Cancer survivorship, excess body fatness and weight-loss intervention—where are we in 2020?

Anderson, Annie S.; Martin, Richard M.; Renehan, Andrew G.; Cade, Janet; Copson, Ellen R.; Cross, Amanda J.; Grimmett, Chloe; Keaver, Laura; King, Angela; Riboli, Elio; Shaw, Clare; Saxton, John M.; UK NIHR Cancer and Nutrition Collaboration (Population Health Stream)

Abstract

Earlier diagnosis and more effective treatments mean that the estimated number of cancer survivors in the United Kingdom is expected to reach 4 million by 2030. However, there is an increasing realisation that excess body fatness (EBF) is likely to influence the quality of cancer survivorship and disease-free survival. For decades, the discussion of weight management in patients with cancer has been dominated by concerns about unintentional weight loss, low body weight and interventions to increase weight, often re-enforced by the existence of the obesity paradox, which indicates that high body weight is associated with survival benefits for some types of cancer. However, observational evidence provides strong grounds for testing the hypothesis that interventions for promoting intentional loss of body fat and maintaining skeletal muscle in overweight and obese cancer survivors would bring important health benefits in terms of survival outcomes and long-term impact on treatment-related side effects. In this paper, we outline the need for studies to improve our understanding of the health benefits of weight-loss interventions, such as hypocaloric healthy-eating plans combined with physical activity. In particular, complex intervention trials that are pragmatically designed are urgently needed to develop effective, clinically practical, evidence-based strategies for reducing EBF and optimising body composition in people living with and beyond common cancers.

Citation

Anderson, A. S., Martin, R. M., Renehan, A. G., Cade, J., Copson, E. R., Cross, A. J., Grimmett, C., Keaver, L., King, A., Riboli, E., Shaw, C., Saxton, J. M., & UK NIHR Cancer and Nutrition Collaboration (Population Health Stream). (2021). Cancer survivorship, excess body fatness and weight-loss intervention—where are we in 2020?. The British Journal of Cancer, 124(6), 1057-1065. https://doi.org/10.1038/s41416-020-01155-2

• Journal Article Type: Review
• Acceptance Date: Oct 22, 2020
• Online Publication Date: Nov 25, 2020
• Publication Date: Mar 16, 2021
• Deposit Date: Aug 30, 2023
• Publicly Available Date: Sep 7, 2023
• Journal: British Journal of Cancer
• Print ISSN: 0007-0920
• Electronic ISSN: 1532-1827
• Publisher: Nature Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 124
• Issue: 6
• Pages: 1057-1065
• DOI: https://doi.org/10.1038/s41416-020-01155-2
• Keywords: Cancer prevention; Risk factors; Weight management
• Public URL: https://hull-repository.worktribe.com/output/4372100