Department of Nutritional Sciences, Faculty of Medicine, University of Toronto and Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Canada.
Ann Oncol. 2013 Dec;24(12):3094-9. doi: 10.1093/annonc/mdt383. Epub 2013 Oct 22.
Carbohydrate foods with high glycemic and insulinemic potential may influence cancer risk possibly through the insulin/growth-factor axis. Two staple carbohydrate foods of the Mediterranean diet, bread and pasta, have different glycemic and insulinemic responses and hence may affect cancer risk differently.
We studied the association of bread and pasta with breast and colorectal cancer risk using data from two Italian case-control studies. These studies included 2569 women with histologically confirmed breast cancer and 1953 men and women with colorectal cancer. Controls were 2588 and 4154, respectively, admitted to the same hospitals as cases for acute, non-neoplastic conditions. Multivariate odds ratios (ORs) were obtained after allowance for relevant confounding factors.
The ORs of breast cancer for the highest versus the lowest quintile were 1.28 (95% confidence interval, CI: 1.03-1.58, P-trend = 0.0342) for bread and 1.07 (95% CI: 0.88-1.31, P-trend = 0.7072) for pasta. The association with bread remained virtually unchanged with postmenopause and overweight. The ORs of colorectal cancer in women for the highest versus the lowest quintile were 2.02 (95% CI: 1.46-2.80, P-trend = 0.0002) for bread and 1.37 (95% CI: 1.00-1.88, P-trend = 0.0164) for pasta. The associations remained significant only for bread in strata of menopausal status and in women with overweight. No significant associations were seen in men for either bread or pasta.
Overall, these two cancer case-control studies showed stronger positive associations with bread than pasta in women, particularly if overweight, suggesting possible hormonal-related mechanisms.
具有高血糖和胰岛素生成潜力的碳水化合物食物可能通过胰岛素/生长因子轴影响癌症风险。地中海饮食的两种主要碳水化合物食物，面包和意大利面，具有不同的血糖和胰岛素反应，因此可能以不同的方式影响癌症风险。
我们使用来自两项意大利病例对照研究的数据研究了面包和意大利面与乳腺癌和结直肠癌风险的关联。这些研究包括 2569 名经组织学证实的乳腺癌女性和 1953 名男性和女性结直肠癌患者。对照组分别为 2588 名和 4154 名，因急性非肿瘤疾病入住与病例相同的医院。在考虑到相关混杂因素后，获得了多变量比值比（OR）。
对于最高与最低五分位数，乳腺癌的 OR 分别为面包 1.28（95%置信区间，CI：1.03-1.58，P-trend = 0.0342）和意大利面 1.07（95% CI：0.88-1.31，P-trend = 0.7072）。与面包的关联在绝经后和超重时几乎没有变化。对于女性，结直肠癌的 OR 最高与最低五分位数相比，面包为 2.02（95% CI：1.46-2.80，P-trend = 0.0002），意大利面为 1.37（95% CI：1.00-1.88，P-trend = 0.0164）。仅在绝经状态和超重女性的亚层中，面包的关联仍然显著。对于男性，面包或意大利面均未见明显关联。
总的来说，这两项癌症病例对照研究表明，女性中面包与癌症的正相关关系强于意大利面，尤其是超重的女性，这表明可能存在与激素相关的机制。
