Predicted basal metabolic rate and cancer risk in the European Prospective Investigation into Cancer and Nutrition

Research output: Contribution to journalArticle


Emerging evidence suggests that a metabolic profile associated with obesity may be a more relevant risk factor for some cancers than adiposity per se. Basal metabolic rate (BMR) is an indicator of overall body metabolism and may be a proxy for the impact of a specific metabolic profile on cancer risk. Therefore, we investigated the association of predicted BMR with incidence of 13 obesity-related cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC). BMR at baseline was calculated using the WHO/FAO/UNU equations and the relationships between BMR and cancer risk were investigated using multivariable Cox proportional hazards regression models. A total of 141,295 men and 317,613 women, with a mean follow-up of 14 years were included in the analysis. Overall, higher BMR was associated with a greater risk for most cancers that have been linked with obesity. However, among normal weight participants, higher BMR was associated with elevated risks of esophageal adenocarcinoma (hazard ratio per 1-standard deviation change in BMR [HR1-SD]: 2.46; 95% CI 1.20; 5.03) and distal colon cancer (HR1-SD: 1.33; 95% CI 1.001; 1.77) among men and with proximal colon (HR1-SD: 1.16; 95% CI 1.01; 1.35), pancreatic (HR1-SD: 1.37; 95% CI 1.13; 1.66), thyroid (HR1-SD: 1.65; 95% CI 1.33; 2.05), postmenopausal breast (HR1-SD: 1.17; 95% CI 1.11; 1.22) and endometrial (HR1-SD: 1.20; 95% CI 1.03; 1.40) cancers in women. These results indicate that higher BMR may be an indicator of a metabolic phenotype associated with risk of certain cancer types, and may be a useful predictor of cancer risk independent of body fatness.


  • Nathalie Kliemann
  • Neil Murphy
  • Vivian Viallon
  • Heinz Freisling
  • Konstantinos K. Tsilidis
  • Sabina Rinaldi
  • Francesca R. Mancini
  • Guy Fagherazzi
  • Marie Christine Boutron-Ruault
  • Heiner Boeing
  • Matthias B. Schulze
  • Giovanna Masala
  • Vittorio Krogh
  • Carlotta Sacerdote
  • Maria S. de Magistris
  • Bas Bueno-de-Mesquita
  • Elisabete Weiderpass
  • Tilman Kühn
  • Rudolf Kaaks
  • Paula Jakszyn
  • Daniel Redondo-Sánchez
  • Pilar Amiano
  • Maria Dolores Chirlaque
  • Aurelio B. Gurrea
  • Therese H. Nøst
  • Dagfinn Aune
  • Anne M. May
  • Anne Tjønneland
  • Christina C. Dahm
  • Kim Overvad
  • Rosario Tumino
  • Jose R. Quirós
  • Antonia Trichopoulou
  • Anna Karakatsani
  • Carlo La Vecchia
  • Lena M. Nilsson
  • Elio Riboli
  • Inge Huybrechts
  • Marc J. Gunter
External organisations
  • International Agency for Research on Cancer, World Health Organization
  • Imperial College London
  • University of Ioannina
  • University of Paris-Sud
  • Versailles Saint-Quentin-en-Yvelines University
  • University of Paris-Saclay
  • German Institute of Human Nutrition
  • University of Potsdam
  • Institute for Cancer Research, Prevention and Clinical Network (ISPRO)
  • Istituto Nazionale dei Tumori
  • Citta' della Salute e della Scienza Hospital-University of Turin
  • National Institute for Public Health and the Environment (RIVM)
  • University Medical Center Utrecht
  • University of Malaya
  • UiT The Arctic University of Norway, Tromsø
  • German Cancer Research Centre
  • Bellvitge University Hospital-IDIBELL
  • Ramon Llull University
  • CIBER Epidemiology and Public Health (CIBERESP)
  • Andalusian School Of Public Health (EASP)
  • University of Granada
  • Hospital Universitario Donostia
  • University of Murcia
  • Health Research Institute of Navarra (IDISNA)
  • Bjørknes University College
  • University of Oslo
  • Danish Cancer Society Research Center
  • Aarhus University
  • Aalborg University Hospital
  • Civic and M.P Arezzo Hospital
  • Public Health Directorate
  • Hellenic Health Foundation, Athens
  • National and Kapodistrian University of Athens
  • University of Milan
  • Umeå University
  • Institut Gustave Roussy
  • Azienda Ospedaliera Universitaria Federico II
  • Navarre Public Health Institute (ISPN)
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology
  • Nutrition and Dietetics


  • basal metabolic rate, cancer, metabolic disorder, obesity
Original languageEnglish
Pages (from-to)648-661
Number of pages14
JournalInternational Journal of Cancer
Issue number3
Early online date2019 Oct 25
Publication statusPublished - 2020 Aug 1
Publication categoryResearch