Association of the Insulinemic Potential of Diet and Lifestyle With Risk of Digestive System Cancers in Men and Women.
Wang W, Fung TT, Wang M, Smith-Warner SA, Giovannucci EL, Tabung FK
JNCI Cancer Spectr 2 pky080 11/01/2018
Background: We examined the role of the insulinemic potential of diet and lifestyle in the development of cancers of the digestive system, using two plasma C-peptide-based indices: the empirical dietary index for hyperinsulinemia (EDIH) and empirical lifestyle index for hyperinsulinemia (ELIH).
Methods: We used Cox regression to analyze data on 45 816 men (Health Professionals Follow-up Study, 1986-2012) and 74 191 women (Nurses' Health Study, 1984-2012) to examine associations between EDIH and ELIH scores and digestive system cancers. We computed the diet-only score (EDIH) from food-frequency questionnaires administered every 4 years. The lifestyle score (ELIH) included diet, body mass index, and physical activity. Outcomes included incident cancer of the digestive system (mouth, throat, esophagus, stomach, small intestine, and colorectum) and its accessory organs (pancreas, gallbladder, and liver).
Results: We found direct associations between higher insulinemic potential of diet or lifestyle and risk of developing digestive system cancers in both men and women. The pooled multivariable hazard ratios (HRs) for participants comparing the highest to lowest EDIH quintile were: HR = 1.27, 95% confidence interval (CI) = 1.15 to 1.40,
Conclusions: The findings suggest that interventions to reduce the insulinemic potential of diet and lifestyle may be a means of preventing digestive system cancer.