Predicted basal metabolic rate and cancer risk in the European Prospective Investigation into Cancer and Nutrition

Abstract

Emerging evidence suggests that a metabolic profile associated with obesity may be a more relevant risk factor for some cancers than adiposity per se. Basal metabolic rate (BMR) is an indicator of overall body metabolism and may be a proxy for the impact of a specific metabolic profile on cancer risk. Therefore, we investigated the association of predicted BMR with incidence of 13 obesity-related cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC). BMR at baseline was calculated using the WHO/FAO/UNU equations and the relationships between BMR and cancer risk were investigated using multivariable Cox proportional hazards regression models. A total of 141,295 men and 317,613 women, with a mean follow-up of 14 years were included in the analysis. Overall, higher BMR was associated with a greater risk for most cancers that have been linked with obesity. However, among normal weight participants, higher BMR was associated with elevated risks of esophageal adenocarcinoma (hazard ratio per 1-standard deviation change in BMR [HR 1-SD ]: 2.46; 95% CI 1.20; 5.03) and distal colon cancer (HR 1-SD : 1.33; 95% CI 1.001; 1.77) among men and with proximal colon (HR 1-SD : 1.16; 95% CI 1.01; 1.35), pancreatic (HR 1-SD : 1.37; 95% CI 1.13; 1.66), thyroid (HR 1-SD : 1.65; 95% CI 1.33; 2.05), postmenopausal breast (HR 1-SD : 1.17; 95% CI 1.11; 1.22) and endometrial (HR 1-SD : 1.20; 95% CI 1.03; 1.40) cancers in women. These results indicate that higher BMR may be an indicator of a metabolic phenotype associated with risk of certain cancer types, and may be a useful predictor of cancer risk independent of body fatness.

Association of body composition with risk of overall and site‐specific cancers: A population‐based prospective cohort study

“…The biological mechanisms underlying the relationship between obesity and cancer are complex. A possible explanation of our findings is that individuals with higher FFM have greater basal metabolic rate (BMR), 33 which may lead to a greater reactive oxygen species generation, and subsequently promote oxidative stress, causing many metabolic alterations, such as insulin resistance, and increase the expression of proinflammatory cytokines including TNFα and IL‐6, resulting in the development of several cancers 13,34 . In line with this, BMR has been associated with elevated risks of several cancers, such as esophageal adenocarcinoma and colon cancer 13 .…”

“…A possible explanation of our findings is that individuals with higher FFM have greater basal metabolic rate (BMR), 33 which may lead to a greater reactive oxygen species generation, and subsequently promote oxidative stress, causing many metabolic alterations, such as insulin resistance, and increase the expression of proinflammatory cytokines including TNFα and IL‐6, resulting in the development of several cancers 13,34 . In line with this, BMR has been associated with elevated risks of several cancers, such as esophageal adenocarcinoma and colon cancer 13 . Another possibility is that individuals with larger body shape have more cells (including stem cells), and thus a higher statistical chance for mutations leading to malignant transformation, 35 which is supported by that taller individuals have higher risk of certain cancers 36,37 .…”

Visceral Adiposity and Cancer: Role in Pathogenesis and Prognosis

“…In this view, it could be intriguing to study if central obesity per se is sufficient to increase cancer risk also in non-metabolic patients. Indeed, regardless of adiposity, a high cancer risk can be determined by insulin resistance [57], dyslipidemia [107], and predicted basal metabolic rate [108], being indicative of the whole-body energy metabolism. Therefore, characterizing the obese state by systemic and tissue-specific measures could provide a more reliable identification of high-risk populations and represents a fascinating approach for the development of preventive and therapeutic strategies [109].…”

Effect of Basal Metabolic Rate on Cancer: A Mendelian Randomization Study

“…Basal metabolic rate (BMR) is a related potential target of intervention. Observationally, BMR is associated with cancer ( Kliemann et al, 2020 ). Observational studies are open to confounding, which may compromise internal validity.…”