Body Fat and the High BMI – Which Cancers place you at risk?
You’ve heard it.
Everyone says it.
But, now it’s time to see where the rumors match the facts.
Overweight lifestyles or maintaining a high body fat body increases your risk directly for specific cancers (Britton et al., 2013; Folsom, 1993). Let’s name them.
High body mass index (BMI) causes kidney cancer (Obesity and Cancer Risk, 2012).
Overweight bodies cause cancer of the pancreas (Obesity and Cancer Risk, 2012).
Thyroid cancer has high BMI as a direct, biological causal risk (Obesity and Cancer Risk, 2012).
Overweight bodies cause cancer of the gallbladder (Obesity and Cancer Risk, 2012).
High body mass index (BMI) causes colon and rectum cancer (Obesity and Cancer Risk, 2012).
Esophagus cancer has high BMI as a direct, biological causal risk (Obesity and Cancer Risk, 2012).
The lining of the uterus or endometrium and breast cancer in post-menopausal women are directly linked to the lifestyle risk of being overweight (Austin, Austin, Partridge, Hatch & Shingleton, 1991; Obesity and Cancer Risk, 2012; Irwin et al., 2005; Morimoto et al., 2002).
Still another overweight-linked risk for cancer added recently was ovarian cancer (Ovarian Cancer 2014 Report: Food, Nutrition, Physical Activity, and the Prevention of Ovarian Cancer, 2014).
Okay, it’s clear living a life overweight, not just obese, will cause cancer. Overweight is a BMI 25.0 – 29.9 kg/m2 (Obesity and Cancer Risk, 2012). You can easily calculate this by converting your weight to kilograms and dividing it by the square of your height (in meters).
So, if your weight is 200 pounds, and your height is 6 feet, then your weight is 90.7 kg, and your height is 1.83 meters or (1.83)2= 3.34 (when squared). 90.7/3.34 = 27.2 BMI, which is clearly overweight.
If your weight is 160 pounds, and your height is 5 feet, 5 inches, then your weight is 72.6 kg, and your height is 1.65 meters or (1.65)2 = 2.72 (when squared). 72.6 kg/2.72 = 26.7 BMI, which is clearly overweight, as well.
So, this matter of the overweight condition, let alone obesity, is a serious risk for many forms of cancer!
Body fat is most associated with cancer risk when it is displaced over the abdomen where the visceral fat apron drapes over most of the organs and swells to create the classic apple-shaped body (Canoy, et al., 2007; Sellers et al., 1993; Swanson et al., 1993; Schapira et al., 1991; Ballard-Barbash et al., 1990). Statistically, greater than 50% of the population is included in this description.
Estrogen and testosterone hormone influence the locations of fat deposits with greater intensity as we age. Indeed, one study discovered that women who have body fat displaced below the abdomen (around the waist, i.e. pear-shaped) seem to have a protective benefit that is temporary only before menopause (Sonnenschein et al., 1999).
Why is it that so many cancers are directly linked to high BMI and the overweight condition? There are many explanations.
The most direct explanation is fat-engorged cells struggle with a chemical response, inflammation cycle; mildly inflamed cells from swollen fat in the membranes stimulate a persistent immune response that should not otherwise be present. Insulin resistance (a known association with the overweight condition) then develops at the cellular membrane, which is the early stage of type 2 diabetes (Chamberlain, Rhinehart, Shaefer & Neuman, 2016).
The unending state of low-grade inflammation prevents the cell’s immune system properties from detecting flaws as the cell constantly regenerates. The cellular stress response is the scientific term that describes this process (Herr & Debatin, 2001). Uncontrollable growth in flawed cellular tissue is the start of cancer. Normally, the body repels the start of cancer on average about 21 times a year, catches these uncontrollable, flawed growths, and stops the process.
One “gets cancer” when this safety check system is preoccupied with fat-engorged cells.
5% is the risk factor that body fat and an overweight BMI contribute to the total risk for cancer, as if the smaller percentile number could be considered a blessing (Calle, EE & Kaaks, 2004). That said body fat reduction is one of the only risk factors an individual can modify other than smoking to decrease the chance of dying from the cancers noted above.
Indeed, cancer is caused by many unchangeable factors such as genetics. But, modifying the diet, adding a moderate exercise plan and stopping smoking are fully within a person’s grasp, and control as proven tools to reduce the risk of cancer (Irwin et al., 2009; Winningham, MacVicar, Bondoc, Anderson, & Minton, 1988).
Walking or climbing stairs or completing aerobics for twenty or thirty minutes a day can become creative additions to the regular ritual (Irwin et al., 2003). Habits can be planned for the day; consider riding the bicycle to work instead of driving, walking all the stairs instead of using the elevator, and walking to the fast food store instead of driving as easy additions to daily activities.
Similarly, diet can become a habit. Create repetition and soon it is a habit.
Make Mondays a lentil and fresh vegetables day. Tuesday’s a chicken day. Or, if you prefer no meat, try tofu and eggplant. Consider supplementing the bulk of the diet with smoothies, which also provide an easy solution to the current federal dietary guidelines that require a 5-portion-a-day fruit and vegetable regimen (Dietary Guidelines, 2015).
Modify the diet to limit calories, and avoid all food from fast food stores, sugar-based sodas, and low-fiber, refined foods or saturated (butter, cheese) fats (Calle, EE & Kaaks, 2004). Processed meats like hot dogs, ham, and bacon, which are smoked, cured, salted or chemically preserved and red meats must be replaced by white meats like chicken, turkey, unsalted pork and fish (West et al., 1998).
Add a little song to it and your repeated habit is an ingrained ritual. At one time, there was a song which described this thoroughly, “This the day we wash the clothes, wash the clothes, wash the clothes (repeat)….early Monday morning. This is the day we scrub the floors (repeat)…early Tuesday morning.”
Austin, H., Austin, J. M., Partridge, E. E., Hatch, K. D., & Shingleton, H. M. (1991). Endometrial cancer, obesity, and body fat distribution. Cancer research, 51(2), 568-572. Retrieved March 20, 2016 from http://cancerres.aacrjournals.org/content/51/2/568.full.pdf
Ballard-Barbash, R., Schatzkin, A., Carter, C. L., Kannel, W. B., Kreger, B. E., D’Agostino, R. B., … & Helsel, W. E. (1990). Body fat distribution and breast cancer in the Framingham Study. Journal of the National Cancer Institute, 82(4), 286-290. doi: 10.1093/jnci/82.4.286
Britton, K. A., Massaro, J. M., Murabito, J. M., Kreger, B. E., Hoffmann, U., & Fox, C. S. (2013). Body fat distribution, incident cardiovascular disease, cancer, and all-cause mortality. Journal of the American College of Cardiology, 62(10), 921-925.doi:10.1016/j.jacc.2013.06.027
Calle, EE & Kaaks, R. (2004). Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nature Reviews Cancer. 4: 579-91. DOI:10.1038/nrc1408.
Canoy, D., Boekholdt, S. M., Wareham, N., Luben, R., Welch, A., Bingham, S., … & Khaw, K. T. (2007). Body Fat Distribution and Risk of Coronary Heart Disease in Men and Women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk Cohort A Population-Based Prospective Study. Circulation, 116(25), 2933-2943. doi: 10.1161/CIRCULATIONAHA.106.673756
Chamberlain JJ, Rhinehart AS, Shaefer CF & Neuman A. (2016). Diagnosis and Management of Diabetes: Synopsis of the 2016 American Diabetes Association Standards of Medical Care in Diabetes. Ann Intern Med. [Epub ahead of print 1 March 2016] doi:10.7326/M15-3016
Dietary Guidelines. (2015). Scientific Report of the 2015 Dietary Guidelines Advisory Committee. Office of Disease Prevention and Health Promotion. Retrieved March 20, 2016 from http://www.health.gov/dietaryguidelines/2015-scientific-report/
Folsom, A. R., Kaye, S. A., Sellers, T. A., Hong, C. P., Cerhan, J. R., Potter, J. D., & Prineas, R. J. (1993). Body fat distribution and 5-year risk of death in older women. Jama, 269(4), 483-487. Retrieved March 20, 2016 from doi:10.1001/jama.1993.03500040049035
Herr, I., & Debatin, K. M. (2001). Cellular stress response and apoptosis in cancer therapy. Blood, 98(9), 2603-2614. Doi: 10.1182/blood.V98.9.2603
Irwin, M. L., Alvarez‐Reeves, M., Cadmus, L., Mierzejewski, E., Mayne, S. T., Yu, H., … & DiPietro, L. (2009). Exercise improves body fat, lean mass, and bone mass in breast cancer survivors. Obesity, 17(8), 1534-1541.DOI: 10.1038/oby.2009.18
Irwin, M. L., McTiernan, A., Baumgartner, R. N., Baumgartner, K. B., Bernstein, L., Gilliland, F. D., & Ballard-Barbash, R. (2005). Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic, and lifestyle factors. Journal of Clinical Oncology, 23(4), 774-782. Retrieved March 20, 2016 from https://jco.ascopubs.org/content/23/4/774.full
Irwin, M. L., Yasui, Y., Ulrich, C. M., Bowen, D., Rudolph, R. E., Schwartz, R. S., … & McTiernan, A. (2003). Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. Jama, 289(3), 323-330.doi:10.1001/jama.289.3.323
Morimoto, L. M., White, E., Chen, Z., Chlebowski, R. T., Hays, J., Kuller, L., … & Stefanick, M. L. (2002). Obesity, body size, and risk of postmenopausal breast cancer: the Women’s Health Initiative (United States). Cancer Causes & Control, 13(8), 741-751. Retrieved March 20, 2016 from https://www.researchgate.net/profile/Ana_Maria_Lopez/publication/8249611_Obesity_body_size_and_risk_of_postmenopausal_breast_cancer_the_Women’s_Health_Initiative_%28United_States%29/links/0046353cd7394af9a9000000.pdf
Obesity and Cancer Risk. (2012). National Cancer Institute at the National Institutes of Health. Retrieved March 20, 2016 from http://www.cancer.gov/cancertopics/factsheet/Risk/obesity
Ovarian Cancer 2014 Report: Food, Nutrition, Physical Activity, and the Prevention of Ovarian Cancer (2014). The American Institute for Cancer Research and the World Cancer Research Fund. Retrieved March 20, 2016 from http://www.aicr.org/continuous-update-project/reports/ovarian-cancer-2014-report.pdf
Sellers, TA, Gapstur, SM, Potter, JD, Kushi, LH, Bostick, RM, and Folsom, AR. (1993). Association of Body Fat Distribution and Family Histories of Breast and Ovarian Cancer with Risk of Postmenopausal Breast Cancer. Am. J. Epidemiol, 138 (10), 799-803.
Schapira, D. V., Kumar, N. B., Lyman, G. H., Cavanagh, D., Roberts, W. S., & LaPolla, J. (1991). Upper-body fat distribution and endometrial cancer risk. Jama, 266(13), 1808-1811. doi:10.1001/jama.1991.03470130088034
Sonnenschein, E., Toniolo, P., Terry, M. B., Bruning, P. F., Kato, I., Koenig, K. L., & Shore, R. E. (1999). Body fat distribution and obesity in pre-and postmenopausal breast cancer. International Journal of Epidemiology, 28(6), 1026-1031.doi: 10.1093/ije/28.6.1026
Swanson, C. A., Potischman, N., Wilbanks, G. D., Twiggs, L. B., Mortel, R., Berman, M. L., … & Brinton, L. A. (1993). Relation of endometrial cancer risk to past and contemporary body size and body fat distribution. Cancer Epidemiology Biomarkers & Prevention, 2(4), 321-327. Retrieved March 20, 2016 from http://cebp.aacrjournals.org/content/2/4/321.full.pdf+html
West, D. B., Delany, J. P., Camet, P. M., Blohm, F., Truett, A. A., & Scimeca, J. (1998). Effects of conjugated linoleic acid on body fat and energy metabolism in the mouse. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 275(3), R667-R672. Retrieved March 20, 2016 from http://ajpregu.physiology.org/content/275/3/R667.full.pdf
Winningham, M. L., MacVicar, M. G., Bondoc, M., Anderson, J. I., & Minton, J. P. (1988, December). Effect of aerobic exercise on body weight and composition in patients with breast cancer on adjuvant chemotherapy. In Oncology nursing forum (Vol. 16, No. 5, pp. 683-689). (PMID:2780404)