BACKGROUND: Although hyperinsulinemia and insulin resistance have been hypothesized to be involved in pancreatic carcinogenesis, studies that have examined glycemic load or individual dietary components that influence glucose concentrations yielded inconclusive results. OBJECTIVE: Our objective was to investigate whether dietary insulin load and dietary insulin index are associated with the risk of pancreatic cancer. DESIGN: We prospectively followed 86,740 women and 46,147 men who were free of cancer and diabetes at baseline in the Nurses' Health Study and the Health Professionals Follow-Up Study. During ≤26 y of follow-up, 691 pancreatic cancer cases were documented. Dietary insulin load was calculated as a function of the food insulin index, and the energy content of individual foods was reported on food-frequency questionnaires. The dietary insulin index was calculated by dividing the dietary insulin load by the total energy intake. RESULTS: Dietary insulin load and dietary insulin index were not associated with the overall risk of pancreatic cancer. In a comparison of the highest with the lowest quintiles, the pooled multivariate RRs of pancreatic cancer were 1.05 (95% CI: 0.82, 1.34) for dietary insulin load and 0.96 (95% CI: 0.75, 1.23) for dietary insulin index. In individuals with an elevated BMI (in kg/m(2); ≥27.5) or with low physical activity, a high insulin load was associated with small, nonsignificant increases in the risk of pancreatic cancer; in a comparison of the highest with the lowest tertile of intake, the positive association became more apparent in those who were both overweight and inactive (RR: 2.03; 95% CI: 1.05, 3.93; P-trend = 0.04). CONCLUSIONS: A diet that induces an elevated postprandial insulin response does not influence the overall risk of pancreatic cancer. However, a diet with a high insulin load may increase the risk in individuals with a preexisting state of insulin resistance.
BACKGROUND: Although hyperinsulinemia and insulin resistance have been hypothesized to be involved in pancreatic carcinogenesis, studies that have examined glycemic load or individual dietary components that influence glucose concentrations yielded inconclusive results. OBJECTIVE: Our objective was to investigate whether dietary insulin load and dietary insulin index are associated with the risk of pancreatic cancer. DESIGN: We prospectively followed 86,740 women and 46,147 men who were free of cancer and diabetes at baseline in the Nurses' Health Study and the Health Professionals Follow-Up Study. During ≤26 y of follow-up, 691 pancreatic cancer cases were documented. Dietary insulin load was calculated as a function of the food insulin index, and the energy content of individual foods was reported on food-frequency questionnaires. The dietary insulin index was calculated by dividing the dietary insulin load by the total energy intake. RESULTS: Dietary insulin load and dietary insulin index were not associated with the overall risk of pancreatic cancer. In a comparison of the highest with the lowest quintiles, the pooled multivariate RRs of pancreatic cancer were 1.05 (95% CI: 0.82, 1.34) for dietary insulin load and 0.96 (95% CI: 0.75, 1.23) for dietary insulin index. In individuals with an elevated BMI (in kg/m(2); ≥27.5) or with low physical activity, a high insulin load was associated with small, nonsignificant increases in the risk of pancreatic cancer; in a comparison of the highest with the lowest tertile of intake, the positive association became more apparent in those who were both overweight and inactive (RR: 2.03; 95% CI: 1.05, 3.93; P-trend = 0.04). CONCLUSIONS: A diet that induces an elevated postprandial insulin response does not influence the overall risk of pancreatic cancer. However, a diet with a high insulin load may increase the risk in individuals with a preexisting state of insulin resistance.
Authors: Rachael Z Stolzenberg-Solomon; Pirjo Pietinen; Philip R Taylor; Jarmo Virtamo; Demetrius Albanes Journal: Am J Epidemiol Date: 2002-05-01 Impact factor: 4.897
Authors: M B Schneider; H Matsuzaki; J Haorah; A Ulrich; J Standop; X Z Ding; T E Adrian; P M Pour Journal: Gastroenterology Date: 2001-04 Impact factor: 22.682
Authors: Dominique S Michaud; Simin Liu; Edward Giovannucci; Walter C Willett; Graham A Colditz; Charles S Fuchs Journal: J Natl Cancer Inst Date: 2002-09-04 Impact factor: 13.506
Authors: S Salvini; D J Hunter; L Sampson; M J Stampfer; G A Colditz; B Rosner; W C Willett Journal: Int J Epidemiol Date: 1989-12 Impact factor: 7.196
Authors: Tsuyoshi Hamada; Natalia Khalaf; Chen Yuan; Ana Babic; Vicente Morales-Oyarvide; Zhi Rong Qian; Jonathan Andrew Nowak; Kimmie Ng; Peter Kraft; Douglas Adam Rubinson; Meir Jonathan Stampfer; Edward Luciano Giovannucci; Charles Stewart Fuchs; Shuji Ogino; Brian Matthew Wolpin Journal: J Gastroenterol Date: 2018-01-23 Impact factor: 7.527
Authors: Maryam S Farvid; A Heather Eliassen; Eunyoung Cho; Wendy Y Chen; Walter C Willett Journal: Cancer Epidemiol Biomarkers Prev Date: 2015-03-24 Impact factor: 4.254
Authors: Dong Hoon Lee; Jun Li; Yanping Li; Gang Liu; Kana Wu; Shilpa Bhupathiraju; Eric B Rimm; Kathryn M Rexrode; JoAnn E Manson; Walter C Willett; Frank B Hu; Fred K Tabung; Edward L Giovannucci Journal: Diabetes Care Date: 2020-09-01 Impact factor: 19.112
Authors: Qi Jin; Phil A Hart; Ni Shi; Joshua J Joseph; Macarius Donneyong; Darwin L Conwell; Steven K Clinton; Zobeida Cruz-Monserrate; Theodore M Brasky; Lesley F Tinker; Simin Liu; Aladdin H Shadyab; Cynthia A Thomson; Lihong Qi; Thomas Rohan; Fred K Tabung Journal: Cancer Epidemiol Biomarkers Prev Date: 2021-04-07 Impact factor: 4.254