Preventing Pancreatic Cancer

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New Report: Thousands of Pancreatic Cancers in the U.S. Can Be Prevented

www.aicr.org » Cancer Research Update

“There is still clear and convincing evidence that diets high in a variety of vegetables, fruits, whole grains and beans lower risk for several cancers, including those of the colorectum, esophagus, stomach and more,” said AICR’s Alice Bender, MS, RD.

 

Pancreatic cancer is one of the most deadly forms of cancer. Usually diagnosed in advanced stages, it claims the lives of nine out of ten patients within five years’ time. Now a report released today from the American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF) finds clear and convincing evidence that many cases of pancreatic cancer can be prevented.

“The latest report from the AICR/WCRF Continuous Update Project, one of the largest cancer prevention research projects in the world, shows that being overweight and obese increases the risk of developing pancreatic cancer,” said Continuous Update Project (CUP) Panel Member Elisa Bandera, MD, PhD, of the Cancer Institute of New Jersey.

AICR/WCRF estimates that being lean can prevent 19 percent of pancreatic cancer cases that occur in the United States every year – or roughly one out of every five. That’s equivalent to 23 cases a day, and approximately 8,300 cases every year, that never have to happen, in the U.S. alone. (See the Cancer Preventability Chart)

In comparison, tobacco use, the number one risk factor for pancreatic cancer, is responsible for 1 out of every 4 cases of the disease, according to the American Cancer Society.

For the latest report on pancreatic cancer, the CUP evaluated an additional 79 recent papers relating to pancreatic cancer, diet and lifestyle. This was added to the 129 research papers already included for the AICR/WCRF 2007 second expert report.

“With the recent news that pancreatic cancer rates are on the rise, this report should be seen as a wake-up call,” Bandera said. “It’s still another example of the severe toll the obesity epidemic is taking on our health.”

Fat and Pancreatic Cancer: What’s the Link?

In addition to pancreatic cancer, carrying excess body fat has been shown to increase risk for cancers of the breast (postmenopausal), colon, esophagus, kidney, endometrium and gall bladder, along with other chronic diseases such as 2 diabetes and heart disease.

The pancreas is a gland located behind the stomach that produces digestive juices as well as insulin and other hormones. Research continues to document several reasons why carrying excess fat increases risk for pancreatic cancer.

Fat tissue produces cytokines (proteins) that cause inflammation, which link to changes that promote cancer in healthy cells. Being overweight and obese also increases blood levels of insulin and related hormones that can encourage the growth of cancer.

The Latest: Folate Link Downgraded

Research on cancer prevention is always evolving, which is why AICR/WCRF created the CUP, a living database of the global cancer research that is investigating links between lifestyle and cancer risk. As research is added to the database, the CUP panel periodically re-evaluates the strength of various links to ensure that AICR’s advice always reflects the state-of-the-science.
The AICR/WCRF CUP Pancreatic Cancer 2012 report also finds that it is no longer clear that foods containing folate protect against pancreatic cancer. This represents a downgrading of the judgment from the AICR/WCRF second expert report, which concluded in 2007 that there was evidence for a probable link between foods containing folate and lower risk for pancreatic cancer.

Foods containing folate include dark leafy greens, beans and peanuts.

But experts at AICR point out that this downgrade does not change the organization’s take-home message that plant-based diets are cancer-protective. “There is still clear and convincing evidence that diets high in a variety of vegetables, fruits, whole grains and beans lower risk for several cancers, including those of the colorectum, esophagus, stomach and more,” said AICR’s Alice Bender, MS, RD.

The new report also confirms the findings that coffee does not link to pancreatic cancer risk.

The Bottom Line

Maintaining a healthy weight is one of the most important things you can do to prevent this deadly disease. Avoiding tobacco use is another. If you smoke, stop now. If you don’t, never start.

http://www.aicr.org/cancer-research-update/2012_10_04/cru-report-thousands.html

Is Belly Fat the Worst Kind of Fat?

by Emily Milam

While excess belly fat may allow for a more impressive splash when flopping into the pool, it also packs some not so stellar abilities, like leading to higher cholesterol levels and increased risks for cardiovascular disease^[1][2]. What’s more, belly fat — also known as visceral fat, abdominal fat, or central adiposity — can lead to type 2 diabetes, a disease that causes blood sugar levels to rise dangerously high^[3]. The good news? Some types of midsection weight are less worrisome than others.

Tubby Tummies — Why It Matters

Photo by Jess Ivy

So why aren’t jelly bellies and thunder thighs equally bad? Of course, excess fat anywhereon the body can contribute to cardiovascular disease and diabetes, but not all fat is created equal: Geography matters^[4].

Abdominal fat is stored in two different ways. First, there is subcutaneous fat (the pinchable stuff!), which sits between the skin and the abdominal wall. This fat is more of a holding tank for extra calories, and is less of a health threat since it does not directly surround organs and the blood vessels that keep them healthy^[5]. Visceral fat, however, sits deeper in the stomach and blankets the abdominal organs^[6]. Now, everyone has some amount of visceral fat, but concerns surface when this inner fat exceeds normal levels. In some cases, the fat can invade the organs themselves (a common occurrence in the liver)^[7]. The organ-swaddling visceral fat negatively affects organ function and integrity by increasing inflammation, clogging blood supplies (which prevents nutrient and oxygen delivery to organs), and eventually causing insulin resistance. Insulin resistance, a pre-cursor to diabetes, is a condition by which the body’s muscle, fat, and liver no longer respond properly to circulating insulin supplies^[8]. This means that insulin — a hormone made in the pancreas that tells glucose to enter the body’s cells to fulfill their energy needs — can’t do its job. The result? The body’s cells starve while the excess glucose accumulates in the blood, ultimately damaging organs and vessels throughout the body. What’s more, visceral fat cells also produces hormones that regulate weight and appetite, sometimes leading to further weight gain or increased feelings of hunger^[9].

Getting Waisted — The Answer/Debate

They say America is a melting pot, but let’s think of it as a fruit basket. Different body shapes are associated with each gender and type of fat^[10]. Pear-shaped women have more padding around the butt and thighs (hence, apple bottom jeans — not be confused with apple shape!). These areas harbor mostly subcutaneous fat. Apple-shaped men and women, or those with fat around the middle, have more visceral fat (the dangerous kind). Banana-shaped are relatively thin throughout, or have a more equal distribution of fat. And we can’t forget beer bellies! Beer guzzlers beware — tummies full of Budweiser also count as dangerous visceral fat^[11][12].

While calculating body mass index (BMI) is a helpful tool to assess the overall health of an individual’s weight, determining a waist-to-hip ratio with a measuring tape is a better method to pinpoint belly fat^[13]. Calculate waist-to-hip ratio by dividing the waist’s circumference at its narrowest point (use the belly button as a guide) by the hips’ circumference at their widest points (near the top of the bony protrusions). Ratios of 0.8 and below are healthy, and those above 0.8 suggest an increased risk for heart disease and diabetes. Some studies have found waist circumference to be a better determinant and to better express the amount of belly fat present^[14]. Measure waist circumference at the spot right above the hip bones right afer breathing out. Risk for developing obesity-related health problems (like cardiovascular disease) increases in women with waists larger than 35 inches and in men with a circumference large than 40 inches.

Ready to battle the bulge? Thankfully, visceral fat typically surrenders to diet and exercise. Trim the fat with the four pillars of a healthy middle: exercise, diet, sleep, and stress management. While core exercises such as the plank and crunches will firm up abs, they won’t blast the belly fat that lies underneath. Instead, try moderate or vigorous intensity aerobic activity — recent research suggests that sprinting is the best way to lose the love handles^[15][16][17]. Complement aerobics with diets low in saturated fat, cholesterol, and carbohydrates (beer lovers, beware), and considerprotein-rich meals and low-fat snacks^[18]. And don’t forget to manage life stressors and catch plenty of Zzzs — increased cortisol levels (the stress hormone) and lack of sleep are both tied to abdominal weight gain^[19][20].

The Takeaway

Belly (aka visceral) fat can be more harmful than other types in terms of leading to bigger health issues. The good news? It also surrenders more easily to improved fitness and diet than other types!

This article was read and approved by Greatist experts Sherry Pagoto and Lisa Moskovitz. 

What do you think about the debate between BMI or waist circumference being the better determinant of health risks? Join the conversation in the comments section below! 

Works Cited

1. Visceral fat positively correlates with cholesterol synthesis in dyslipidaemic patients. Lupattelli, G., Pirro, M., Mannarino, M. et al. Internal Medicine, Angiology and Atherosclerosis, Department of Clinical and Experimental Medicine, University of Perugia, Italy. European Journal of Clinical Investigation, 2012 Feb;42(2):164-70. [↩]
2. Cardiovascular disease under the influence of excess visceral fat. Despres, J. Québec Heart Institute, Québec, QC, Canada. Critical Pathways in Cardiology, 2007 Jun;6(2):51-9. [↩]
3. Insulin resistance and body fat distribution. Yamashita, S., Nakamura, T., Shimomura, I., et al. Second Department of Internal Medicine, Osaka University Medical School, Japan. Diabetes Care, 1996 Mar;19(3):287-91. [↩]
4. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Fox, C., Massaro, J., Hoffman, U., et al. National Heart, Lung and Blood Institute’s Framingham Heart Study, Framingham, Mass, USA. Circulation,  2007 Jul 3;116(1):39-48. [↩]
5. Beneficial effects of subcutaneous fat transplantation on metabolism. Tran, T., Yamamoto, Y., Gesta, S. et al. Joslin Diabetes Center and Harvard Medical School, Boston, MA. Cell Metabolism, 2008 May;7(5):410-20. [↩]
6. Metabolic obesity: the paradox between visceral and subcutaneous fat. Hamdy, O., Porramatikul, S., Al-Ozairi, E. Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA. Current Diabetes Review, 2006 Nov;2(4):367-73. [↩]
7. Obesity, Visceral Fat, and NAFLD: Querying the Role of Adipokines in the Progression of Nonalcoholic Fatty Liver Disease. Mirza, M. SpR Surgery, Ninewells Hospital, Dundee, UK. ISRN Gastroenterology, 2011;2011:592404. [↩]
8. Brown fat lipoatrophy and increased visceral adiposity through a concerted adipocytokines overexpression induces vascular insulin resistance and dysfunction. Gomez-Hernandez, A., Otero, Y., de las Heras, N., et al. Biochemistry and Molecular Biology Department, School of Pharmacy, Complutense University of Madrid, Madrid, Spain. Endocrinology, 2012 Mar;153(3):1242-55. [↩]
9. Adipose tissue as an endocrine organ. Galic, S., Oakhill, J., and Steinberg, G. St. Vincent’s Institute of Medical Research and Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia. Molecular and Cellular Endocrinology, 2010 Mar 25;316(2):129-39. [↩]
10. A weight shape index for assessing risk of disease in 44,820 women. Rimm, A., Hartz, A., and Fischer, M. Department of Medicine, Medical College of Wisconsin, Milwaukee. Journal of Clinical Epidemiology, 1988;41(5):459-65. [↩]
11. The association of lifetime alcohol use with measures of abdominal and general adiposity in a large-scale European cohort. Bergmann, M., Schutze, M., Steffen, A., et al. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. European Journal of Clinical Nutrition, 2011 Oct;65(10):1079-87. [↩]
12. Relationship of abdominal obesity with alcohol consumption at population scale. Scroder, H., Morales-Molina, J., Bermejo, S., et al. Lipids and Cardiovascular Epidemiology Research Unit, Institut Municipal d’Investigació Mèdica, Barcelona, Spain. European Journal of Nutrition, 2007 Oct;46(7):369-76. [↩]
13. Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk–a review of the literature. Huxley, R., Mendis, S., Zhelezyakov, E., et al. Renal and Metabolic Division, The George Institute for International Health, The University of Sydney, Sydney, Australia. European Journal of Clinical Nutrition, 2010 Jan;64(1):16-22. [↩]
14. Waist circumference in children and adolescents correlate with metabolic syndrome and fat deposits in young adults. Spolidoro, JV, Pitrez Filho, ML, Vargas LT, et al. Medical School of the Pontifficia Universidade Catolica do RS, Moinhos de Vento Hospital, Porto Alegre, Brazil. Clinical Nutrition, 2012 Jul 28. [↩]
15. A systematic review and meta-analysis of the effect of aerobic vs. resistance exercise training on visceral fat. Ismail, I., Keating, S., Baker, M., et al. Discipline of Exercise and Sport Science, University of Sydney, Sydney, New South Wales, Australia. Obesity Reviews, 2012 Jan;13(1):68-91. [↩]
16. Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT. Slentz, C., Bateman, L., Willis, L., et al. Div. of Cardiology, Dept. of Medicine, Duke Univ. Medical Center, Durham, NC, USA. American Journal of Physiology: Endocrinology and Metabolism, 2011 Nov;301(5):E1033-9. [↩]
17. The effect of high-intensity intermittent exercise on body composition of overweight young males. Heydari, M., Freund, J., Boutcher, S.H. School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia. Journal of Obesity, 2012;2012:480467. [↩]
18. Relationship between bread consumption, body weight, and abdominal fat distribution: evidence from epidemiological studies. Bautista-Castano, I. and Serra-Marjem, L. Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. Nutrition Reviews, 2012 Apr;70(4):218-33. [↩]
19. Stress-induced cortisol response and fat distribution in women. Moyer, A., Rodin, J., Grilo, C., et al. Department of Psychology, Yale University, New Haven, CT, USA. Obesity Research, 1994 May;2(3):255-62. [↩]
20. Obesity and metabolic syndrome: Association with chronodisruption, sleep deprivation, and melatonin suppression. Reiter, R., Tan, D., Korkmaz, A., et al. Department of Cellular and Structural Biology, UT Health Science Center , San Antonio, Texas USA. Annals of Medicine, 2011 Jun 13. [↩]

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