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      Carbohydrate Nutrition and the Risk of Cancer


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          Purpose of Review

          This review summarizes a selection of epidemiologic research assessing the associations between carbohydrate intake and cancer incidence and survival. Evidence for plausible biological mechanisms is also considered.

          Recent Findings

          The mechanistic paradigm explaining the relationship between carbohydrates and cancer risk has been contested by numerous observational studies.


          Carbohydrates have conventionally been ascribed a deleterious role in the field of cancer research due to previous preclinical findings. A breadth of studies suggests that complex carbohydrate intake is inversely associated with risk of a number of cancer types. Data from studies assessing simple carbohydrates and cancer risk are mixed. Furthermore, recommendations for subsequent studies are framed.

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          Most cited references 64

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          Circulating concentrations of insulin-like growth factor-I and risk of breast cancer.

          Insulin-like growth factor (IGF)-I, a mitogenic and antiapoptotic peptide, can affect the proliferation of breast epithelial cells, and is thought to have a role in breast cancer. We hypothesised that high circulating IGF-I concentrations would be associated with an increased risk of breast cancer. We carried out a nested case-control study within the prospective Nurses' Health Study cohort. Plasma concentrations of IGF-I and IGF binding protein 3 (IGFBP-3) were measured in blood samples collected in 1989-90. We identified 397 women who had a diagnosis of breast cancer after this date and 620 age-matched controls. IGF-I concentrations were compared by logistic regression with adjustment for other breast-cancer risk factors. There was no association between IGF-I concentrations and breast-cancer risk among the whole study group. In postmenopausal women there was no association between IGF-I concentrations and breast-cancer risk (top vs bottom quintile of IGF-I, relative risk 0.85 [95% CI 0.53-1.39]). The relative risk of breast cancer among premenopausal women by IGF-I concentration (top vs bottom tertile) was 2.33 (1.06-5.16; p for trend 0.08). Among premenopausal women less than 50 years old at the time of blood collection, the relative risk was 4.58 (1.75-12.0; p for trend 0.02). After further adjustment for plasma IGFBP-3 concentrations these relative risks were 2.88 and 7.28, respectively. A positive relation between circulating IGF-I concentration and risk of breast cancer was found among premenopausal but not postmenopausal women. Plasma IGF-I concentrations may be useful in the identification of women at high risk of breast cancer and in the development of risk reduction strategies. Additional larger studies of this association among premenopausal women are needed to provide more precise estimates of effect.
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            Hypoxia-inducible factor 1: master regulator of O2 homeostasis.

            Hypoxia-inducible factor 1 (HIF-1) is a transcription factor that mediates essential homeostatic responses to reduced O2 availability in mammals. Recent studies have provided insights into the O2-dependent regulation of HIF-1 expression, target genes regulated by HIF-1, and the effects of HIF-1 deficiency on cellular physiology and embryonic development.
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              Is Akt the "Warburg kinase"?-Akt-energy metabolism interactions and oncogenesis.

              The serine/threonine kinase Akt - also known as protein kinase B (PKB) - has emerged as one of the most frequently activated protein kinases in human cancer. In fact, most, if not all, tumors ultimately find a way to activate this important kinase. As such, Akt activation constitutes a hallmark of most cancer cells, and such ubiquity presumably connotes important roles in tumor genesis and/or progression. Likewise, the hypermetabolic nature of cancer cells and their increased reliance on "aerobic glycolysis", as originally described by Otto Warburg and colleagues, are considered metabolic hallmarks of cancer cells. In this review, we address the specific contributions of Akt activation to the signature metabolic features of cancer cells, including the so-called "Warburg effect".

                Author and article information

                217-244-4890 , aarthur@illinois.edu
                Curr Nutr Rep
                Curr Nutr Rep
                Current Nutrition Reports
                Springer US (New York )
                20 March 2019
                20 March 2019
                : 8
                : 3
                : 230-239
                [1 ]ISNI 0000 0004 1936 9991, GRID grid.35403.31, Division of Nutritional Sciences, , University of Illinois at Urbana-Champaign, ; 905 S Goodwin Ave, 386 Bevier Hall, Urbana, IL 61801 USA
                [2 ]ISNI 0000 0004 1936 9991, GRID grid.35403.31, Department of Food Science and Human Nutrition, , University of Illinois at Urbana-Champaig, ; Urbana, IL USA
                [3 ]ISNI 0000 0004 0476 3224, GRID grid.413441.7, Carle Cancer Center, , Carle Foundation Hospital, ; Urbana, IL USA
                © The Author(s) 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                Cancer (MF Leitzmann, Section Editor)
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                © Springer Science+Business Media, LLC, part of Springer Nature 2019


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