Endometrial cancer is a hormone-dependent disease and has been consistently associated with obesity. Non genetic lifestyle factors may account for more than 75% of endometrial cancer cases and represent potential targets for prevention of this disease. Insulin resistance induced by diet may play a particularly pernicious role in the development of endometrial cancer, possibly by reducing levels of sex-hormone binding globulin and insulin like growth factor binding proteins. Increases in IGF-1 are known to stimulate cell proliferation and differentiation, inhibit apoptosis, and promote tumor angiogenesis. Increases in expression of proteins involved in glucose transport and breakdown may promote tumor cell survival. Therefore there was a potential role for the glycemic nature of a diet in the incidence of endometrial cancer. The aim of this review article is to study the role of dietary glycemic index (GI), glycemic load, and the risk of endometrial cancer.
Materials and methods
This review article prepared by studying articles obtained from Google and PubMed sites with key words such as endometrial cancer; insulin resistance; diet and glycemic index.
The relationship of dietary GI or GL and endometrial cancer risk yielded contradictory findings. In case-control studies, there was a positive association of GI with endometrial Cancer. But in cohort studies this association was much weaker or absent. Almost all studies observed a null association between total carbohydrate intake and endometrial cancer. The pooled results from observational studies in Australia supported an increased risk for high GL, but not GI. The result of a recent study in China conducted among 30–69 year old residents recruited between 1997 and 2003, showed intake of high GL or GI foods, but not carbohydrates per se, may increase risk for endometrial cancer. The positive GL–cancer association was reported to be more pronounced among premenopausal women, obese women, and non diabetic women
This review suggested that maintaining lower intake of foods with a high GL value may reduce the risk of endometrial cancer.