-analyses showed a weak-to-moderate association of high dietary GI/GL with increased risk of some cancers. High dietary GI but not GL was significantly and consistently associated with increased colorectal cancer risk in both cohort and case-control studies. Dietary GL was directly associated with breast and endometrial cancer risk in cohort studies. Positive associations between dietary GI or GL and cancer risk were found more frequently in case-control studies than cohort studies. The main mechanism for these associations is thought to be chronic hyperinsulinemia. Insulin is itself a mitogen and also increases the bioactivity of insulin-like growth factors which can promote cancer by inhibiting apoptosis and stimulating cell proliferation.

Conclusions

The review has uncovered consistent evidence that high dietary GI is associated with increased risk of colorectal cancer, and that high dietary GL is associated with increased risk of breast and endometrial cancer. However the risk increases are small or moderate.