This is Roswell. Rookie by Roswell Park Cancer Institute. European opinion where your total options. -- -- him -- welcome back to Ron's mom is a comprehensive look at all aspects of cancer here treatment diagnosis and research. From a comprehensive source Roswell park cancer and. Do right here in Buffalo, New York that's where I am and to my anger and today. Talking about obesity and its relationship with cancer lots of interesting and eye opening information for you today. With doctor Chee Chen Hong she's an epidemiologist and assistant member in the department of cancer prevention. And control doctor -- thank you for being here appreciate it. If you can no stone is left unturned here at Roswell park I've been here you know offer a few years in doing these these programs I had no idea that we had. You know someone like yourself looking into. You know this this subject matter this relationship between obesity and in in cancer removed as we walk through the show I think I know what cancers are more prevalent. Within folks who are obese obesity in and of itself in this country though. From my understanding is. It's an epidemic and it really has grown. To be quite a problem -- Yes that's absolutely true so obesity really has risen since 1990s the rate of obesity and I would say it in 1970s knows about 15% of people who are actually a piece and then now it's about 35% so now there's about even -- there's about. Thirty like that it individuals are overweight splintered as individuals or -- fell 13 of individuals are normally. And the way we're different. Let's just step -- -- -- of the wayward declining obesity is five by mass index of 1% so that is a com. -- to look at weight accounting for how tall you are. So -- applied mass index is calculated by taking awaiting kilograms and dividing it by your height in meters. And so. Individuals with a body mass index less than 25 are considered normal weight those between 25 and place ever considered overweight. And those who haven't be migrating thirty are considered obese. Okay. When we be you know those numbers I know it's really go online and in production it's very easy to find one of those BMI calculator so. You know it's it's pretty comments of anybody listening would like to do that you can go online do that. I'm in calculate your own with the you know we know him you don't need to know the the meters and the kilograms you can just plug in height -- weight. In US measurements but. You know a body mass of an -- 25 in that eighteen the upper under the 25. You know is that. Let's see how do you characterize it means that someone that is really. You know is significantly overweight or. Now also if you actually look at individuals. Who's had to be in my about 2527. -- you wouldn't think that they weren't that. Overweight at all and and I think that's probably shifted a little somewhat in the previous insert in the past -- piece of what we considered normal. Weight and so. Really a person 25 to thirty. Are slightly -- but they're not grossly you know they're not grossly obese. What is it pretty they're contributing factors to put the problem with obesity in the United States you just mentioned some statistics of you know was 15% and now we've grown. You know I'm not looking for statistics but. What what is that the the root cause of this nation's. These chronic I guess we could go I characterize it. Problem with obesity. So there's a number of factors that I she could contribute to obesity that is sort of changed over the previous decades. One is there's an analyst increase in portion sizes. There is site increased consumption of high calorie conveniences a lot of sugary drinks. Drinking a pop. A lot of times. We work more now and so there's less time for food preparation will be just -- didn't kitchen and so there's more reliance on restaurant meals. And also there's a declining activity a physical activity and that happens. Right through high school we see that children when they're younger half higher levels of his captivity in -- baker. Through high school of the levels decline and that sort of carries into adulthood. For ten interest thing in our society because we do we require kids you know up through that age of eighteen and in sometimes in the college they have that regiment. Of some sort of a physical activity may be a sport around and it's just you know is that in school. And that that tells off you know -- -- I felt like when we start working and we don't if he has the regiment indeed probably the time. Absolutely and you know -- once you get into words and then you have children it becomes harder and you really have to make some time to. He'll try to prepare meals tried to go well for blocks you'll have access connectivity built into your daily life. Tim we'll get into that later there are some recommendations that will cool over on the eighth I think -- fairly common sense but important things they think that we can all. Make some changes in our lifestyles they couldn't. Need to keep our our BMI below that 25 were it is so -- you mentioned portion sizes it's always of interest to me. When -- restaurants today I -- portion sizes are just out of control I mean they're huge. Today. Yeah when you are you know I've watched television shows with nutritionists and -- dietitians. You know telling me how much you know a portion of steak is -- the the inside palm of your hand written I think that's what our -- I mean that's not the way it is when you go out. Now it is and it's funny because what I well it like it. We actually will order some times two meals and share three -- amongst three people and things like that we'll do different things to try to get portion size. And that's how children you know we have that the plates at home. And instead of you -- you just -- he'll play great that's what you do you feel pleased with it. And if you try to use a smaller -- US food and so what we've done at home recently. On this -- Apple's just because they. -- less than intent that the restaurants love you when you show up in order and then I get your whole family there today. You know we'll get into some real specifics here of obesity and cancer risk interest in what you do is an epidemiologist here Russell -- how do you study all this where you get. All of these did that this kind of information and in apply it to cancer research -- like here Russell park. So. I don't so. I can connect epidemiologist and I have a background in nutrition. And I end. A master's degree that was focusing on obesity. So when I first came here I was interested in the eyes and -- -- relationship between obesity and weight gain amongst breast cancer patients. So what happens and breast cancer patients as they go through treatment the actual gain weight. And that -- -- has been shown to be independently associated with -- poor prognosis. So they have increased risk of recurrence they have increased risk. Died from their press cancer and so. The right now we really don't understand why. Individuals -- breast cancer patients gain weight and through their treatment and so a lot of things I do obviously is focused on that and so when I first came here. I set up a cool toward breast cancer patients. With the help of -- breast cancer surgeons. As well as doctor Christiane -- who thinks that your cancer prevention when it first came here with her post doc. And so we at that point set -- -- -- where we Britain enrolling women who -- newly diagnosed with breast cancer who hadn't gone through treatment yet. And we were tracking their weight gain as they went through treatment and at the same time we were looking at a number of factors -- -- -- -- social factors through work. So all these women hatfill. Fairly extensive survey on a number of risk factors that could be related to -- game. I'm so they're looking at diet exercise psychosocial factors stress. Cost us the support from their families and then we also. Collected blood. And so what we're trying to do is figure out what are the factors contributing to -- in this in these women and how potentially doesn't affect. Their quality of life and then down the -- potentially there. There was a recurrence. Of costs. Obesity. Being in folks who are overweight. Fourteen to 20% as -- read -- of all of cancer related mortality. Is represented by by people would be considered. To be obese to you that's a pretty daunting daunting number. I'm I'm curious that -- you know that we talked a lot about tobacco and smoking that -- you know -- it's never too late to quit that and even upon admission for treatment it's not too late. 22 to quit tobacco it's not as easy to. Lose weight. I mean. Is there a significant. Improvement in someone's. Prognosis or outcome if they make some changes even right up at the point of diagnosis and mean in some of these different cancers. So this is actually really good question -- and is actually a very time. This is very important research question that a lot of people are sort of looking into right now because we know that. Wait at the time of diagnosis is associated with poor prognosis. OK so at the moment there's a lot of speculation that weight loss after diagnosis can potentially improve survival. And so. There's been. Very few studies have really been able to address this question so at the moment there's. There's one study that's trying to recruit about 700 women. And it's looking it's being conducted an early stage breast cancer patients and the aim of this study specifically. Is -- energy study which is to exercise and nutrition. To enhance recovery in good health and you study. And so that eight of the study is really to explore whether weight loss. Impacts quality of life and -- disease breast cancer patients as well as their overall recurrence as well as well as their chance of getting breast cancer recurrence. And disease free survival. So I was really never too late I mean it's just. And making them like I don't know her okay we really RS in question yes but. Let it it is I guess my point you know if there at the beginning that question is that. You know stop smoking immediate effect. It's easy to -- can't lose weight that quickly he can't. You know for most of us -- what -- can say is that from the from earlier studies that affect cancer risk that if you can't make modifications. Particularly at this intentional that you wanted to lose weight. It looks like a lot of the bio markers that are associated with cancer -- change immediately and so then. If you make it different then you -- it would suggest that if you change. If you reduce your waiter -- if you -- lose weight that the affection for pretty. -- an interesting information here today this is Roswell this and we're in studio today here at Roswell Park Cancer Institute. With doctor Qi Chen Hong an epidemiologist and assistant member in the department of cancer prevention. And control talking. So far pretty much in general about obesity cancer and and now what they'd like to do doctor -- is. Is get a little bit more specific with a different types of cancer that. Might be. Related to obesity and I do you mentioned breast cancers being one. Of the cancers that. Obesity has a relationship with a correct. That's right. So. -- so I'm. So BC is. Assistant with a number of cats increased risk of a number of cancers and the strongest winds are four. Post menopause -- -- cancer not so much for pre menopausal breast cancer. So for those women on those rupees compared to those who aren't there. Approximately 50%. They have approximately 50% higher risk of peace. -- I'm so the other cancers that are says it was obesity would be colon and rectum. For women there's about a 50% increased risk if Euro. If your peace and for men is about to fold increased risk. And then the other one that's big ones and Dmitry and so. -- that sounds so that's the lining of the unit uterus and so far those sort of these there's about three and a half fold increased risk. I cancer amongst those who are apiece. Do we know although it did the YE in all of this we know that there you know that that the relationship is there -- -- you know obviously the researchers establish that. And we know what the cause is why why obesity leads to those. You know is is -- related to those particular cancer see very mentioned. We also something's about -- settle in terms of the mechanism so -- early bird. Particulate breast cancer and look at sex are. We know that. At a -- issues is the site where a lot of the estrogens and hormones are our army and so. For breast cancer we know. Especially postmenopausal. It. Whitman that. Most of their estrogen is neat in. Fat tissue at a -- issue. And so those who have. Who are overweight tend to have higher cash levels that puts them at higher risk for breast cancer. Now suspect subsequently more recently now. We've done now on there's not worth looking into other. Potential mechanism so we know now that insulin. And I GM -- which are both. Associated with obesity. Our associated with increased risk of press counselor and I think colorectal cancer. Prostate cancer is prostate cancer related at all. Prostate cancer. Obesity doesn't seem to be associated directly -- prostate cancer risk but it seems to be related more aggressive prostate cancers. And also. It seems to be related to. Poor prognosis. For prostate cancer. That. You know we all see it like we mentioned through our schooling years you know might be more active and involved in in in a regular exercise routine and some of those try to continue that into our. Adult life but just as -- nature of aging. We do gain weight on and some people gain more some people -- less as people go through their their lives what can you tell us about. You know someone who is real active and in making every effort is to stay fit and in India. You know healthy weight vs someone who just lets that natural aging you know maybe doesn't go out of control and gain a ton of weight which -- does not. You know quite as fit and trim is the person that's making all those efforts is there is avoiding that that game. Gonna make an impact and I'm someone's. Potential for. Developing cancer. It could hurt specific cancer so thanks to some breast cancer we know that I don't licking his associated with increased risk. Breast cancer so an end and it doesn't have to be huge so you can game. You know 51015. Pounds and that's and a -- I think the 7% of counts are higher than it's gonna happen that if an impact. So I'm certainly. You would want to try to prevent. That he that creeping up from -- that happens. Or naturally over the years. When we talk about that obesity you know someone can be just generally obese but a lot of us fight. The abdominal fat you know that that's probably that the first thing that people notice. And probably the most stubborn. That the people tried to rid themselves of and I know abdominal that is of of particular concern. -- it is so there's just growing evidence that abdominal obesity is really detrimental -- For a lot of chronic diseases and that includes them. I diabetes. Having high class levels and inflammation and so. Whether. Research interest out there now is looking abdominal fat and cancer risk. And so now there's pretty good evidence that abdominal obesity is associated with colorectal cancer. And possibly also to pancreatic cancer endometrial cancer and postmenopausal breast cancer. So one of the reasons that it can do this this. Before we have taught that at a post issue or Arafat was pretty generic vote now looks like Tom. Fat tissue for -- those around after them on you know are pretty metabolic an active and so one of the things that. That comes up in chosen how and mechanisms for how. Obesity can -- fact -- cancer risk. Is through information so one of the things is that. Fact releases certain chemicals chemicals called -- kinds and different kinds. Now one of them has left ten and which is pro inflammatory. And if you're leaner you tend to -- higher levels act out of connected and so these are anti inflammatory. And so one of the things that has been shown is that information. Increases overall cancer risk and seems to be potentially related to our prognosis. We know there's a relationship obviously staged here between you know obesity and cancer is or anything that we can do or they can be done. To change that relationship and and modified. So just really good question so one of the things that you know is really interesting is the idea of well. If we're fitter -- disk activity if we're fit and even despite the fact that we're appeasement that potentially lower our risk. A cancer and and improve our prognosis if he has cancer. And so we know. There's really strong evidence that fiscal activity associated with reduced cancer risk. And a lot of the mechanisms that it may be immediately -- it is you know similar to the ones obesity and so -- since it reduces inflammation. It and found reduces certain hormones levels that are associated with -- increased risk of movies of cancer. So -- question will be well if we're fed can -- reduce. Can't believe modifying the association between. Obesity and cancer and so. That's really asks a part of research that's now just beginning. And there's been once study recently that was kind of interesting when it showed us that. That fiscal activity -- used. Cancer risk but. If individuals are obese fat. That benefit is actually lost so it looks like. Even if it looks like. -- just based on that that physical activity. Probably won't be able to modify their risk between a piece. Obesity cancer. Come very much. Can cut a what are let's get news in the universe follow what our stands and a lot of people around them in the -- there's a relationship peer to right. Potentially so what happens is with them. With that obesity and cancer risk. What you wanna do is look at the time. Identify potential factors that could modify this risk and so things that's interesting is that it's because a lot of obese individuals have -- Apple's announced that its. And sat -- kind of interesting because. They actually block -- -- and time. That the findings -- cholesterol. And they're taken by a lot of people and salute a common ones -- Lipitor. And so there's a lot of research in animals and also observational studies -- people that suggests that the these drugs can actually lower risk of certain cancers so one and a and so one of them is colorectal cancer where the -- is fairly strong. So so the strongest candidates is first abilities and fashion news conference to risk. And down at the moment the NTI had to study going on. Which is testing whether Staten might actually used present colorectal cancer so it's under the NCI's cancer prevention clinical tries consortium with regard to obesity and in -- quality of life for for cancer patients have become an and that for me. So right up to now we've really talked about obesity and cancer risk of cancer prognosis -- obesity can also affect a lot of issues associated with. Quality -- -- cancer patients. For instance of obesity will lengthened -- recovery times for cancer patients. After surgery on -- tend to have more blood loss they have poor healing higher infection rates. So if you compare those herpes compared to those living on -- they're more likely to have. Here thoughtful more likely -- have complication rates as they go through their cancer treatment at least with surgery. With breast cancer patients for instance obesity and increased their risk of lymph edema which is when you get swelling of the iron. -- you to you blockage of the lymph vessels. So that's about 3.5. Fold increased risk. Other things is that obesity for instance. Obese patients tend to report higher rates fatigue it can't be more tired. And so there's a lot of ways that a PC potentially can affect quality of life and cancer patients. Finally it all you know with what it boils down to you know you know I think is that we need to make some you know some choices that are our lifestyle and in the in the earlier the better I'm assuming. The American Cancer Society has guidelines out. You know that. I know. You're familiar with if you could comment on what the ACS is recommending that we we do and against some of these are pretty common sense but I think they're really important based on what you told us today. Great they are and so ACS really puts out these recommendations every five years -- sullen and it was last updated just last year in 2012. And so. They have a number of recommendations sensor targeted towards individuals as well as towards the community so if we just look at the ones -- targeted towards. I individuals' choices that people could make they're. They're basically three prong in their approach the first is that. They're recommending that we have to maintain how unhealthy weight throughout our lifetime. And so -- it's important to be as little as possible without being underweight. We have to avoid excess weight gain. I'm throughout all the ages. Throughout our entire lifetime and so those who are currently over greater peace. The recommendation is that even if we -- a really small amount of weight. That is gonna have to -- -- health benefits and that's just a good place to start. Come they also recommend that we engage in regular physical activity and limit consumption of you know high calorie foods such -- You know the high fat foods that we we have mr. briefings that we alike and beverages and so that's sort of a strategy for maintaining. I'm healthy way. Announcing they recommend is that we all adopt tough physically active lifestyles so. Adults should enter engaged at least a 115 minutes of moderate intensity or arson in five minutes of vigorous intensity. Activities. And then one of the important things are areas is coming out his -- we should -- last secondary nation's. Reduced amount and that we actually sent and so there's some evidence now that increasing. And that. The amount time that we sit contributes to cancer risk pretty fast vascular risk and so forth. And then there's their recommendation as is that we eat healthy diet. With an emphasis on classes so you want to eat lots of fruits and vegetables get that five. Servings in early size servings and. That's one of the problems in this country vegetables so when I go home tonight I'm gonna go for a runner walk in Eminem -- -- and have a little portion of of whatever it is played with the portion control is is probably the hardest thing that. I deal with I think a lot of us -- here in the United States feel that this is really interesting stuff. The relationship of obesity. To our lives in and today and specificity. Its relationship to cancer. Doctor -- thank you so much appreciate it thank. That is doctor Chee Chen Hong an epidemiologist and assistant member in the department of cancer prevention and control. Here at Roswell park a few more questions. About any of this you can of course called Roswell anytime it on the toll free line that's 877 ask our PCI. That's 8772757724. The website has lots of information you can go there anytime of course at Roswell park dot. Listen to Roswell this Sunday mornings at 630 young WB EN. -- by Roswell Park Cancer Institute -- team opinion for your total options on line at Roswell this god of war. You -- And -- do you. Then.