The Times
Rhys Blakely
Gerry Gajadharsingh writes:
“When I heard about the Metabolic Balance program around 14 years ago, I was intrigued by one of the principles, in relation to reducing the body’s insulin response by minimising snacking in between meals.
Every time we eat, we provoke an insulin response. All foods that contain some carbohydrate (starch, fruit and vegetables primarily but almost all foods have some degree of carbs contained within them), it hits our bloodstream as blood glucose and the pancreas releases insulin to move glucose out of the bloodstream and into cells. Hopefully into muscle cells but sadly for many people because of how their metabolism works into fat cells.
Blood glucose regulation is one of the processes in the body where it tries at all costs to keep blood sugar regulated, it does this by the release of insulin. Because of how people eat, primarily snacking or eating between meals or eating high glycaemic load carbs, we will often find a sustained insulin response and increasing numbers of patients are found to have elevated fasting insulin.
An elevated insulin response, if allowed to go on for months or years, will eventually cause trouble. Insulin tends to activate a whole cascade of other inflammatory cytokines and inflammation tends to underpin most disease processes within the body.
Whilst the research below confirms the association of being overweight with an increase in risk of developing endometrial cancer for women, it also suggests that the risk is tied particularly to hormones insulin and testosterone. Therefore, whilst being overweight will be obvious to many people having elevated levels of insulin won’t be, unless it’s tested.
Whilst elevated blood glucose associated with decreased insulin sensitivity has been recognised for many years in conditions such as type two diabetes, there is now increasing association of elevated insulin with a number of other health problems, now including endometrial cancer.
My advice to patients is to make sure breakfast, lunch and dinner is good enough to minimise snacking in between meals. Eating good quality protein and fat and low glycaemic load carbohydrates, mainly in the form of vegetables, will, in the majority of patients, lead to good glucose control and reduction in insulin.”
Scientists have begun to unravel why being overweight sharply increases the risks of one of the UK’s most common cancers, potentially paving the way for new treatments.
Researchers found that for every extra five units of body mass index (BMI), the risk of a woman having endometrial cancer increased by nearly 90 per cent. An extra five BMI units is the equivalent of a 5ft 5in woman being two stone heavier.
The findings also suggest that this is tied to two hormones: insulin and testosterone.
Endometrial cancer affects the lining of the womb — the endometrium — and is the most common type of womb cancer. It is the most frequently diagnosed gynaecological cancer in high-income countries and the fourth most common cancer for women in the UK. About one British woman in 36 will be told she has the disease. Among British cases, it is estimated that a third are a result of being overweight or obese.
It is thought that more than one in 20 cancer cases in the UK is caused by excess weight.
The study sought to shed light on the biological mechanisms that link excess weight to the risk of endometrial cancer. The researchers looked at the genetics of 120,000 women, including about 13,000 with womb cancer , from Australia, Belgium, Germany, Poland, Sweden, the UK and the US.
They focused on 14 genetic features thought potentially to be connected to obesity and the disease. The results showed that genetic features linked to fasting insulin levels and testosterone increased the risk of developing it.
Dr James Yarmolinsky, of the University of Bristol, senior author of the study, said it was possible that in the future drugs could be used to manage the level of these hormones in people already at a higher risk of cancer. However, he cautioned that the research was still at an early stage.
Drugs such as metformin, used in diabetes treatment, can reduce hormone levels. Studies have also suggested that the drug also affects cancer risk, though it is not yet clear why.
Emma Hazelwood, also from Bristol University and lead author of the new paper, published in the journal BMC Medicine, said: “This study is an interesting first step into how genetic analyses could be used to uncover exactly how obesity causes cancer, and what can be done to tackle it. Links between obesity and womb cancer are well known but this is one of the largest studies which has looked into why that is on a molecular level. We look forward to further research exploring how we can now use this information to help reduce the risk of cancer.”
Dr Julie Sharp, head of health information at Cancer Research UK, said: “Studies like this bolster the fact that being overweight or obese is the second-biggest cause of cancer in the UK and can help us start to pinpoint why. This will play a pivotal role in uncovering how to prevent and treat cancer.
“More research is needed to investigate exactly which treatments and drugs could be used to manage cancer risk among people struggling with obesity. We already know that being overweight or obese increases your risk of developing 13 different types of cancer.
“To reduce your cancer risk, it’s important to maintain a healthy weight by eating a balanced diet and staying active.”
Case study
When Kath first started experiencing bleeding in 2013, she put it down to the menopause. Despite urges from her daughter to get checked out, she carried on working as a bra fitter in Debenhams in Trafford, Greater Manchester. However, just before Christmas that year she had a heavy bleed which prompted her to make an appointment with the doctor.
In January 2014 Kath went to her GP and was referred to Royal Bolton Hospital where she had a biopsy. She was diagnosed with womb cancer.
“When you hear the word cancer your mind runs riot and I was thinking, ‘Am I going to live to see my grandchildren grow up?’” she said.
“I felt sick as I didn’t know what was going on. It was as though I was in a dream. I was devastated when I found out and cried with my husband holding my hand.”
Thankfully, Kath’s cancer was caught at the earliest possible stage, which meant she could have life-saving surgery which removed her ovaries and cervix. The operation removed all the cancer, which meant she didn’t need radiotherapy or chemotherapy, and she is now cancer free.
It did not end there, though. “After finishing my treatment, I wanted to make some changes,” Kath said. “We don’t know what caused my cancer, but I have to admit that I was carrying a few extra pounds. So now I exercise and eat better to be healthier. I also wanted to be a role model for my family.”
Kath takes part in Cancer Research’s Race For Life every year, raising both money and awareness about cancer.
“Reading some of the words on people’s backs about why they were running brought it all back to me about how important this is,” she said. “My daughter’s notes said: ‘Running for our Mum who beat womb cancer!’ ”
Kath added: “It’s worrying to see that womb cancer rates are on the rise, and although weight isn’t the only risk factor, I want to encourage other women to live healthily so that fewer women go through what I went through.
“I hope that my story helps others make a change in their life.”