Research seemingly “proves” that obese older women are stuck with higher breast cancer risk. So untrue.

Obese Older Women Stuck With Higher Breast Cancer Risk?

Losing weight didn’t lower risk. Neither did hormone therapy

This is the actual headline for the article; “Obese older women STUCK with higher breast cancer risk”.  This sentence takes the wind out of the sails of obese postmenopausal  women who CAN decrease their risk for breast cancer with fat loss from an insulin normalizing way of life.  

Shame on the researchers for putting the spotlight on the wrong marker and concluding that weight loss doesn’t help decrease breast cancer risk.  Weight loss focused on insulin normalization (fat loss) does significantly decrease all womens’ chance of breast cancer.  Low calorie, low fat diets will never help these women decrease cancer risk.  A carbohydrate balanced fat loss diet WILL.  

obese woman 1

 It angers me that  researchers had the evidence right in their hands, and chose to use the wrong marker (weight loss) to seemingly doom post-menopausal obese women to be powerless against breast cancer.

 If they had used fat loss and insulin normalization as their marker, they would have concluded that obese, post menopausal women…in fact any woman… can markedly decrease her risk of developing breast cancer. Don’t give up and please don’t believe all research; research data can be manipulated to show what the researchers and funders of the research want you to believe.  Please read and live The Metabolism Miracle.   

My Comment:

 Diane Kress, RD CDE


I want to discuss the picture used for this article. Notice that the measuring tape is placed under the woman’s breasts. When discussing overweight and obesity as it relates to cancer risk, the correct placement of the measuring tape is around the largest part of the belly. Why? The truth is, the greatest percentage of women who develop breast cancer already have insulin imbalance, insulin resistance, and higher circulating insulin. Insulin is a fat gain hormone and the majority of fat placement for those with metabolic issues is midline adiposity. Secondly, the real issue is not necessarily weight or weight gain; it is fat gain. Losing weight will not decrease the risk of breast cancer if insulin is not normalized. The headline should be: Normalize insulin and decrease risk of breast cancer and 24 other health issues. I apologize to all the women who will throw in the towel losing fat and normalizing insulin because this article focused on the wrong area: weight loss. Please read: linked-break-the-link-and-help-prevent-and-trea-breast-cancer/

Here is the actual article that appeared on MedPage 6/12/2015.

Note that they only focus on “weight loss”.  If a woman loses weight but does not normalize her insulin level, she does not decrease her risk for breast cancer.



Obese Older Women Stuck With Higher Breast Cancer Risk?

Losing weight didn’t lower risk. Neither did hormone therapy

This article is a collaboration between MedPage Today® and AACE

Overweight and obese postmenopausal women were at increased risk for invasive breast cancer, but losing weight didn’t reduce that risk, according to a secondary analysis of data from theWomen’s Health Initiative (WHI) clinical trials.

Hormone therapy didn’t lower the risk either, contradicting the results of many observational studies, said lead investigator Marian Neuhouser, MD, PhD, of the Fred Hutchinson Cancer Research Center in Seattle, and colleagues.


The investigators reported in JAMA Oncology that they found a strong, linear dose-response relationship between body-mass index (BMI) and breast cancer risk, with the heaviest women 58% more likely to get the disease compared with normal weight women.

Women with normal BMIs at baseline who gained more than 5% of their body weight increased their breast cancer risk by 36%. But women who were overweight or obese at baseline and then lost more than 5% of their body weight didn’t benefit from any risk reduction, the study found.

“This was a surprise,” Neuhouser told MedPage Today. “Several studies have looked at body weight and postmenopausal breast cancer risk, but there is not much data on weight change and risk, so this is kind of new.”

The researchers analyzed data from more than 67,000 postmenopausal women ages 50 to 79 enrolled in the WHI clinical trials, a series of studies exploring health issues related to postmenopausal women. The women were enrolled from 1993 to 1998 with a median of 13 years of follow-up.

Height and weight were measured at baseline and weight was measured at annual visits. Mammograms and clinical breast exams were done at baseline and annually. A total of 3,388 cases of invasive breast cancer were observed during the study. These were verified by medical records and pathology report reviews by physician adjudicators.

The investigators used Cox models to calculate hazard ratios and 95% confidence intervals. Key findings included the following:

Overweight women (BMI 25 to <30) had a relatively small increase in breast cancer risk (hazard ratio 1.17; 95% CI 1.06-1.29), obese grade 1 women (BMI 30 to <35) had higher risk (HR 1.37; 95% CI 1.23-1.53), and obese grade 2/3 women (BMI ≥35) had the highest risk (HR 1.58; 95% CI 1.40-1.79), with a P value for the trend of <0.001.

The researchers observed a similar linear trend for breast cancer prognosis and outcomes, with woman in the highest BMI category having the greatest risk for:

  • Estrogen and progesterone receptor-positive breast cancers (HR 1.86; 95% CI 1.60-2.17)
  • Larger tumor size (HR 2.12; 95% CI 1.67-2.17)
  • Positive lymph nodes (HR 1.89; 95% CI 1.46-2.45)
  • Regional and/or distant stage (HR 1.94; 95% CI 1.52-2.47)
  • Breast cancer deaths (HR 2.25; 95% CI 1.51-3.36)

Women with normal BMIs who gained more than 5% of their body weight during follow up increased their breast cancer risk relative to women with stable weight (HR 1.36; 95% CI 1.11-1.65). The investigators speculated that weight-gain induced increases in breast adipocytes, and exposure to cytokines and estrogens might explain this finding.

“The take-home message here is that maintaining a healthy weight at midlife and beyond is critical,” Neuhouser said. “This is a risk factor that is modifiable. We can’t control genetic risk, but we can control body weight to a certain extent.”

However, for women who were overweight or obese at baseline, no weight loss or gain further changed their risk. For example, women in the highest BMI category who lost more than 5% of their body weight had no risk change relative to women whose weight remained stable (HR 1.01; 95% CI 0.79-1.29).

One possible explanation for this finding is that if women are at the upper end of the BMI range and have been there for enough time, the biological damage may already be done, Neuhouser said.

However, “It is important to note that the WHI clinical trial was not a weight-loss trial, and the weight change data we present may reflect both intentional and unintentional weight loss,” the research team wrote. “Well-designed clinical trials are needed to definitively test whether weight loss and body composition changes in overweight and obese women or obesity prevention in women of normal weight will reduce breast cancer risk.”

No Protective Effect for HT

Another unexpected finding was that postmenopausal hormone therapy did not significantly affect the relationship between BMI and breast cancer risk, either for current users, past users, or never users, the researchers said.

This result contradicts that of many previous observational studies which reported that hormone therapy appeared to mitigate breast cancer risk in obese women. However, Neuhouser and colleagues argued that their results are more reliable. “Differences in findings may be due to observational studies’ reliance on self-reported height, weight, and HT and may be subject to mammography screening and ascertainment bias when outcomes are collected by self-report,” they wrote.

“Notably, there are higher rates of routine screening mammograms for women receiving postmenopausal HT,” they said. “The larger detection rates from screening mammograms could introduce bias in the observational studies if obese women underwent screening mammography at a different rate than women of normal weight.”

“The WHI clinical trial findings of consistent dose-response risks across the BMI categories regardless of postmenopausal HT use have clinical implications,” the investigators wrote. “One report suggested that since the obesity-breast cancer risk was attenuated or not observed among HT users, obese women may benefit from HT use because they observed no excess breast cancer risk for these women.”

“However, the preponderance of evidence suggests that postmenopausal HT is not beneficial for multiple health outcomes, including breast cancer, and the risks outweigh the benefits,” the investigators said.

Neuhouser added that, “The bottom line is there is no blanket recommendation here. Patients and providers need to weigh the risks and benefits.”

In an editorial accompanying the study, Clifford Hudis, MD, of the Memorial Sloan Kettering Cancer Center, and Andrew Dannenberg, MD, of Weill Cornell Medical College, wrote that “Neuhouser et al. help refine our understanding of the risk of overweight and obesity; it is a particular concern for the most common form of breast cancer, hormone receptor-positive postmenopausal disease.”

“These investigators also made a frustrating observation with regard to weight loss: it was not protective, whereas weight gain (among women who were in the non-overweight/non-obese category at baseline) raised risk. This challenges the simple suggestion that patients who are overweight or obese should just lose weight to reduce their cancer risk,” Hudis and Dannenberg said.

“We need clinical trials to determine whether weight loss and body composition changes in overweight and obesity will reduce breast cancer risk,” they said.

This research was supported by the National Heart, Lung, and Blood Institute.

One investigator reported financial relationships with Novartis, Novo Nordisk, Pfizer, Genentech, and Amgen. Marian Neuhouser and the other investigators reported no financial relationships with industry.



Love Diane Kress’ work?  Here are links to her books and support site!


The Metabolism Miracle:

The Metabolism Miracle Cookbook:

The Metabolism Miracle Update:  (Brand new!)

The Diabetes Miracle:

The Interactive Support Group for Followers of The Metabolism Miracle and The Diabetes Miracle:



About Diane Kress

Author of The New York Times Bestseller; The Metabolism Miracle, The Metabolism Miracle Cookbook, and The Diabetes Miracle. and The Metabolism Miracle, Revised Edition. Owner, developer, and administrator of The Metabolism Miracle's support site: Registered Dietitian, Certified Diabetes Educator, Email:
This entry was posted in ADA, AMA, AND, breast cancer, breast cancer prevention, Diane Kress, Diet, excess insulin, low carb, Met B, Metabolic syndrome, Metabolism B,, obesity, overweight, pre diabetes, prediabetes, The Diabetes Miracle, The Metabolism Miracle, The Metabolism Miracle Cookbook, The Metabolism Miracle Update, type 2 diabetes and tagged , , , , , , , , , , . Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s