Predicted basal metabolic rate and cancer risk in the European Prospective Investigation into Cancer and Nutrition

Emerging evidence suggests that a metabolic profile associated with obesity may be a more relevant risk factor for some cancers than adiposity per se . Basal metabolic rate (BMR) is an indicator of overall body metabolism and may be a proxy for the impact of a specific metabolic profile on cancer risk. Therefore, we investigated the association of predicted BMR with incidence of 13 obesity‐related cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC). BMR at baseline was calculated using the WHO/FAO/UNU equations and the relationships between BMR and cancer risk were investigated using multivariable Cox proportional hazards regression models. A total of 141,295 men and 317,613 women, with a mean follow‐up of 14 years were included in the analysis. Overall, higher BMR was associated with a greater risk for most cancers that have been linked with obesity. However, among normal weight participants, higher BMR was associated with elevated risks of esophageal adenocarcinoma (hazard ratio per 1‐standard deviation change in BMR [HR 1‐SD ]: 2.46; 95% CI 1.20; 5.03) and distal colon cancer (HR 1‐SD : 1.33; 95% CI 1.001; 1.77) among men and with proximal colon (HR 1‐SD : 1.16; 95% CI 1.01; 1.35), pancreatic (HR 1‐SD : 1.37; 95% CI 1.13; 1.66), thyroid (HR 1‐SD : 1.65; 95% CI 1.33; 2.05), postmenopausal breast (HR 1‐SD : 1.17; 95% CI 1.11; 1.22) and endometrial (HR 1‐SD : 1.20; 95% CI 1.03; 1.40) cancers in women. These results indicate that higher BMR may be an indicator of a metabolic phenotype associated with risk of certain cancer types, and may be a useful predictor of cancer risk independent of body fatness.