Hugo Pomares-Millan, Solange M Saxby, Sham Al-Mashadi Dahl, Margaret R Karagas, Michael N Passarelli
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In the last decade, several large epidemiological studies have investigated these associations, suggesting the need to revisit the current body of evidence.</p><p><strong>Objective: </strong>The aim of this study was to update a systematic review and meta-analysis conducted by Schlesinger et al in 2017 using recent scientific evidence published since 2015.</p><p><strong>Data sources: </strong>Publications indexed in PubMed, Embase, and The Cochrane Library were retrieved from the inception of the database up to January 2024.</p><p><strong>Data extraction: </strong>Two reviewers independently extracted data and assessed each study's quality.</p><p><strong>Data analysis: </strong>A random-effects model was used to estimate summary risk ratios (RRs) and 95% CIs for a meta-analysis that included 33 publications, with 26 prospective cohort studies cumulatively enrolling 2 212 645 women, among whom 79 777 were diagnosed with incident BC.</p><p><strong>Results: </strong>Dietary GI and GL (highest vs lowest exposure intake) were both associated with 5% higher BC risk-RR (95% CI): 1.05 (1.01-1.09; P = .007) and 1.05 (0.97-1.13; P = .24), respectively. No clear associations were observed for sugar and total dietary fiber intake (highest vs lowest exposure intake)-RR (95% CI): 1.12 (0.95-1.11; P = .16) and 0.93 (0.86-1.00; P = .05), respectively. For the latter, the association was more pronounced among premenopausal women (RR: 0.78; 95% CI: 0.68-0.90; P = .0008).</p><p><strong>Conclusion: </strong>This meta-analysis supports a significant positive association between high dietary GI intake and higher risk of BC and a significant inverse association between high dietary fiber intake and lower risk of BC. Interventions promoting a high-fiber and low-sugar diet may be useful components of BC-prevention strategies.</p><p><strong>Systematic review registration: </strong>PROSPERO registration no. 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In the last decade, several large epidemiological studies have investigated these associations, suggesting the need to revisit the current body of evidence.</p><p><strong>Objective: </strong>The aim of this study was to update a systematic review and meta-analysis conducted by Schlesinger et al in 2017 using recent scientific evidence published since 2015.</p><p><strong>Data sources: </strong>Publications indexed in PubMed, Embase, and The Cochrane Library were retrieved from the inception of the database up to January 2024.</p><p><strong>Data extraction: </strong>Two reviewers independently extracted data and assessed each study's quality.</p><p><strong>Data analysis: </strong>A random-effects model was used to estimate summary risk ratios (RRs) and 95% CIs for a meta-analysis that included 33 publications, with 26 prospective cohort studies cumulatively enrolling 2 212 645 women, among whom 79 777 were diagnosed with incident BC.</p><p><strong>Results: </strong>Dietary GI and GL (highest vs lowest exposure intake) were both associated with 5% higher BC risk-RR (95% CI): 1.05 (1.01-1.09; P = .007) and 1.05 (0.97-1.13; P = .24), respectively. No clear associations were observed for sugar and total dietary fiber intake (highest vs lowest exposure intake)-RR (95% CI): 1.12 (0.95-1.11; P = .16) and 0.93 (0.86-1.00; P = .05), respectively. For the latter, the association was more pronounced among premenopausal women (RR: 0.78; 95% CI: 0.68-0.90; P = .0008).</p><p><strong>Conclusion: </strong>This meta-analysis supports a significant positive association between high dietary GI intake and higher risk of BC and a significant inverse association between high dietary fiber intake and lower risk of BC. Interventions promoting a high-fiber and low-sugar diet may be useful components of BC-prevention strategies.</p><p><strong>Systematic review registration: </strong>PROSPERO registration no. 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引用次数: 0
摘要
背景：几项前瞻性队列研究调查了血糖生成指数（GI）、血糖生成负荷（GL）、膳食糖和总膳食纤维摄入量与女性乳腺癌（BC）风险之间的关系，报告的结果并不一致。近十年来，几项大型流行病学研究对这些关联进行了调查，表明有必要重新审视现有证据：本研究旨在利用 2015 年以来发表的最新科学证据，更新 Schlesinger 等人于 2017 年进行的系统综述和荟萃分析：检索了PubMed、Embase和The Cochrane Library收录的从数据库建立之初到2024年1月的文献：两名审稿人独立提取数据并评估每项研究的质量：数据分析：采用随机效应模型估算荟萃分析的总风险比（RRs）和95% CIs，荟萃分析包括33篇文献，26项前瞻性队列研究，累计纳入212 645名女性，其中79 777人被诊断为偶发性BC：膳食 GI 和 GL（最高摄入量与最低摄入量）均与 BC 风险增加 5%有关--RR（95% CI）：分别为 1.05 (1.01-1.09; P = .007) 和 1.05 (0.97-1.13; P = .24)。糖和总膳食纤维摄入量（最高摄入量与最低摄入量）--RRR（95% CI）分别为 1.12 (0.95-1.11; P = .16) 和 0.93 (0.86-1.00; P = .05)，没有观察到明显的相关性。就后者而言，绝经前妇女的相关性更为明显（RR：0.78；95% CI：0.68-0.90；P = .0008）：这项荟萃分析支持高膳食 GI 摄入量与较高 BC 风险之间存在显著的正相关，而高膳食纤维摄入量与较低 BC 风险之间存在显著的反相关。促进高纤维和低糖饮食的干预措施可能是 BC 预防策略的有用组成部分：系统综述注册：PROSPERO 注册编号CRD42023463143。
Dietary Glycemic Index, Glycemic Load, Sugar, and Fiber Intake in Association With Breast Cancer Risk: An Updated Meta-analysis.
Context: Several prospective cohort studies have investigated the association between glycemic index (GI), glycemic load (GL), dietary sugar, and total dietary fiber intake, with female breast cancer (BC) risk and reported inconsistent results. In the last decade, several large epidemiological studies have investigated these associations, suggesting the need to revisit the current body of evidence.
Objective: The aim of this study was to update a systematic review and meta-analysis conducted by Schlesinger et al in 2017 using recent scientific evidence published since 2015.
Data sources: Publications indexed in PubMed, Embase, and The Cochrane Library were retrieved from the inception of the database up to January 2024.
Data extraction: Two reviewers independently extracted data and assessed each study's quality.
Data analysis: A random-effects model was used to estimate summary risk ratios (RRs) and 95% CIs for a meta-analysis that included 33 publications, with 26 prospective cohort studies cumulatively enrolling 2 212 645 women, among whom 79 777 were diagnosed with incident BC.
Results: Dietary GI and GL (highest vs lowest exposure intake) were both associated with 5% higher BC risk-RR (95% CI): 1.05 (1.01-1.09; P = .007) and 1.05 (0.97-1.13; P = .24), respectively. No clear associations were observed for sugar and total dietary fiber intake (highest vs lowest exposure intake)-RR (95% CI): 1.12 (0.95-1.11; P = .16) and 0.93 (0.86-1.00; P = .05), respectively. For the latter, the association was more pronounced among premenopausal women (RR: 0.78; 95% CI: 0.68-0.90; P = .0008).
Conclusion: This meta-analysis supports a significant positive association between high dietary GI intake and higher risk of BC and a significant inverse association between high dietary fiber intake and lower risk of BC. Interventions promoting a high-fiber and low-sugar diet may be useful components of BC-prevention strategies.
期刊介绍：
Nutrition Reviews is a highly cited, monthly, international, peer-reviewed journal that specializes in the publication of authoritative and critical literature reviews on current and emerging topics in nutrition science, food science, clinical nutrition, and nutrition policy. Readers of Nutrition Reviews include nutrition scientists, biomedical researchers, clinical and dietetic practitioners, and advanced students of nutrition.
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