Takeaways and beers: Experts discover the lifestyle choices that trigger most dangerous

People with fatty livers are significantly more likely to develop one of the most aggressive types of bowel cancer, new research has found. 

The finding comes following a fourfold increase in liver disease deaths in the UK. 

One in five people across the country are now thought to have a form of liver disease unrelated to alcohol and instead linked to obesity, unhealthy diets and increasingly sedentary lifestyles. 

At the same time, the number of under-50s being diagnosed with bowel cancer is on the rise – with obesity thought to be a key driver. 

The new findings – published in the journal Nature – suggest the disease could be behind one of the most aggressive forms of colorectal cancer. 

Researchers – from the KU Leuven and Leuven Cancer Institute in Belgium – found that patients with fatty liver are significantly more likely to develop aggressive metastases – where the cancer spreads from the bowel to another organ. 

This, they say, is important given the rapidly increasing prevalence of fatty liver disease globally, driven by raising obesity and type 2 diabetes rates. 

‘This work shows that a condition we typically consider a background metabolic issue can directly shape how cancer behaves,’ Professor Sarah-Maria Fendt, the study’s lead author, said. 

Fatty liver disease will affect 1.8 billion people worldwide by 2050, driven by rising obesity and blood sugar levels 

According to the researchers, in fatty livers, elevated levels of fatty acids rewire the behaviour of cancer cells by stabilising a protein that is known to drive cancer growth – called MYC. 

This in turn increases the production of an amino acid called proline, which is involved in the production of collagen.

This extra collagen creates a structure for tumour cells to invade and expand within the liver, replacing healthy liver cells in the process. 

‘In simple terms, the fatty liver provides both the signal and the construction materials that tumours need to grow more aggressively,’ Prof Fendt explains. 

‘It fundamentally changes the rules of how metastases develop.

‘This gives us a powerful new way to stratify patients. By identifying those most likely to benefit, we can make clinical trials more efficient and ultimately bring effective treatments to patients faster.’ 

Results from patient-derived tissue showed that by targeting different steps in this pathway – such as the MYC protein, amino acid production or collagen formation – the team were able to reduce the growth of aggressive tumours. 

This should allow doctors to tailor treatment to a patient’s metabolic condition, specifically targeting the most dangerous forms of metastatic cancer – particularly those with liver conditions. 

‘This work shifts our perspective,’ Dr Yiming Peng-Winkler, the study’s first author added. 

‘It shows that, to effectively treat cancer, we need to consider not just the tumour but also the environment it depends on. Only then can we design truly precise and effective therapies.’ 

More broadly, the research highlights a fundamental principle: cancer progression is shaped not only by tumours themselves, but also by their environment within the body. 

By maintaining a healthy weight, cutting back on alcohol and eating a healthy and well-balanced diet, then, people can help mitigate their risk of aggressive forms of the disease. 

It comes as the number of under-50s being diagnosed with bowel cancer is on the rise in the UK. 

Research has pointed to everything from obesity to poor sleep as key drivers behind the trend, but a single smoking gun is yet to be found. 

Lifestyle changes have long been shown to have a positive impact on both fatty liver and cancer risk. Not smoking, maintaining a healthy weight and regular exercise have all been shown to have a protective effect.