“You put on a lot of bacon”, “Maybe you should drink a few less beers?“. Between the serious and the facetious, many men often hear it, especially after the age of 50. But there is much more at stake than physical fitness: for every extra 10 centimeters in the waist, the risk of getting sick and dying from prostate cancer would rise by 7%. This is indicated by my broader analysis of the association between obesity and the risk of prostate cancer, presented by the University of Oxford last week at the European Congress on Obesity in Maastricht (Netherlands) and published simultaneously in BMC Medicine.
I study
The British researchers used data from 2.5 million men from 19 different studies, as well as data from a new analysis of over 200,000 individuals from the UK Biobank. None of the study participants had cancer at the start of the investigation. The body weight of each of them was monitored for a period of 12 years through four different measures: the body mass index (or BMI, Body Mass Index, given by the ratio between body weight and the square of height) , waist circumference, waist / hip ratio and body fat percentage.
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It thus emerged that men with a higher central adiposity (the excessive accumulation of adipose tissue in the abdominal area), but also total, had a higher risk of dying from prostate cancer than men with a normal weight. In particular, the risk of not surviving the disease appeared to be increased: by 10% for every five points more than the body mass index; 7% for every 10 centimeters more of the waist circumference; of 6% for each “shot” of 0.05 points in the waist-hip ratio. Unsurprisingly, the participants with the most body fat were older and more sedentary, and those who consumed the most alcohol.
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“Having more information on the factors that increase the risk of prostate cancer is the key to preventing it,” explains Aurora Perez-Cornago, epidemiologist at the University of Oxford and first author of the study: “Age, family history and ethnicity they are in fact known but non-modifiable risk factors, so it is important to find out which ones it is possible to act on. In fact, although many prostate cancers grow slowly, others have a poor prognosis and could be associated with various environmental factors “.
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An unclear correlation
But if the cause-and-effect link between obesity and prostate cancer risk is pretty clear, the reasons why it exists are not. Among the most accredited hypotheses, one concerns the endocrine action carried out by abdominal fat which is deposited in depth, therefore more difficult to dispose of and considered more harmful than subcutaneous fat, which instead accumulates between the skin and muscles. These fat deposits would function as a gland capable of synthesizing molecules that promote inflammation, estrogen and fatty acids. All compounds that can contribute to cancer. “It is not yet completely clear – continues Perez-Cornago – what determines the association between fat and mortality from prostate cancer, and therefore why this tumor is more aggressive for overweight men. It is possible that some metabolic and nutritional disorders at the molecular level increase the risk, but also that men with obesity problems have a delayed diagnosis – because the cancer is more difficult to detect – and that the disease can therefore be diagnosed at a more advanced state. advanced, when it is more difficult to treat “.
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The most common cancer in men
If the mean body mass index were five points lower, the researchers point out, there would be around 1,300 fewer deaths per year from prostate cancer in the UK. This is in fact the most common cancer among English men – as well as among Italian ones, where every year there are 36,000 new cases a year. It is also the third leading cause of cancer death in the male population, with over 7,000 deaths a year (Istat 2017 data). In the UK, seven out of ten men are overweight or obese, and it is estimated that within a decade the country could reach some of the most alarming levels of obesity in all of Europe. Diet high in saturated fat, alcohol consumption, obesity, and lack of exercise are among the major known risk factors associated with lifestyle for this and many other cancers. This is why oncologists will never tire of repeating how important it is to maintain weight within the norm, exercise and follow a balanced diet.
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