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World Cancer Research Fund - Expert Report

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Advisory Board
Cure for cancer just might be prevention

New report promotes cutting back on fatty, sugary foods, exercising regularly and slimming down

MARTIN MITTELSTAEDT

From Thursday's Globe and Mail

February 26, 2009 at 9:11 AM EST

Some of the world's leading experts in nutrition epidemiology have cast a resounding vote in the decades-long debate between treating or preventing cancer: Prevention wins.

Their report, being released today, argues strenuously for diet and exercise as the keys to fighting cancer. It calls research and spending on the treatment of cancer "necessary but not sufficient," and contends that a far better strategy for reducing the world's annual tally of 11 million cancer cases would be to develop a public-health policy aimed at preventing people from getting the disease in the first place.

The report, issued by the World Cancer Research Fund/American Institute for Cancer Research, is based on an exhaustive review of nearly 7,000 scientific studies into whether cancer rates are influenced by diet, obesity and exercise.

Based on this review, it concludes that cancer "is mostly preventable," estimating that about one-third of all cases in advanced countries like Canada could be eliminated by diets that aren't loaded with fatty, sugary foods, by people exercising regularly and, if they are obese, by slimming down to an appropriate weight. Among the cancers with links to these factors are those of the breast, prostate, mouth and colon.


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Another third of cancers are due to smoking, indicating that well over half the cases of the disease could easily be prevented.

"It's a very compelling case" that cancer incidence could be cut dramatically through prevention, said Shiriki Kumanyika, an epidemiologist at the University of Pennsylvania in Philadelphia and a member of an expert panel that oversaw the writing of the report. Also on the panel were such nutrition luminaries as the Harvard School of Public Health's Walter Willett.

Dr. Kumanyika said scientific evidence strongly supports the estimate that poor diet, obesity and lack of exercise cause one out of three cancers. "I definitely feel confident that it's at least that much," she said.

Much of the medical research into the causes of cancer has looked at factors such as genetic susceptibility. But Dr. Kumanyika said studies tracking immigrants and their children who move from areas of low cancer incidence, such as Asia, to countries with high rates, such as the United States, suggest the genetic factor may be overrated. Over time, cancer rates among migrants and their children rise toward the levels prevalent in their adopted countries, suggesting that something common to everyone in the new environment is the cause.

Although individuals can make decisions to get more exercise or eat better food, thereby reducing their chances of developing cancer, the report says that entities ranging from governments to schools need to develop public-health strategies to reduce the incidence of the disease.

Among the steps it recommends are banning advertising of sugary drinks and unhealthy foods directed at children, a step Quebec has already taken. The report says the Quebec action has led to a decrease in the amount of sugary cereals purchased, particularly among francophones.

It also calls for vending machines that dispense high-fat, sugary sweets or drinks to be moved out of schools and workplace cafeterias.

Another approach that should be considered is having processed meals, snacks and food reformulated to contain less sugar, refined starches, fat and salt, the report says.

To encourage more physical activity, it says society should place less emphasis on elite professional sports that lead people to be sedentary spectators, and instead develop entertainment that inspires everyone to be physically active.

It says cities should be designed for walking and cycling, rather than the current practice of promoting automobile use through road expansion.

The Canadian Cancer Society supports the report's approach, saying Canada needs a two-pronged strategy for dealing with cancer that involves both individual action and public-policy interventions that help people reduce their cancer risk.

"There are things that individuals can do, among them not smoking, having a healthy body weight, eating a healthy diet," said Heather Logan, a spokesperson for the society. "But it's insufficient merely to tell Canadians to do that. We need to make those healthy choices easy choices."

Prevention: the best cure

U.S. estimates of cancers that can be prevented with appropriate nutrition and physical activity:

Endometrium: 70%

Esophagus: 69%

Mouth, pharynx, larynx: 63%

Stomach: 47%

Colorectum: 45%

Pancreas: 39%

Breast: 38%

Lung: 36%

Kidney: 24%

Gallbladder: 21%

Liver: 15%

Prostate: 11%

Total for these cancers: 34%

Total for all cancers: 24%

TRISH McALASTER / THE GLOBE AND MAIL / SOURCE: WORLD CANCER RESEARCH FUND


http://www.theglobeandmail.com/serv...cancer26/BNStory/specialScienceandHealth/home
 
Re: World Cancer Research Fund - Expert Report

Here is the link to the summary of the report:

http://www.dietandcancerreport.org/?p=summary

(sign up, not subscription, required)


And recommendations:

http://www.dietandcancerreport.org/?p=recommendations


Recommendations

The Second Expert Report, Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective, features eight general and two special recommendations. The 10 recommendations are listed below. Together they comprise a blueprint that people can follow to help reduce their risk of developing cancer.

Click on each recommendation to find out more about it.

CHAPTER 12 of the Report features the recommendations in detail as does the Report summary.

BODY FATNESS
Be as lean as possible within the normal range of body weight

PHYSICAL ACTIVITY
Be physically active as part of everyday life

FOODS AND DRINKS THAT PROMOTE WEIGHT GAIN
Limit consumption of energy-dense foods
Avoid sugary drinks

PLANT FOODS
Eat mostly foods of plant origin

ANIMAL FOODS
Limit intake of red meat and avoid processed meat

ALCOHOLIC DRINKS
Limit alcoholic drinks

PRESERVATION, PROCESSING, PREPARATION
Limit consumption of salt
Avoid mouldy cereals (grains) or pulses (legumes)

DIETARY SUPPLEMENTS
Aim to meet nutritional needs through diet alone

BREASTFEEDING (Special Recommendation)
Mothers to breastfeed; children to be breastfed

CANCER SURVIVORS (Special Recommendation)
Follow the recommendations for cancer prevention

The policy implications of the recommendations are explored in the Policy Report.
 
Re: World Cancer Research Fund - Expert Report

The report is here, but this link might not work:

http://www.dietandcancerreport.org/?p=er&JServSessionIdr006=66qh2kfdy2.app43a

And the table of contents: (Chapter 2 is a fantastic short course in micro biology):

The Second Expert Report:

The Second Expert Report by chapter:


Introductory Pages

Part 1 Intro
Chapter 1: International variations and trends
Chapter 2: The cancer process
Chapter 3: Judging the evidence

Part 2 Intro
Chapter 4: Foods and drinks
Chapter 5: Physical activity
Chapter 6: Body composition, growth, and development
Chapter 7: Cancers
Chapter 8: Determinants of weight gain, overweight and obesity
Chapter 9: Cancer survivors
Chapter 10: Findings of other reports
Chapter 11: Research issues

Part 3 Intro
Chapter 12: Public health goals and personal recommendations

Appendix
Glossary
References
Index

Fold Outs:
The Panel's judgements
The cancer process and summary recommendations



Errors and Omissions
 
Re: World Cancer Research Fund - Expert Report

Excerpt from the intro to Chapter 2:

The integrity of the genetic information is
protected by many systems that prevent DNA
damage, or remove or repair damaged DNA if it
occurs. Imperfections in these systems limit the
ability to block all damage and allow both helpful
and harmful mutations to occur. Cancers result when
sufficient mutations have accumulated, most
presenting at an age that was rarely reached in the
evolutionary past of human beings. The
development of cancer may be seen as a corollary of
the ability of humans to evolve and adapt.

Ultimately it is both the genetic information
(genotype) and its expression that control the
characteristics (or phenotype) of an individual. Any
exposure during the life course that affects the
genotype or its expression may also have an effect
on the phenotype. At any point in time, the
phenotype is related not only to the genotype but
also to a host of environmental factors, including
nutritional exposures. This accumulated metabolic
experience may begin during maternal and early life,
and proceed throughout a person?s lifetime.

Excerpt from the intro to Chapter 6:

The picture that emerges is impressive: much
more so than that based on the evidence gathered
in the mid-1990s using the then agreed
methodology. Its implications are also impressive.
Some of the most persuasive evidence in the whole
field of food, nutrition, and physical activity
indicates that the basis for prevention of cancer
should be a whole life course approach, starting at
the beginning of life, or even in maternal
preparation for pregnancy.
 
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