Doctor insights: UK Biobank reveals how 'Life's Essential Eight' influence cancer risk

Clinical researcher Kenna Stephenson practices family and forensic medicine and is an Associate Professor at The University of Arizona College of Medicine.

Having previously spent time serving communities in New Zealand, Dr Stephenson has a special affinity with Aotearoa and its people.

This month, she shares the emerging data from the UK Bio-Bank, the world’s most comprehensive, large-scale biomedical database and research resource, on how it is informing us on how 'Life's Essential 8' can impact cancer risks. 

'The UK Biobank suggests future battles with cancer could be won today - even those with a higher genetic risk'

Dr Stephenson writes: “As a Family Medicine physician, my practice includes caring for multiple generations of families and patients of all ages and stages. Prevention is a hallmark of my counseling, and the UK Biobank study is an excellent guide in illuminating paths to creating health and well-being.  

This blog features findings related to cancer risk and next month, I shall discuss results related to dementia risk.

The UK Biobank study is a community-based study which enrolled 500,000 British participants between the ages of 40-69 years and will follow the individuals for 25 years. The comprehensive assessment of each enrollee includes questionnaires evaluating health, disability, social characteristics, sleep, dietary habits and tobacco and alcohol use.

Physical measures include tests of heart and lung function, bone density and exercise tolerance. Biological samples of blood, urine and saliva provide extensive evaluation including genetic factors. This trifecta of information offers the potential to profoundly alter our approach to prevention of diseases that family physicians frequently diagnose and treat.

'This is the first study to look at connections between heart-healthy lifestyles and cancer diagnoses'

Some patients express attitudes towards cancer as an inevitable experience, pondering not if, but when, whereas others fear cancer after caring for a loved one with a cancer diagnosis.

Rather than waiting until one’s turn to battle cancer at the time of a diagnosis, the UK Biobank results suggest that the battle may be won today by making lifestyle choices - even for those at high genetic risk.

This study is the first to look at connections between heart-healthy lifestyle practices and cancer diagnoses in the UK Biobank.

In my clinical research, I have focused on connections between the immune system, the inflammatory cascade, hormone factors and the cardiovascular system, so it is exciting to see this focus in such a large research project.

The study begins with a tool recognized by cardiologists for assessing cardiovascular disease risk, called the Life’s Essential 8 (LE8), which measures eight components in the patient:

1. Diet - how closely the patient’s eating habits compare to the DASH (Dietary Approaches to Stop Hypertension) diet which emphasizes fruits, vegetables, low-fat dairy, and decreased consumption of red meat, sweets, and added sugars, saturated fat and total fat.
2. Sleep - the number of hours of sleep (ideal is 7 hours)
3. Tobacco use
4. Blood glucose level measured as hemoglobin A1c
5. Exercise - (ideal is 150 minutes per week, with increased benefits at 300 minutes weekly)
6. Non-HDL cholesterol level (Total cholesterol minus HDL cholesterol)
7. Blood pressure level
8. Body Mass Index - (ideal is 18.5-25 kg/m2)

These eight components are mathematically factored and weighted such that the higher the score, the better - and the lower the risk of heart disease and stroke.

Eleven years post enrollment, the participants’ scores on the LE-8 were assessed for a relationship to a cancer diagnosis.

Researchers found participants with higher LE-8 scores had significantly less lung, bladder, liver, kidney, esophagus, breast, colorectum and pancreas cancers.

Even for individuals in the group with a high genetic risk of these eight cancers, the finding held steady - the higher the LE-8, the less cancer was found.

This suggests that everyone may lower their risks of these cancers, even those with a strong family history.

This research study further suggests that even in patients currently with a low LE-8 score, if they make lifestyle changes to improve their diet, sleep, physical activity, blood sugar and blood pressure they may lower their cancer risk over time - it is not too late to enhance their score!

For me as a family physician, these findings help me effectively counsel patients on improving heart health and overcoming cancer fears. These numbers reveal that healthy lifestyle practices may overcome genetics.

References:

Lin L, Hu Y, Lei F, et al. Cardiovascular health and cancer mortality: evidence from US NHANES and UK Biobank cohort studies. BMC Med. 2024;22(1):368. Published 2024 Sept

Roux J, Stephenson K, Kapur S, Zava D, et al. Neuroendocrine, inflammatory, and immune biomarkers associated with body composition, depression, and cognitive impairment in elderly men and women. Cleveland Clinic Heart and Brain Summit. 2010. Las Vegas, Nevada.

Stephenson K, Neuenschwander P, Kurdowska A The effects of compounded bio-identical transdermal hormone therapy on hemostatic, inflammatory, immune factors; cardiovascular biomarkers; quality of life measures; and health outcomes in perimenopausal and postmenopausal women. International Journal of Pharmaceutical Compounding,2013;17(1):74-85.

More information on Dr. Stephenson’s clinical work and research, please visit: www.doctorkenna.com