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Postdiagnostic Dietary Glycemic Index, Glycemic Load, Dietary Insulin Index, and Insulin Load and Breast Cancer Survival
- Source :
- Cancer Epidemiology, Biomarkers & Prevention. 30:335-343
- Publication Year :
- 2021
- Publisher :
- American Association for Cancer Research (AACR), 2021.
-
Abstract
- Background: We investigated the associations of postdiagnostic dietary glycemic index (GI), glycemic load (GL), insulin index (II), and insulin load (IL) with breast cancer–specific and all-cause mortality. Methods: Among 8,932 women with stage I–III breast cancer identified in the Nurses' Health Study (NHS; 1980–2010) and NHSII (1991–2011), we prospectively evaluated the associations between postdiagnostic GI, GL, II, and IL, and breast cancer–specific and all-cause mortality. Participants completed a validated food frequency questionnaire every 4 years after diagnosis. Results: During follow-up by 2014 in the NHS and 2015 in the NHSII, 2,523 deaths, including 1,071 from breast cancer, were documented. Higher postdiagnostic GL was associated with higher risk of both breast cancer–specific mortality [HRQ5vsQ1 = 1.33; 95% confidence interval (CI) = 1.09–1.63; Ptrend = 0.008] and all-cause mortality (HRQ5vsQ1 = 1.26; 95% CI = 1.10–1.45; Ptrend = 0.0006). Higher all-cause mortality was also observed with higher postdiagnostic GI (HRQ5vsQ1 = 1.23; 95% CI = 1.08–1.40; Ptrend = 0.001), II (HRQ5vsQ1 = 1.20; 95% CI = 1.04–1.38; Ptrend = 0.005), and IL (HRQ5vsQ1 = 1.23; 95% CI = 1.07–1.42; Ptrend = 0.0003). The associations were not modified by insulin receptor or estrogen receptor status of the tumor, or body mass index. Conclusions: We found that higher dietary GL, reflecting postprandial glucose response, after a breast cancer diagnosis was associated with higher risk of breast cancer–specific mortality. Higher dietary GI, GL, II, and IL after a breast cancer diagnosis were associated with higher risk of death from any cause. Impact: These results suggest that carbohydrate quantity and quality may be important in breast cancer prognosis. See related commentary by McTiernan, p. 252
- Subjects :
- Blood Glucose
0301 basic medicine
Oncology
medicine.medical_specialty
Epidemiology
medicine.medical_treatment
Breast Neoplasms
03 medical and health sciences
0302 clinical medicine
Breast cancer
Risk Factors
Internal medicine
Glycemic load
Dietary Carbohydrates
medicine
Humans
Insulin
Estrogen Receptor Status
business.industry
Glycemic Load
Prognosis
medicine.disease
Diet
030104 developmental biology
Postprandial
Glycemic index
Glycemic Index
030220 oncology & carcinogenesis
Female
Insulin index
business
Body mass index
Subjects
Details
- ISSN :
- 15387755 and 10559965
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- Cancer Epidemiology, Biomarkers & Prevention
- Accession number :
- edsair.doi.dedup.....2e55038d8af436802d34fa983c03856f
- Full Text :
- https://doi.org/10.1158/1055-9965.epi-20-0764