Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Body mass index and risk of brain tumors: a systematic review and dose–response meta-analysis

European Journal of Clinical Nutrition volume 70, pages 757–765 (2016)Cite this article

Subjects

Abstract

Background/Objectives:

Data regarding the relationships between body mass index (BMI) and brain tumors are inconsistent, especially for the commonly seen gliomas and meningiomas. Therefore, we conducted a dose–response meta-analysis to unravel the issue.

Subjects/Methods:

Cochrane Library, PubMed and Embase were searched for pertinent case–control and cohort studies updated to November 2014. Dose–response and quantitative analysis were conducted with random-effect model.

Results:

Sixteen studies were included, containing 3 887 156 participants and 11 614 cases. In categorical analysis for the relationships between abnormal weight and BMI, the summary risk ratio (RR) of brain tumors was 1.34 (95% confidential interval (CI), 1.15–1.56) for obesity, 1.12 (95% CI, 1.05–1.19) for overweight and 0.77 (95% CI, 0.64–0.93) for underweight; the summary RR of gliomas was 1.13 (95% CI, 1.02–1.26) for overweight and 0.71 (95% CI, 0.58–0.88) for underweight; the summary RR of meningiomas was 1.48 (95% CI, 1.30–1.69) for obesity and 1.18 (95% CI, 1.07–1.31) for overweight. In dose–response analysis, for every 5 kg/m2 increment of BMI, the summary RR was 1.13 (95% CI, 1.07–1.20) for overall brain tumors, 1.07 (95% CI, 0.97–1.19) for gliomas and 1.19 (95% CI, 1.14–1.25) for meningiomas.

Conclusions:

Excess weight was associated with increased risk of brain tumors and meningiomas but not with gliomas. Selective screening for brain tumors among obesity, especially for the females, might be more instructive.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7

Similar content being viewed by others

References

  1. Obesity and overweight. Fact sheet No. 311. Updated August. Available at http://www.who.int/mediacentre/factsheets/fs311/en/, 2014 (accessed 26 November 2014).

  2. Wiseman M . The second World Cancer Research Fund/American Institute for Cancer Research expert report. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Proc Nutr Soc 2008; 67: 253–256.

    Article  PubMed  Google Scholar 

  3. Kitahara CM, Platz EA, Freeman LEB, Hsing AW, Linet MS, Park Y et al. Obesity and thyroid cancer risk among U.S. men and women: a pooled analysis of five prospective studies. Cancer Epidemiol Biomarkers Prev 2011; 20: 464–472.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Lichtman MA . Obesity and the risk for a hematological malignancy: leukemia, lymphoma, or myeloma. Oncologist 2010; 15: 1083–1101.

    Article  PubMed  PubMed Central  Google Scholar 

  5. CBTRUS. Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2004-2008. Central Brain Tumor Registry of the United States: Hinsdale, IL, USA, 2012.

  6. Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D et al. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ 2007; 335: 1134–1139.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Benson VS, Pirie K, Green J, Casabonne D, Beral V et alMillion Women Study collaborators. Lifestyle factors and primary glioma and meningioma tumours in the Million Women Study cohort. Br J Cancer 2008; 99: 185–190.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Jhawar BS, Fuchs CS, Colditz GA, Stampfer MJ . Sex steroid hormone exposures and risk for meningioma. J Neurosurg 2003; 99: 848–853.

    Article  CAS  PubMed  Google Scholar 

  9. Wiedmann M, Brunborg C, Lindemann K . Body mass index and the risk of meningioma, glioma and schwannoma in a large prospective cohort study (The HUNT Study). Br J Cancer 2013; 304: 1–6.

    Google Scholar 

  10. Johnson DR, Olson JE, Vierkant RA . Risk factors for meningioma in postmenopausal women: results from the Iowa Women’s Health Study. Neuro Oncol 2011; 13: 1011–1019.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Helseth A, Tretli S . Pre-morbid height and weight as risk factors for development of central nervous system neoplasms. Neuroepidemiology 1989; 8: 277–282.

    Article  CAS  PubMed  Google Scholar 

  12. Michaud DS, Bove G, Gallo V . Anthropometric measures, physical activity and risk of glioma and meningioma in a large prospective cohort study. Cancer Prev Res (Phila) 2011; 4: 1385–1392.

    Article  Google Scholar 

  13. Moore SC, Rajaraman P, Dubrow R, Darefsky AS, Koebnick C, Hollenbeck A et al. Height, body mass index, and physical activity in relation to glioma risk. Cancer Res 2009; 69: 8349–8355.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000; 283: 2008–2012.

    Article  CAS  PubMed  Google Scholar 

  15. Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M et al The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available at http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp, 2008 (accessed 23 August 2014).

  16. World Health Organisation. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894: 1–253.

    Google Scholar 

  17. Greenland S, Longnecker MP . Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol 1992; 135: 1301–1309.

    Article  CAS  PubMed  Google Scholar 

  18. Orsini N, Bellocco R, Greenland S . Generalized least squares for trend estimation of summarized dose-response data. Stata J 2006; 6: 40–57.

    Article  Google Scholar 

  19. Wang X, Dong Y, Qi XQ, Huang C, Hou L . Cholesterol levels and risk of hemorrhagic stroke: a systematic review and meta-analysis. Stroke 2013; 44: 1833–1839.

    Article  CAS  PubMed  Google Scholar 

  20. Higgins JP, Thompson SG, Deeks JJ, Altman DG . Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557–560.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Egger M, Davey Smith G, Schneider M, Minder C . Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629–634.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Duval S, Tweedie R . Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000; 56: 455–463.

    Article  CAS  PubMed  Google Scholar 

  23. Higgins JP, Green S, Collaboration C. Cochrane Handbook for Systematic Reviews of Interventions. Wiley Online Library, 2008. Available from http://handbook.cochrane.org/.

  24. Edlinger M, Strohmaier S, Jonsson H, Bjørge T, Manjer J, Borena WT et al. Blood pressure and other metabolic syndrome factors and risk of brain tumour in the large population-based Me-Can cohort study. J Hypertens 2012; 30: 290–296.

    Article  CAS  PubMed  Google Scholar 

  25. Oh SW, Yoon YS, Shin SA . Effects of excess weight on cancer incidences depending on cancer sites and histologic findings among men: Korea National Health Insurance Corporation Study. J Clin Oncol 2005; 23: 4742–4754.

    Article  PubMed  Google Scholar 

  26. Samanic C, Chow WH, Gridley G, Jarvholm B, Fraumeni JF Jr . Relation of body mass index to cancer risk in 362,552 Swedish men. Cancer Causes Control 2006; 17: 901–909.

    Article  PubMed  Google Scholar 

  27. Claus EB, Calvocoressi L, Bondy ML, Wrensch M, Wiemels JL, Schildkraut JM . Exogenous hormone use, reproductive factors, and risk of intracranial meningioma in females. J Neurosurg 2013; 118: 649–656.

    Article  CAS  PubMed  Google Scholar 

  28. Custer B, Longstreth WT Jr, Phillips LE, Koepsell TD, Van Belle G . Hormonal exposures and the risk of intracranial meningioma in women: a population-based case-control study. BMC Cancer 2006; 6: 152–160.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Duan B, Hu XB, Zhao HY, Qin J, Luo J . The relationship between urinary bisphenol A levels and meningioma in Chinese adults. Int J Clin Oncol 2013; 18: 492–497.

    Article  CAS  PubMed  Google Scholar 

  30. Lee E, Grutsch J, Persky V, Glick R, Mendes J, Davis F . Association of meningioma with reproductive factors. Int J Cancer 2006; 119: 1152–1157.

    Article  CAS  PubMed  Google Scholar 

  31. Little RB, Madden MH, Thompson RC, Olson JJ, Larocca RV, Pan E et al. Anthropometric factors in relation to risk of glioma. Cancer Causes Control 2013; 24: 1025–1031.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Schildkraut JM, Calvocoressi L, Wang F, Wrensch M, Bondy ML, Wiemels JL et al. Endogenous and exogenous hormone exposure and the risk of meningioma in men. J Neurosurg 2014; 120: 820–826.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Preston-Martin S, Munir R, Chakrabarti I . Nervous system. In: Schottenfeld D, Fraumeni JF (eds), Cancer Epidemiology and Prevention, 3rd edn. Oxford University Press: New York, NY, USA, 2006, pp 1173–1195.

    Chapter  Google Scholar 

  34. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 2007; 114: 97–109.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Ron E, Modan B, Boice JD, Alfandary E, Stovall M, Chetrit A et al. Tumors of the brain and nervous system after radiotherapy in childhood. N Engl J Med 1988; 319: 1033–1039.

    Article  CAS  PubMed  Google Scholar 

  36. Preston-Martin S, Mack W, Henderson BE . Risk factors for gliomas and meningiomas in males in Los Angeles County. Cancer Res 1989; 49: 6137–6143.

    CAS  PubMed  Google Scholar 

  37. Preston-Martin S, Pogoda JM, Schlehofer B, Blettner M, Howe GR, Ryan P et al. An international case-control study of adult glioma and meningioma: the role of head trauma. Int J Epidemiol 1998; 27: 579–586.

    Article  CAS  PubMed  Google Scholar 

  38. Schlehofer B, Blettner M, Preston-Martin S, Niehoff D, Wahrendorf J, Arslan A et al. Role of medical history in brain tumour development. Results from the international adult brain tumour study. Int J Cancer 1999; 82: 155–160.

    Article  CAS  PubMed  Google Scholar 

  39. Pergola GD, Silvestris F . Obesity as a major risk factor for cancer. J Obes 2013; 2013: 291546.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Renehan AG, Roberts DL, Dive C . Obesity and cancer: pathophysiological and biological mechanisms. Arch Physiol Biochem 2008; 114: 71–83.

    Article  CAS  PubMed  Google Scholar 

  41. McKeown-Eyssen G . Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk? Cancer Epidemiol Biomarkers Prev 1994; 3: 687–695.

    CAS  PubMed  Google Scholar 

  42. Giovannucci E . Insulin and colon cancer. Cancer Causes Control 1995; 6: 164–179.

    Article  CAS  PubMed  Google Scholar 

  43. Calle EE, Kaaks R . Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 2004; 4: 579–591.

    Article  CAS  PubMed  Google Scholar 

  44. Giovannucci E . Nutrition, insulin, insulin-like growth factors and cancer. Horm Metab Res 2003; 35: 694–704.

    Article  CAS  PubMed  Google Scholar 

  45. Renehan AG, Frystyk J, Flyvbjerg A . Obesity and cancer risk: the role of the insulin–IGF axis. Trends Endocrinol Metab 2006; 17: 328–336.

    Article  CAS  PubMed  Google Scholar 

  46. Kaaks R, Lukanova A, Kurzer MS . Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomarkers Prev 2002; 11: 1531–1543.

    CAS  PubMed  Google Scholar 

  47. Basen-Engquist K, Chang M . Obesity and cancer risk: recent review and evidence. Curr Oncol Rep 2011; 13: 71–76.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Roberts DL, Dive C, Renehan AG . Biological mechanisms linking obesity and cancer risk: new perspectives. Annu Rev Med 2010; 61: 301–316.

    Article  CAS  PubMed  Google Scholar 

  49. Shao C, Bai LP, Qi ZY, Hui GZ, Wang Z . Overweight, obesity and meningioma risk: a meta-analysis. PLoS One 2014; 9: e90167.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Foundation from the National Natural Science Fund of China (81371382) for LH and Science and Technology of Commission of Shanghai Municipality (14430721300) for YD.

Author information

Author notes

  1. D Zhang, J Chen, J Wang and S Gong: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China

    D Zhang, J Chen, J Wang, S Gong, H Jin, P Sheng, X Qi, L Lv, Y Dong & L Hou

  2. Department of Neurosurgery, Neuroscience Center, Changzheng Hospital, Second Military Medical University, Shanghai, China

    Y Dong

Authors
  1. D Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S Gong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P Sheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. X Qi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. L Lv
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Y Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. L Hou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L Hou.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, D., Chen, J., Wang, J. et al. Body mass index and risk of brain tumors: a systematic review and dose–response meta-analysis. Eur J Clin Nutr 70, 757–765 (2016). https://doi.org/10.1038/ejcn.2016.4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2016.4

This article is cited by

Search

Advanced search

Quick links