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More fodder for the fat-but-healthy debate

One of the most divisive and emotional debates regarding obesity is whether being fat automatically equals being unhealthy. While many experts point to mounds of evidence linking excess weight to such life-shortening conditions as cancer, Type 2 diabetes and heart disease, others argue that those conditions aren't necessarily caused by fat itself but by related issues such as poor diet and lack of physical activity.

The argument may escalate after this morning's release of newly compiled data that suggests that "excess body fat alone is responsible for more than 100,000 cancer cases in the U.S.," according to press materials.

The report comes from the American Institute for Cancer Research, whose mission is to support research into the relationship between nutrition, physical activity and cancer, and to provide guidance on reducing cancer risk through lifestyle changes. Researchers speaking this morning are expected to make note of the public's lack of awareness of the link between cancer and obesity.

To quantify that link -- and perhaps to help raise that public awareness -- Laurence Kolonel of the Cancer Research Center of Hawaii paired the findings of the AICR's report "Policy and Action for Cancer Prevention,' which was released in February, and cancer-prevalence data from the American Cancer Society. He came up with an estimate of the total number of cancer cases in the U.S. that can be attributed solely to excess body fat.

That number, 100,500 (which reflects the percentages of cases of endometrial, esophageal, pancreatic, kidney, gallbladder, breast and colorectal cancers that the earlier report found could be attributed to excess body fat) certainly sounds dramatic, though it really is just a way of repackaging information we already knew.

Kolonel says the studies on which those percentages were based controlled for other risk factors, allowing for body fat's role as a cancer risk factor to be determined. Though the link between fat and cancer appears strong and consistent across the studies, he does allow that the findings stop short of establishing a cause-and-effect relationship.

Nor has anyone pinned down exactly how body fat might increase cancer risk. Kolonel explains that body fat isn't just sitting around waiting to be drawn on when your body's starving. In fact, he says, there are "all kinds of thing going on in fat tissue," including production of estrogen and other cancer-promoting hormones. Fat tissue also contributes to inflammation, an established cancer precursor, he says.

Do you believe that body weight and diseases such as cancer are directly related? Or do you think it's far more complicated than that? Please register your view in today's poll.

By Jennifer LaRue Huget  |  November 5, 2009; 7:00 AM ET
Categories:  Cancer , Nutrition and Fitness , Obesity , Prevention  
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Ok, first, I have a real problem with this guy's sound bite. "Excess body fat alone is responsible for more than 100,000 cancer cases in the U.S." -- ?? And "Kolonel says the studies on which those percentages were based controlled for other risk factors, allowing for body fat's role as a cancer risk factor to be determined." Really?

Please show me where the study he relied on said that. Because when I look at the link, here is what the table describes: "PERCENTAGE OF CANCERS THAT COULD BE PREVENTED VIA HEALTHY DIET, REGULAR PHYSICAL ACTIVITY AND HEALTHY WEIGHT" Where does it make any distinction between these three? Where are those results that looked just at weight, controlling for diet and exercise? And how is it even remotely legit to claim that fat alone is responsible for 100,000 cancers every year, when the percentage figures he used were associated with fat, diet, AND exercise?

There's nothing new here. At all. These numbers are based on taking percentages in a February report and doing the math. The February report was a summary that came from a 2007 study. The 2007 study was a review of 7000 EARLIER studies from around the world. It's just packaging and repackaging things we already knew. But, of course, you don't make headlines if you just tell people that being fat, eating poorly, and being out of shape is bad for you, do you?

I expect people who claim to be scientists to be a little more straightforward about what their data do and don't support -- and a little less focused on making a big splash in the papers. And I expect the Post to look a little more closely at those "splashes" when they do hit. Look at the earlier study: does it, in fact, control for weight separately than diet and/or exercise? I couldn't find it in the info linked to, but I haven't seen the underlying study. If it does, THAT is worth your headline.

Posted by: laura33 | November 5, 2009 8:48 AM | Report abuse

Always enjoyable to watch the obese rationalize their excess fat as "healthy."

You only get one life, folks. Do you actually think that those 25, 50, or 100 pounds of excess fat tissue are GOOD for you? Because, merely claiming "there's only *circumstantial* evidence that this is killing me" seems to be an awfully low bar for something as important as your life.

Posted by: DupontJay | November 5, 2009 2:42 PM | Report abuse

According to the National Cancer Institute, obese pre-menopausal women have a LOWER risk of breast cancer than their non-obese counterparts. Read that again!

Thanks Laura for your intelligent post. Even if there is correlation between obesity and diseases, is there necessarily a causation relationship?

Jay Dupont, you might have been brainwashed into thinking that any amount of fat is unhealthy, but using actual data the CDC found out that people in the overweight category (BMI 25-29.9) actually live longer than people in any other weight category. Yes, longer than people in the so-called "healthy" weight and underweight categories. So if you want to talk about excess fat tissue being good for you, it turns out that some is. >:-)

Posted by: tanya_t | November 5, 2009 4:55 PM | Report abuse

Laura, Tanya -

The numbers released today by the American Institute for Cancer Research are estimates, yes - and they ARE based on some serious number crunching involving the conclusions of our 2007 AICR/WCRF report, "Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective," which judged the global evidence.

We've released the percentages attributable to all lifestyle-related risk factors previously, but for the first time, we're focusing on obesity and turning those percentages into real-world numbers, based on the most recent cancer incidence data.

The methodology for these estimates is laid out -- in GREAT detail -- at (Click on Policy Report, and then Appendix A. You'll see how our panel controlled for various other risk factors.)

These numbers are, if anything, conservative estimates of the actual number of cancers attributable to carrying excess body fat.

The link between excess body fat and cancer is one that, according to our survey, only half of Americans have heard about. As an organization devoted to studying cancer prevention and educating the public about the results, we are committed to raising awareness about this link - and allowing people to make their own informed choices.

But you're right -- the convincing evidence linking obesity to cancer is part of the equation. About 1/3 of the most common cancers can be prevented via healthy diet, regular physical activity, and maintaining a healthy weight.

Posted by: gweldon | November 5, 2009 5:16 PM | Report abuse

Did you crunch the numbers to see if the increased risk from extra weight holds true across the spectrum? That is, among those individuals who eat a healthy diet, get adequate exercise, have blood pressure, cholesterol numbers, and stress test results in normal ranges, does extra weight still show an increased risk of cancer. (I'm guessing that such individuals are a relatively small percentage among the overweight and obese, so the large number of not-healthy obese and overweight individuals could be slanting your results.)

Posted by: dc-native | November 5, 2009 7:39 PM | Report abuse

There have been dozens and dozens of studies showing obesity and being overweight contributes to cancer, diabetes, heart disease, metabolic syndrome, etc.

The U.S. and Mexico are the fattest two nations on earth with the highest rates of diabetes. Why? Because Mexicans are adopting our eating habits and guzzle lots of Coke and other soft drinks with high fructose corn syrup. This poison is deadlier than tobacco and asbestos.

Posted by: alance | November 5, 2009 11:36 PM | Report abuse

I am 55, my BMI is 27, a little overweight. I jog 3 miles a day, wear size 10 and my doctor has never suggested I need to loose weight.

My diet is very strict. I do not eat out and make my every meal. I do not drink sweetened drinks or use any sweetener. I follow the NIH diet pyramid of excellence.

I really believe the measure is wrong. Lots of people in excellent health in up in this category. The measure needs to be fitness, Vo2Max, and a balanced diet. I suspect that measure would make an important statement on general health and resilience, but it's not new news.

Posted by: TinMan2 | November 7, 2009 8:27 AM | Report abuse

So what if a BMI in the obese category DOES increase the risk of cancer? What are we supposed to do about it? Diets just do not work for the vast majority of people. In fact, dieting over the long-haul tends to make us fatter, and is one of the myriad reasons why we are heavier now than 40 years ago. Dieting creates stress, anxiety, guilt, emotional eating, yo-yo weight loss, and we KNOW that these things aren't healthy. There is no debate about that. Something that people do have control over is healthy food and participating in enjoyable activity. While it may not result in weight loss, or at least as much as most people would like to see, it will definitely be an improvement over the failure that dieting has been for the past 40 years. Our culture has been obsessed with thinness for years and we're fatter than ever. Twiggy woke up the Karma Fairy!

Posted by: GenU | November 7, 2009 8:43 AM | Report abuse

On the average, those with excessive body weight are more prone to illness than those who are within the norm……….But obesity is one thing……..being in top physical condition with muscle mass exceeding fatty tissue is another. Any professional football player, basketball player, body builder, etc…undoubtedly would exceed accepted standards for body weight. If you are active, eat well, and somewhat over weight you will probably live a long while…..If you are overweight and all you do is reach for the remote and chips you are on your way to an early demise!

Posted by: tonyholst | November 9, 2009 12:34 PM | Report abuse

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