Increased body fat can create a chronic subclinical inflammatory environment, altering the regional inflammatory state and increasing the abundance of specific microorganisms in the intestinal microbiota, thereby affecting colorectal adenoma formation.[31–35] Metabolic factors have also been implicated in the development and progression of adenomatous polyps, involving increases in insulin-like growth factor 1 and insulin and the interaction of adiponectin and leptin.[36,37] In summary, weight control through an active lifestyle may delay the age at onset of colorectal polyps. Here, IGF1 is linked to colorectal adenoma.