This review synthesizes emerging evidence on modifiable risk factors for endometrial cancer (CE) – the sixth most common malignant tumor in the world with increasing incidence despite diagnostic progress. Obesity leads to around 60% of avoidable cases, positioning the diet and the lifestyle as a critical prevention targets. This work assesses current evidence, unresolved controversies and the ways to personalized prevention executives.
Introduction
The EC incidence increased by 1.5% per year after 2010, especially among premenopausal women in developed countries. Obesity underpins 40 to 60% of avoidable cases, establishing a diet and physical activity as a modifiable pivot factors. The journal Cartocie of evidence from 2014 to 2024 to clarify the prevention mechanisms of the EC and treat the variability specific to the population.
Food modes: evidence and controversies
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Mediterranean regime: Associated with a risk reduction of 13% (high intake of whole fruits / vegetables / grains; anti-inflammatory effects), but efficiency varies according to BMI, ethnicity and socioeconomic status.
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Ketogenic diet (KD): Improves insulin sensitivity and weight management (key for CE prevention) but risks a nutritional imbalance and hepatic / renal toxicity.
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Diabetes Risk Diet Reduction (DRD): The low fiber and low sugar content patterns reduce the risk of this, although less effective in older, obese or non-white subgroups.
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Soybean isoflavones: Show double-protection effects in Asian populations with high food consumption but potentially harmful in hormonal subgroups or cancer survivors.
Key debate: If the diet affects the CE directly Or indirectly via the mediation of the BMI (for example, the BMI explains 84 to 93% of food associations-EC in cohort studies). Regional variations (for example, Asia VS Ouest) require specific directives to the population.
Lifestyle factors beyond the diet
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Physical activity: 7.5–15 HEAURS METS / Week reduces the risk of this by improving insulin sensitivity and reducing inflammation. Sedentary behavior increases the risk by 28 to 30%.
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Smoking: Paradoxically lower the risk of this (anti-esrogenic effects) but increases the mortality all causes.
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Alcohol: A low contribution can reduce the risk in obese / insulin resistant women; A higher contribution shows neutral effects.
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Psychological stress: Depression / anxiety is correlated with a bad prognosis, mediated by an immune-endocrine disturbance.
Hereditary (Lynch syndrome (LS)) VS Sporadique
Nutrient debate: reductionist vs Holistic approaches
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Reductionist view: Focuses on unique nutrients:
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Omega-3 fatty acids have contradictory results (15 to 23% risk reduction compared to 9% with docosahexaenoic acid).
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Selenium / Vitamin C has pro- / contingent anti-tumoral effects on the dose and context.
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Holistic view: Emphasizes food regimes (for example, Mediterranean / plant -based diets surpass isolated nutrients). The challenges include marketing influences and cultural food preferences.
Consensus: WHOWS SHEET TO MODELS FOUR-PRIORATION-PRIORATION, then refine with ideas specific to nutrients.
The “dose-effee” paradox in the interventions
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Low intensity interventions (for example, walking) often surpass high intensity patterns due to better adhesion and metabolic sustainability.
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Obese women need higher exercise intensity (≥15 hours is a week / week) for a significant reduction in the risks of this.
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Self-evaluation bias overestimates conformity; Portable devices improve data accuracy.
To personalized prevention
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Metabolic phenotyping: Target the resistance / inflammation of insulin. Example: Omega-3 advantages are pronounced in overweight women.
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Genetic stratification: LS patients need distinct strategies (for example, aspirin prophylaxis on OCS).
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Barriers:
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Limited multi-ordinary (genomic / metabolomic) cohorts.
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Lack of validated biomarkers (for example, inflammatory markers like IL-6).
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Profitable screening tools for high-risk subgroups.
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Clinical integration: Digital health tools, culturally tailor -made interventions and multidisciplinary teams (dietitists / oncologists) allow feasible and prolonged prevention.
Limitations et orientations futures
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EPPTATIONS OF PROFACTING: Heterogeneous methodologies, BMI confusion, self-assessment and sub-studied populations (racial / age / genetic subgroups).
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Priorities:
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Large cohorts integrating genomic data / lifestyle.
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Culturally suitable interventions and digital health integration (applications / laptops).
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Political support for public education and interdisciplinary collaboration.
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Conclusions
The diet (Mediterranean / plant patterns) and the lifestyle (sedentary activity / reduction) are significantly lower than the risk of this, but efficiency is modulated by BMI, genetics and socio -cultural factors. Stratié by prevention personalized by the metabolic phenotype, genetic risk (for example, LS) and the cultural context – is essential. Future work must fill the research differences in research through multi-orders, digital surveillance and tailor-made public health strategies.
