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Several studies analysed the associations between dietary carbohydrate intake, glycaemic index (GI) and glycaemic load (GL) and digestive system cancers; however, the results remain controversial. This study was to perform a meta-analysis evaluating the quantitative and dose-response associations between carbohydrate intake, GI and GL, and risk of digestive system cancers. We searched medical and biological databases up to June 2018 and identified twenty-six cohort studies and eighteen case-control studies. Meta-analytic fixed or random effects models were applied to process data. We also performed dose-response analysis, meta-regression and subgroup analyses. We found that high levels of GI were significantly associated with the risk of digestive system cancers at the highest compared with the lowest categories from cohort studies (summary relative risk (RR)=1·10, 95 % CI 1·05, 1·15). Similar effects were observed from case-control studies of the comparison between the extreme categories, but the difference did not reach statistical significance (summary OR=1·28, 95 % CI 0·97, 1·69). We also observed significant dose-response association between GI and digestive system cancers, with every 10-unit increase in GI (summary RR=1·003; 95 % CI 1·000, 1·012 for cohort studies; summary OR=1·09; 95 % CI 1·06, 1·11 for case-control studies). In addition, both cohort studies and case-control studies indicated that neither dietary carbohydrate intake nor GL bore any statistical relationship to digestive system cancers from the results of the highest compared with the lowest categories analyses and dose-response analyses. The results suggest a moderate association between high-GI diets and the risk of digestive system cancers.

Background/objectives: To assess the association between processed meat and the risk of selected digestive tract and laryngeal cancers., Subjects/methods: We conducted a series of case-control studies between 1985 and 2007 in Italy. The studies included a total of 1475 cases of cancer of the oral cavity and pharynx, 1077 of the larynx, 716 of the esophagus, 999 of the stomach, 684 of the liver, 159 of the biliary tract, 688 of the pancreas, and a total of 9720 controls. Odds ratios (ORs), and the corresponding 95% confidence intervals (CIs), were estimated by unconditional logistic regression models, including terms for socio-demographic factors, tobacco smoking, and alcohol intake., Results: Compared to the lowest tertile of processed meat consumption, the ORs for subjects in the highest one were 1.18 (95% CI 0.98-1.43) for oral cavity and pharyngeal, 1.51 (95% CI 1.18-1.91) for esophageal, 1.19 (95% CI 0.96-1.47) for laryngeal, 0.98 (95% CI 0.81-1.18) for stomach, 0.85 (95% CI 0.51-1.40) for biliary tract, 1.20 (95% CI 0.94-1.54) for liver, and 1.46 (95% CI 1.15-1.85) for pancreatic cancers., Conclusions: Our findings support the hypothesis that high processed meat consumption increases esophageal and pancreatic cancers risk. Residual confounding by socio-demographic factors, tobacco smoking, and alcohol intake may, partly or largely, account for these associations. We found no overall association with other digestive tract and laryngeal cancers.

Background: Various dietary components have been studied in relation to overall mortality; however, little is known about the relationship between the inflammatory potential of overall diet and mortality., Materials and Methods: We examined the association between the dietary inflammatory index (DII) and mortality in the National Health and Nutrition Examination Survey III follow-up study. The DII was computed from baseline dietary intake assessed using 24-h dietary recalls (1988-1994). Mortality was determined from the National Death Index records through 2006. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95 % confidence interval (95 % CI). During the follow-up, 2795 deaths were identified, including 1233 due to cardiovascular disease (CVD), and 615 due to cancer, 158 of which were due to digestive-tract cancers., Results: Multivariate Cox proportional hazards regression analyses, adjusting for age, race, diabetes status, hypertension, physical activity, body mass index, poverty index, and smoking, revealed positive associations between higher DII scores and mortality. Comparing subjects in DII tertile 3 versus tertile 1, significant associations were noted for all-cause mortality (HR Tertile3vs1 1.34; 95 % CI 1.19-1.51, P trend  < 0.0001), CVD mortality (HR Tertile3vs1 1.46; 95 % CI 1.18-1.81, P trend  = 0.0006), cancer mortality (HR Tertile3vs1 1.46; 95 % CI 1.10-1.96, P trend  = 0.01), and digestive-tract cancer mortality (HR Tertile3vs1 2.10; 95 % CI 1.15-3.84, P trend  = 0.03)., Conclusion: These results indicate that a pro-inflammatory diet, as indicated by higher DII scores, was associated with higher risk of all-cause, CVD, and cancer mortality.

Time trends of consumption of the principal food and nutrients in Italy are evaluated in relation with geographic area, using most of the published data. A progressive enrichment was observed for the Italian diet, with an increasing intake of animal proteins, saturated fats and sugars, and a decreasing intake of bread and pasta. Differences of dietary habits among different geographical areas are also decreasing. The main geographical and temporal patterns of digestive sites cancer are in agreement with the above described trends and with the principal hypothesis on nutritional causation of cancer.

Dietary factors are widely considered to be largely responsible for the different cancer incidences observed in different populations. In the present study we investigated the possible influence of dietary habits on the incidence of digestive cancer in the provinces of Spain. Data on specific mortality due to digestive cancer corresponding to the period 1975 to 1985 were obtained from the Instituto Nacional de Estadística. Nutritional data on the different provinces were in turn gathered from the Instituto de Nutrición del Consejo Superior de Investigaciones Científicas. The information was processed by the SPSS statistical software package. Lifestyle and socio-cultural factors are found to influence dietary risk factors in digestive cancer, particularly among women. The most significant correlations with the different cancers studied corresponded to total energy intake (responsible for 27.4% of variance), animal fats, and smoked fish and coffee. The latter is related to oral and esophageal cancer in particular (responsible for 15.4% of variance). Consumption of carrots and frozen vegetables is responsible for 6.5% of variance, vs. 4.4% of variance for alcoholic beverages, sugar, and Vitamin D. Differences are noted between both the sexes and their relationship to the different cancers studied.

Differences in the frequency of consumption of 30 selected foods and in the estimated intake of total calories and selected nutrients in relation to alcohol drinking, tobacco smoking, and education were described using information obtained from 1,774 controls of a case-control study of digestive tract cancers conducted in northern Italy. Heavy alcohol consumption, tobacco smoking, and lower level of education were associated with a diet poorer in several aspects, including lower consumption of fresh fruit and green vegetables and higher intake of specific indicator foods, such as sausages and canned meat. For instance, the mean number of portions of fresh fruit per week was 10.5 among male nondrinkers vs. 9.0 among heavy drinkers, 10.4 among male nonsmokers vs. 8.1 among heavy smokers, and 8.8 in less educated individuals vs. 10.7 among those more educated. Consequently, intake of beta-carotene, ascorbic acid, and calcium tended to be inversely related to alcohol and tobacco and directly related to education. Most associations were stronger in males, for whom alcohol consumption was also more common in less educated individuals. Calorie intake was directly related to alcohol consumption, largely reflecting calories provided by alcohol itself. However, alcohol drinking was also directly related to fat consumption. In both sexes, there was a strong positive correlation between cigarette smoking and coffee drinking. These results provide quantitative documentation that alcohol drinking, tobacco smoking, and education, three of the major determinants of cancer risks, were also correlates of dietary patterns and, hence, may exert an important confounding or modifying effect on the diet and cancer relationship.

The average per capita consumption of certain foods in 29 countries during 1964-66 was related to the average mortality rates for cancers of the oesophagus, stomach and pancreas in these same countries for the period 1978-79. No significant correlation was found between consumption of nutrients from different food groups and mortality rates for oesophageal cancer, with the exception of meat intake in females. Consumption of eggs, milk and particularly meat was inversely related to mortality from stomach cancer in males and females. Caloric and fat intakes from animal sources were also significantly and negatively related to mortality from stomach cancer in both sexes, while caloric intake from vegetable sources was positively associated, particularly in females. The absence of correlation between vegetable fat intake and mortality from stomach cancer strongly suggests carbohydrates as a major caloric source related to stomach cancer. Mortality from pancreatic cancer was strongly and positively related to consumption of eggs, milk and meat in both sexes. Caloric and fat intakes from animal sources had a strong positive correlation with mortality from pancreatic cancer in males and females, while caloric intake from vegetable sources showed a strong negative correlation in both sexes. The weak and not significant correlation of vegetable fat with mortality from pancreatic cancer mortality strongly suggests carbohydrates as a major caloric source related to pancreatic cancer. No significant correlation was found between age-adjusted mortality rates from stomach or pancreatic cancer or a given per capita caloric intake from animal or vegetable source. For both cancers, age-adjusted mortality rates were about twice those of females.

The relationships between areal differences in mortality from six digestive-tract cancers and consumption of selected foods in 46 of the 47 Japanese prefectures (Okinawa being excluded) were analyzed. Statistical analyses disclosed that the groups of foods positively associated with cancer death were as follows: for esophageal cancer, pork, oil, popular-grade sake, and green tea; for stomach cancer, fresh fish, salted or dried fish, salt, and special-grade sake; for colon cancer, bread, milk, butter, margarine, ketchup, beer, and salted or dried fish; for rectal cancer, fresh fish, salted or dried fish, salt, and popular-grade sake; for cancer of the biliary passages, pork, popular-grade sake, and green tea; and for pancreatic cancer, oil, mayonnaise, fresh fish, and salted or dried fish. These results are based on statistical analyses. Further epidemiological analyses are required to find a biological causal relationship.

This study involved 97 male veterans (age range, 45-65) in four approximately equal groups, classified as follows: 1) colon or rectal cancer, 2) upper digestive-tract cancers, 3) other cancers, and 4) additional controls (no cancer). Dietary histories of these cancer and noncancer inpatients were recorded to see whether or not consumption of particular substances could be predictive of cancer. The interactions of substances in combination such as sugar x fat, and alcohol x smoking, proved to be important predictors of cancer of the upper digestive tract. The degree of coffee consumption was a predictor of nondigestive-tract cancer. However, colorectal cancer patients could not be distinguished from non-cancer patients by the dietary variables examined.