by Jenna Koroly, MS, RD, CSOWM, CDN
Lung cancer is associated with smoking, genetic factors, and exposure to carcinogens [Wood et al., 2018 as cited in reference i]. In addition, intake of fruits and vegetables may be protective against lung cancer, while intake of alcohol and red meat may be risk factors [Kushi et al., 2012 as cited in reference i]. The below study explores the relationship between different types of carbohydrates and lung cancer risk.
Journal: Lung Cancer
This prospective study involved over 100,000 participants from the PLCO Cancer Screening Trial. Participants were from 10 cancer screening centers throughout the United States from the years 1993-2001. Individuals completed a baseline questionnaire about demographics, lifestyle including smoking, and medical history, as well as a study update form annually for more than 10 years asking about cancer diagnoses. The Diet Questionnaire (DQX) and The Diet History Questionnaire (DHQ) were also administered [i].
The authors found:
1. A higher percentage of energy intake from carbohydrates and glycemic load were associated with a lower risk of lung cancer
2. Higher intake of fiber was associated with a lower risk of lung cancer in a dose response pattern (30.5 g compared to 8.8 g)
3. Higher intake of whole grains was associated with a lower risk of lung cancer in a dose response pattern (2.3 servings compared to 0.3 servings)
4. Higher intake of carbohydrates from soft drinks and high glycemic index foods were associated with a higher risk of lung cancer
5. There was an even stronger association between intake of carbohydrates, fiber, and whole grains and lower risk of squamous cell carcinoma compared to total lung cancer [i]
For the Patient and Caregiver
The glycemic index (GI) ranks foods by how they influence blood sugar levels after consumption based on a standard amount of carbohydrate, while glycemic load (GL) is the GI multiplied by the amount of carbohydrate in a serving of food. For more information, check out this article on GI and GL, and this article on GI foods, both from Harvard Health. Consider the types of carbohydrates you consume, and if they are mostly carbohydrates rich in fiber such as vegetables, fruits, whole grains, and beans and lentils compared to processed foods with a lot of added sugars. For more information on nutrition during cancer treatment, take a look at this article.
For the Healthcare Team
Low GI foods contain fiber, and this fiber may play a role in the immune response via gut microbiota and regulation of secretion of insulin-like growth factors, which is related to cell proliferation [Klement & Kammerer, 2011 and London et al., 2002 as cited in reference i]. Specifically, when fiber moves into the large intestine, it is fermented by gut microbes, producing short chain fatty acids (SCFAs), which stabilize insulin secretion, and have a role in anti-inflammatory pathways, cytokine production, and immune response — all a part of the body’s anticancer defense mechanism [Lattimer & Haub, 2010 and Anand & Mande, 2018 as cited in reference i]. These SCFAs make gut microbiota that may have an effect on “respiratory inflammation and immune response through the gut-lung axis” [Anand & Mande, 2018 and Tao et al., 2019 as cited in reference i].
[i] Tao J, Jatoi A, Crawford J, Lam WWT, Ho JC, Wang X, and Pang H. (2021). Role of dietary carbohydrates on risk of lung cancer. Lung Cancer. https://doi.org/10.1016/j.lungcan.2021.03.009