Adipositas, Ernährung und Mammakarzinom

Zusammenfassung

Das Mammakarzinom ist die häufigste Tumorerkrankung der Frau. Neuere Studien weisen darauf hin, dass Lebensstilfaktoren wie Über-gewicht, Ernährung und körperliche Aktivität eine signifikante Bedeutung für die Entstehung und Prognose des Mammakarzinoms haben. Auf der Grundlage zahlreicher Kohortenstudien gibt es heute eine überzeugende Evidenz, dass Adipositas ein potenter Risiko-faktor sowohl für die Entstehung als auch für die Prognose dieser Erkrankung ist. Adipositas erhöht die Gesamtmortalität und die Brustkrebs-spezifische Mortalität der betroffenen Frauen um etwa 30 %. Auch Gewichts-zunahme nach Diagnose ist mit einer erhöhten Mortalität assoziiert. Inwieweit das Fettverteilungsmuster dabei eine spezifische Bedeutung hat, ist derzeit noch unklar. Unab-hängig vom Körpergewicht scheint eine gesunde bzw. mediterrane Kost, charakterisiert durch einen hohen Verzehr von Obst, Gemüse, Ballaststoffen und Fisch einen mäßigen protektiven Effekt gegen Brustkrebs auszuüben, während eine typische westliche Kost mit hoher Zufuhr gesättigter Fette und reichlich rasch resorbierbaren Kohlenhydraten mit einem schlechteren Outcome assoziiert ist. Daraus läßt sich die Empfehlung ableiten, lebenslang normalgewichtig zu bleiben und eine ausgewogene Ernährung einzuhalten.

Summary

Breast cancer is the most frequent type of cancer in women. Recent data suggest that lifestyle factors including dietary factors and physical activity play a significant role in the development of and survival from breast cancer. In particular, there is convincing evidence that obesity is a potent risk factor for both cancer development and prognosis, increasing the risk of total and breast cancer-specific mortality by approximately 30 %. In addition, weight gain was found to be associated with a poorer prognosis, whereas the role of the fat distribution pattern remains to be determined. In contrast, there is still only limited evidence that specific dietary patterns or dietary components affect breast cancer outcome. However, current knowledge suggests that a healthy/ mediterranean-like diet characterized by a high intake of fruit, vegetables, fiber, fish and unsaturated oils, particularly Omega-3 fatty acids, has a modest protective effect on breast cancer survival, whereas a typical Western diet characterized by high intake of total/saturated fat, refined carbohydrates, processed and red meat and low fiber intake is associated with modestly poorer outcome. Based on this evidence, weight control and a life-long health-promoting diet are key recommendations for the primary and secondary prevention of breast cancer.

Schlüsselwörter

Brustkrebs - Überleben/Prognose - Mortalität - Ernährung - Adipositas

Keywords

Breast cancer - prognosis/survival - mortality - diet - obesity

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