Cancer Prevention: The Role of Nutrition and Lifestyle

by Christian Maino Vieytes, Doctoral Student, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign.

When it comes to cancer, genes may play a significant role. The contributions made by genes on our cancer fate manifests through a unique phenomenon: mutations. For instance, carrying a defective mutation in the Familial Adenomatous Polyposis (FAP) gene may result in the form of cancer that implicates the colon or rectum.1 Nevertheless, these types of cancer are few and far between. Roughly 1 in 100 cases of colorectal cancer are attributable to mutations in FAP. Another question arises naturally: if genetic destiny is not equal to cancer destiny, then are there other factors that affect our predisposition to developing malignant cancer or tumor?

What is the Epidemiology of Cancer?

  Health behaviors can have a powerful role in our ability to develop a severe chronic disease like cancer. Epidemiological studies are studies that examine patterns amongst individuals in a population. These studies have become an invaluable resource for scientists investigating how behaviors and lifestyle factors affect a person’s risk of developing a malignant cancer. Randomized controlled or clinical trials that involve cancer or deaths from cancer as measured outcomes are not ethically feasible. These population-level studies have become especially important. There have been massive and coordinated efforts across international borders to collect quality data of this caliber.2 

The European Prospective Investigation into Cancer and Nutrition (EPIC) Study is such an example of these types of studies. The EPIC study took over fifteen years, collecting data on over 520,000 individuals from ten different European countries.3 The study amassed numerous data on diet and lifestyle factors (such as exercise and smoking) and carefully recorded cancer diagnoses, deaths, and other important clinical outcomes. Many of the key findings from this study highlighted the importance of healthy eating on cancer risk. For instance, body-size and obesity were found to elevate a woman’s risk of developing breast cancer.

Eating higher quantities of dietary fiber-containing foods protected against the development of colorectal cancer. More generally, higher consumption of fruits and vegetables may protect against developing several forms of cancers.

Higher meat consumption was found to increase the risk for some types of cancer.

How do we put it all together?

Different lifestyle factors may have different effects on different types of cancers. It may become overwhelming to know the exact roles of different lifestyle and dietary factors and how they modify cancer risk. The EPIC study is not the only large population-level study concerned with determining how lifestyle factors influence cancer risk. 

Fortunately, several public health organizations are dedicated to consolidating the evidence for us and communicating it effectively to the general public. 

The American Institute for Cancer Research and World Cancer Research Fund (AICR/WCRF) is one such organization established over thirty years ago with the primary purpose of increasing public awareness of diet and its links to cancer. 

Since its inception, the AICR/WCRF has published three expert reports, which combine to make a set of publications that assess modifiable lifestyle factors, diet, physical activity, other behaviors, and environmental agents, and their relationships to cancer. These expert reports summarize the totality of what scientists have learned from studies, such as the EPIC study, evaluating the links between diet and cancer. A part of the summary of the expert report, now in its third iteration, is a set of general guidelines that any individual can follow for lowering their general risk of cancer. The “10 Cancer Prevention Guidelines” provided below are taken from the report from AICR/WCRF at www.aicr.org/cancer-prevention.

AICR/WCRF 10 Cancer Preventive Guidelines

• Be a healthy weight
• Be physically active
• Eat a diet rich in whole grains, fruits, vegetables, and beans
• Limit consumption of “fast foods” and other processed foods high in fat, starches, or sugar
• Limit consumption of red and processed meat
• Limit consumption of sugar-sweetened drinks
• Limit alcohol consumption
• Do not use supplements for cancer prevention
• For mothers: breastfeed your baby if you can

After a cancer diagnosis: follow these recommendations, if you can.

The recommendations have been analyzed in numerous studies since their publication. Many studies have reported that adhering to these guidelines did confer protection against several cancers or death by cancer.

There is no magic bullet for preventing cancer.

There is no single food that will cure or shield your body from this devastating illness. However, making comprehensive changes to the entirety of one’s lifestyle may help. 

Cancer is a complex family of diseases with origins that are sometimes elusive and difficult to understand. Nevertheless, on average, we can expect to lower our risk of developing a malicious form of cancer by adhering as closely as possible to the guidelines cited above. 

Living a healthy lifestyle confers benefits and prevents a whole host of diseases beyond just cancer. 

It is an approach that anyone can adopt with proper planning, guidance, and execution. 

References

1. Wang D, Zhang Z, Li Y, et al. Adenomatous Polyposis Coli Gene Mutations in 22 Chinese Pedigrees with Familial Adenomatous Polyposis. Med Sci Monit Int Med J Exp Clin Res. 2019;25:3796-3803. doi:10.12659/MSM.913911
2. Theodoratou E, Timofeeva M, Li X, Meng X, Ioannidis JPA. Nature, Nurture, and Cancer Risks: Genetic and Nutritional Contributions to Cancer. Annu Rev Nutr. 2017;37:293-320. doi:10.1146/annurev-nutr-071715-051004
3. Riboli E, Hunt K, Slimani N, et al. European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection. Public Health Nutr. 2002;5(6b):1113-1124. doi:10.1079/PHN2002394
4. Lahmann PH, Hoffmann K, Allen N, et al. Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer And Nutrition (EPIC). Int J Cancer. 2004;111(5):762-771. doi:10.1002/ijc.20315
5. Murphy N, Norat T, Ferrari P, et al. Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC). PloS One. 2012;7(6):e39361. doi:10.1371/journal.pone.0039361
6. Bradbury KE, Appleby PN, Key TJ. Fruit, vegetable, and fiber intake in relation to cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr. 2014;100 Suppl 1:394S-8S. doi:10.3945/ajcn.113.071357
7. González CA, Jakszyn P, Pera G, et al. Meat Intake and Risk of Stomach and Esophageal Adenocarcinoma Within the European Prospective Investigation Into Cancer and Nutrition (EPIC). JNCI J Natl Cancer Inst. 2006;98(5):345-354. doi:10.1093/jnci/djj071
8. The American Institute for Cancer Research/World Cancer Research Fund. Diet, Nutrition, Physical Activity and Cancer: A Global Perspective. Vol 3. 3rd ed.
9. Hastert TA, Beresford SAA, Patterson RE, Kristal AR, White E. Adherence to WCRF/AICR Cancer Prevention Recommendations and Risk of Postmenopausal Breast Cancer. Cancer Epidemiol Biomarkers Prev. 2013;22(9):1498-1508. doi:10.1158/1055-9965.EPI-13-0210
10. Romaguera D, Ward H, Wark PA, et al. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study. BMC Med. 2015;13(1):107. doi:10.1186/s12916-015-0332-5
11. Inoue-Choi M, Robien K, Lazovich D. Adherence to the WCRF/AICR Guidelines for Cancer Prevention Is Associated with Lower Mortality among Older Female Cancer Survivors. Cancer Epidemiol Biomarkers Prev. 2013;22(5):792-802. doi:10.1158/1055-9965.EPI-13-0054

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