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Br J Nutr. 2017 Nov;118(9):722-729. doi: 10.1017/S0007114517002574. Epub 2017 Oct 9.

Associations of dietary carbohydrates, glycaemic index and glycaemic load with risk of bladder cancer: a case-control study.

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1National Cancer Institute 'Istituto Nazionale Tumori Fondazione Giovanni Pascale',Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS),Via Mariano Semmola 1,80131 Naples,Italy.
3Cancer Epidemiology Unit,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro di Riferimento Oncologico,Via F. Gallini 2,Aviano,33081 PN,Italy.
4Section of Clinical & General Pathology & Oncology,Department of Biomedical & Biotechnological Sciences,University of Catania,Via Androne 83,95124 Catania,Italy.
5Department of Clinical Sciences and Community Health,Università degli Studi di Milano,Via Vanzetti, 5,20133 Milan,Italy.
6Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto di Ricerche Farmacologiche 'Mario Negri',Via La Masa 19,20156 Milan,Italy.
7Uroginecology Unit,National Cancer Institute,G. Pascale Foundation,80131 Naples,Italy.
2Clinical Nutrition and Risk Factor Modification Center,St. Michael's Hospital,61 Queen Street East,Toronto,ON M5C 2T2,Canada.


Carbohydrate foods with high glycaemic index (GI) and load (GL) may negatively influence cancer risk. We studied the association of dietary carbohydrates, GI, GL, intake of bread and pasta with risk of bladder cancer using data from an Italian case-control study. The study included 578 men and women with histologically confirmed bladder cancer and 608 controls admitted to the same hospitals as cases for acute, non-neoplastic conditions. OR were estimated by logistic regression models after allowance for relevant confounding factors. OR of bladder cancer for the highest v. the lowest quantile of intake were 1·52 (95 % CI 0·85, 2·69) for available carbohydrates, 1·18 (95 % CI 0·83, 1·67) for GI, 1·96 (95 % CI 1·16, 3·31, P trend<0·01) for GL, 1·58 (95 % CI 1·09, 2·29, P trend=0·03) for pasta and 1·92 (95 % CI 1·28, 2·86, P trend<0·01) for bread. OR for regular consumption of legumes and whole-grain products were 0·78 (95 % CI 0·60, 1·00) and 0·82 (95 % CI 0·63, 1·08), respectively. No heterogeneity in risks emerged across strata of sex. This case-control study showed that bladder cancer risk was directly associated with high dietary GL and with consumption of high quantity of refined carbohydrate foods, particularly bread. These associations were apparently stronger in subjects with low vegetable consumption.


GI glycaemic index; GL glycaemic load; Bladder cancer risk; Bread; Dietary glycaemic index; Pasta; Whole grains

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