Breast Cancer Research and Treatment

, Volume 126, Issue 2, pp 287–294 | Cite as

Dietary glycemic index, glycemic load, and risk of breast cancer: meta-analysis of prospective cohort studies



Consumption diets of high glycemic index (GI) and glycemic load (GL) may increase the risk of breast cancer. We aimed to conduct a meta-analysis of prospective cohort studies to evaluate the associations between dietary GI and GL and risk of breast cancer. We searched the PubMed database for relevant studies through November 2010, with no restrictions. We included prospective cohort studies that reported relative risk (RR) with 95% confidence intervals (CIs) for the associations of dietary GI and GL with breast cancer risk. Summary RRs were calculated using both fixed- and random-effects models. We identified 10 prospective cohort studies eligible for analysis, involving 15,839 cases and 577,538 participants. The summary RR of breast cancer for the highest GI intake compared with the lowest was 1.08 (95% CI: 1.02–1.14), with no evidence of heterogeneity (P = 0.72, I 2 = 0%). For GL, the summary RR was 1.04 (95% CI: 0.95–1.15), and substantial heterogeneity was observed (P = 0.02, I 2 = 55.6%). The GI and GL and breast cancer associations did not significantly modified by geographic region, length of follow-up, number of cases, or menopausal status at baseline. Dose–response analysis was not performed due to limited number of eligible studies. There was no evidence of publication bias. In summary, the present meta-analysis of prospective cohort studies suggests that high dietary GI is associated with a significantly increased risk of breast cancer. However, there is no significant association between dietary GL and breast cancer risk.


Glycemic index Glycemic load Breast cancer Cohort studies Meta-analysis 



Jia-Yi Dong and Li-Qiang Qin were responsible for study design, data acquisition, statistical analysis, and results interpretation. Jia-Yi Dong wrote the article. Li-Qiang Qin provided material support and supervised the research. All authors critically revised the manuscript for important intellectual content and approved the final manuscript. There was no funding for this study. None of the authors had a conflict of interest.


  1. 1.
    Jenkins DJ, Wolever TM, Taylor RH et al (1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr 34(3):362–366PubMedGoogle Scholar
  2. 2.
    Ludwig DS (2002) The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA 287(18):2414–2423PubMedCrossRefGoogle Scholar
  3. 3.
    Larsson SC, Mantzoros CS, Wolk A (2007) Diabetes mellitus and risk of breast cancer: a meta-analysis. Int J Cancer 121(4):856–862PubMedCrossRefGoogle Scholar
  4. 4.
    Gunter MJ, Hoover DR, Yu H et al (2009) Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Inst 101(1):48–60PubMedGoogle Scholar
  5. 5.
    Kabat GC, Kim M, Caan BJ et al (2009) Repeated measures of serum glucose and insulin in relation to postmenopausal breast cancer. Int J Cancer 125(11):2704–2710PubMedCrossRefGoogle Scholar
  6. 6.
    Salmeron J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC (1997) Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 277(6):472–477PubMedCrossRefGoogle Scholar
  7. 7.
    Mulholland HG, Murray LJ, Cardwell CR, Cantwell MM (2008) Dietary glycaemic index, glycaemic load and breast cancer risk: a systematic review and meta-analysis. Br J Cancer 99(7):1170–1175PubMedCrossRefGoogle Scholar
  8. 8.
    Larsson SC, Bergkvist L, Wolk A (2009) Glycemic load, glycemic index and breast cancer risk in a prospective cohort of Swedish women. Int J Cancer 125(1):153–157PubMedCrossRefGoogle Scholar
  9. 9.
    Wen W, Shu XO, Li H, Yang G, Ji BT, Cai H, Gao YT, Zheng W (2009) Dietary carbohydrates, fiber, and breast cancer risk in Chinese women. Am J Clin Nutr 89(1):283–289PubMedCrossRefGoogle Scholar
  10. 10.
    Linos E, Willett WC, Cho E, Frazier L (2010) Adolescent diet in relation to breast cancer risk among premenopausal women. Cancer Epidemiol Biomarkers Prev 19(3):689–696PubMedCrossRefGoogle Scholar
  11. 11.
    Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283(15):2008–2012PubMedCrossRefGoogle Scholar
  12. 12.
    Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560PubMedCrossRefGoogle Scholar
  13. 13.
    DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188PubMedCrossRefGoogle Scholar
  14. 14.
    Greenland S, Longnecker MP (1992) Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol 135(11):1301–1309PubMedGoogle Scholar
  15. 15.
    Berlin JA, Longnecker MP, Greenland S (1993) Meta-analysis of epidemiologic dose–response data. Epidemiology 4(3):218–228PubMedCrossRefGoogle Scholar
  16. 16.
    Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634PubMedGoogle Scholar
  17. 17.
    Frazier AL, Li L, Cho E, Willett WC, Colditz GA (2004) Adolescent diet and risk of breast cancer. Cancer Causes Control 15(1):73–82PubMedCrossRefGoogle Scholar
  18. 18.
    Nielsen TG, Olsen A, Christensen J, Overvad K, Tjonneland A (2005) Dietary carbohydrate intake is not associated with the breast cancer incidence rate ratio in postmenopausal Danish women. J Nutr 135(1):124–128PubMedGoogle Scholar
  19. 19.
    Giles GG, Simpson JA, English DR, Hodge AM, Gertig DM, Macinnis RJ, Hopper JL (2006) Dietary carbohydrate, fibre, glycaemic index, glycaemic load and the risk of postmenopausal breast cancer. Int J Cancer 118(7):1843–1847PubMedCrossRefGoogle Scholar
  20. 20.
    Cho E, Spiegelman D, Hunter DJ, Chen WY, Colditz GA, Willett WC (2003) Premenopausal dietary carbohydrate, glycemic index, glycemic load, and fiber in relation to risk of breast cancer. Cancer Epidemiol Biomarkers Prev 12(11 Pt 1):1153–1158PubMedGoogle Scholar
  21. 21.
    Jonas CR, McCullough ML, Teras LR, Walker-Thurmond KA, Thun MJ, Calle EE (2003) Dietary glycemic index, glycemic load, and risk of incident breast cancer in postmenopausal women. Cancer Epidemiol Biomarkers Prev 12(6):573–577PubMedGoogle Scholar
  22. 22.
    Higginbotham S, Zhang ZF, Lee IM, Cook NR, Buring JE, Liu S (2004) Dietary glycemic load and breast cancer risk in the Women’s Health Study. Cancer Epidemiol Biomarkers Prev 13(1):65–70PubMedCrossRefGoogle Scholar
  23. 23.
    Holmes MD, Liu S, Hankinson SE, Colditz GA, Hunter DJ, Willett WC (2004) Dietary carbohydrates, fiber, and breast cancer risk. Am J Epidemiol 159(8):732–739PubMedCrossRefGoogle Scholar
  24. 24.
    Silvera SA, Jain M, Howe GR, Miller AB, Rohan TE (2005) Dietary carbohydrates and breast cancer risk: a prospective study of the roles of overall glycemic index and glycemic load. Int J Cancer 114(4):653–658PubMedCrossRefGoogle Scholar
  25. 25.
    Sieri S, Pala V, Brighenti F et al (2007) Dietary glycemic index, glycemic load, and the risk of breast cancer in an Italian prospective cohort study. Am J Clin Nutr 86(4):1160–1166PubMedGoogle Scholar
  26. 26.
    Lajous M, Boutron-Ruault MC, Fabre A, Clavel-Chapelon F, Romieu I (2008) Carbohydrate intake, glycemic index, glycemic load, and risk of postmenopausal breast cancer in a prospective study of French women. Am J Clin Nutr 87(5):1384–1391PubMedGoogle Scholar
  27. 27.
    Monninkhof EM, Elias SG, Vlems FA, van der Tweel I, Schuit AJ, Voskuil DW, van Leeuwen FE (2007) Physical activity and breast cancer: a systematic review. Epidemiology 18(1):137–157PubMedCrossRefGoogle Scholar
  28. 28.
    Ambrosone CB, Kropp S, Yang J, Yao S, Shields PG, Chang-Claude J (2008) Cigarette smoking, N-acetyltransferase 2 genotypes, and breast cancer risk: pooled analysis and meta-analysis. Cancer Epidemiol Biomarkers Prev 17(1):15–26PubMedCrossRefGoogle Scholar
  29. 29.
    Racette SB, Evans EM, Weiss EP, Hagberg JM, Holloszy JO (2006) Abdominal adiposity is a stronger predictor of insulin resistance than fitness among 50–95 year olds. Diabetes Care 29(3):673–678PubMedCrossRefGoogle Scholar
  30. 30.
    Barclay AW, Petocz P, McMillan-Price J, Flood VM, Prvan T, Mitchell P, Brand-Miller JC (2008) Glycemic index, glycemic load, and chronic disease risk—a meta-analysis of observational studies. Am J Clin Nutr 87(3):627–637PubMedGoogle Scholar
  31. 31.
    Gnagnarella P, Gandini S, La Vecchia C, Maisonneuve P (2008) Glycemic index, glycemic load, and cancer risk: a meta-analysis. Am J Clin Nutr 87(6):1793–1801PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  1. 1.Department of Nutrition and Food HygieneSchool of Radiation Medicine and Public Health, Soochow UniversitySuzhouPeople’s Republic of China

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