Horm Metab Res 2003; 35(11/12): 694-704
DOI: 10.1055/s-2004-814147
Review
© Georg Thieme Verlag Stuttgart · New York

Nutrition, Insulin, Insulin-like Growth Factors and Cancer

E.  Giovannucci1
  • 1Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston MA, and Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston MA, USA
Further Information

Publication History

Received 1 September 2003

Accepted after Revision 27 October 2003

Publication Date:
07 January 2004 (online)

Abstract

The incidence of colon, pancreatic, and kidney cancers, as well as aggressive prostate cancer in men, and breast and endometrial cancer in women is invariably high in Western countries. Nutritional and related factors have been typically implicated. This review presents a model integrating nutrition, insulin and IGF-1 physiology (”bioactive” IGF-1), and carcinogenesis based on the following: (1) insulin and the IGF-1 axis function in an integrated fashion to promote cell growth and survival; (2) chronic exposure to these growth properties enhances carcinogenesis; (3) factors that influence bioactive IGF-1 will affect cancer risk. The model presented here summarizes the data that chronic exposure to high levels of insulin and IGF-1 may mediate many of the risk factors for some cancers that are high in Western populations. This hypothesis may help explain some of the epidemiologic patterns observed for these cancers, both from a cross-national perspective and within populations. Of particular importance is that some of relevant factors are modifiable through nutritional and lifestyle interventions. Out of a variety of perspectives presented, nutritional manipulation through the insulin pathway may be more feasible than attempting to influence total IGF-1 concentrations, which are determined largely by growth hormone. Further study is required to test these conclusions.

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E. Giovannucci

Department of Nutrition · Harvard School of Public Health

665 Huntington Avenue · Boston MA 02115 · USA

Phone: 617-432-4648

Fax: 617-432-2435 ·

Email: edward.giovannucci@channing.harvard.edu

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