Obesity Raises Odds for Many Common Cancers

Steven Reinberg wrote . . . . . . . . .

Being obese or overweight can increase the odds of developing several types of cancers, new research from the United Kingdom reveals.

But shedding the excess pounds can lower the risk, researchers say.

Reducing obesity cuts the risk for endometrial cancer by 44% and uterine cancer by 39%, and could also prevent 18% of kidney cancers and 17% of stomach and liver cancers, according to the study.

“It all depends on keeping the weight off,” said lead researcher Carlos Celis-Morales of the BHF Institute of Cardiovascular and Medical Sciences at the University of Glasgow in Scotland. He noted that many people lose weight only to regain it back — and then some.

“What we need is kind of a long-term healthy weight and people that achieve that will reduce the risk,” Celis-Morales said. “That is why it’s so important that people improve the quality of their lifestyle in order to keep a healthy body weight.”

He cautioned, however, that this study can’t prove that excess weight causes cancer or that losing weight prevents it, only that there seems to be a strong connection between excess weight and cancer risk.

For the study, Celis-Morales and his colleagues drew on data from the U.K. Biobank on more than 400,000 men and women who were cancer-free.

The investigators wanted to know the risk of developing and dying from 24 cancers based on six markers of obesity: body fat percentage, waist-to-hip ratio, waist-to-height ratio, waist and hip circumferences and body mass index (BMI), an estimate of body fat based on height and weight.

No matter which way it was measured, obesity increased the odds of developing 10 of the most common cancers, the study found. A larger waist and hips, BMI or percentage of body fat all provided similar cancer risk.

Celis-Morales said BMI is an adequate way to gauge weight-related cancer risk, and there’s no benefit in turning to more complex or costly measures such as waist size or body fat percentage.

For example, a BMI score of 24.9 is considered normal, and every addition of about 4 for men and 5 for women above 25 was linked a 3% higher risk of cancer overall.

It also increased the risk of cancers of the stomach (35%), gallbladder (33%), liver (27%), kidney (26%), pancreas (12%), colon (10%), and bladder (9%).

That same amount of excess weight was also associated with a sharply higher odds of two cancers affecting women — 73% for endometrial cancer and 68% for uterine cancer. It also was linked to an 8% increase for postmenopausal breast cancer.

Lauren Teras, scientific director for epidemiology research at the American Cancer Society, reviewed the findings.

“Some of the ways in which obesity is thought to impact cancer includes elevated levels of sex hormones such as estrogen and progesterone, also insulin-related growth factors and leptin and adiponectin, which are proteins given off by fat tissue,” she said.

Despite strong evidence that excess weight boosts risk for many cancers, less is known about whether losing weight can successfully reverse it, Teras said.

“This is likely because losing weight in adulthood is relatively uncommon, making it difficult to study,” she said. “However, several studies of patients undergoing major weight-loss surgeries have found lower risk of several types of cancer in these patients.”

Maintaining a normal weight, eating a balanced diet and being physically active are beneficial for many aspects of health, Teras said.

“My advice is to find a plan that works for you and stick with it until it becomes a habit,” she suggested. “To increase your physical activity, do what sounds fun to you. Eat a diet that is customized to your preferences, but includes fruits, vegetables and whole grains. Limit portion sizes.”

Then find an accountability partner to keep you on track. “We’re all more likely to succeed when we have support,” Teras said.

The findings were published in the journal BMC Medicine.

Source: HealthDay

In Breast Cancer Survivors, Obesity Raises Odds for Cancer’s Return

Cara Murez wrote . . . . . . . . .

Most people know obesity can lead to diabetes or heart disease, but excess weight can play a role in cancer, too, researchers say.

A new study found that breast cancer survivors who are overweight have a statistically significant increased risk of developing a second primary cancer – one not connected to their previous cancer.

The risk likely owes to shared risk factors between the two cancers – of which obesity is one – as well as genetic susceptibility and long-term effects of breast cancer treatment, the study authors said.

“The risk is comparable to what we would see for an initial breast cancer,” said Heather Spencer Feigelson, senior investigator at the Kaiser Permanente Colorado Institute for Health Research, in Aurora. “It’s just another piece of evidence showing us how [excess weight] is really important.”

For the study, the researchers reviewed data from nearly 6,500 women treated at Kaiser Permanente in Colorado and Washington state. Roughly equal percentages were normal weight, overweight and obese.

Women who had an invasive breast cancer had a small, but significantly higher risk for a second cancer as their body mass index (BMI) increased, the study found. (BMI is an estimate of body fat based on height and weight.)

That link was more pronounced when the analysis focused on obesity-related cancers or second breast cancers, the researchers said. The link was strongest for a diagnosis of estrogen receptor-positive second breast cancer.

Of the 14 cancers listed by the International Agency for Research on Cancer as obesity-related, some are common and some are harder to treat, Feigelson said.

The investigators found that 822 (nearly 13%) of the women developed a second cancer after an average follow-up of just over seven years. Of those, nearly 62% were an obesity-related cancer and 40% were a second breast cancer.

The 508 obesity-related cancers included 283 postmenopausal breast cancers; 70 colon/rectal cancers; 68 uterine cancers; 21 ovarian cancers; 23 pancreatic cancers; and 14 kidney cancers. There were fewer than 10 cases each of thyroid, esophageal, gallbladder, multiple myeloma, meningioma, liver and upper stomach cancers.

Though having excess weight appears to increase risk, evidence that shedding pounds and keeping them off reduces risk is limited, because losing weight is hard, Feigelson said.

“The science suggests that, yes, if you lose weight you should reduce your risk, but really the best studies … are studies of women who have gotten bariatric [weight-loss] surgery, and those who lose that large amount of weight do have lower risk of cancer,” Feigelson said.

About 55% of all cancers in women occur in those who are overweight or obese.

Feigelson noted there are a lot of breast cancer risk factors that women can’t do much about.

“For example, for these second breast cancers or second cancers after breast cancer, one risk factor is treatment, and obviously you’re not going to forgo treatment,” she said. “But this is something that women actually can have control over. And I think if you’re worried about cancer or you’re a cancer survivor, having those things that you can control and do something about can be very important to you.”

Building some healthy habits into your everyday life can help with cancer prevention. Maintain a healthy body weight, be active and don’t sit so much, Feigelson advised.

The findings were recently published in the Journal of the National Cancer Institute.

The researchers noted that one limitation of the study was a lack of diversity, because about 82% of the participants were white women.

Dr. Jennifer Ligibel, director of the Zakim Center for Integrative Therapies and Healthy Living at Dana-Farber Cancer Institute in Boston, reviewed the findings.

“I think this paper really provides a compelling rationale for why thinking about weight loss after being diagnosed with breast cancer is important,” she said.

Excess weight has a multipronged effect on a person’s body, increasing levels of insulin and other metabolic markers, as well as inflammation, Ligibel said. It probably also depresses the immune system, she added.

In addition, she noted that excess weight raises levels of sex hormones that can also lead to the development of certain types of cancer.

“It’s probably not one thing, but the complex interplay between these different systems,” said Ligibel, who is part of another study that is investigating whether a weight-loss program as part of breast cancer treatment can lead to lower rates of new cancers.

For many years, she noted, the American Cancer Society has made recommendations about nutrition, physical activity and weight for cancer prevention and for cancer survivors. They include trying to achieve and maintain a healthy weight.

“Unfortunately, [a lot of people have] gained weight as a result of the quarantining and everything else through this last year, but I think that this is a goal that we really need to be thinking about on a societal level,” Ligibel said.

Source : HealthDay

Report: COVID Death Rates 10 Times Higher in Countries Where Most Are Overweight

Robin Foster and Ernie Mundell wrote . . . . . . . . .

In a finding that suggests overweight people should be prioritized for COVID-19 vaccines, a new report released Thursday shows the risk of death from coronavirus infection is about 10 times higher in countries where most of the population is overweight.

The World Obesity Federation report found that 88 percent of deaths due to COVID-19 in the first year of the pandemic were in countries where more than half of the population is classified as overweight, the Washington Post reported. Having a body mass index (BMI) above 25 is considered overweight.

The results prompted the London-based federation to urge governments to prioritize overweight and obese people for both coronavirus testing and vaccinations, the Post reported.

Among the nations with overweight populations above the 50 percent threshold were also those with some of the largest proportions of coronavirus deaths — including countries such as Britain, Italy and the United States, the Post reported. In the United States, nearly three-quarters of the population is considered overweight or obese, according to the U.S. Centers for Disease Control and Prevention. So far, more than 518,000 Americans have died from COVID-19.

Conversely, in countries where less than half of the adult population is classified as overweight, the risk of death from COVID-19 was about one-tenth of the levels in countries with higher shares of overweight adults. A higher BMI was also associated with increased risk of hospitalization, admission to intensive or critical care and the need for mechanically assisted ventilation, the Post said.

These findings were fairly uniform across the globe, the report said. In fact, increased body weight was the second greatest predictor — after old age — of hospitalization and higher risk of death of COVID-19.

To reach that conclusion, the researchers examined mortality data on 160 countries from Johns Hopkins University and the World Health Organization. Of the 2.5 million COVID-19 deaths reported by the end of February, 2.2 million were in countries where more than half the population is overweight, CNN reported.

Every country where less than 40% of the population was overweight had a COVID-19 death rate of no more than 10 people per 100,000.

But in countries where more than 50% of the population was overweight, the COVID-19 death rate was much higher — more than 100 per 100,000.

“An overweight population is an unhealthy population, and a pandemic waiting to happen,” the group wrote in its report.

All American adults can get vaccines by end of May: Biden

The United States is now poised to have enough COVID-19 vaccines for every American adult by the end of May, President Joe Biden said this week.

The announcement, which came during a brief speech at the White House on Tuesday, accelerates the country’s vaccination goals by two months.

“As a consequence of the stepped-up process that I’ve ordered and just outlined, this country will have enough vaccine supply — I’ll say it again — for every adult in America by the end of May,” Biden said. “By the end of May. That’s progress — important progress.”

How was it possible to speed up the U.S. vaccine rollout?

Biden said his administration provided support to Johnson & Johnson so the company and its partners can make vaccines around the clock, The New York Times reported. In addition to that, the administration brokered a deal in which the pharmaceutical giant Merck & Co. would help manufacture the newly approved Johnson & Johnson single-shot coronavirus vaccine.

Although its own attempt at making a COVID-19 vaccine failed, Merck is the world’s second-largest vaccine manufacturer, according to the Times. White House officials described the partnership between the two competitors as historic and said it harkens back to the wartime manufacturing campaigns that former President Franklin D. Roosevelt put into place.

Biden also said Tuesday that he wanted all teachers to receive at least one shot by the end of this month, the Times reported.

Biden’s announcement came days after the U.S. Food and Drug Administration authorized the emergency use of the Johnson & Johnson vaccine. As of Thursday, 80.5 million Americans had been vaccinated, with nearly 27 million getting their second shot.

Even as vaccinations ramp up, public health officials worry about another surge of coronavirus cases, as new, more infectious variants emerge and states like Texas and Mississippi lift their mask mandates and roll back many of their coronavirus restrictions. Although cases have dropped significantly since January, they are now leveling off, the Times reported.

“We cannot let our guard down now or assure that victory is inevitable,” Biden said Tuesday. “We can’t assume that.”

U.S. will stick with two doses of Pfizer, Moderna vaccines: Fauci

The United States will stick with its plan to give millions of Americans two doses of the Pfizer and Moderna coronavirus vaccines, Dr. Anthony Fauci said Monday.

The nation’s top infectious diseases expert told the Post that shifting to a single-dose strategy for those two vaccines could leave people less protected, allow more contagious variants to spread and make Americans already hesitant to get the shots even more wary.

“We’re telling people [two shots] is what you should do … and then we say, ‘Oops, we changed our mind’?” Fauci said. “I think that would be a messaging challenge, to say the least.”

Fauci said he spoke on Monday with health officials in the United Kingdom, who are delaying second doses to give more people shots more quickly. He said that although he understands the strategy, it wouldn’t make sense in America. “We both agreed that both of our approaches were quite reasonable,” Fauci told the Post.

Some public health experts have asked U.S. policymakers to reconsider whether millions of doses intended as second shots could be distributed as first doses instead — to offer at least some protection to a greater number of people. The issue gained steam after a CDC advisory committee on Monday tackled the question while approving Johnson & Johnson’s single-shot coronavirus vaccine.

About 80 percent of adults have yet to get a single dose, according to CDC data.

Fauci told the Post the science shows that a two-shot regimen creates enough protection to fend off more contagious coronavirus variants, while a single shot could leave Americans at risk from these variants. There is insufficient data showing how long the immunity provided by one shot would last. “You don’t know how durable that protection is,” he noted.

Fauci also argued that Pfizer’s and Moderna’s recent commitment to deliver 220 million total doses by the end of March, in addition to Johnson & Johnson’s pledge to deliver nearly 20 million shots this month, should make the issue moot.

“Very quickly the gap between supply and demand is going to be diminished and then overcome in this country,” he said. “The rationale for a single dose — and use all your doses for the single dose — is when you have a very severe gap between supply and demand.”

A global scourge

By Thursday, the U.S. coronavirus case count passed 28.8 million while the death toll passed 518,000, according to a Times tally. On Thursday, the top five states for coronavirus infections were: California with nearly 3.6 million cases; Texas with nearly 2.7 million cases; Florida with over 1.9 million cases; New York with over 1.6 million cases; and Illinois with nearly 1.2 million cases.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

In India, the coronavirus case count was more than 11.1 million by Thursday, a Johns Hopkins University tally showed. Brazil had over 10.7 million cases and more than 259,000 deaths as of Thursday, the Hopkins tally showed.

Worldwide, the number of reported infections passed 115.3 million on Thursday, with over 2.5 million deaths recorded, according to the Hopkins tally.

Source: HealthDay

“Game Changer” Drug for Treating Obesity Cuts Body Weight by 20%

The findings from the large-scale international trial, published in the New England Journal for Medicine, are being hailed as a “game changer” for improving the health of people with obesity and could play a major part in helping the UK to reduce the impact of diseases, such as COVID-19.

The drug, semaglutide, works by hijacking the body’s own appetite regulating system in the brain leading to reduced hunger and calorie intake.

Rachel Batterham, Professor of Obesity, Diabetes and Endocrinology who leads the Centre for Obesity Research at UCL and the UCLH Centre for Weight Management, is one of the principal authors on the paper which involved almost 2,000 trial participants in 16 countries.

Professor Batterham (UCL Medicine) said: “The findings of this study represent a major breakthrough for improving the health of people with obesity. Three quarters (75%) of people who received semaglutide 2.4mg lost more than 10% of their body weight and more than one-third lost more than 20%. No other drug has come close to producing this level of weight loss – this really is a game changer. For the first time, people can achieve through drugs what was only possible through weight-loss surgery.”

Professor Batterham added: “The impact of obesity on health has been brought into sharp focus by COVID-19 where obesity markedly increases the risk of dying from the virus, as well as increasing the risk of many life-limiting serious diseases including heart disease, type 2 diabetes, liver disease and certain types of cancers. This drug could have major implications for UK health policy for years to come.”

The average participant in the trial lost 15.3kg (nearly 3 stone); this was accompanied by reductions in risk factors for heart disease and diabetes, such as waist circumference, blood fats, blood sugar and blood pressure and reported improvements in their overall quality of life.

The trial’s UK Chief Investigator, Professor John Wilding (University of Liverpool) said: “This is a significant advance in the treatment of obesity. Semaglutide is already approved and used clinically at a lower dose for treatment of diabetes, so as doctors we are already familiar with its use. For me this is particularly exciting as I was involved in very early studies of GLP1 (when I worked at the Hammersmith Hospital in the 1990s we were the first to show in laboratory studies that GLP1 affected appetite), so it is good to see this translated into an effective treatment for people with obesity.”

With evidence from this trial, semaglutide has been submitted for regulatory approval as a treatment for obesity to the National Institute of Clinical Excellence (NICE), the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA).

About the trial

The Phase III ‘STEP’* randomised controlled trial involved 1,961 adults who were either overweight or had obesity (average weight 105kg/16.5 stone; body mass index 38kg/m2), and took place at 129 sites in 16 countries across Asia, Europe, North America, and South America.

Participants took a 2.4mg dose of semaglutide (or matching placebo) weekly via subcutaneously (under the skin) injection; similar to the way people with diabetes inject insulin. Overall, 94.3% of participants completed the 68-week study, which started in autumn 2018.

Those taking part also received individual face-to-face or phone counselling sessions from registered dietitians every four weeks to help them adhere to the reduced-calorie diet and increased physical activity, providing guidance, behavioural strategies and motivation. Additionally, participants received incentives such as kettle bells or food scales to mark progress and milestones.

In those taking semaglutide, the average weight loss was 15.3kg (nearly three stone), with a reduction in BMI of -5.54. The placebo group observed an average weight loss of 2.6kg (0.4 stone) with a reduction in BMI of -0.92.

Those who had taken semaglutide also saw reductions in risk factors for heart disease and diabetes, such as waist circumference, blood fats, blood sugar and blood pressure and reported improvements in their overall quality of life.

About the drug

Semaglutide is clinically approved to be used for patients with type 2 diabetes, though is typically prescribed in much lower doses of 1mg.

The drug possesses a compound structurally similar to (and mimics) the human glucagon-like peptide-1 (GLP-1) hormone, which is released into the blood from the gut after meals.

GLP-1 induces weight loss by reducing hunger, increasing feelings of fullness and thereby helping people eat less and reduce their calorie intake.

While the STEP study has been through Phase I and II trials, assessing the 2.4mg doses for safety, in the Phase III trial some participants reported side effects from the drug including mild-to-moderate nausea and diarrhoea that were transient and generally resolved without permanent discontinuation from the study.

* Semaglutide Treatment Effect in People with Obesity (STEP)

Source: University College London,

Obesity Contributes to Up to Half of New Diabetes Cases Annually in the United States

Reducing the prevalence of obesity may prevent up to half of new Type 2 diabetes cases in the United States, according to new research published today in the Journal of the American Heart Association, an open access journal of the American Heart Association. Obesity is a major contributor to diabetes, and the new study suggests more tailored efforts are needed to reduce the incidence of obesity-related diabetes.

Type 2 diabetes is the most common form of diabetes, affecting more than 31 million Americans, according to the U.S. Centers for Disease Control and Prevention[1]. The risk factors for Type 2 diabetes include being overweight or having obesity; being over the age of 45; having an immediate family member diagnosed with Type 2 diabetes; being physically active less than 3 times per week; or a history of gestational diabetes (diabetes during pregnancy). Type 2 diabetes is more common among people who are Black, Hispanic or Latino, American Indian, Alaska Native, Pacific Islander or Asian American.

The number of deaths due to Type 2 diabetes in people younger than 65 is increasing along with serious complications of the condition, including amputations and hospitalizations. In addition, Type 2 diabetes impacts heart disease and stroke risk: adults with Type 2 diabetes are twice as likely to have a heart attack or stroke than people without diabetes.

Type 2 diabetes can be prevented or delayed with healthy lifestyle changes, such as losing weight, eating healthy food and being physically active. According to the National Diabetes Prevention Program, behavior changes have been shown to help people with prediabetes lose 5% – 7% of their body weight and reduce their risk of developing type 2 diabetes by 58% (71% for people older than age 60). Researchers examined the prevalence and excess risk of Type 2 diabetes associated with obesity.

“Our study highlights the meaningful impact that reducing obesity could have on Type 2 diabetes prevention in the United States. Decreasing obesity needs to be a priority. Public health efforts that support healthy lifestyles, such as increasing access to nutritious foods, promoting physical activity and developing community programs to prevent obesity, could substantially reduce new cases of Type 2 diabetes,” says the study’s first author Natalie A. Cameron, M.D., a resident physician of internal medicine at the McGaw Medical Center of Northwestern University in Chicago.

Researchers used information from the Multi-Ethnic Study of Atherosclerosis (MESA) and four pooled cycles (2001-2016) of the National Health and Nutrition Examination Survey (NHANES). MESA is an ongoing, longitudinal study of 45 to 84-year-olds who did not have cardiovascular disease upon recruitment. MESA data included in this study was collected during five visits from 2000 to 2017 at six centers across the U.S. NHANES is a cross-sectional study of the American population that takes place every other year using patient questionnaires and examination data.

For this analysis, authors limited data to participants ages 45 to 79-years old. They included only those who were non-Hispanic white, non-Hispanic Black or Mexican American and who did not have either Type 1 or Type 2 diabetes at the beginning of the study. Researchers calculated both the prevalence of obesity and the excess risk of Type 2 diabetes associated with obesity.

The study’s findings include:

  • Among NHANES participants, the overall prevalence of obesity increased from 34% to 41% and was consistently higher among adults with Type 2 diabetes.
  • Among MESA participants
    • about 1 in 10 (11.6%) developed Type 2 diabetes after nine years.
    • People with obesity were nearly three times as likely to develop Type 2 diabetes compared to those without obesity (20% vs. 7.3%, respectively).
  • In both the MESA and NHANES groups:
    • Obesity was linked to the development of Type 2 diabetes in 30 – 53% of cases.
    • a greater proportion of participants with obesity had an annual family income of less than $50,000, and they were more likely to be non-Hispanic Black or Mexican American.
    • Obesity prevalence was the lowest among non-Hispanic white females, however, this group experienced the highest obesity-related Type 2 diabetes.

“Our study confirms there is a higher prevalence of obesity among non-Hispanic Black adults and Mexican-American adults compared to non-Hispanic white adults. We suspect these differences may point to important social determinants of health that contribute to new cases of Type 2 diabetes in addition to obesity,” says Cameron.

“Additionally, the obesity epidemic has collided with the COVID-19 pandemic,” says Sadiya S. Khan, M.D., M.Sc., the study’s senior author and an assistant professor of medicine and preventive medicine at Northwestern University’s Feinberg School of Medicine. “The greater severity of COVID-19 infection in individuals with obesity is concerning because of the growing burden of adverse health consequences they could experience in the coming years; therefore, further efforts are needed to help more adults adopt healthier lifestyles and hopefully reduce the prevalence of obesity.”

This analysis included only middle-aged to older adults without cardiovascular disease who were non-Hispanic white, non-Hispanic Black or Mexican-American, so results may not be generalizable to the entire U.S. population. Future research is required to assess the burden of obesity on new cases of Type 2 diabetes in other age groups and racial and ethnic groups.

Source: American Heart Association