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Background: Very few studies have focused on the relationship among dietary carbohydrates, glycemic index (GI), glycemic load (GL), and breast cancer risk in Latin American women. Our objective was to assess the associations among dietary carbohydrate, GI, GL, and risk of breast cancer, and to further investigate these associations by levels of overweight/obesity and physical activity.Methods: We used data from a Mexican population-based case-control study. We recruited a 1,000 women with incident breast cancer and 1,074 matched control women ages 35 to 69 years between 2004 and 2007. We used conditional logistic regression models and energy-adjusted carbohydrates, GI, and GL using the residual method.Results: Total carbohydrate intake was associated with an increased risk of breast cancer among premenopausal women. The odds ratio in the highest versus the lowest quartile was 1.3 (95% confidence interval = 1.0, 1.7; P trend = 0.03). In stratified analyses by body mass index (BMI), the positive association between carbohydrate and risk of premenopausal breast cancer was only observed among overweight women. The odds ratio comparing the top with the bottom quartile was 1.9 (95% confidence interval = 1.2, 3.0; P trend = 0.01) among women with BMI ≥ 25 kg/m. No association was observed among women with BMI < 25 kg/m.Conclusions: Our findings suggest that high carbohydrate diets are associated with an increased risk of breast cancer among premenopausal Mexican women. [ABSTRACT FROM AUTHOR]