Bread Consumption and Cancer Risk: Systematic Review and Meta-Analysis of Prospective Cohort Studies

Because bread can contain potential carcinogens such as acrylamide, and is widely consumed, we conducted a systematic review and meta-analysis to determine whether bread consumption is associated with increased cancer risk. PubMed and Medline databases were searched up to 1 March 2024, for studies t...

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Main Authors: Glenn A Gaesser, Siddhartha S Angadi, Craig Paterson, Julie Miller Jones
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Current Developments in Nutrition
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Online Access:http://www.sciencedirect.com/science/article/pii/S2475299124024351
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author Glenn A Gaesser
Siddhartha S Angadi
Craig Paterson
Julie Miller Jones
author_facet Glenn A Gaesser
Siddhartha S Angadi
Craig Paterson
Julie Miller Jones
author_sort Glenn A Gaesser
collection DOAJ
description Because bread can contain potential carcinogens such as acrylamide, and is widely consumed, we conducted a systematic review and meta-analysis to determine whether bread consumption is associated with increased cancer risk. PubMed and Medline databases were searched up to 1 March 2024, for studies that provided hazard ratios (HRs) (or similar) for bread consumption and cancer incidence or mortality. Only prospective cohort studies were included. We used the Preferred Reporting Items of Systematic reviews and Meta-Analyses checklist. Meta-analysis was performed with Cochrane’s RevMan 5.4.1 software using a DerSimonian–Laird random-effects model. Heterogeneity was assessed with Cochrane’s Q (χ2) and I2 statistics, and publication bias was assessed with Egger’s test. Twenty-four publications met inclusion criteria, including 1,887,074 adults, and were included in the systematic review. Ten publications that provided HRs were included in the meta-analysis for highest compared with lowest intakes, and an additional 7 publications that provided mortality or incident rate ratios or relative risks were included in supplemental meta-analyses. Of 108 reported HRs (or similar), 97 (79%) were either not statistically significant (n = 86) or indicated lower cancer risk (n = 11) associated with the highest intakes of bread. The meta-analysis indicated that bread intake was not associated with site-specific cancer risk [HR: 1.01; 95% confidence interval (CI): 0.89, 1.14; P = 0.92; 8 publications] or total cancer mortality (HR: 0.90; 95% CI: 0.73, 1.11; P = 0.32; 2 publications). Supplemental meta-analyses using all risk estimates in addition to HRs confirmed these findings. Whole-grain bread was associated with a lower site-specific cancer risk, mainly because of reduced colorectal cancer risk. Results of the systematic review and meta-analysis indicate that bread consumption is not associated with increased site-specific cancer risk, whereas high whole-grain/nonwhite bread consumption is associated with lower total cancer mortality and colorectal cancer risk.This study was registered at Clinical Trials Registry of PROSPERO as registration number CRD42023414156.
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spelling doaj-art-9b42e055c46b4ad2bbbd03e00a5e9e0e2024-12-26T08:56:56ZengElsevierCurrent Developments in Nutrition2475-29912024-12-01812104501Bread Consumption and Cancer Risk: Systematic Review and Meta-Analysis of Prospective Cohort StudiesGlenn A Gaesser0Siddhartha S Angadi1Craig Paterson2Julie Miller Jones3College of Health Solutions, Arizona State University, Phoenix, AZ, United States; Corresponding author.Department of Kinesiology, University of Virginia, Charlottesville, VA, United StatesPopulation Health Sciences, Bristol Medical School, University of Bristol, United KingdomDepartment of Family, Consumer, and Nutritional Science, St. Catherine University, Minneapolis, MN, United StatesBecause bread can contain potential carcinogens such as acrylamide, and is widely consumed, we conducted a systematic review and meta-analysis to determine whether bread consumption is associated with increased cancer risk. PubMed and Medline databases were searched up to 1 March 2024, for studies that provided hazard ratios (HRs) (or similar) for bread consumption and cancer incidence or mortality. Only prospective cohort studies were included. We used the Preferred Reporting Items of Systematic reviews and Meta-Analyses checklist. Meta-analysis was performed with Cochrane’s RevMan 5.4.1 software using a DerSimonian–Laird random-effects model. Heterogeneity was assessed with Cochrane’s Q (χ2) and I2 statistics, and publication bias was assessed with Egger’s test. Twenty-four publications met inclusion criteria, including 1,887,074 adults, and were included in the systematic review. Ten publications that provided HRs were included in the meta-analysis for highest compared with lowest intakes, and an additional 7 publications that provided mortality or incident rate ratios or relative risks were included in supplemental meta-analyses. Of 108 reported HRs (or similar), 97 (79%) were either not statistically significant (n = 86) or indicated lower cancer risk (n = 11) associated with the highest intakes of bread. The meta-analysis indicated that bread intake was not associated with site-specific cancer risk [HR: 1.01; 95% confidence interval (CI): 0.89, 1.14; P = 0.92; 8 publications] or total cancer mortality (HR: 0.90; 95% CI: 0.73, 1.11; P = 0.32; 2 publications). Supplemental meta-analyses using all risk estimates in addition to HRs confirmed these findings. Whole-grain bread was associated with a lower site-specific cancer risk, mainly because of reduced colorectal cancer risk. Results of the systematic review and meta-analysis indicate that bread consumption is not associated with increased site-specific cancer risk, whereas high whole-grain/nonwhite bread consumption is associated with lower total cancer mortality and colorectal cancer risk.This study was registered at Clinical Trials Registry of PROSPERO as registration number CRD42023414156.http://www.sciencedirect.com/science/article/pii/S2475299124024351dietwhole-grainrefined graingrainsgrain foodsbaked goods
spellingShingle Glenn A Gaesser
Siddhartha S Angadi
Craig Paterson
Julie Miller Jones
Bread Consumption and Cancer Risk: Systematic Review and Meta-Analysis of Prospective Cohort Studies
Current Developments in Nutrition
diet
whole-grain
refined grain
grains
grain foods
baked goods
title Bread Consumption and Cancer Risk: Systematic Review and Meta-Analysis of Prospective Cohort Studies
title_full Bread Consumption and Cancer Risk: Systematic Review and Meta-Analysis of Prospective Cohort Studies
title_fullStr Bread Consumption and Cancer Risk: Systematic Review and Meta-Analysis of Prospective Cohort Studies
title_full_unstemmed Bread Consumption and Cancer Risk: Systematic Review and Meta-Analysis of Prospective Cohort Studies
title_short Bread Consumption and Cancer Risk: Systematic Review and Meta-Analysis of Prospective Cohort Studies
title_sort bread consumption and cancer risk systematic review and meta analysis of prospective cohort studies
topic diet
whole-grain
refined grain
grains
grain foods
baked goods
url http://www.sciencedirect.com/science/article/pii/S2475299124024351
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