Abstract | BACKGROUND: OBJECTIVE: 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.
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Authors | Ying Bao, Katharina Nimptsch, Brian M Wolpin, Dominique S Michaud, Jennie C Brand-Miller, Walter C Willett, Edward Giovannucci, Charles S Fuchs |
Journal | The American journal of clinical nutrition
(Am J Clin Nutr)
Vol. 94
Issue 3
Pg. 862-8
(Sep 2011)
ISSN: 1938-3207 [Electronic] United States |
PMID | 21775564
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
- Dietary Carbohydrates
- Insulin
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Topics |
- Adult
- Carbohydrate Metabolism
- Dietary Carbohydrates
(metabolism)
- Energy Intake
- Female
- Humans
- Incidence
- Insulin
(blood)
- Insulin Resistance
- Male
- Middle Aged
- Obesity
(complications)
- Pancreatic Neoplasms
(blood, epidemiology, etiology)
- Postprandial Period
- Prospective Studies
- Risk Factors
- Sedentary Behavior
- Surveys and Questionnaires
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