Obesity serves as the gateway to a myriad of diseases, opening the Pandora’s Box to conditions ranging from diabetes to cardiovascular diseases, neurological disorders, mental health issues, and even cancer. However, not all excess adiposity impacts the body in the same manner. A recent international study, published in Science Advances, refines our understanding of obesity’s impact on colorectal cancer, identifying two specific body shapes associated with a higher risk of developing these tumors: individuals with generalized obesity and tall individuals with excess abdominal fat.

Understanding Colorectal Cancer

Colorectal cancer stands as the third most common cancer globally and the second leading cause of cancer-related deaths, according to the World Health Organization (WHO). In 2020 alone, there were nearly two million new cases and 930,000 deaths attributed to this disease. Apart from age, obesity, along with other lifestyle factors such as smoking and alcohol consumption, ranks among the primary risk factors for colorectal cancer. Individuals classified as overweight or obese—identified by a body mass index (BMI) above 25 or 30, respectively—face a higher likelihood of developing these tumors. As such, the scientific community now focuses on precisely defining these risk profiles.

The Complexity of Obesity and Cancer

Previous research efforts have identified body shape phenotypes associated with a higher risk of developing up to 17 different types of tumors. This new study delves deeper into the context of colorectal cancer. While the association between obesity and colorectal cancer is well-established, this study aimed to discern how different subtypes of adiposity correlate with colorectal cancer risk. The study characterized participants using four body shape patterns based on six different anthropometric indices, including BMI, weight, waist circumference, and hip circumference.

Refining Risk Profiles

The research categorized individuals into four distinct body shapes—labeled as 1, 2, 3, and 4—based on their similarity to each pattern. The study revealed that body shape 1, characterized by individuals with overall adiposity, was associated with colorectal cancer. Similarly, body shape 3, describing tall individuals with abdominal fat accumulation, also showed a correlation with colorectal cancer risk. Conversely, body shape 2, representing tall individuals without general adiposity, appeared to have no association with colorectal cancer. Body shape 4, identified as more athletic individuals with higher weight but less abdominal adiposity, was theorized to have weight primarily derived from muscle rather than adipose tissue accumulation.

Distinguishing Associations from Causality

It’s crucial to note that these findings establish associations rather than causality. Not all individuals with body shapes 1 and 3 will develop colorectal cancer. The study merely indicates an increased likelihood within certain phenotypes. For instance, body shape 1 individuals exhibit a 13% higher relative risk, while body shape 3 individuals show a 9% increased risk compared to the baseline population risk.

Genetic Insights and Implications

The study also delved into the genetic underpinnings of these four body shape phenotypes, uncovering differences in the origin of adiposity among them. The molecular pathways involved in body shape 1 differed from those in body shape 3. While the exact pathways leading from these phenotypes to cancer development remain unclear, understanding the genetic basis allows for tailored preventive strategies. For example, individuals with behavior-driven obesity may benefit from psychological interventions, while those with metabolically driven obesity may require different approaches.

Personalized Preventive Approaches

These differential genetic expressions pave the way for personalized preventive approaches. By identifying the genetic factors contributing to each type of obesity, future studies may develop targeted therapies to prevent weight gain. While these findings may not immediately impact clinical practice, they add to the growing body of evidence supporting the hypothesis that the distribution of body fat can influence cancer risk due to metabolic imbalances in tissues.

Clinical Implications and Randomness of Cancer Development

From a clinical perspective, these specific findings may not have immediate implications. However, they contribute valuable evidence to the understanding of how body fat distribution affects cancer risk. It’s essential to remember that cancer development involves a significant element of randomness, with up to 50% of tumors attributed to uncontrollable factors such as genetic predisposition and sheer chance.

In conclusion, obesity’s impact on colorectal cancer is nuanced, with different body shapes presenting varying levels of risk. By elucidating the genetic and metabolic mechanisms underlying these associations, researchers can pave the way for more personalized preventive strategies tailored to individual risk profiles. While these findings may not revolutionize clinical practice immediately, they represent a significant step forward in our understanding of the complex interplay between obesity and cancer.