Obesity is on an increasing trend worldwide. Over 2 billion (39 per cent) adults are overweight, and 650 million (13 per cent) are obese in 2019.
According to the National Health and Morbidity Survey (NHMS) 2019, 50.1 per cent of the adult population in Malaysia is overweight (30.4 per cent) or obese (19.7 per cent). Our country’s rate of obesity is greater than the global obesity rate of 13.0 percent(1).
Obesity is associated with an increased risk for non-communicable diseases (NCDs) such as hypertension, diabetes, heart disease, dyslipidemia, and certain types of cancer.
NCDs are responsible for 71 per cent of premature deaths and more than 70 per cent of the disease burden in Malaysia(1, 2).
The burden of disease (disability-adjusted life years, DALY) costs Malaysia about RM100 billion, or 7.35 percent of the national gross domestic product (GDP)(3).
Cancer is one of the leading causes of premature death and illness in Malaysia. Breast cancer is the most common cancer among Malaysian women, accounting for 34.6 per cent of all cancers.
Over a person’s lifetime, about one out of twenty women is at risk(4). The cancer burden has risen due to several causes, including population growth and ageing.
It is also linked to rapid economic and social development, notably cancers associated with obesity and lifestyle-related behaviours.
Fat tissue increases estrogen levels and insulin resistance which translate into a higher risk for breast cancer. A higher BMI is associated with a risk increase of breast cancer.
For a five-unit increase in BMI results in a 12 per cent increase in breast cancer risk(5).
Obese postmenopausal women have a 20 to 40 per cent chance of having breast cancer than normal-weight women(6).
Increasing exercise or physical activities helps to reduce breast cancer risk(7). As little as 75 to 150 minutes of brisk walking each week may be beneficial.
Maintain a healthy diet with less energy-dense and high-energy meals (such as deep-fried foods or fast food), reduced processed foods, red meats, chips, and snacks. Avoid sugar- or calorie-dense beverages (such as sweetened juices) and alcohol.
Increase intake of high-fibre fruits, vegetables, legumes, cereals, nuts, and fish are dietary measures to minimise the risks of breast cancer(8).
Obesity is preventable, and will need action from individuals to change preferences and attitudes.
Get regular physical activity, eat a healthy diet, maintain a healthy weight, have adequate daily sleep, be free of tobacco or alcohol, and maintain an optimistic outlook on life. All this can reduce the risk of obesity and breast cancer.
In conjunction with the World Obesity Day theme “Everybody Needs to Act”, let us all start acting by managing our body weight through the above measures to prevent the risk of obesity and breast cancer.
1. MOH. National Health and Morbidity Survey 2019 (NHMS 2019). Volume II-Non-communicable diseases, risk factors & other health problems Kuala Lumpur, Ministry of Health Malaysia: Institute for Public Health, Department PH; 2020 2020. Report No.
2. Yusoff U. Burden of premature mortality in Malaysia. Int J Public Health Res. 2013;3(1):249-56.
3. MOH. The Impact of Non-communicable Diseases and Their Risk Factors on Malaysia’s Gross Domestic Product. Putrajaya, Ministry of Health Malaysia: Institute for Public Health, 2020.
4. Azizah A, Hashimah B, Nirmal K, Siti Zubaidah A, Puteri N. Malaysia National cancer registry report (MNCR). 2019.
5. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569-78. doi: 10.1016/s0140-6736(08)60269-x. PubMed PMID: 18280327.
6. Munsell MF, Sprague BL, Berry DA, Chisholm G, Trentham-Dietz A. Body mass index and breast cancer risk according to postmenopausal estrogen-progestin use and hormone receptor status. Epidemiol Rev. 2014;36(1):114-36. doi: 10.1093/epirev/mxt010. PubMed PMID: 24375928; PubMed Central PMCID: PMCPMC3873844.
7. Guo W, Fensom GK, Reeves GK, Key TJ. Physical activity and breast cancer risk: results from the UK Biobank prospective cohort. British Journal of Cancer. 2020;122(5):726-32. doi: 10.1038/s41416-019-0700-6.
8. Molina-Montes E, Ubago-Guisado E, Petrova D, Amiano P, Chirlaque M-D, Agudo A, et al. The Role of Diet, Alcohol, BMI, and Physical Activity in Cancer Mortality: Summary Findings of the EPIC Study. Nutrients. 2021;13(12):4293. doi: 10.3390/nu13124293. PubMed PMID: doi:10.3390/nu13124293.
Dr Soh Yih Harng is a DrPH candidate, and Prof Dr Moy Foong Ming is from the Centre for Epidemiology and Evidence Based Practice, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of Ova.