Up to 75 percent of breast cancers associated with modifiable factors like obesity, smoking, and inactivity | Ruth Patterson
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The majority of breast cancers occur sporadically as opposed to being genetically determined. Simple, moderate healthy behaviors can add up to reduce the risk of breast cancer. Such lifestyle choices include diet quality and timing, engaging in physical activity, maintaining a healthy weight, drinking alcohol in moderation, and not smoking. In this clip, Dr. Ruth Patterson discusses how healthful choices, such as even modest weight loss, can have beneficial effects that reduce the risk of breast cancer and a variety of other diseases.
Rhonda: I think a lot of people have in their minds, at least in the context of breast cancer, many women think about risk factors being genetic, you know, there are certain gene polymorphisms which are variations in the sequence of DNA that alter the function somewhat that can put a woman at risk. Particularly genes that are involved in repairing DNA damage, specifically in the breast tissue.
Ruth: Right.
Rhonda: BRCA1, BRCA2, I think many people are familiar with these genes. But really what your research and what a lot of research out there has shown is that there are lifestyle factors that play a if not equally important role, and certainly in combination with these genetic risk factors would probably be very, very important in modifying breast cancer risk. And not only risk but recurrence. So there are a few types of lifestyle factors that we talked about today that may, you know, dramatically lower a female's breast cancer risk, and also people out...women out there that have had breast cancer, certain lifestyles they should adopt in order to lower their recurrence.
Ruth: Right.
Rhonda: So what do you...if you want to talk about maybe top one.
Ruth: Yeah, you know, sure. You know, BRCA1 and BRCA2, if you have that gene, you know, polymorphism, that's a pretty special case. And those women are at very high risk of breast cancer and recurrence. And it's hard to know for that small percentage of women, how much lifestyle matters. But again, they're a special case, majority of cancers are just sporadic. We think that less than five percent overall of breast cancers are the result of genetic factors. And more like 65 percent to 75 percent are the result of lifestyle factors, including obesity, diet, physical activity, and smoking. And alcohol we think maybe for breast cancer. So those are all things you can modify. So the idea that you're doomed by your genetics couldn't be more wrong. For the majority...the vast majority of women, it is your lifestyle choices that will make the biggest difference in your risk, which is not the same thing as saying you're to blame because a lot of cancers are sporadic, but that there are things you can do to reduce your personal risk, a lot.
Rhonda: Well, that's good news.
Ruth: Yeah.
Rhonda: So don't smoke, moderate drink, you know, don't drink a lot. Lose weight.
Ruth: Lose weight if...and even a small amount of weight. Recently there was a study that seemed to show like they saw a huge improvements in metabolic health in the first five percent of weight loss. And then they said, if you looked at five percent to 10 percent of weight loss, it's like it flattened out. There wasn't, you know, it isn't like a linear thing. So it looks like even modest weight loss can really improve your metabolic health. So I think there's this perception that, well, if I don't get to model skinny, there's no point in even trying. And I think that's a really wrong way of looking at weight loss. Five percent weight loss could really make a difference.
Rhonda: Five percent of your...
Ruth: Five percent and keep it, you know, keep it off. You know, and maybe in a year or two you might go, "Well, maybe I'll lose another 5 percent," you know? But, the idea that there's like some very linear thing going on, I'm not sure the data really support that. So even modest weight loss, you know, work on the quality of your diet, work on the timing your diet, get some physical activity, please. You know, avoid long periods of sedentary behavior, all those things combined, good sleep, you know, and good food choices I think are...that's the total combination of things is the best thing you can work toward. And just make it a lifestyle to always be working on improving those things as your whole life.
Rhonda: I think that's fantastic advice. And I just want to mention that number again because it really is, you know, the best obviously...no one wants cancer, you know? That...if you can do whatever you can within your, you know, control to give yourself the best possible chance of not getting cancer...
Ruth: Right.
Rhonda: ...then really, really, really, really, really you should do it. That's, you know...
Ruth: And there's a super benefit here, is that it likely will reduce your risk of cardiovascular disease which after all is still the number one killer of women. So, you know, you're really getting a 360 effect on your risk of all the major killers in America, some unpleasant conditions like diabetes and also, hopefully, just feeling better every day.
Rhonda: Absolutely. And that's...
Ruth: Quality of life. Basic quality of life.
Rhonda: I think there's been studies showing like weight loss...
Ruth: Right.
Rhonda: ...improve your mood. You know, inflammations associate with depression...
Ruth: Yeah.
Rhonda: ...you know, and inflammation associated with obesity. So yeah, you're right.
Ruth: Right.
Rhonda: All these things, quality of life.
Ruth: Physical activity is associated with reduced risk of depression or ameliorating some of the effects. So there's, you know, it's not like there's a separate list of things you should do for one disease versus another, it's like the total benefit package.
Rhonda: Right. Yeah, they're all overlapping.
Ruth: Much more overlapping. We used to not think that as much. We used to think they were completely...here's the disease pathway for cardiovascular disease, it's very metabolic, it's blood pressure, it's cholesterol. And here's cancer, and it's a genetic disease and there are two separate pathways. Now, we see that they're actually way more overlapping than we ever knew and it's really good news because it means you don't have to do separate things for each disease. It means the same suite of healthful behaviors can give you 360 protection.
Rhonda: Well said.
Five to ten percent of breast cancers in the U.S. are linked to an inherited gene mutation, BRCA1 and BRCA2 (BReast CAncer genes 1 and 2) are the best-known genes linked to breast cancer. People who have a BRCA1/2 mutation have a greatly increased risk of breast cancer and (for women) ovarian cancer.
A waxy lipid produced primarily in the liver and intestines. Cholesterol can be synthesized endogenously and is present in all the body's cells, where it participates in many physiological functions, including fat metabolism, hormone production, vitamin D synthesis, and cell membrane integrity. Dietary sources of cholesterol include egg yolks, meat, and cheese.
A mood disorder characterized by profound sadness, fatigue, altered sleep and appetite, as well as feelings of guilt or low self-worth. Depression is often accompanied by perturbations in metabolic, hormonal, and immune function. A critical element in the pathophysiology of depression is inflammation. As a result, elevated biomarkers of inflammation, including the proinflammatory cytokines interleukin-6 and tumor necrosis factor-alpha, are commonly observed in depressed people. Although selective serotonin reuptake inhibitors and cognitive behavioral therapy typically form the first line of treatment for people who have depression, several non-pharmacological adjunct therapies have demonstrated effectiveness in modulating depressive symptoms, including exercise, dietary modification (especially interventions that capitalize on circadian rhythms), meditation, sauna use, and light therapy, among others.
A major contributing factor to aging, cellular senescence, and the development of cancer. Byproducts of both mitochondrial energy production and immune activity are major sources of DNA damage. Additionally, environmental stressors can increase this base level of damage. DNA damage can be mitigated by cellular repair processes; however, the effectiveness of these processes may be influenced by the availability of dietary minerals, such as magnesium, and other dietary components, which are needed for proper function of repair enzymes.
A critical element of the body’s immune response. Inflammation occurs when the body is exposed to harmful stimuli, such as pathogens, damaged cells, or irritants. It is a protective response that involves immune cells, cell-signaling proteins, and pro-inflammatory factors. Acute inflammation occurs after minor injuries or infections and is characterized by local redness, swelling, or fever. Chronic inflammation occurs on the cellular level in response to toxins or other stressors and is often “invisible.” It plays a key role in the development of many chronic diseases, including cancer, cardiovascular disease, and diabetes.
A change in one nucleotide DNA sequence in a gene that may or may not alter the function of the gene. SNPs, commonly called "snips," can affect phenotype such as hair and eye color, but they can also affect a person's disease risk, absorption and metabolism of nutrients, and much more. SNPs differ from mutations in terms of their frequency within a population: SNPs are detectable in >1 percent of the population, while mutations are detectable in <1 percent.
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