American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention (includes cancer questions and answers).

From: CA: A Cancer Journal for Clinicians

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  • The paper offers guidance based on the strongest evidence-based medicine.

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  • The paper offers guidance based on the strongest evidence-based medicine.

Results

ACS Recommendations for Individual Choices

Maintain a healthy weight throughout life. Balance caloric intake with physical activity. Avoid excessive weight gain throughout the life cycle. Achieve and maintain a healthy weight if currently overweight or obese.

Adopt a physically active lifestyle. Adults: engage in at least 30 minutes of moderate to vigorous physical activity, above usual activities, on 5 or more days of the week.

Forty-five to 60 minutes of intentional physical activity are preferable. Children and adolescents: engage in at least 60 minutes per day of moderate to vigorous physical activity at least 5 days per week.

Consume a healthy diet, with an emphasis on plant sources. Choose foods and beverages in amounts that help achieve and maintain a healthy weight. Eat five or more servings of a variety of vegetables and fruits each day. Choose whole grains in preference to processed (refined) grains. Limit consumption of processed and red meats.

If you drink alcoholic beverages, limit consumption. Drink no more than one drink per day for women or two per day for men.

 

ACS Recommendations for Community Action

Public, private, and community organizations should work to create social and physical environments that support the adoption and maintenance of healthful nutrition and physical activity behaviours. Increase access to healthful foods in schools, worksites, and communities. Provide safe, enjoyable, and accessible environments for physical activity in schools, and for transportation and recreation in communities.

Choose foods and beverages in amounts that help achieve and maintain a healthy weight. Become familiar with standard serving sizes, and read food labels to become more aware

of actual servings consumed. Eat smaller portions of high-calorie foods. Be aware that “low-fat” or “nonfat” does not mean “low-calorie,” and that low-fat cakes, cookies, and similar foods are often high in calories.

Substitute vegetables, fruits, and other low- calorie foods and beverages for calorie-densefoods and beverages such as French fries, cheeseburgers, pizza, ice cream, doughnuts and other sweets, and regular sodas.

When you eat away from home, choose food low in calories, fat, and sugar, and avoid large portion sizes.

Eat five or more servings of vegetables and fruits each day. Include vegetables and fruits at every meal and for snacks. Eat a variety of vegetables and fruits each day. Limit French fries, chips, and other fried vegetable products. Choose 100% juice if you drink vegetable or

fruit juices. Choose whole grains in preferences to processed (refined) grains and sugars. Choose whole grain rice, bread, pasta, and cereals. Limit consumption of refined carbohydrates, including pastries, sweetened cereals, and other high-sugar foods.

Limit consumption of processed and red meats. Choose fish, poultry, or beans as an alternative to beef, pork, and lamb. When you eat meat, select lean cuts and eat smaller portions. Prepare meat by baking, broiling, or poaching rather than by frying or charbroiling.

 

DIET AND PHYSICAL ACTIVITY FACTORS THAT AFFECT RISKS FOR SELECT CANCERS

Bladder Cancer - Limited evidence suggests that drink- ing more fluids may lower the risk of bladder cancer, as may eating more vegetables.

Brain Tumours - There are no known nutritional risk factors for brain tumours at this time.

Breast Cancer - At the present time, the best nutritional advice to reduce the risk of breast cancer is to engage in moderate to vigorous physical activity 45 to 60 minutes on 5 or more days per week, minimize lifetime weight gain through the combination of caloric restriction and regular physical activity, and avoid or limit intake of alcoholic beverages.

Colorectal Cancer - The best nutritional advice to reduce the risk of colon cancer is to increase the intensity and duration of physical activity; limit intake of red and processed meat; consume recommended levels ofcalcium; eat more vegetables and fruits; avoid obesity; and avoid excess alcohol consumption (eg, no more than one drink/day in women, two drinks/day in men).

Endometrial Cancer - At the present time, the best advice to reduce the risk of endometrial cancer is to maintain a healthy weight through diet and regular physical activity, and eat a predominantly plant-based diet rich in vegetables, whole grains, and beans.

Kidney Cancer - At the present time, the best advice to reduce the risk of kidney cancer is to maintain a healthy weight and avoid tobacco use.

Leukemias and Lymphomas - There are no known nutritional risk factors for leukemias or lymphomas at this time.

Lung Cancer - At the present time, the best advice to reduce the risk of lung cancer is to avoid tobacco use and environmental tobacco smoke and to avoid radon exposure. Eating at least five servings of vegetables and fruits every day is also advised.

Ovarian Cancer - The overall evidence seems to indicate that alcohol consumption at moderate levels may reduce the risk of ovarian cancer.

Pancreatic Cancer - At the present time, the best advice to reduce the risk of pancreatic cancer is to avoid tobacco use, maintain a healthful weight, remain physically active, and eat five or more servings of vegetables and fruits each day.

Prostate Cancer - At the present time, the best advice to reduce the risk of prostate cancer is to eat five or more servings of a wide variety of vegetables and fruits each day, limit intake of red meats and dairy products, and maintain an active lifestyle and healthy weight.

Stomach Cancer - At the present time, the best advice for reducing the risk of stomach cancer is to eat at least five servings of vegetables and fruits daily, reduce salt-preserved food consumption, and maintain a healthy weight.

Upper Aerodigestive Tract Cancers - At the present time, the best advice to reduce the risk of cancers of the upper digestive and respiratory tracts is to avoid all forms of tobacco, restrict alcohol consumption, avoid obesity, and eat at least five servings of a variety of vegetables and fruits each day.

 

COMMON QUESTIONS ABOUT DIET, PHYSICAL ACTIVITY, AND CANCER

  1. Does alcohol increase cancer risk? Yes. Alcohol increases the risk of cancers of the mouth, pharynx, larynx, esophagus, liver, colorectum, and breast.

  2. Does aspartame cause cancer? No. Aspartame is a low-calorie artificial sweetener that is about 200 times sweeter than sugar. Current evidence does not demonstrate any link between aspartame ingestion and increased cancer risk.

  3. Does beta carotene reduce cancer risk? Undetermined.

  4. Is calcium related to cancer? Undetermined (Recommended intake levels of calcium are 1,000 mg/day for people aged 19 to 50 and 1,200 mg/day for people older than 50 years.)

  5. Does cholesterol in the diet increase cancer risk? There is no evidence that lowering blood cholesterol has an effect on cancer risk.

  6. Does drinking coffee cause cancer? No.

  7. Will eating less fat lower cancer risk? There is little evidence that the total amount of fat consumed increases cancer risk. However, diets high in fat tend to be high in calories and may contribute to obesity, which in turn is associated with increased risk of cancers at several sites.

  8. Does eating fish protect against cancer? Fish is a rich source of omega-3 fatty acids. Studies in animals have found that these fatty acids suppress cancer formation or hinder cancer progression, but there is limited suggestive evidence of a possible benefit in humans.

  9. Do fluorides cause cancer? No

  10. Do food additives cause cancer? no convincing evidence exists that any additive consumed at the levels found in food causes human cancers.

  11. Can garlic prevent cancer? Undetermined

  12. Do irradiated foods cause cancer? No.

  13. Will lycopene reduce cancer risk? Lycopene is the red-orange carotene pigment found primarily in tomatoes and tomato-based foods, and to a lesser extent, in pink grapefruit and watermelon. the conclusion cannot be made that high doses taken as supplements would be either more effective or safe.

  14. Should I avoid processed meats? Consumption of processed meats and meats preserved by methods involving smoke or salt increases exposure to potentially carcinogenic chemicals, and so should be minimized.

  15. Does being overweight increase cancer risk? Yes.

  16. Does olive oil affect cancer risk? Consumption of olive oil is associated with a reduced risk of cardiovascular disease, but it is not associated with any increased risk of cancer and is most likely neutral with respect to cancer risk.

  17. Do pesticides in foods cause cancer? At present, there is no evidence that residues of pesticides and herbicides at the low doses found in foods increase the risk of cancer. However, produce should be thoroughly washed before consumption.

  18. Will increasing physical activity lower cancer risk? Yes.

  19. Does saccharin cause cancer? No.

  20. Do high levels of salt in the diet increase cancer risk? No evidence suggests that moderate levels of salt used in cooking or in flavouring foods affect cancer risk.

  21. Can nutritional supplements lower cancer risk? There is strong evidence that a diet rich in vegetables, fruits, and other plant-based foods may reduce the risk of cancer, but there is no evidence at this time that supplements can reduce cancer risk, and some evidence exists that indicates that high-dose supplements can increase cancer risk.

  22. Can I get the nutritional equivalent of vegetables and fruits in a pill? No. Many healthful compounds are found in vegetables and fruits, and it is likely that these compounds work synergistically to exert their beneficial effect.

  23. Can drinking tea reduce cancer risk? Presently, tea has not been proven to reduce cancer risk in humans.

  24. Will eating vegetables and fruits lower cancer risk? Yes.

  25. Is there a difference in the nutritional value of fresh, frozen, and canned vegetables and fruits? Yes, but they can all be good choices.

  26. Does cooking affect the nutritional value of vegetables? Microwaving and steaming are the best ways to preserve the nutritional content in vegetables.

  27. Do vegetarian diets reduce cancer risk? It is not possible to conclude at this time, that a vegetarian diet has any special benefits for the prevention of cancer.

  28. Does vitamin A lower cancer risk? Vitamin A supplements, whether in the form of beta carotene or retinol, have not been shown to lower cancer risk.

  29. Does vitamin C lower cancer risk? The few studies in which vitamin C has been given as a supplement, however, have not shown a reduced risk for cancer.

  30. Does vitamin D lower cancer risk? There is a growing body of evidence from epidemiologic studies (not yet tested in RCTs) that vitamin D may have beneficial effects on some types of cancer, including cancers of the colon, prostate, and breast.

  31. Does vitamin E lower cancer risk? Undetermined

  32. How much water and other fluids should I drink? Consumption of water and other liquids may reduce the risk of bladder cancer, and also reduce the risk of colon cancer. Drinking at least 8 cups of liquid a day is usually recommended.

Answer

  • The guidelines emphasise the importance of maintaining a healthy body weight, adopting a physically active lifestyle, and consuming a healthy diet, particularly within the context of weight management.

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