Role of Age and Sex on Simple and Complex Carbohydrates Rich Foods Consumption and Thyroid Cancer Risk: Hospital Based Case - Control Study

Maria Fiore1, *, Antonio Cristaldi1, Valeria Okatyeva1, Salvatore Lo Bianco1, Gea Oliveri Conti1, Pietro Zuccarello1, Chiara Copat1, Rosario Caltabiano1, Matteo Cannizzaro1, Margherita Ferrante1
1 Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Santa Sofia, 87 – 95123 Catania, Italy

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© 2021 Fiore et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Santa Sofia, 87 – 95123 Catania, Italy; Tel: 39+95+3782188; Fax: 39+95+3782177; E-mail:



The risk of thyroid cancer has already been related to diet/carbohydrates rich foods, but the association has not been investigated in terms of age and sex implications.


We studied the relationship between thyroid cancer and the consumption of simply and complex carbohydrates rich foods, mainly investigating the possible predictive role of age and sex.


We analyzed data from a hospital case-control study conducted in Italy from 2015 to 2018, including 106 cases of thyroid cancer and 121 controls. The consumption of simple and complex carbohydrates rich foods was investigated through the validated Lifestyles Questionnaire using a 4-level scale (never, 1 time per week, 2–3 times a week, 6 times a week). Statistical data analysis was conducted using the IBM SPSS Statistics 21.0 program.


We found a moderate negative correlation between simple carbohydrates rich foods consumption and age (rho= -0.364, p:0.00), particularly in females (females: rho= -0.374, p:0.00; males: rho=-0.266, p=0.036). A weak positive correlation was found between age and complex carbohydrates-rich foods only in males (rho= 0.244, p=0.054). The Two-Way Analysis of Variance confirmed that, overall, simple carbohydrates rich foods consumption decreased with age categories (Case: F=2.59, p=0.032; Control: F=3.14, p=0.011), although it remains higher for female than male cases at all age categories (≤38, 39-52, 53+years). Conversely the complex carbohydrates rich foods intake had interaction with age categories only in controls group (Control: F=1.95, p=0.09; Case: F=0.744, p=0.592), where based on sex, it remains higher for female than male at ≤38 and 39-52 age categories. It should be emphasized that in category ≤38 we had only one male cases.


Our study adds new and relevant information to support the hypothesis that age and sex could impact the thyroid cancer risk by their involvement in simple carbohydrates rich foods consumption. Therefore, future interventions are needed for an understanding of the pathophysiological associations between only carbohydrates rich foods intake and thyroid cancer, mainly for older and female populations, and also for the improvement of preventive public health policies and “Gender Medicine”.

Keywords: Age, Sex, Simply and complex carbohydrates rich foods, Thyroid cancer risk, Case-control study, Epidemiology.