This article explores modifiable risk factors for endometrial cancer (EC), the sixth most common cancer in women worldwide. Despite advances in diagnostic methods, the number of cases continues to rise. Obesity alone accounts for about 60% of preventable cases, highlighting the importance of diet and lifestyle in prevention.
The incidence of EC has increased by 1.5% each year since 2010, especially among premenopausal women in wealthy countries. Obesity is a major factor, showing that our eating habits and activity levels play critical roles in reducing risk. This review draws on research from the last decade to clarify how these factors affect different populations.
Diet can significantly influence EC risk. The Mediterranean diet, rich in fruits, vegetables, and whole grains, is linked to a 13% reduction in risk. However, this impact differs based on body mass index (BMI), ethnicity, and social background. On the other hand, low-carb diets like the ketogenic diet might help with weight loss but could pose risks if not balanced properly. High-fiber diets also show promise, particularly in reducing risk among specific groups such as younger women or those who are not obese.
A key debate exists over whether diet affects EC directly or indirectly through its influence on BMI. For example, studies suggest that BMI mediates 84-93% of the relationship between diet and EC risk. This implies that tailored dietary guidelines may be necessary based on regional dietary habits.
Beyond diet, various lifestyle factors can also impact risk. Regular physical activity of 7.5 to 15 MET-hours per week helps lower risk by improving insulin sensitivity and reducing inflammation. Conversely, sedentary behavior can increase the risk significantly. Interestingly, while smoking seems to lower EC risk due to its anti-estrogenic effects, it raises the risk of other health problems, making it a poor choice overall.
Psychological stress also impacts health and has been linked to poorer outcomes for EC patients, potentially altering immune function. Understanding how mental well-being interacts with physical health is an emerging area of research.
When it comes to genetics, conditions like Lynch Syndrome require unique strategies for prevention. Individuals with this hereditary risk are often advised to use specific medications like aspirin to manage their risk effectively.
The ongoing debate between reductionist and holistic approaches to dietary recommendations continues. A reductionist view focuses on individual nutrients, while the holistic view emphasizes balanced diets. Recent studies show that patterns like Mediterranean and plant-based diets are more effective overall compared to isolated nutrients. It’s essential to prioritize whole-diet patterns while still refining with specific nutrient knowledge.
Interestingly, lower-intensity exercise, like walking, often has better adherence rates compared to more vigorous activity. Obese women, however, need higher-intensity workouts to see significant risk reductions. Challenges remain in accurately measuring activity levels, but wearables are helping address this issue.
Looking forward, personalized prevention strategies are key. These might include metabolic phenotyping, which targets issues like insulin resistance, or genetic screening for tailored recommendations. Yet, barriers do exist, including a lack of large-scale studies integrating lifestyle and genetic data and limited validated screening tools for high-risk groups.
The path to effective prevention also involves digital health tools and culturally tailored strategies. Collaborations between healthcare professionals can enhance patient care and access to essential resources.
In summary, diet and lifestyle choices, especially patterns like the Mediterranean diet and increased physical activity, play essential roles in reducing EC risk. Personalization in prevention strategies, taking into account genetic and cultural factors, is vital for success. As research continues to advance, bridging gaps between scientific findings and practical application will be crucial for improving outcomes.
For more detailed insights, refer to the following article: Zhuang, X., et al. (2025). Dietary and Lifestyle Strategies for Endometrial Cancer Prevention: Emerging Evidence and Unanswered Questions.
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Cancer, Cancer Prevention, Endometrial Cancer, Anti-Inflammatory, Antioxidant, Aspirin, Chronic, Diet, Efficacy, Fatty Acids, Genetic, Genomics, Inflammation, Insulin, Mediterranean Diet, Nutrients, Obesity, Oncology, Physical Activity, Research, Vegetables
