The problem of weight gain is not to taken lightly, even though the unending and often too-good-to-be-true solutions coming from the ever burgeoning weight management industry seem to suggest so. Be warned — for a few extra kilos today can multiply tomorrow, putting you at increased risk of many diseases, including cancer.
They include cancers of the breast (in postmenopausal women), ovary, colon and rectum, liver, kidney, pancreas, gastric cardia, oesophagus (food pipe), and endometrium of the uterus, as well as advanced prostate cancer, cancers of the gallbladder and thyroid, and multiple myeloma (blood cancer) and meningioma brain tumour, according to a report by the World Health Organisation’s International Agency for Research on Cancer (IARC).
In fact, so enormous has been the burden of obesity-related cancers that in some countries in the western world, they account for close to half of all cancers. In the US, overweight and obesity-related cancers make up 40 per cent of all cancers, according to a report of the US Centers for Disease Control and Prevention (CDC) in October.
The situation in India is not yet so scary, but the burden of obesity and its consequences are increasing here as well. “In India, up to one-fourth of all cancers (25 per cent) may be directly or indirectly linked to obesity,” Harit Chaturvedi, a cancer care specialist at Max Super Speciality Hospital at Saket, New Delhi said.
“The cases are more common in urban areas and metropolitan cities, where the diet is more rich in saturated fat content and lifestyle is rather more sedentary.” “Obesity alters the intrinsic hormonal milieu, thereby disturbing the cell cycle control. This, in turn, affects the various check points of cancer control in the body, making them ineffective and rendering a person prone to develop cancers,” Chaturvedi said.
“Moreover, an obese patient with cancer undergoing surgery is at higher risk of complications as compared to a lean person,” added Deep Goel, Director, Surgical Gastroenterology, Bariatric & Minimal Access Surgery, BLK Super Speciality Hospital in New Delhi. Interestingly, or rather sadly, women are disproportionately affected by cancer attributable to obesity overall.
“Women are more at risk of obesity-related cancers because of periodic shift in the hormonal balance in their body. Also, the feminine body has more adipose (fat) tissue content which interacts with certain intrinsic factors making them more prone to cancers,” Chaturvedi said.
The IARC report highlights that the excess of energy intake over energy expenditure is the main driver of weight gain. So, during adulthood, the maintenance of a stable body weight depends on the energy derived from food and drink (energy intake) being equal to the total energy expenditure over time.
“This report shows that excess energy intake is the main responsible factor. Although genetic factors play a role, these cannot explain the upward trends in obesity rates, and in turn the report shows that increased physical activity alone cannot solve the problem,” said Isabelle Romieu, a scientist at IARC.
What, however, is worrying is that excess weight develops progressively, so that a relatively small excess of energy intake can easily produce large weight changes over time. Therefore, it is important to regularly monitor what you eat and how much you exercise.
“Just as ‘Swachh Bharat’, we need a ‘Swastha Bharat’ campaign, which will encourage people to eat and live healthy,” Chaturvedi added. “We should adopt a healthier lifestyle such as weight control, eating before 8 p.m., walking or running for a minimum of 5 km daily. We must also avoid any habit-forming substances like tobacco and alcohol.”
According to the World Obesity Federation, the percentage of Indian adults living with obesity is set to jump to around 10 per cent (3.1 per cent male and 6.9 per cent female) by 2025 from 7.5 per cent (2.3 per cent male and 5.2 per cent female) in 2014.
The annual cost of treating the consequences of obesity such heart disease, diabetes, liver disease, depression and many types of cancer will reach a staggering $13 billion in India by 2025, according to the analysis.
“The most effective way to prevent obesity-related cancer would be by maintenance of the weight,” said Rajesh Kapoor, Director, Gastrointestinal & Hepato-Pancreatico-Biliary Surgery, Jaypee Hospital, Noida.
Weight can be maintained, according to Kapoor, by lifestyle modification which includes dietary modification, exercise regime and behavioural modifications.
Limiting the amount of fat and sugar intake, drinking a lot of water while avoiding sugary drinks and soda is critical to maintaining healthy weight, said Sunali Sharma, Dietician and Nutritionist at Amandeep Hospital in Punjab.
Public awareness programme, training school children to follow a healthy diet and exercise, and curbing advertisements promoting unhealthy foods are also important to arrest the rise of the obesity burden in India, said Jaydeep Palep, Director & Head of Bariatric and Minimal Access Surgery, Nanavati Super Specialty Hospital in Mumbai.
Dietary patterns that include higher intakes of fruits, vegetables, legumes, whole grains, nuts, seeds, and unsaturated fat, as well as lower intakes of refined starch, red meat, trans and saturated fats, and sugar-sweetened foods and drinks can contribute to long-term weight control, according to the IARC.
So do not forget to put on your running shoes every day or engage in other physical activities, and introduce some elements of fun in your life without indulging in processed and fatty foods to stave off the diseases associated with overweight and obesity including cancer, rightly called the “emperor of all maladies”.