Investigating the associations of glycemic load and glycemic index with lung cancer risk in the Southern Community Cohor
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ORIGINAL PAPER
Investigating the associations of glycemic load and glycemic index with lung cancer risk in the Southern Community Cohort Study Xiang Shu1,2 · Danxia Yu1 · Xiao‑ou Shu1,3 · Heather M. Munro4 · Wei Zheng1,3 · William J. Blot1,3,5 Received: 4 May 2020 / Accepted: 30 August 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose Diets with a high glycemic load (GL) or glycemic index (GI) may increase cancer risk. Findings from prior studies on the relationship between GL, GI, and lung cancer risk are inconsistent. We investigated this relationship in a large prospective cohort. Methods We analyzed data from the Southern Community Cohort Study, a prospective cohort that includes diverse racial groups predominantly low-income adults aged 40–79 in 12 southeastern states of the USA. We estimated dietary GL and GI values using data collected from food frequency questionnaires at baseline. Dietary GL and GI were energy adjusted by residual method and categorized into sex-specific quintiles. Cox proportional hazard regression was used to assess the associations between dietary GL, GI, and lung cancer risk. We further performed stratified analyses by various factors. Results Intakes of individual food items or food groups that commonly contribute to GL were similar between blacks and whites in the cohort. After excluding the first two years of follow-up, 947 incident lung cancers were ascertained among 55,068 participants. Neither dietary GL nor GI was significantly associated with incident lung cancer risk in the overall population (GL: Q5 vs. Q1, HR = 0.88, 95% CI 0.72–1.07, ptrend = 0.29; GI: Q5 vs. Q1, HR = 1.06, 95% CI 0.86–1.30, ptrend = 0.71), nor in subgroups of populations (ptrend > 0.05), in multivariable-adjusted analyses. Conclusion Dietary GL and GI were not independently associated with incident lung cancer risk in a large understudied population. Keywords Lung cancer risk · Glycemic load · Glycemic index · Socioeconomic status · Blacks
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10552-020-01344-7) contains supplementary material, which is available to authorized users. * Xiang Shu [email protected] 1
Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
2
Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
3
Vanderbilt‑Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
4
International Epidemiology Institute, Rockville, MD, USA
5
Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
Lung cancer is the second most commonly diagnosed cancer in the USA with non-Hispanic black men having the highest incidence and mortality rates [1]. Although cigarette smoking is the most well-recognized risk factor for lung cancer, a growing body of studies have demonstrated that dietary factors, for example fruit and vegetable
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