03 Feb Tall People Have Less Risk of Heart Disease, More Risk of Cancer
Prof. Norbert Stefan, MD
Department of Molecular Epidemiology
German Institute of Human Nutrition
MedicalResearch: What is the background for this study?
Prof. Stefan: Cardiovascular disease, type 2 diabetes, and cancer are among the most important causes of morbidity and mortality worldwide. Although the body mass index and waist circumference are established variables that help to predict the risk of these disease, adult height also predicts mortality independently of adiposity measures. However, compared to these risk factors, it has been somewhat neglected in clinical practice. Based on the finding that in recent decades the height of children and adults has steadily increased throughout the world, the question arises whether this secular trend in height might be a marker of a yet not well understood mechanism that affects not only stature, but also the development of cardiometabolic disease and cancer.
MedicalResearch: What are the main findings?
Prof. Stefan: We summarized and interpreted data from different areas of research and also could provide some novel data to better understand the causes of the worldwide increase in height and its relationships with cardiometabolic disease and incidence of cancer. There is strong epidemiological evidence that tall people, in comparison to short people, have a lower risk of cardiovascular disease and type 2 diabetes but have a higher cancer risk. Per 6.5 cm in height the risk of cardiovascular mortality decreases by six percent, but cancer mortality, by contrast, increases by four percent. We suspect that the increase in body height is a marker of overnutrition of high-calorie food rich in animal protein during different stages of growth. Thus, already in utero, lifelong programming might take place that until now has mainly been established for the insulin-like growth factor 1 and 2 and the IGF-1/2 system. Among other consequences, activation of this system causes the body to become more sensitive to insulin action, thus positively influencing the lipid metabolism. Accordingly, our new data show that tall people are more sensitive to insulin and have lower fat content in the liver, which may explain their lower risk for cardiovascular disease and type 2 diabetes. However, this activation of the IGF-1/2 system and other signaling pathways may be related to an increased risk of certain cancers, especially breast cancer, colon cancer, and melanoma because cell growth is permanently activated.
MedicalResearch: What should clinicians and patients take away from your report?
Prof. Stefan: We advocate to consider the factor growth and adult height more than hitherto in the prevention of the above-mentioned major diseases. In particular, physicians should be made more aware of the fact that tall people – although less often affected by cardiovascular disease or type 2 diabetes – have an increased risk of cancer. Furthermore, more focus should be given to the diet, especially during pregnancy and in children and adolescents, when it comes to the prediction and prevention of cardiometabolic diseases and cancer.
Prof. Norbert Stefan, MD (2016). Tall People Have Less Risk of Heart Disease, More Risk of Cancer