Nutritional Wellness Check-up

Thursday, March 11, 2010
By: Foundation for Cancer Research & Wellness
http://www.cancerrecovery.org/site/PageServer?pagename=adult_homepage
Answer these 16 questions to consider how you eat.

Instructions: In front of each statement, place one of four "grades:" When appropriate, I have inserted wording to allow non-cancer patients to take this "Check-up".

A=I'm doing outstanding

B=My self-care is acceptable

C=There's room for improvement
D=My self-care needs strengthening here

1)___ I have asked for an appointment to see a Registered Dietitian at my cancer center for nutritional advice that has been individualized to take into account all of my medical needs.

2)___ I know the diet guidelines for reducing my risk of cancer published by The American Cancer Society (ACS) and The American Institute for Cancer Research (ACIR). [See note below]

3)___ I know which foods will help [strengthen my immune system] my body recover from cancer and which foods are less helpful to my efforts to recover from cancer [to reduce my risk of cancer].

4)___ I am willing to incorporate new foods, beverages, herbs, and spices into my diet.

5)___ I choose foods to eat that will nourish my [immune system] cancer recovery.

6)___ I eat my meals in a loving manner, reflecting positive thoughts about my food choices, and giving thanks for the healing [protective] energy my food is giving me.

7)___ I am moving toward a plant-based diet.

8)___ I consume a minimum of 5 servings of fruits and vegetables every day, striving for 9 or more servings of fruits and vegetables most days of the week, and choose deeply colored fruits and vegetables with at least 3 colors eaten every day. [See below: “What counts as a serving?”]

9)___ I include at least 3 servings of whole grain foods in my diet every day.

10)___ I have tried several types of soy foods and have found a way to include at least one serving of a soy food in my diet daily. [See caution for cancer patients, especially breast cancer patients, at the end of ACIR guidelines.]

11)___ I have reduced the amount of meats I eat at my meals and replaced them with types of fish which are high in omega-3 fatty acids and/or plant foods as entrees. [Refer to “What counts as a serving?” under #8]

12)___ I include dried beans or legumes in my diet on a daily basis and use Beano(r) if needed to help achieve physical comfort and "social acceptability".

13)___ I know which foods contain saturated fats, trans fats, mono-unsaturated fats, omega- 3 fats, omega-6 fats; which types of fat are potentially harmful or helpful, and have shifted my diet to maximize the intake of the helpful fats in an amount that will help me achieve a body weight within 10 pounds of the optimum for my height and gender. (See BMI explanation & charts below)

14)___ I can adjust recipes to reduce fat content, increase fiber, and add phytochemicals.

15)___ I know how to choose (or request) foods to optimize my cancer recovery [health] when eating in a restaurant.

16)___ I believe that food nourishes the soul in addition to the body and choose foods for this aspect of my recovery [health] occasionally in a mindful manner and do not feel guilty.

Use your findings: Congratulate yourself on the items you could honestly rate A. Make note of those items rated C or D about which you would like to take some action.

#2 – I have summarized the diet guidelines for reducing your risk of cancer published by The American Cancer Society (ACS) and The American Institute for Cancer Research (AICR) in the next 2 blogs. The websites are provided so you can visit them to read them in their entirety, if you desire. As you read this information, you realize how important your eating & physical activity habits are with respect to reducing your risk of cancer, improving your prognosis if you are a current cancer patient, & preventing recurrence of cancer if you are a recovered/recovering cancer patient. However, you will notice, if you read the reports in their entirety, that there are endorsements by other health organizations. The guidelines are clearly as applicable in reducing your risk of type II diabetes, heart disease & obesity. 

#8 What Counts as a Serving?
Fruits
1 medium apple, banana, or orange
six strawberries, two plums, fifteen grapes
1/2 cup of chopped, cooked, or canned fruit
3/4 cup of 100% fruit juice
¼ cup of dried fruit

Vegetables
1 cup of raw, leafy vegetables
1/2 cup of other cooked or raw vegetables, chopped
3/4 cup of 100% vegetable juice
five broccoli florets, ten baby carrots, one roma tomato
3/4 cup tomato juice, ½ cup V-8
half of a baked sweet potato, one ear of corn, four slices of an onion

Grains
1 slice of bread
1 ounce of ready-to-eat cereal
1/2 cup of cooked cereal, rice, or pasta

Beans and nuts
1/2 cup of cooked dry beans
2 tablespoons of peanut butter
1/3 cup nuts

Dairy foods and eggs
1 cup of milk or yogurt
1 1/2 ounces of natural cheese
2 ounces of processed cheese
1 egg

Meats
2-3 ounces of cooked, lean meat, poultry, or fish

Sources:
US Department of Agriculture and US Department of Health and Human Services. Nutrition and Your Health: Dietary Guidelines for Americans, 4th ed. Home and Garden Bull 232. Washington, DC: Government Printing Office, 1995.

http://nutrition.about.com/od/fruitsandvegetables/f/servingfruit.htm

#13 – Your BMI, or Body Mass Index, is used to determine whether or not you are at your perfect weight. The BMI uses a mathematical formula that takes into account a person’s height and weight. As a strict formula, the body mass index equals a person’s weight in kilograms divided by height in meters squared. Have no fear. You do not need to make the conversions. The table below is given in pounds & feet & inches. Just find your height in the left-hand column, & then swish your finger over to your weight. The column above your weight is your BMI.

The BMI breakdown goes like this:
• 18 or lower: underweight
• 19 – 24: normal
• 25 – 29: overweight
• 30-39: obese
• 40 – 54: extremely or morbidly obese

The BMI is referenced in the ACS & AICR Guidelines on Nutrition. The tables below were re-printed from the book Perfect Weight America, by Jordan Rubin. (You can left mouse-click on any chart to enlarge it.)

American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention

Reducing the Risk of Cancer with Healthy Food Choices and Physical Activity

When I copied this 2001 set of guidelines into a Word document I found that it is 23.5 pages long, with another 4.5 pages of footnotes & references. I don’t think you want to read all of it, so I decided to summarize it for you by printing selected portions that represent a little less than one quarter of the report.

The Importance of Diet and Physical Activity in Cancer Prevention
For the great majority of Americans who do not smoke cigarettes, dietary choices and physical activity are the most important modifiable determinants of cancer risk. Evidence suggests that one third of the more than 500,000 cancer deaths that occur in the United States each year can be attributed to diet and physical activity habits [emphasis added], with another third due to cigarette smoking. Although genetic inheritance influences the risk of cancer, and cancer arises from genetic mutations in cells, most of the variation in cancer risk across populations and among individuals is due to factors that are not inherited. Behavioral factors such as smoking cigarettes, consuming foods along certain patterns of diet [emphasis added], and staying active across the lifespan can substantially affect one's risk of developing cancer. Because healthful individual behaviors are most effectively enabled by social and environmental support within communities, these 2001 guidelines include, for the first time, an explicit recommendation for community action. . .

Although the randomized, controlled trial is often considered the gold standard for scientific conclusions, such evidence is not presently available—and may never become available—for many dietary factors associated with cancer risk. Inferences about the many complex interrelationships among diet, physical activity, and cancer risk are based, for the most part, on observational studies coupled with advancing understanding of the biology of cancer. In considering the totality of evidence from a variety of sources, these guidelines take into consideration both the benefits to cancer risk reduction and overall health benefits. Although no diet can guarantee full protection against any disease, these guidelines offer the best information currently available about how diet and physical activity can reduce the risk of cancer. The ACS guidelines are consistent with guidelines from the American Heart Association for the prevention of coronary heart disease as well as for general health promotion, as defined by the Department of Health and Human Services' 2000 Dietary Guidelines for Americans. . .

AMERICAN CANCER SOCIETY GUIDELINES FOR NUTRITION AND PHYSICAL ACTIVITY
Social, economic, and cultural factors strongly influence individual choices about diet and physical activity. While most Americans would like to adopt a healthful lifestyle, many encounter substantial barriers that make it difficult to follow diet and activity guidelines. Indeed, current trends toward increasing consumption of high-calorie convenience foods and restaurant meals, and declining levels of physical activity are contributing to an alarming epidemic of obesity among Americans of all ages and across all population segments. Longer workdays and more households with multiple wage earners reduce the amount of time available for preparation of meals, with a resulting shift toward increased consumption of food outside the home—often processed foods, fast foods, and snack foods. Reduced leisure time, increased reliance on automobiles for transportation, and increased availability of electronic entertainment and communications media all contribute to a less active and increasingly sedentary lifestyle. These trends are of particular concern, especially with regard to the adverse effects they have on the long-term health of children, who are establishing lifetime patterns of diet and physical activity, as well as on the poor, who live in communities with less access to safe and healthful lifestyle options. . .

Recommendations for Individual Choices
There is strong scientific evidence that healthful dietary patterns, in combination with regular physical activity, can reduce cancer risk. Approximately 35 percent of cancer deaths in the United States may be avoidable through dietary modification [emphasis added]. The scientific study of nutrition and cancer is highly complex, and many important questions remain unanswered. It is not presently clear how single nutrients, combinations of nutrients, overnutrition and energy imbalance, or the amount and distribution of body fat at particular stages of life affect one's risk of specific cancers. However, epidemiological studies have shown that populations whose diets are high in vegetables and fruits and low in animal fat, meat, and/or calories have a reduced risk of some of the most common types of cancer. Until more is known about the specific components of diet that influence cancer risk, the best advice is to emphasize whole foods and certain broad dietary patterns, as described within these guidelines.

1. Eat a variety of healthful foods, with an emphasis on plant sources.
Eat five or more servings of a variety of vegetables and fruits each day.
• Include vegetables and fruits at every meal and for snacks.
• Eat a variety of vegetables and fruits.
• Limit French fries, snack chips, and other fried vegetable products.
• Choose 100% juice if you drink fruit or vegetable juices.

Choose whole grains in preference to processed (refined) grains and sugars.
• Choose whole grain rice, bread, pasta, and cereals.
• Limit consumption of refined carbohydrates, including pastries, sweetened cereals, soft drinks, and sugars.

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

Choose foods that help you maintain a healthful weight.
• When you eat away from home, choose foods that are low in fat, calories, and sugar, and avoid large portion sizes.
• 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 for calorie-dense foods such as French fries, cheeseburgers, pizza, ice cream, doughnuts, and other sweets.

Beneficial Effects of Vegetables and Fruits
Greater consumption of vegetables, fruits, or both together has been associated in the majority of epidemiological studies with a lower risk of lung, oral, esophageal, stomach, and colon cancer. . .
It is presently unclear which components of vegtetables and fruits are most protective against cancer. Vegetables and fruits are complex foods, each containing more than 100 potentially beneficial vitamins, minerals, fiber, and other substances that may help to prevent cancer.

Vegetables and fruits also contain specific phytochemicals, such as carotenoids, flavonoids, terpenes, sterols, indoles, and phenols that show benefit against certain cancers in experimental studies. There is ongoing research, for example, on the potential benefits of green and dark yellow vegetables, plants related to the cabbage family, soy products, legumes, allium (onion and garlic), and tomato products. Until more is known about specific food components, the best advice is to eat five or more servings of a variety of vegetables and fruits in their various forms: fresh, frozen, canned, dried, and juiced. . .

Whole Grains
Grains such as wheat, rice, oats, and barley, and the foods made from them, constitute the basis of a healthful diet. Whole grains are an important source of many vitamins and minerals that have been associated with lower risk of colon cancer, such as folate, vitamin E, and selenium. Whole grains are higher in fiber, certain vitamins, and minerals than processed (refined) flour products. Although the association between fiber and cancer risk is inconclusive, consumption of high-fiber foods is still recommended. Since the benefits grain foods impart may derive from their other nutrients as well as from fiber, it is best to obtain fiber from whole grains—and vegetables and fruits—rather than from fiber supplements. . .

Dietary Fat and Consumption of Red Meat
High-fat diets have been associated with an increase in the risk of cancers of the colon and rectum, prostate, and endometrium. . . Research continues to examine whether the association between high-fat diets and various cancers in some epidemiological studies is due to the total amount of fat, the particular type of fat (saturated, monounsaturated, or polyun-saturated), the calories contributed by fat, or some other factor associated with high-fat foods. Fats such as the saturated fat in red meats, omega-3 fatty acids in fish oils, or monounsaturated fats in olive oil, for example, likely differ in their effects on cancer risk. . .

Foods from animal sources remain major contributors of total fat, saturated fat, and cholesterol in the American diet. Although meats are good sources of high-quality protein and can supply many important vitamins and minerals, consumption of meat—especially red meats (beef, pork, lamb)—has been associated with cancers in many studies, most notably those of the colon and prostate. How much of this association is due to specific constituents within meat (such as saturated fats) or to correlated dietary factors is presently unclear. . .

Much evidence indicates that saturated fat may be particularly important in increasing risk of cancer as well as for heart disease. The best way to reduce saturated fat intake is to make wise choices in the selection and preparation of animal-based foods. Choose lean meats and lower-fat dairy products, and substitute vegetable oils for butter or lard. Food labels can be a useful guide to choosing packaged foods lower in saturated fat. Choose smaller portions and use meat as a side dish rather than as the focus of a meal. Emphasize beans, grains, and vegetables in meals to help shift dietary patterns to include more foods from plant rather than animal sources.

Preparation methods are also important. Baking and broiling meat, rather than frying, reduces its overall fat content. Meat should be cooked thoroughly to destroy harmful bacteria and parasites, but should not be charred.

Choosing Foods that Help Maintain a Healthful Body Weight
Most people cannot maintain a healthful body weight without limiting caloric intake while maintaining regular physical activity. Current trends indicate that the largest percentage of calories in the American diet comes from foods high in fat, sugar, and refined carbohydrates. Consuming a varied diet that emphasizes plant-based foods may help to displace these calorie-dense foods. Limiting portion sizes, especially of these types of foods, is another important strategy to reduce total caloric intake.
Replacing dietary fat with foods that are high in calories from sugar and other refined carbohydrates does not protect against obesity. The decrease in fat intake and increase in consumption of refined carbohydrates that occurred in the United States between 1977 and 1995 coincided with an 8% increase in the prevalence of obesity. Excessive intake of sugar and other highly-refined carbohydrates may contribute to insulin insensitivity, alterations in the amount and distribution of body fat, and increased concentrations of growth factors that may promote the growth of cancers.

2. Adopt a physically active lifestyle.
• Adults: engage in at least moderate activity for 30 minutes or more on five or more days of the week; 45 minutes or more of moderate-to-vigorous activity on five or more days per week may further enhance reductions in the risk of breast and colon cancer.
• Children and adolescents: engage in at least 60 minutes per day of moderate-to-vigorous physical activity for at least five days per week.

Benefits of Physical Activity
Scientific evidence indicates that physical activity may reduce the risk of several types of cancer, including cancers of the breast and colon, and can provide other important health benefits. Physical activity acts in a variety of ways to impact cancer risk. Regular physical activity helps maintain a healthful body weight by balancing caloric intake with energy expenditure. Other mechanisms by which physical activity may help to prevent certain cancers may involve both direct and indirect effects. . . The benefits of physical activity go far beyond reducing the risk of cancer, however, and include reducing the risk of other chronic diseases, such as heart disease, diabetes, osteoporosis, and hypertension.

Recommended Amount of Activity
There are many unanswered questions about the optimal intensity, duration, and frequency of physical activity needed to reduce cancer risk. However, current evidence suggests that there is substantial risk reduction for colon cancer from simply not being sedentary. And by participating in moderate-to-vigorous physical activity at least 45 minutes on five or more days of the week, individuals may achieve optimal activity levels needed to reduce the risk of developing both breast and colon cancers, as well as several other types of cancer, including kidney, endometrial, and esophageal cancer. Moderate-to-vigorous physical activity is needed to metabolize stored body fat and to modify physiological functions that affect insulin, estrogen, androgen, prostaglandins, and immune function. This recommendation to include physical activity in one's lifestyle to reduce cancer risk is supported by a recent extensive review by the World Health Organization.

For people who are largely inactive or just beginning a physical activity program, a gradual increase to 30 minutes per day of moderate-to-vigorous physical activity on at least five days per week will provide substantial cardiovascular benefits and aid in weight control. Those who are already active at least 30 minutes on most days of the week should strive toward accumulating 45 minutes of moderate-to-vigorous activity on most days of the week.

Moderate activities are those that require effort equivalent to a brisk walk. Vigorous activities generally engage large muscle groups and cause an increase in heart rate, breathing depth and frequency, and sweating. These activities can be performed in a variety of settings: occupational, recreational, in the home or garden, and with friends or family. While there is limited evidence regarding whether physical activity is most protective if done in a single session or incrementally throughout the day, it is reasonable to assume that benefit can be accumulated in separate sessions of 20 to 30 minutes each. . .

Because one of the best predictors of adult physical activity is activity levels during childhood and adolescence, and because of the critical role physical activity plays in weight maintenance, children and adolescents should be encouraged to be physically active at moderate-to-vigorous intensities for at least 60 minutes per day on five or more days per week. Such activities should include sports and fitness activities at school and at home. To help achieve activity goals, daily physical education programs and activity breaks should be provided for children at school, and television viewing and computer game time should be minimized at home. . .

3. Maintain a healthful weight throughout life.
• Balance caloric intake with physical activity.
• Lose weight if currently overweight or obese.

Balancing Energy Intake and Expenditure
Overweight and obesity are associated with increased risk for cancers at several sites: breast (among postmenopausal women), colon, endometrium, adenocarcinoma of the esophagus, gallbladder, pancreas, and kidney. These findings are supported both by animal studies and by epidemiological studies.

The Body Mass Index (BMI) is an expression of weight-for-height calculated as body weight in kilograms divided by height in meters, squared. Exact cut-offs for BMI levels at elevated risk are difficult to define, since epidemiological studies have used different cutpoints in calculating cancer risks associated with body weight. However, experts consider a BMI within the range of 18.5 to 25.0 kg/m to be healthful, a BMI between 25.0 and 29.9 to be overweight, and a BMI of 30.0 and over to be obese (Figure 1 ). Individuals should strive to maintain a BMI between 18.5 and 25.0 kg/m2.

The best way to achieve a healthful body weight is to balance energy intake (food intake) with energy expenditure (physical activity). Excess body fat can be reduced by restricting caloric intake and increasing physical activity. Caloric intake can be reduced by decreasing the size of food portions and limiting the intake of calorie-dense foods high in fat and refined sugars (e.g., fried foods, cookies, cakes, candy, ice cream, and soft drinks). Such foods should be replaced with foods like vegetables and fruits, whole grains, and beans. People should be aware that meals served in restaurants typically exceed the portion sizes needed to meet recommended daily caloric intake. Physical activity as well as diet is essential for maintenance of a healthful weight.

. . . Even though our knowledge about the relationship between weight loss and cancer risk is incomplete, individuals who are overweight and obese should be encouraged and supported in their efforts to reduce weight. Obesity is a major risk factor not only for cancer, but also for diabetes, stroke, and coronary heart disease.

Because overweight in youth tends to continue throughout life, the increasing prevalence of overweight and obesity in pre-adolescents and adolescents may increase the incidence of cancer in the future. For these reasons, efforts to establish healthful weight, physical activity habits, and patterns of weight gain should begin in childhood.

4. If you drink alcoholic beverages, limit consumption.
People who drink alcohol should limit their intake to no more than two drinks per day for men and one drink a day for women. The recommended limit is lower for women because of their smaller body size and slower metabolism of alcohol. A drink of alcohol is defined as 12 ounces of beer, five ounces of wine, or 1.5 ounces of 80-proof distilled spirits. Alcohol consumption is an established cause of cancers of the mouth, pharynx, larynx, esophagus, liver, and breast. Alcohol consumption may also be related to increased risk of colon cancer. For each of these cancers, risk increases substantially with intake of more than two drinks per day. . . [R]egular consumption of even a few drinks per week has been associated with an increased risk of breast cancer in women. The mechanism by which alcohol is related to breast cancer is not known with certainty, but may be due to alcohol-induced increases in circulating estrogens or other hormones in the blood, reduction of folic acid levels, or to a direct effect of alcohol or its metabolites on breast tissue. Reducing alcohol consumption may be an important way for many women to reduce their risk of breast cancer. Some studies suggest that consuming the recommended amount of the vitamin folic acid can minimize the increased risk of breast cancer from alcohol, but this relationship has not been firmly established.

Tim Byers, MD, MPH, Marion Nestle, PhD, MPH, Anne McTiernan, MD, PhD, Colleen Doyle, MS, RD, Alexis Currie-Williams, MPH, CHES, Ted Gansler, MD, Michael Thun, MD and the American Cancer Society 2001 Nutrition and Physical Activity Guidelines Advisory Committee*
Dr. Byers is Professor, Preventive Medicine, University of Colorado Health Science Center, Denver, CO.
Dr. Nestle is Professor and Chair, Department of Nutrition and Food Studies, New York University, New York, NY.
Dr. McTiernan is Associate Member, Fred Hutchinson Cancer Research Center, Seattle, WA.
Ms. Doyle is Director, Nutrition and Physical Activity, American Cancer Society, Atlanta, GA.
Ms. Currie-Williams is Manager, Nutrition and Physical Activity, American Cancer Society, Atlanta, GA.
Dr. Gansler is Director of Medical Strategies, American Cancer Society, Atlanta, GA, and Editor of CA.
Dr. Thun is Vice President, Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.

This is the website where you can read the full report: http://caonline.amcancersoc.org/cgi/content/full/52/2/92

Recommendations for Cancer Prevention, by the American Institute for Cancer Research

These ten recommendations for cancer prevention are drawn from the WCRF/AICR Second Expert Report (World Cancer Research Fund International/American Institute for Cancer Research). The recommendations are followed by more details. Rather than print all 14 pages, I have chosen to print selected portions of the details from the report that represent less than half of it.

1. Be as lean as possible without becoming underweight.
2. Be physically active for at least 30 minutes every day.
3. Avoid sugary drinks. Limit consumption of energy-dense foods.
4. Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans.
5. Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats.
6. If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day.
7. Limit consumption of salty foods and foods processed with salt (sodium).
8. Don't use supplements to protect against cancer.
9. * It is best for mothers to breastfeed exclusively for up to 6 months and then add other liquids and foods.
10. * After treatment, cancer survivors should follow the recommendations for cancer prevention.
*Special Population Recommendations

1. Be as lean as possible without becoming underweight.
Maintaining a healthy weight is one of the most important things you can do to reduce your risk of cancer. Aim to be at the lower end of the healthy Body Mass Index (BMI) range.

Maintaining a healthy weight brings an array of health benefits. As well as making us feel better, it also means that we are less likely to develop not only cancer, but also other chronic diseases such as type 2 diabetes and heart disease.

We also know that where we store extra weight affects cancer risk. Scientists have discovered that carrying excess fat around our waists can be particularly harmful – it acts like a ‘hormone pump’ releasing estrogen into the bloodstream as well as raising levels of other hormones in the body. This is strongly linked to colon cancer and probably to cancers of the pancreas and endometrium (lining of the uterus), as well as breast cancer (in postmenopausal women).

See Recommendations 2 and 3 for strategies for weight management.

2. Be physically active for at least 30 minutes every day.
Physical activity in any form helps to lower cancer risk. Aim to build more activity, like brisk walking, into your daily routine.

As well as helping us avoid weight gain, activity itself can help to prevent cancer. Studies show that regular activity can help to keep hormone levels healthy, which is important because having high levels of some hormones can increase your cancer risk.

Physical activity may also strengthen our immune system, help keep our digestive system healthy and allow us to consume more food and more cancer-protective nutrients – without gaining weight.
If you’re not used to doing much activity, start by working toward 30 minutes of moderate activity each day – remember that anything is better than nothing. You can build up slowly until you reach your target. Shorter bouts of activity are just as beneficial. (It’s the total time that’s important.)

Research shows that to avoid weight gain, doing more activity is beneficial. For maximum health benefits, scientists recommend that we aim for 60 minutes or more of moderate activity every day, or 30 minutes or more of vigorous activity.

Moderate and Vigorous Activity
• Moderate activity is anything that gets your heart beating a bit faster and makes you breathe more deeply – like brisk walking.
• Vigorous activity means raising your heart rate so that you warm up, start to sweat and feel out of breath.

3. Avoid sugary drinks. Limit consumption of energy-dense foods (particularly processed foods high in added sugar, or low in fiber, or high in fat).

Choosing healthy foods and drinks instead of those that are high in refined carbohydrates and often in added sugar and fat (energy-dense foods) can help us avoid overweight and obesity and thereby reduce our cancer risk.

What are energy-dense foods?

Most foods provide us with energy (calories), but some foods contain more energy ounce-for-ounce than others. Energy-dense foods tend to be processed foods with sugar and fat added to improve the taste. The result is more calories per ounce. . .

It can be difficult to control how much energy you are consuming if you eat a lot of energy-dense foods because you only need to eat a small amount to take in a lot of calories. It’s okay to eat energy-dense foods occasionally, or in small quantities, but try not to make them the basis of your diet. By choosing a diet based on low-energy-dense foods, you can actually eat more food but consume fewer calories.

Foods that are low in energy density, like an apple, are high in fiber and water. Most vegetables, fruits and beans fall into the low-energy-dense category. It is yet another reason to base your diet on plant-based foods.

Sugary drinks and weight gain

The expert report found that regularly consuming sugary drinks contributes to weight gain. These drinks are easy to drink in large quantities but don’t make us feel full, even though they are quite high in calories. Sugary drinks include: soft drinks like colas and juice flavored drinks. We should try to avoid these drinks.

Water is the best alternative. Unsweetened tea and coffee are also healthy options. Natural fruit juice counts as one of our recommended 5 or more daily portions of vegetables and fruits, but it does contain a lot of sugar. It’s best not to drink more than one glass a day.

4. Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans.
Basing our diets on plant foods (like vegetables, fruits, whole grains and legumes such as beans), which contain fiber and other nutrients, can reduce our risk of cancer.

For good health, AICR recommends that we base all of our meals on plant foods. When preparing a meal, aim to fill at least two-thirds of your plate with vegetables, fruits, whole grains and beans.

Research shows that vegetables and fruits probably protect against a range of cancers, including mouth, pharynx, larynx, esophagus, stomach, lung, pancreas and prostate. There are many reasons why vegetables and fruits may protect against cancer. As well as containing vitamins and minerals, which help keep the body healthy and strengthen our immune system, they are also good sources of substances like phytochemicals. These are biologically active compounds, which can help to protect cells in the body from damage that can lead to cancer.

Foods containing fiber are also linked to a reduced risk of cancer. These foods include whole-grain bread and pasta, oats and vegetables and fruits. Fiber is thought to have many benefits, including helping to speed up ‘gut transit time’ - how long it takes food to move through the digestive system.

Plant foods can also help us to maintain a healthy weight because many of them are lower in energy density (calories).

5. Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats.
To reduce your cancer risk, eat no more than 18 oz. (cooked weight) per week of red meats, like beef, pork and lamb, and avoid processed meat such as ham, bacon, salami, hot dogs and sausages.

Red meat refers to beef, pork and lamb–foods like hamburgers, steak, pork chops and roast lamb. The term processed meat refers to meats preserved by smoking, curing or salting, or by the addition of preservatives. Examples include ham, bacon, pastrami and salami, as well as hot dogs and sausages.

The evidence from the expert report that red meat is a cause of colorectal cancer is convincing. This evidence is much stronger now than it was in the mid-1990s. Red meat contains substances that are linked to colon cancer. ..

Studies also show that people who eat a lot of red meat tend to eat less plant-based foods, so they benefit less from their cancer-protective properties.

. . . Studies show we can eat up to 18 ounces a week of red meat without raising cancer risk. Research on processed meat shows cancer risk starts to increase with any portion.

When meat is preserved by smoking, curing or salting, or by the addition of preservatives, cancer-causing substances (carcinogens) can be formed. These substances can damage cells in the body, leading to the development of cancer.

6. If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day.
For cancer prevention, AICR recommends not to drink alcohol. However, our expert report recognizes that modest amounts of alcohol may have a protective effect on coronary heart disease. If you do drink alcohol, limit your consumption to no more than two drinks a day for men and one drink a day for women.

The evidence that all types of alcoholic drinks increase the risk of a number of cancers is now stronger than it was in the mid-1990s. There is convincing evidence that alcohol increases the risk of cancer of the mouth, pharynx, larynx, esophagus and breast, as well as colorectal cancer in men.

Alcoholic drinks also probably increase the risk of colorectal cancer in women as well as liver cancer.

Scientists are still researching how alcohol causes cancer. One theory is that alcohol can directly damage our DNA, increasing our risk of cancer. Research shows that alcohol is particularly harmful when combined with smoking.

7. Limit consumption of salty foods and foods processed with salt (sodium).
Consuming too much salt can be harmful to our health, increasing our risk of stomach cancer as well as high blood pressure.

Our daily intake of salt should be less than 2,400 milligrams. We actually need much less than this. Most people in the United States currently consume more than 2,400 mg, but there are simple ways to cut down on our intake.

. . . Most of the salt in our diets comes from processed foods. We are not always aware that these foods are high in salt because they may not taste "salty," so make sure to read the sodium content on the Nutrition Facts label. Watch out for breakfast cereals, bread, frozen meals, pizza and chips. Also, check the amount of sodium in canned products, such as soups and sauces, and avoid processed meats. Even sweet foods like cookies can contain high levels of salt.

8. Don't use supplements to protect against cancer.
To reduce your risk of cancer, choose a balanced diet with a variety of foods rather than taking supplements.

The expert report found strong evidence that high-dose supplements of some nutrients can affect the risk of different cancers. The panel judged that in general, the best source of nourishment is food and drink, not dietary supplements. Nutrient-rich whole foods contain substances that are necessary for good health–like fiber, vitamins, minerals and phytochemicals. (The plant-based foods are the source of many cancer-fighting compounds. Be sure to fill your plate two-thirds (or more) with a variety of vegetables, fruits, whole grains and beans, and one-third (or less) of animal protein.)

Some studies have shown that supplements can upset the balance of nutrients in the body. More research needs to be done, but this is one way that they might affect our risk of cancer.

There are some situations when supplements are recommended. . .

9. It is best for mothers to breastfeed exclusively for up to 6 months and then add other liquids and foods.
Evidence shows that breastfeeding can help protect mothers from breast cancer. It also protects babies from excess weight gain that can lead to their being overweight in adult life. And overweight adults have higher cancer risk.

According to the expert report, the evidence that breastfeeding protects mothers against breast cancer is convincing. Having been breastfed probably protects children against overweight and obesity. Overweight and obese children tend to remain overweight in adult life.

Breastfeeding lowers the levels of some cancer-related hormones in the mother’s body, reducing the risk of breast cancer. At the end of breastfeeding, the body gets rid of any cells in the breast that may have DNA damage. This reduces the risk of breast cancer developing in the future.

Research shows that babies who are breastfed are less likely to consume too many calories and too much protein than babies who are fed infant formula. This means that they are less likely to become overweight or obese as they grow up. . .

10. After treatment, cancer survivors should follow the recommendations for cancer prevention.
Anyone who has received a diagnosis of cancer should receive specialized nutritional advice from an appropriately trained professional. Once treatment has been completed, if you are able to do so (and unless otherwise advised), aim to follow our cancer prevention recommendations for diet, physical activity and healthy weight maintenance.

Cancer survivors are people who are living with a diagnosis of cancer, including those who have recovered from the disease.

There is growing evidence that physical activity and other measures that help us to maintain a healthy weight, such as a balanced diet, may help to prevent cancer recurrence, particularly for breast cancer. However, the evidence is not yet clear enough to be able to make any specific recommendations for cancer survivors in general, or for those who are survivors of any specific form of cancer.

These recommendations can also reduce the risk of other chronic diseases like heart disease and diabetes.

The Weight-Cancer Link

AICR's second expert report, Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective, has confirmed the relationship between excess body fat and increased cancer risk. According to the scientific literature, there is convincing evidence that body fat increases risk for cancers of the esophagus, pancreas, colon and rectum, edometrium, kidney and breast (in postmenopausal women). Because of the overwhelming evidence, AICR recommends maintaining a healthy weight throughout life to best reduce your chances of developing cancer. Read the full list of AICR’s Recommendations for Cancer Prevention.

Laboratory studies help to explain why being overweight increases your cancer risk. The fat we store on our bodies is not an inert mass. Fat cells produce estrogen, which promotes cell growth. They also produce a variety of proteins that cause inflammation and insulin resistance, which in turn promote cell growth and cell reproduction. Fat at the waist is even more active in producing these growth stimulants. So overweight people – particularly if they are apple-shaped – have high levels of substances circulating in their blood that stimulate cell division. The more often cells divide, the more opportunity there is for cancer to develop.

AICR experts stress that this potentially dangerous condition is preventable. In fact, maintaining a healthy weight may be the single most important way to protect against cancer. At a time when two-thirds of Americans are overweight or obese, making changes to lower your cancer risk by preventing weight gain is more important than ever.

The following lifestyle modifications can help:
• Avoid sugary drinks. Limit consumption of energy-dense foods.
• Be physically active for at least 30 minutes every day.
• Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans.

Foods That Fight Cancer?

No single food or food component can protect you against cancer by itself. But scientists believe that the combination of foods in a predominantly plant-based diet may. There is evidence that the minerals, vitamins and phytochemicals in plant foods could interact in ways that boost their individual anti-cancer effects. This concept of interaction, where 1 + 1 = 3, is called synergy.

In addition, vegetables, fruits, whole grains and beans are low in calorie-density and protect against weight gain. According to the second expert report, carrying excess body fat is implicated in the development of cancer. Eating a predominantly plant based diet can help prevent weight gain and protect against those cancers whose risk is convincingly increased by higher body fat (cancers of the colorectum, esophagus, endometrium, pancreas, kidney and breast in postmenopausal women).

That is why AICR recommends that at least 2/3 of your plate should be filled with vegetables, fruit, whole grains and beans.

Information & Caution given concerning soy & soy products:
Soybeans are a type of legume, or bean. Foods made from soybeans include tofu, soymilk, soybeans, soynuts, miso (soy paste), tempeh, soy burgers and soynut butter.

Scientists believe that several active ingredients in soy may have anti-cancer effects. These include: isoflavones (which have been studied most), saponins, phenolic acids, phytic acid, phytosterols, and protein kinase inhibitors.

Soy appears to contain some components that resemble very weak forms of the body’s natural hormones. As a result, soy foods can mimic the actions of hormones under certain conditions and counteract these hormonal actions at other times. Because of such complexities, most of the studies that have investigated soy’s role in cancer development have dealt with hormone-related cancers such as those of the breast and prostate. . .

As a general rule of thumb, soy seems to be a good food to include in your diet (along with other beans) as a source of protein and nutrients. But, there's limited evidence in U.S. populations supporting hopes that soy food might offer special protection against breast cancer.

Current research shows that it is safe to eat moderate amounts of soy foods (e.g., soymilk, tofu), up to two to three servings per day. As a precaution, women receiving anti-estrogen treatments such as tamoxifen, should minimize soy foods and avoid isoflavone supplements.

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