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Ahmadirad H, Teymoori F, Nateghi R, Shabanian A, Mirmiran P. The Association of Empirical Dietary Index for Hyperinsulinemia with the Risk of Cancer and Cancer Mortality: A Meta-analysis of Observational Studies. Nutr Cancer 2023:1-14. [PMID: 37155247 DOI: 10.1080/01635581.2023.2189042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This meta-analysis aimed to assess the association between the empirical dietary index for hyperinsulinemia (EDIH) and cancer mortality risk. We performed a comprehensive search across the online literature up to November 2022 databases. Then, hazard ratio (H.R.) and 95% confidence intervals (CI) were extracted. A total of 14 and seven cohort studies that reported H.R. for the risk of cancer incidence and cancer mortality respectively were included. The pooled H.R. (95% CI) of the association between EDIH and cancer incidence was 1.13 (1.05-1.23) in overall meta-analyses, 1.15 (1.08-1.22) in female subgroups, 1.27 (1.14-1.41) in digestive cancer subgroups, and 1.15 (1.07-1.24) in breast cancer subgroups. Also, the pooled H.R. (95% CI) of the association between EDIH and incidence of cancer mortality was 1.19 (1.13-1.26) in overall meta-analyses, 1.23 (1.13-1.34) in males, 1.18(1.10-1.28) in females, and 1.20 (1.13-1.27) in studies conducted on all cancers as an outcome. Our findings revealed that a higher EDIH was significantly associated with an increased risk of cancer incidence, particularly in females, digestive cancers, and breast cancer. Also, a higher EDIH score was related to a higher risk of cancer mortality overall in both male and female subgroups and with all cancers.
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Affiliation(s)
- Hamid Ahmadirad
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshad Teymoori
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Reyhane Nateghi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arman Shabanian
- Department of Food Science and Technology, Faculty of Nutrition Science, Food Science and Technology/National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Haluszka E, Niclis C, Diaz MDP, Osella AR, Aballay LR. Higher dietary glycaemic index, intake of high glycaemic index foods and insulin load are associated with the risk of breast cancer, with differences according to body mass index in women from Córdoba, Argentina. Nutr Res 2022; 104:108-117. [DOI: 10.1016/j.nutres.2022.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/12/2022] [Accepted: 05/20/2022] [Indexed: 01/10/2023]
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The association of dietary insulin load and index with the risk of cancer and cancer mortality: a systematic review and meta-analysis. J Diabetes Metab Disord 2022; 21:1105-1118. [PMID: 35673451 PMCID: PMC9167375 DOI: 10.1007/s40200-022-01013-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/21/2022] [Indexed: 10/19/2022]
Abstract
Purpose Insulin levels play an important role in cancer development. However, the link between an insulinogenic diet and cancer is still unclear. Therefore, we performed a systematic review with meta-analysis to investigate the association between dietary insulin index (II) and load (IL) with cancer risk and mortality. Methods A comprehensive search between electronic databases (Web of Science, PubMed/Medline, Scopus, and Google Scholar) was conducted to identify relevant studies up to January 2022. The relative risks (RR) and Odds ratios (OR) were extracted from eligible studies, and meta-analysis was performed to calculate the pooled effect size. Result 12 papers including 14 studies (10 cohorts and 4 case-control) were included for the meta-analysis. Among them, 10 studies reported effect size for the risk of cancer, and 4 studies reported effect size for cancer mortality. We observed no significant association between II and IL with cancer overall (RRII: 1.03, 95%CI: 0.91-1.17, RRIL: 1.16, 95%CI: 0.94-1.42) and in cohort studies, however, in case-control studies was related with higher odds of cancer (ORII: 2.30, 95%CI: 1.21-4.38, ORIL: 2.57, 95%CI: 1.64-4.02). Higher II and IL scores were associated with the increased risk of total (RRII: 1.29, 95%CI: 1.02-1.63) and (RRIL: 1.39, 95%CI: 1.06-1.83) and colorectal cancer mortality (RRII: 1.29, 95%CI: 1.13-1.48) and (RRIL: 1.37, 95%CI: 1.18-1.60). Conclusion Higher dietary II and IL were not associated with cancer risk in overall and cohort studies, whereas related with a higher risk of cancer in case-control studies. We observed a significant positive relation of II and IL with cancer mortality, especially CRC mortality. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01013-3.
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Amiry F, Barekzai AM, Aminianfar A, Esmaillzadeh A. The Association between Dietary Insulin Index and Load with Gastric Cancer in Afghanistan. Nutr Cancer 2021; 74:2489-2498. [PMID: 34894928 DOI: 10.1080/01635581.2021.2014906] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Insulin has a critical role in the pathogenesis of several cancers. We are aware of no study that examined the association between dietary insulin index (DII) and dietary insulin load (DIL) and gastric cancer. OBJECTIVE This study aimed to investigate the relationship between dietary insulin index and DIL and odds of gastric cancer in Afghanistan. METHODS In this hospital-based case-control study, we recruited 90 patients with newly-diagnosed gastric cancer and 180 healthy controls in Kabul, Afghanistan. Cases were chosen based on convenience-sampling method from the patients with pathologically confirmed gastric cancer aged between 20 and 75 years that had been referred to Jamhuriat Hospital, Kabul, Afghanistan. We applied a pre-tested food frequency questionnaire for dietary assessment of study participants. DIL and DII were calculated based on earlier publications. Multivariable logistic regression models were applied to examine the association between DII and DIL and gastric cancer. RESULTS Mean BMI of study participants was 23.55 ± 3.06 kg/m2, of them 73% were males. After adjustment for potential confounders, participants in the top tertile of DII had 3.96 times greater odds for gastric cancer compared with those in the first tertile (95% CI: 1.23, 12.69; P-trend = 0.03). After adjustment for potential confounders, people in the highest tertile of DIL were 3.41 times more likely to have gastric cancer compared with those in the lowest tertile (95% CI: 1.28, 9.09; P-trend = 0.01). These associations remained significant even after further controlling for BMI, family history of cancer, H. pylori infection and salt intake. CONCLUSION A significant positive association was seen between dietary insulin index and insulin load and odds of gastric cancer in Afghan adults. Prospective cohort studies are required to confirm our findings.
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Affiliation(s)
- Freshta Amiry
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Department of Public Health Management, School of Public Health, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Ahmad Mujtaba Barekzai
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Aminianfar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Ghorbaninejad P, Imani H, Sheikhhossein F, Tijani Jibril A, Mohammadpour S, Shab-Bidar S. Higher dietary insulin load and index are not associated with the risk of metabolic syndrome and obesity in Iranian adults. Int J Clin Pract 2021; 75:e14229. [PMID: 33864715 DOI: 10.1111/ijcp.14229] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/12/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Data about the relation between dietary insulin load (DIL) and dietary insulin index (DII) with metabolic syndrome (MetS) and obesity are scarce. Therefore, the present study aimed to examine the association of the insulinemic potential of the diet with MetS and obesity amongst Iranian adults. METHODS This cross-sectional study was conducted amongst 850 adults aged 20-59 years. Dietary data were collected using a 168-item food frequency questionnaire. DIL was calculated using a standard formula and DII was obtained by dividing DIL by the total energy intake of each participant. The guidelines of the International Diabetes Federation were used to define MetS. General obesity was considered as body mass index ≥ 30 kg/m2 , and abdominal obesity as waist circumference ≥ 94 cm for men and ≥ 80 cm for women. RESULTS Mean DIL and DII values were 101 684 ± 54 802 and 49.4 ± 33.4, respectively. The mean age of participants was 44.9 ± 10.7 years and 36.8%, 28.5% and 48.8% of participants were suffering from MetS, general and abdominal obesity, respectively. In contrast with DIL (P = .73), participants in the last quartile of DII (P = .62) had lower odds of MetS than the first quartile. There were non-significant inverse associations between DIL (P = .91, P = .85) and DII (P = .59, P = .53) with odds of general and abdominal obesity before and after the adjustment of confounders, respectively. CONCLUSIONS We did not observe any significant association of DIL and DII with the risk of MetS and obesity amongst the Iranian population. Further prospective studies are needed to confirm the findings of this study.
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Affiliation(s)
- Parivash Ghorbaninejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hosein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Aliyu Tijani Jibril
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Saba Mohammadpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Sheikhhossein F, Shab-Bidar S, Amini MR, Hosseini F, Imani H. Dietary Insulin Index and Insulin Load in Relation to Breast Cancer: Findings from a Case-Control Study. Clin Breast Cancer 2021; 21:e665-e674. [PMID: 34052108 DOI: 10.1016/j.clbc.2021.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/20/2021] [Accepted: 04/16/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND No data are available on the association between dietary insulin index (DII) and dietary insulin load (DIL) and the risk of breast cancer (BC). PATIENTS AND METHODS This hospital-based case-control study enrolled 150 newly diagnosed cases of BC and 150 age-matched controls. All cases were patients with pathologically confirmed BC, with no history of any type of other pathologically confirmed cancers. Controls were selected from visitors, relatives, and friends of non-cancer patients in other wards who had no family relationships with the cases. We assessed the dietary intakes of study participants using a validated 147-item semiquantitative food frequency questionnaire. DII and DIL were obtained from previously published data. RESULTS A significant positive association was found between DII and BC (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.02-3.25), such that after considering energy intake and age, participants in the highest tertile of DII had 1.86 times greater risk of BC than those in the lowest tertile (OR, 1.86; 95% CI, 1.03-3.35). However, this association became non-significant after controlling for further potential risk factors (OR, 3.26; 95% CI, 0.9-11.7). Furthermore, we observed a significant positive association between DIL and BC (OR, 1.9; 95% CI, 1.06-3.40). The association remained significant even after controlling for age and energy intake. Further controlling for other potential confounders resulted in the disappearance of the association (OR, 3.06; 95% CI, 0.87-10.6). CONCLUSION Adherence to a diet with high DII and DIL was not associated with odds of BC after controlling for potential confounders.
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Affiliation(s)
- Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Amini
- Department of Clinical Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hosseini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Hatami Marbini M, Amiri F, Sajadi Hezaveh Z. Dietary glycemic index, glycemic load, insulin index, insulin load and risk of diabetes-related cancers: A systematic review of cohort studies. Clin Nutr ESPEN 2021; 42:22-31. [PMID: 33745582 DOI: 10.1016/j.clnesp.2021.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/05/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND & AIMS It is believed that diets high in glycemic index (GI), glycemic load (GL), Insulin index (II), and Insulin load (IL) are associated with the increased risks of certain cancers through increasing serum glucose or insulin levels. METHODS We conducted this systematic review of cohort studies to evaluate the possible relation between GI, GL, II, and IL with diabetes-related cancers, including colorectal, bladder, breast, endometrium, liver, pancreas, and prostate cancers. Two separate investigators conducted a literature search through PubMed/Medline, Scopus, and Web of Science databases up to February 2020, plus reference lists of relevant articles. RESULTS Fifty-three cohort studies with a total of 100 098 cancer cases were included in this systematic review. Fifteen out of eighteen studies among breast cancer cases reported no significant association between GI/GL and cancer risk. These numbers were 4 out of 13 for colorectal cancer, 7 out of 9 for endometrial cancer, 2 out of 3 for liver cancer, 8 out of 10 for pancreatic cancer, and 3 out of 3 for prostate cancer. Only one cohort investigated this association in terms of bladder cancer and reported a significant association. Also, five studies reported this relation in terms of II/IL, and only one cohort among endometrial cancer patients observed a significant positive association between the risk of cancer and IL. CONCLUSION We concluded a weak association between dietary GI/GL and no association between II/IL with diabetes-related cancer risk. More cohort studies are required to be performed regarding II/IL and the risk of cancer.
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Affiliation(s)
- Motahare Hatami Marbini
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemehsadat Amiri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Zohreh Sajadi Hezaveh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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8
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Dietary Insulin Index and Dietary Insulin Load in Relation to Metabolic Syndrome: The Shahedieh Cohort Study. J Acad Nutr Diet 2020; 120:1672-1686.e4. [DOI: 10.1016/j.jand.2020.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 03/10/2020] [Indexed: 12/14/2022]
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9
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Koshiyama M. The Effects of the Dietary and Nutrient Intake on Gynecologic Cancers. Healthcare (Basel) 2019; 7:healthcare7030088. [PMID: 31284691 PMCID: PMC6787610 DOI: 10.3390/healthcare7030088] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/23/2019] [Accepted: 07/03/2019] [Indexed: 12/19/2022] Open
Abstract
The contribution of diet to cancer risk has been considered to be higher in advanced countries than in developing countries. In this paper, I review the current issues (a review of the relevant literature), and the effects of the dietary and nutrient intake on three types of gynecologic cancer (cervical, endometrial and ovarian cancers). In cervical cancer, the most important roles of diet/nutrition in relation to cancer are prophylaxis and countermeasures against human papillomavirus (HPV) infection. The main preventive and reductive factors of cervical cancer are antioxidants, such as vitamin A, C, D and E, carotenoids, vegetables and fruits. These antioxidants may have different abilities to intervene in the natural history of diseases associated with HPV infection. For endometrial cancer, the increase in peripheral estrogens as a result of the aromatization of androgens to estrogens in adipose tissue in obese women and insulin resistance are risk factors. Thus, we must mainly take care to avoid the continuous intake of fat energy and sugar. In ovarian cancer, the etiology has not been fully understood. To the best of our knowledge, the long-term consumption of pro-inflammatory foods, including saturated fat, carbohydrates and animal proteins is a risk factor. The intake of acrylamide is also a risk factor for both endometrial and ovarian cancer. Most papers have been epidemiological studies. Thus, further research using in vitro and in vivo approaches is needed to clarify the effects of the dietary and nutrient intake in detail.
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Affiliation(s)
- Masafumi Koshiyama
- Department of Women's Health, Graduate School of Human Nursing, The University of Shiga Prefecture, Shiga 522-8533, Japan.
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Anjom-Shoae J, Shayanfar M, Mohammad-Shirazi M, Sadeghi O, Sharifi G, Siassi F, Esmaillzadeh A. Dietary insulin index and insulin load in relation to glioma: findings from a case-control study. Nutr Neurosci 2019; 24:354-362. [PMID: 31240996 DOI: 10.1080/1028415x.2019.1631594] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Although hyperinsulinemia is assumed to be involved in brain carcinogenesis, data on the link between dietary insulin index (DII) and dietary insulin load (DIL) and risk of glioma are lacking. OBJECTIVE The current study aimed to investigate the relation between DII and DIL and risk of glioma in a case-control study among Iranian adults. METHODS In this hospital-based case-control study, 128 pathologically confirmed cases of glioma and 256 age and sex-matched controls were enrolled. Dietary intakes of study participants were assessed using a validated Block-format 123-item semi-quantitative FFQ. DII and DIL were computed using a published food insulin index (FII) data. RESULTS A significant positive association was found between DIL and glioma (OR: 3.56; 95% CI: 1.85-6.58, P < 0.001); such that after controlling for potential confounders, participants in the highest quartile of DIL had 2.95 times greater odds of glioma than those in the lowest quartile (OR: 2.95; 95% CI: 1.40-6.24, Ptrend = 0.006). Furthermore, we observed a significant positive association between DII and glioma (OR: 2.65; 95% CI: 1.43-4.93, Ptrend = 0.001). This association remained significant even after considering energy intake (OR: 2.66; 95% CI: 1.43-4.95, Ptrend = 0.001). However, when further potential confounders were taken into account, this relationship became non-significant (OR: 1.87; 95% CI: 0.92-3.80, Ptrend = 0.03), despite a significant trend of increased odds ratios (P = 0.03). CONCLUSIONS In conclusion, we found a significant positive association between DIL and odds of glioma. DII was not significantly associated with odds of glioma after controlling for confounders.
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Affiliation(s)
- Javad Anjom-Shoae
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Shayanfar
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Mohammad-Shirazi
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Sadeghi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Giuve Sharifi
- Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereydoun Siassi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
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11
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Association between dietary insulin index and load with obesity in adults. Eur J Nutr 2019; 59:1563-1575. [PMID: 31147833 DOI: 10.1007/s00394-019-02012-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 05/23/2019] [Indexed: 01/16/2023]
Abstract
PURPOSE Hyperinsulinemia is linked to the development of various chronic diseases, especially obesity given to the role of insulin responses in body fat accumulation; hence, the current study aimed to examine the association of insulinemic potential of the diet with general and abdominal obesity among a large population of Iranian adults. METHODS This cross-sectional study was carried out among 8691 adult participants aged 18-55 years. Dietary data were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire. Dietary insulin index (DII) was computed through considering food insulin index values published earlier. Dietary insulin load (DIL) was also calculated using a standard formula. Assessment of anthropometric measures was conducted through a self-administered questionnaire. General obesity was defined as body mass index ≥ 25 kg/m2, and abdominal obesity as waist circumference ≥ 94 cm for men and ≥ 80 cm for women. RESULTS Mean age of study participants was 36.8 ± 8.1 years; 60.3% were women. Compared with the lowest quintile, women in the highest quintile of DIL were less likely to be abdominally obese (OR 0.73; 95% CI 0.57-0.92). Such significant association was not seen after controlling for potential confounders (OR 0.86; 95% CI 0.44-1.67). Neither in crude nor in adjusted models, we observed a significant association between DIL and general obesity among men and women. In terms of dietary insulin index, men in the top quintile of DII were more likely to be generally overweight or obese compared with those in the bottom quintile (OR 1.27; 95% CI 1.00-1.62). This association became non-significant after controlling for demographic characteristics (OR 1.14; 95% CI 0.84-1.56). Furthermore, in thefully adjusted model, women in the top quintile of DII were more likely to have general obesity compared with those in the bottom quintile (OR 1.40; 95% CI 1.07-1.84). CONCLUSIONS We found that adherence to a diet with a high DII was associated with greater odds of general obesity among women, but not in men. Although such information might help to draw conclusions on the practical relevance of the shown findings, further studies, specifically of prospective design, are warranted.
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Tabung FK, Nimptsch K, Giovannucci EL. Postprandial Duration Influences the Association of Insulin-Related Dietary Indexes and Plasma C-peptide Concentrations in Adult Men and Women. J Nutr 2019; 149:286-294. [PMID: 30590589 PMCID: PMC6374149 DOI: 10.1093/jn/nxy239] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/23/2018] [Accepted: 08/23/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The dietary insulin index (II) directly quantifies dietary effects on postprandial insulin secretion, whereas the empirical dietary index for hyperinsulinemia (EDIH), based on fasting C-peptide concentrations, is primarily reflective of insulin resistance. How these scores are related to nonfasting C-peptide in cohort studies has not been examined. OBJECTIVE We investigated the extent to which EDIH and II scores predict plasma C-peptide concentrations, in cross-sectional analyses by postprandial duration at blood collection from 1 to ≥15 h. METHODS Both EDIH and II scores were calculated from food-frequency questionnaire data reported by 3964 men in the Health Professionals Follow-up Study (1993-1995) and 6215 women in the Nurses' Health Study (1989-1990) who were not diabetic. We constructed 12 multivariable-adjusted linear regression models separately in men and women, by postprandial duration, to calculate relative differences and absolute values of plasma C-peptide concentrations in dietary index quintiles. RESULTS In both men and women, C-peptide concentrations were elevated 1-2 h after eating and declined with increasing postprandial duration. In men, percent differences in C-peptide concentration in the highest compared with lowest dietary index quintile were: EDIH: 0-1 h: 50%; 2 h: 22%; 14 h: 14%; ≥15 h: 30% (all P-trend< 0.05). II: 0-1 h: 19% (P-trend = 0.09); 2 h: 3% (P-trend = 0.09); 14 h: -6% (P-trend = 0.17); ≥15 h: -15% (P-trend = 0.02). Corresponding results among women were: EDIH: 0-1 h: 29% (P-trend = 0.002); 2 h: 33% (P-trend = 0.009); 14 h: 44% (P-trend < 0.0001); ≥15 h: 40% (P-trend < 0.0001). II: 0-1 h: -12% (P-trend = 0.09); 2 h: 17% (P-trend = 0.09); 14 h: -14% (P-trend = 0.009); ≥15 h: -3% (P-trend = 0.37). CONCLUSION The EDIH was superior to the II in predicting both fasting and nonfasting C-peptide concentrations, suggesting that the EDIH may be better in assessing dietary effects of hyperinsulinemia on disease risk in adult men and women.
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Affiliation(s)
- Fred K Tabung
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH
- Departments of Nutrition
| | - Katharina Nimptsch
- Departments of Nutrition
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Edward L Giovannucci
- Departments of Nutrition
- Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
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13
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Does alcohol consumption modify the risk of endometrial cancer? A dose-response meta-analysis of prospective studies. Arch Gynecol Obstet 2016; 295:467-479. [PMID: 27975130 DOI: 10.1007/s00404-016-4263-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 12/02/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Epidemiological studies have provided controversial evidence of an association between alcohol intake and endometrial cancer (EC) risk. The World Cancer Research Fund/American Institute for Cancer Research classifies alcohol as having a "limited-no conclusion" grade of evidence in the Endometrial Cancer 2013 Report (the latest version). OBJECTIVE The purpose of this meta-analysis is to systematically analyze the effect of alcohol intake on EC risk. METHODS We conducted a dose-response meta-analysis of prospective cohort studies identified from the PubMed, Embase, Cochrane Library and China Biological Medicine databases. Categorical and dose-response meta-analyses were conducted to estimate the effects of alcohol on EC risk. RESULTS A total of 10 studies involving 9766 cases and 1,612,798 participants were included in this meta-analysis. Overall, the relative risk(RR) for alcohol intake on EC was 1.04 (95% CI 0.88-1.22). The RRs for alcohol intake from wine, beer, and liquor were 1.10 (95% CI 0.80-1.51), 0.94 (95% CI 0.72-1.22), and 1.04 (95% CI 0.86-1.27), respectively). When alcohol consumption was stratified by drinking level, the RRs for moderate and heavy alcohol intake were 0.95 (95% CI 0.89-1.01) and 1.00 (95% CI 0.88-1.13), respectively. In the subgroup analyses, this association was not modified by other lifestyle factors or the characteristics of the study design and population. No significant associations were detected in the dose-response meta-analyses. CONCLUSIONS Alcohol intake is not associated with EC regardless of the beverage choice and alcohol consumption level. More studies are warranted in other populations, such as Asians and Africans.
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Scazzina F, Dei Cas A, Del Rio D, Brighenti F, Bonadonna RC. The β-cell burden index of food: A proposal. Nutr Metab Cardiovasc Dis 2016; 26:872-878. [PMID: 27381989 DOI: 10.1016/j.numecd.2016.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 04/05/2016] [Accepted: 04/27/2016] [Indexed: 01/09/2023]
Abstract
The quantity and quality of dietary fat and/or carbohydrate may alter one or more of the basic components of the insulin-glucose system, which in turn affect the pathways leading to alterations in glucose homeostasis and, possibly, to cardiovascular disease. This viewpoint article, reviewing some of the currently available tools aiming at quantifying the impact of dietary carbohydrates on the glucose-insulin homeostatic loop, highlights the unmet need of a more thorough assessment of the complex interaction between dietary factors and the glucose-insulin system. A novel index, the "β-cell burden index", may turn out to be a valuable tool to quantify the role played by the diet in shaping the risk of type 2 diabetes, cardiovascular disease and other metabolic and degenerative disorders, ideally orienting their prevention with strategies based on dietary modifications.
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Affiliation(s)
- F Scazzina
- Human Nutrition Unit, Department of Food Science, University of Parma, Parma, Italy.
| | - A Dei Cas
- Department of Clinical and Experimental Medicine, University of Parma, Italy; Division of Endocrinology, Azienda Ospedaliera Universitaria of Parma, Parma, Italy.
| | - D Del Rio
- Human Nutrition Unit, Department of Food Science, University of Parma, Parma, Italy.
| | - F Brighenti
- Human Nutrition Unit, Department of Food Science, University of Parma, Parma, Italy.
| | - R C Bonadonna
- Department of Clinical and Experimental Medicine, University of Parma, Italy; Division of Endocrinology, Azienda Ospedaliera Universitaria of Parma, Parma, Italy.
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Mirmiran P, Esfandiari S, Bahadoran Z, Tohidi M, Azizi F. Dietary insulin load and insulin index are associated with the risk of insulin resistance: a prospective approach in tehran lipid and glucose study. J Diabetes Metab Disord 2016; 15:23. [PMID: 27446819 PMCID: PMC4955203 DOI: 10.1186/s40200-016-0247-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 07/13/2016] [Indexed: 12/02/2022]
Abstract
Background The aim of this study was to investigate the relationship between dietary insulin load (DIL) and insulin index (DII) and the risk of insulin resistance in Tehranian adults. Methods In this study, 927 men and women, aged 22–80 years, participated in Tehran Lipid and Glucose Study were included. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of follow-up. Usual dietary intakes were measured using a validated 168 item semi-quantitative food frequency questionnaire and DIL and DII were calculated. Logistic regression models were used to estimate the occurrence of the IR across tertile categories of DIL and DII with adjustment for potential confounding variables. Result Mean age of participants was 40.71 ± 12.14 y, and mean body mass index (BMI) was 27.23 ± 4.9 kg/m2, at baseline. Mean of DIL and DII was 937 ± 254 and 84.0 ± 6.3. Participants with higher DIL had higher weight and waist circumference at baseline (P < 0.05). A borderline positive association was observed between DII and the risk of insulin resistance in fully adjusted model (odds ratio = 1.66, 95 % confidence interval = 0.96–2.86, P for trend = 0.06). After adjustment of potential confounders, highest compared to the lowest tertile of DIL was also significantly associated with increased risk of insulin resistance (odds ratio = 1.69, 95 % confidence interval = 1.01–2.89, P for trend = 0.06). Conclusion Dietary insulin load and DII could be considered as independent dietary risk factors for development of insulin resistance.
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Affiliation(s)
- Parvin Mirmiran
- Nutrition and Endocrine Research Center, and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Esfandiari
- Nutrition and Endocrine Research Center, and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; No. 24., Shahid Erabi St., Yeman St., P.O. Box: 19395-4763, Velenjak, Tehran Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Coffee consumption and risk of endometrial cancer: a dose-response meta-analysis of prospective cohort studies. Sci Rep 2015; 5:13410. [PMID: 26302813 PMCID: PMC4548216 DOI: 10.1038/srep13410] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 07/27/2015] [Indexed: 12/27/2022] Open
Abstract
This is a dose-response (DR) meta-analysis to evaluate the association of coffee consumption on endometrial cancer (EC) risk. A total 1,534,039 participants from 13 published articles were added in this meta-analysis. The RR of total coffee consumption and EC were 0.80 (95% CI: 0.74–0.86). A stronger association between coffee intake and EC incidence was found in patients who were never treated with hormones, 0.60 (95% CI: 0.50–0.72), and subjects with a BMI ≥25 kg/m2, 0.57 (95% CI: 0.46–0.71). The overall RRs for caffeinated and decaffeinated coffee were 0.66 (95% CI: 0.52–0.84) and 0.77 (95% CI: 0.63–0.94), respectively. A linear DR relationship was seen in coffee, caffeinated coffee, decaffeinated coffee and caffeine intake. The EC risk decreased by 5% for every 1 cup per day of coffee intake, 7% for every 1 cup per day of caffeinated coffee intake, 4% for every 1 cup per day of decaffeinated intake of coffee, and 4% for every 100 mg of caffeine intake per day. In conclusion, coffee and intake of caffeine might significantly reduce the incidence of EC, and these effects may be modified by BMI and history of hormone therapy.
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Farvid MS, Eliassen AH, Cho E, Chen WY, Willett WC. Adolescent and Early Adulthood Dietary Carbohydrate Quantity and Quality in Relation to Breast Cancer Risk. Cancer Epidemiol Biomarkers Prev 2015; 24:1111-20. [PMID: 25805068 DOI: 10.1158/1055-9965.epi-14-1401] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/14/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We investigated quantity and quality of dietary carbohydrate as well as insulin load and insulin index during adolescence and also early adulthood in relation to risk of breast cancer in the Nurses' Health Study II. METHODS During 20 years of follow-up of 90,534 premenopausal women who completed a diet questionnaire in 1991, 2,833 invasive breast cancer cases were documented. In 1998, 44,263 of these women also completed a questionnaire about their diet during high school; among these women, we documented 1,118 cases of breast cancer. Multivariable-adjusted Cox proportional hazards regression was used to model relative risks (RR) and 95% confidence intervals (95% CI) for breast cancer across categories of dietary carbohydrate, glycemic index (GI), glycemic load (GL), as well as insulin load and insulin index scores. RESULTS Adolescent or early adult intakes of GI or GL were not associated with risk of breast cancer. Comparing women in the highest versus lowest quintile, the multivariable-adjusted RRs were 1.14 (0.95-1.38) for adolescent GI scores and 1.03 (0.91-1.16) for early adulthood GI scores. We also did not observe associations with insulin index and insulin load scores in adolescence or early adulthood and breast cancer risk. CONCLUSIONS We found that diets high in GI, GL, insulin index, and insulin load during adolescence or early adulthood were not associated with an increased risk of breast cancer in this cohort study. IMPACT Diets with a high glucose or insulin response in adolescence or early adulthood were not significant predictors of breast cancer incidence.
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Affiliation(s)
- Maryam S Farvid
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eunyoung Cho
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Wendy Y Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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