推荐意见8：建议控制体重来降低胃癌的发生风险（弱推荐，证据级别：中）。 肥胖被认为是一种诱发炎症和致癌的状态，也是一个可改变的致病因素。研究证据表明，身体脂肪分布，尤其是腹部肥胖与多种慢性疾病的发生有关，腹部肥胖对健康的威胁比一般肥胖更大。 指南小组对该问题研究进行了系统评价，综合分析截至2022年全球相关8项研究数据的结果显示，腹型肥胖可以显著增加人群发生胃癌的风险，腰围越大胃癌的风险越高，与腰围较小的人群相比，腰围较大的人群胃癌发生风险升高了38%（表9）。 因此，推荐控制体重，减少腹部肥胖，保持腰围在健康范围内（男性腰围<90 cm，女性腰围<80 cm）来降低胃癌的发生风险。 参考文献（下滑查看）： [1]SungH, FerlayJ, SiegelRL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660. [2]ThriftAP, El-SeragHB. Burden of gastric cancer[J]. Clin Gastroenterol Hepatol, 2020, 18(3): 534-542. DOI: 10.1016/j.cgh.2019.07.045. [3]XiaC, DongX, LiH, et al. Cancer statistics in China and united states, 2022: profiles, trends, and determinants[J]. Chin Med J (Engl), 2022, 135(5): 584-590. DOI: 10.1097/CM9.0000000000002108. [4]中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会胃癌临床诊疗指南(2021版)[J]. 中华医学杂志, 2022, 102(16): 1169-1189. DOI: 10.3760/cma.j.cn112137-20220127-00197. 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