Association of the glycaemic index and glycaemic load with colorectal cancer in the population of Cordoba (Argentina): results of a case-control study using a multilevel modelling approach

The glycaemic index (GI) and glycaemic load (GL) are involved in the aetiology of different diseases, and they could be related to the development of colorectal cancer (CRC). The aim of this study was to evaluate the association between the quality and quantity indicators of carbohydrates consumed by the population of Cordoba (Argentina) and the odds of developing CRC in 2008-2016 period. A case-control study was conducted with 492 participants (161/331 cases/controls), interviewed through a validated FFQ. Multilevel logistic regression models were used to assess the effect of GI, GL and the quantity or weekly intake of high-GI foods on CRC occurrence, following adjustment for individual/first-level covariates, and using level of urbanisation as the contextual variable. The models were stratified by sex. Participants in the highest v. lowest tertile of dietary GL and weekly intake of high-GI foods had increased odds of CRC presence in the entire sample (OR 1 center dot 64, 95 % CI 1 center dot 16, 2 center dot 34 and OR 1 center dot 11, 95 % CI 1 center dot 09, 1 center dot 14, respectively) and in women (OR 1 center dot 98, 95 % CI 1 center dot 24, 3 center dot 18 and OR 1 center dot 41, 95 % CI 1 center dot 09, 1 center dot 83, respectively). In men, the second tertile of GL and weekly intake of high-GI foods were associated with CRC (OR 1 center dot 44, 95 % CI 1 center dot 04, 1 center dot 99 and OR 1 center dot 48, 95 % CI 1 center dot 32, 1 center dot 65, respectively). Also, GI was associated with CRC in women (highest v. lowest tertile OR 2 center dot 12, 95 % CI 1 center dot 38, 3 center dot 27). In addition to the quantity and quality of carbohydrates intake, it is important to consider the frequency of consumption of high-GI foods in CRC prevention.