Dietary and Lifestyle Management Strategies
Increase Physical Activity and Maintain a Healthy Weight
Epidemiological studies have shown that increased physical activity is associated with an up to 30% reduction in the risk of developing endometrial cancer (Cust 2011). Physical inactivity and obesity are well-documented risk factors associated with the development of endometrial cancer (Terry 1999; Goodman, Hankin 1997; Fader 2009). This can be attributed to significant increases in exposure of the endometrium to estrogen generated by fatty tissue deposits. Several studies have shown that obesity increases the risk of endometrial cancer by over 4-fold, and sedentary lifestyle can increase the risk by up to 46% (Wynder 1966; Goodman, Hankin 1997; Fader 2009; Terry 1999; Schouten 2004). A study completed in 2011 found that while overweight women had 1.5 times the risk of developing endometrial cancer compared to women at a healthy weight, obese women had almost 5 times a normal-weight woman’s risk of developing the disease. Importantly, women who experienced a 35% weight gain in their 20s developed endometrial cancer approximately 10 years earlier compared to women without such weight changes early in their lives (Lu 2011).
Achieving a healthy weight may be one of the most impactful lifestyle changes women can make to reduce endometrial cancer risk and potentially improve treatment outcomes. Life Extension® has developed a comprehensive Obesity and Weight Loss protocol that outlines several strategies that may help achieve a healthy weight.
Reduce Sugar Intake and Avoid Type 2 Diabetes
Although type 2 diabetic women have for many decades been observed to have a higher risk of developing endometrial cancer, the actual contribution of insulin resistance and diabetes toward developing endometrial cancer has only relatively recently been appreciated (Soliman 2006; Berstein 2004). Since diabetes typically leads to weight gain, and because fat deposits in overweight and obese people secrete estrogen that promotes endometrial cancer development, it was thought that the contribution of diabetes to endometrial cancer risk was only indirect. It is now understood that diabetic, non-obese women who are otherwise healthy continue to be at a higher risk of developing endometrial cancer (Weiderpass 2000; Burzawa 2011; Soliman 2006; Berstein 2004). This information is supported by the fact that metformin, an anti-diabetic agent, appears to hold considerable promise in the prevention of endometrial cancer (Zhang 2011; Xie 2011). The potential role of metformin in the prevention and treatment of endometrial cancer is outlined thoroughly earlier in this protocol in the “Novel and Emerging Therapies” section. In addition, a number of strategies for achieving healthy glucose regulation are available in the Diabetes protocol.
Adhere to a Mediterranean Dietary Pattern
The traditional dietary pattern of populations of the Mediterranean region has come to be regarded as one of the healthiest eating styles in the world. Centering upon whole grains, vegetables, fruits, olive oil, fish, moderate dairy, and wine, the Mediterranean diet has been shown in a large body of published scientific literature to reduce the risk of several of today’s most prominent ailments including obesity, cardiovascular disease, and cancer (Hadziabdić 2012; Altomare 2013). Accordingly, rates of endometrial cancer in the Mediterranean region are lower than in the United States and United Kingdom, and this discrepancy is thought to be due, at least in part, to differences in eating styles between these regions. In fact, it has been estimated that 10% of endometrial cancer cases could be prevented if “Western” societies shifted to a Mediterranean diet (Trichopoulou 2000). In one study, adherence to a “Western” diet, which is high in saturated and animal fats as well as refined carbohydrates, was associated with a 60% increased risk of endometrial cancer (Dalvi 2007).