'Spare Tire' Increases Cancer Risk More Than High BMI and Fat Percentage

More than overweight alone, central obesity — defined as  high ratio of trunk fat to peripheral fat — places postmenopausal women at a higher risk for cancer diagnosis, according to a study.

"The findings put a new spin on weight management priorities for women in this age group, who are prone to abdominal weight gain," said study investigator.

In assessing cancer risk, body mass index (BMI) and fat percentage may not be adequate measures because they fail to assess the distribution of fat mass, she explained. "Fat is not just fat, but where in your body it is stored is significant," she added.

"Our study shows that avoiding central obesity may confer the best protection," she said.

The Danish Study and Results

The Prospective Epidemiologic Risk Factor study was an observational, prospective cohort study designed to improve understanding of age-related diseases in postmenopausal women. From 1999 to 2001, 5855 women (mean age, 71 years) were enrolled. Investigators accessed medical and demographic background information. Dual-energy x-ray absorptiometry (DXA) was performed at time of enrollment. DXA scans are the most accurate way to measure bone mass, bone-free lean mass, and fat mass, the authors note.

Data were sub-grouped into three different categories: breast/ovarian cancer, lung/gastrointestinal cancer, and other cancers. Cox proportional hazard regression models were used to examine the association between body fat distribution and the risk for cancer incidence, adjusted for standard risk factors, including BMI.
  
Cancer diagnoses and information on death causes were obtained from different registries up to 2012. Mean follow-up was 12 years.

Using information from national cancer registries, the study investigators reported 811 solid cancers in the women and showed that central obesity was a significant independent predictor of cancer diagnosis up to 12 years after baseline (hazard ratio [HR], 1.30; 95% confidence interval [CI], 1.11 to 1.52; P < .001). Surprisingly, researcher noted, neither BMI nor fat percentage posed a significant risk for cancer diagnoses.

Specifically, there were 293 breast and ovarian cancers, 345 lung and gastrointestinal cancers, and 173 other cancers. Among these cancer groups, central obesity was a risk for only lung and gastrointestinal cancer diagnoses (HR, 1.42; P < .01).

Researcher was also surprised that central obesity was not an independent risk factor for breast and ovarian cancer diagnoses.

Looking in detail at specific cancers and risk factors, the investigators determined that only lung and gastrointestinal cancers were associated with central obesity (for lung cancer: HR, 1.68 [95% CI, 1.12 - 2.53; P < .05]; for gastrointestinal cancer: HR, 1.34 [95% CI, 1 to 1.8; P < .05]).
 
Additional cancer risk factors were older age, receipt of hormone replacement therapy, and smoking, but after adjustment for these risk factors, fat ratio remained an independent risk factor, the study authors reported.

"The average elderly women can very much use this information, as it is known that the menopause transition initiates a shift in body fat towards the central trunk area. Therefore, elderly women should be especially aware of their lifestyle when they approach the pre-menopause age," researcher said.

"Clinicians can additionally use the information for a preventive conversation with women who are in higher risk of cancer. While clinicians have access to whole-body DXA scanners at most hospitals, portable DXA scanners have become available on the commercial market, and this may allow regional bone and fat scanning. However, it may not be the most reliable for measuring central obesity," she concluded.

The study  provides important confirmation of the role of obesity and particularly insulin resistance in the etiology of several cancers.

"While obesity has previously been linked to cancer risk, the link to lung cancer is new and intriguing," he said in a statement.

 "Increases in insulin, resulting from over-consumption of simple carbohydrates, such as potatoes, wheat, rice, and corn, result in fat accumulation that is specifically visceral and abdominal," Dr explained. Insulin also has detrimental effects on hormone production, and adipose cells in fat tissue increase chronic inflammation throughout the body, another risk factor for several cancers.

"These data open the door for clinicians to initiate a number of interventions in obese patients. In addition to fat loss with diet and exercise, there may be a potential role for a diabetes drug, such as metformin, which can lower insulin effects and contribute to cancer prevention," Dr  said.

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Obese Teens At Risk Of Permanent Bone Loss

It has been found that overweight status in teenagers may lead to long term bone attrition.

Teens who also happen to be overweight may be causing permanent damage to their skeletal system. This has been proved by the results of a novel study.

Obesity is a scourge of modern existence. It is associated with CV disease and diabetes among youngsters and adolescents. The more weight our younger generation has the greater the load on their bones which then tend to degenerate and deform. 

Earlier, obesity was instead thought to protect bone health. Yet the recent evidence on the contrary proves the trend to be otherwise. Many adolescents have forearm fractures due to their obese status.
 
The exact link between obesity and bone health in youth was what the scientists set out to gauge in a formal manner. 23 obese teenagers were recruited to take part in the experiment.

The average age was 17 years. BMI was approximately 44 kg/m2. Adolescence is a time when the bone density is at its max so bone loss during this period in one’s life is a serious cause for concern. 

Such conditions which are the opposite of obesity such as anorexia nervosa are also linked to increased chances of fractures. This tendency of bone breakage remains constant throughout one’s mature years.

Even with the conquest of health via a normalization of body weight, the problem persists. So, this issue needs attention early onwards. The experts performed a sort of computerized tomography exam to diagnose the condition.

It gauged bone mineral density and microfractures in the bones. Also dual-energy x-ray absorptiometry (DXA) was used to go in depth into this condition. Both lean mass and visceral fat were determined in the body composition tests which took place. 

Visceral fat surrounds the internal organs of the human body. Visceral fat has a bad effect on the bones. It lets loose a volley of chemicals that cause inflammation.

This in turn leads to osteoclasts which are cellular structures that break down the bones. Even vitamin D which is essential for the bones gets trapped in this fat. Also growth hormone is lowered in overweight adolescents.

 The bones and the hormones not to mention one’s general BMI all determine the outcome for the long term. Especially high visceral fat and low lean muscle mass led to a loss of bone. These findings will help shape future policy regarding teenagers and the obesity epidemic.

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