Visceral Adiposity and Cancer: Role in Pathogenesis and Prognosis

Abstract

The prevalence of being overweight and obese has been expanded dramatically in recent years worldwide. Obesity usually occurs when the energetic introit overtakes energy expenditure from metabolic and physical activity, leading to fat accumulation mainly in the visceral depots. Excessive fat accumulation represents a risk factor for many chronic diseases, including cancer. Adiposity, chronic low-grade inflammation, and hyperinsulinemia are essential factors of obesity that also play a crucial role in tumor onset. In recent years, several strategies have been pointed toward boundary fat accumulation, thus limiting the burden of cancer attributable to obesity. While remodeling fat via adipocytes browning seems a tempting prospect, lifestyle interventions still represent the main pathway to prevent cancer and enhance the efficacy of treatments. Specifically, the Mediterranean Diet stands out as one of the best dietary approaches to curtail visceral adiposity and, therefore, cancer risk. In this Review, the close relationship between obesity and cancer has been investigated, highlighting the biological mechanisms at the basis of this link. Finally, strategies to remodel fat, including browning and lifestyle interventions, have been taken into consideration as a major perspective to limit excess body weight and tumor onset.

Keywords: Mediterranean diet; cancer; fasting; lifestyle interventions; obesity; visceral adiposity.

Figure 1

Overweight and obesity increased the risk for developing cancer in different sites. Body fat has been associated with increased risks for a number of cancers that occur in different sites according to sex. The cancer types depicted in the figure displayed increased mortality rate if in association with an obesity condition. Parts of the figure were drawn by using pictures from Servier Medical Art. Servier Medical Art by Servier is licensed under a Creative Commons Attribution 3.0 Unported License.

Figure 2

Main biological mechanisms linking obesity and cancer risk. Obesity constitutes major determinants of the increasing incidence and prevalence of cancer. Several aspects underlying obesity, such as hyperinsulinemia, adiposity, and low grade inflammation, have been found as the major causes leading to cancer onset. Downward arrow indicates a decrease, whereas upward arrow indicates an increase. Abbreviations: GHR: Growth Hormone Receptor; IGFBP-1: Insulin-like growth factor-binding protein 1; SHBG: Sex Hormone Binding Globulin; TNF-alfa, Tumor Necrosis Factor-alfa; IL-6: Interleukin-6; IGF-1: Insulin Growth Factor-1. Parts of the figure were drawn by using pictures from Servier Medical Art. Servier Medical Art by Servier is licensed under a Creative Commons Attribution 3.0 Unported License.