New Research Sheds Light On Extent BMI Matters In Endometrial Cancer
As a longtime cancer doctor who’s also a functional medicine practitioner, I keep on top of the latest research. That includes how your lifestyle can impact your health, and how cells function, repair and maintain themselves, because they relate to larger functions in your body.
This is driven across in a recent University of Bristol study out of England that looked at the link between obesity and cancer of the endometrium: the lining of the uterus. In my view, the newly released study also emphasizes the importance of keeping on top of things yourself — but more on that later!
The study, published in April 2022 in the journal BMC Medicine, looked at 120,000 women from seven countries, including the U.S. About 13,000 of those women had endometrial carcinoma, the most common type of cancer in the uterus.
Doctors and scientists have long known of the link between an unhealthy weight and disease. For this British study, the researchers looked at the BMI (a measure of body fat based on height and weight) of the study subjects. They found levels of both fasting insulin (a hormone made by the pancreas that helps the body use sugar for energy) and testosterone (a male hormone present in women for reproductive and bone health) increase the risk of uterine carcinoma. BUT, it also indicates the cancer link depended on the study subjects’ BMI. In short, for every five extra BMI units, a woman’s risk of developing endometrial carcinoma rises by up to 88%.
In the United States alone, some 35,000 to 40,000 women a year will develop endometrial carcinoma. Caught early, it can be cured with surgery. And the researchers in the Bristol study said work using genetic analysis may also reveal how obesity causes cancer and possibly lead to newer medications, to treat cancer or maybe even prevent it.
But imagine how many women may be able to avoid this cancer in the first place if they maintained a normal BMI — that’s where functional medicine, which starts with the gut, plays such a key role.
How to get and maintain a healthy BMI can get complicated. But functional medicine gets right to the point: Looking at your “diet.” (While most people associate the word with cutting calories and starving yourself, when I speak about “diet” in my counseling, it’s in reference to the specific foods we eat, and may involve cutting calories to achieve your goals). Practitioners such as myself will often start with elimination diets (and/or use other eating plans to help with the gastrointestinal (G.I.) system, and may even incorporate an intermittent fasting program (ie., eating for eight hours in a day and then not eat for the remaining 16 hours; or limiting intake to about 600 calories a day on a twice-weekly schedule).
Over my career as an oncologist, we weighed patients at each visit and calculated their BMI.
While not a perfect tool (because each of us is different and some people have more muscle mass than others, for instance), I’ve found it to give a pretty accurate idea of if someone is at a good weight for their height.
For women and men alike, obesity plays a big role in a variety of malignancies, and whether someone develops diabetes, heart disease and other problems. When it comes to uterine cancer, one of the highest risk factors is obesity, along with hypertension (high blood pressure) and diabetes. Even with the cutting-edge robotic-assisted procedures now available to treat uterine cancer patients, an obese person has a higher risk of complications from surgery. They can also have more difficulty tolerating any followup radiation and chemotherapy. All the more reason for maintaining a BMI in the normal range.
You too can be involved in your health goals: for instance, keep track of your BMI with this free calculator and free Body Fat Percentage Calculator on my website.
Of course, that’s not to say getting to and maintaining a healthy weight is always simple. Overweight and obesity, especially morbid obesity, can be complicated to address. But that’s why it’s important to get back to baby steps: The first involves controlling what and how we eat, and that’s something available to everyone.
Now, here’s a quick look at BMI classifications and what the numbers point to:
Less than 19: Underweight for height
19 to 24: Normal weight for height
25 to 29: Overweight
30 to 39: Obese Greater than 40: Morbidly obese