Introduction
For years, the medical community has focused on genetic mutations as the primary drivers of cancer. However, a growing body of research is shifting that narrative, highlighting a crucial, often overlooked factor: metabolic health. Conditions like hypertension, diabetes, obesity, high cholesterol, and triglycerides have long been linked to heart disease and diabetes. Now, scientists are discovering that these metabolic disorders may also be significant contributors to cancer development.
At the forefront of this research is Dr. Urvi Shah, a myeloma specialist at Memorial Sloan Kettering Cancer Centre. After being diagnosed with Hodgkin lymphoma during her fellowship in hematology-oncology, Shah began to question the role diet and lifestyle might play in cancer development and survival. “As a patient, I wanted to feel empowered to do something to support my health,” Shah recalls. Her personal experience led her to focus her research on metabolic health and its potential to influence cancer outcomes.
The Metabolic-Cancer Connection
Metabolic syndrome, a term used to describe a cluster of conditions that includes high blood pressure, elevated blood sugar, excess body fat around the waist, and abnormal cholesterol levels, affects over 40 percent of Americans. While this syndrome is commonly associated with cardiovascular disease, recent studies suggest it may also be a significant driver of cancer.
Chronic inflammation, often fuelled by poor diets and sedentary lifestyles, is a hallmark of metabolic diseases. This inflammation damages DNA over time, increasing the likelihood that normal cells will become cancerous. In fact, a 2024 study published in Cancer revealed that individuals with three or more components of metabolic syndrome had a 30 percent higher risk of developing cancer than those without these risk factors .
The connection between metabolic disorders and cancer is not limited to obesity. Research shows that even normal-weight individuals with metabolic syndrome have a heightened risk of developing cancer. This suggests that the issue is not just about body mass but about how the body processes and responds to food, hormones, and energy.
The Role of Inflammation and Insulin Resistance
One of the key mechanisms linking metabolic syndrome to cancer is chronic inflammation. Excess body fat, particularly around the abdomen, promotes inflammation and increases levels of insulin-like growth factor (IGF-1), a hormone that plays a role in cell growth. High levels of IGF-1 can stimulate the growth of cancer cells and inhibit the normal process of cell death, allowing cancerous cells to thrive and spread .
Dr. Stephen Freedland, director of the Centre for Integrated Research in Cancer and Lifestyle at Cedars-Sinai, explains that this metabolic dysfunction is a common denominator in many types of cancer. “The mechanisms may be different for different cancers, but metabolic dysfunction—whether it's driven by insulin resistance, inflammation, or abnormal lipid levels—is at the root of many cancer cases,” Freedland says.
This dysfunction is particularly evident in obesity-related cancers. Studies have shown that obese women have a threefold greater risk of developing endometrial cancer and a significantly higher risk of kidney cancer compared to their normal-weight counterparts.
Can We "Starve" Cancer Cells?
The relationship between cancer and metabolism dates back to the 1920s when German scientist Otto Warburg discovered that cancer cells have a unique metabolic profile. Unlike normal cells, which can use both glucose (sugar) and fats for energy, cancer cells rely almost exclusively on glucose to fuel their rapid growth. This quirk, known as the "Warburg effect," suggests that controlling blood sugar levels could be a potential strategy for limiting cancer growth .
This discovery has led some researchers to ask, Can we “starve” cancer cells by reducing glucose intake? While the idea is intriguing, most scientists are cautious about making such claims. However, there is evidence that poorly controlled blood sugar, particularly from diets high in refined carbohydrates and sugary beverages, can increase cancer risk. Several studies have found that diabetes patients who take metformin, a drug that helps stabilize blood sugar levels, have a lower incidence of cancer than those who do not take the drug.
The Power of Diet in Cancer Prevention
Dr. Shah is now leading four dietary intervention studies to explore how nutrition can help prevent or even treat cancer. Her work builds on research showing that high-fibre plant foods, such as vegetables, fruits, legumes, and whole grains, may reduce cancer risk by promoting healthy gut bacteria, lowering inflammation, and improving insulin sensitivity.
“There’s strong data suggesting that metabolic syndrome plays a significant role in cancer development, but we don’t often think about how diet and lifestyle changes can modify that risk,” Shah says. One of her studies, which focused on the impact of sweetened beverages, found that individuals who consumed large amounts of sugary drinks had a 40 to 60 percent higher risk of developing multiple myeloma-related abnormalities. Conversely, those who consumed whole grains and plant-based foods had a 30 to 50 percent lower risk of developing this precancerous condition .
These findings echo what other studies have shown: A diet rich in antioxidants, fibre, and plant-based foods can significantly lower the risk of cancer. Antioxidants, found in fruits and vegetables, help neutralize harmful molecules known as free radicals, which can damage cells and lead to cancer. Additionally, fibre helps regulate blood sugar levels and supports the growth of beneficial gut bacteria, which play a crucial role in modulating the immune system and reducing inflammation.
Beyond Diet, The Role of Lifestyle
Diet is not the only factor influencing cancer risk. Research has shown that stress, poor sleep, physical inactivity, and loneliness can all contribute to metabolic dysfunction, even in individuals who maintain a healthy weight. Chronic stress, for example, can lead to elevated cortisol levels, which interfere with insulin regulation and promote inflammation—a key driver of cancer .
Regular physical activity, on the other hand, has been shown to improve insulin sensitivity, reduce inflammation, and lower the risk of several types of cancer. Even moderate exercise, such as walking or cycling, can have a significant impact on metabolic health and cancer prevention.
“Lifestyle changes are often overlooked in cancer prevention strategies, but they are incredibly powerful,” Freedland says. “What we eat, how active we are, how well we sleep—these all influence our metabolic health, and in turn, our risk of developing cancer.”
Looking Ahead, The Future of Cancer Prevention
As the understanding of cancer’s metabolic roots grows, so does the potential for new prevention and treatment strategies. Shah believes that focusing on metabolic health offers a promising avenue for reducing cancer risk across the population. “There’s still scepticism in the medical community about whether modifiable risk factors like diet and lifestyle can make a significant difference,” she says. “But the evidence is there, and patients are eager for this information.”
By monitoring metabolic markers such as blood sugar, cholesterol, and inflammatory proteins, doctors may one day be able to detect cancer earlier or even prevent it altogether. And for those already diagnosed with cancer, improving metabolic health through diet and lifestyle changes could enhance survival outcomes.
The bottom line? While we can’t control all the factors that contribute to cancer, we can take meaningful steps to improve our metabolic health, and, in doing so, reduce our risk of this devastating disease.
Reference
- Metabolic syndrome and cancer risk- Cancer, 2024
- Chronic inflammation and cancer - Journal of Cancer Research and Clinical Oncology, 2020
- Obesity and cancer risk - National Cancer Institute, 2021
- Warburg effect in cancer cells - Frontiers in Oncology, 2021
- Metformin and cancer risk - International Journal of Cancer, 2020
- Sweetened beverages and myeloma risk - Cancer Epidemiology, Biomarkers & Prevention, 2019
- Antioxidants and cancer prevention - Molecular Cancer Research, 2018
- Stress and metabolic dysfunction - Frontiers in Psychiatry, 2019