Energy balance and gastrointestinal cancer: risk, interventions, outcomes and mechanisms

Nature Reviews. Gastroenterology & Hepatology
Cornelia M UlrichStephen D Hursting

Abstract

Obesity increases the risk of multiple gastrointestinal cancers and worsens disease outcomes. Conversely, strong inverse associations have emerged between physical activity and colon cancer and possibly other gastrointestinal malignancies. The effect of weight loss interventions - such as modifications of diet and/or physical activity or bariatric surgery - remains unclear in patients who are obese and have gastrointestinal cancer, although large clinical trials are underway. Human intervention studies have already shed light on potential mechanisms underlying the energy balance-cancer relationship, with preclinical models supporting emerging pathway effects. Central to interventions that reduce obesity or increase physical activity are pluripotent cancer-preventive effects (including reduced systemic and adipose tissue inflammation and angiogenesis, altered adipokine levels and improved insulin resistance) that directly interface with the hallmarks of cancer. Other mechanisms, such as DNA repair, oxidative stress and telomere length, immune function, effects on cancer stem cells and the microbiome, could also contribute to energy balance effects on gastrointestinal cancers. Although some mechanisms are well understood (for ins...Continue Reading

Associated Clinical Trials

Dec 31, 2014·Cornelia Ulrich

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Methods Mentioned

BETA
gastric bypass
xenograft
biopsy
GTPase

Clinical Trials Mentioned

NCT02780284
NCT00819208
NCT02780921
NCT03187951
NCT03082495
NCT01977066
NCT00303875
NCT02850172
NCT00470119
NCT01511276

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