1. Preventing Cancer Through Lifestyle Abbi Kifer R.D., L.D. FSNE Educator

2. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective World Cancer Research Fund American Institute for Cancer Research Washington DC: AICR, 2007

3. Prevention of Cancer “Prevention” does not mean elimination Cancer is mostly a preventable disease Cancer is a disease of genes Nutrition is an important factor in the likelihood of some mutations Only a small proportion of cancer is inherited

4. What does the public think? You are the public, what are your thoughts? Cancer is a top concern 25-49% say reducing is highly unlikely or very difficult >70% say they don’t know which of the many recommendations to follow

5. Background Food production and consumption has changed Economic development Improves nutrition Can shift what made up a populations diet

6. Background Body composition has changed Estimate: 6 million American adults are now morbidly obese (BMI 40+) Almost 2x since 1980 In 2002-1 billion overweight or obese people worldwide US Census 2000; NHANES III

7. Background Physical activity has changed Technology driven Vehicles for transportation 2002 WHO recommends 30 minutes moderate- intensity (every day) 60% of worlds population fails to achieve this level

8. Cancer 2002-more than 10 million new cases of cancer world wide Nearly 7 million cancer deaths By 2020-estimated rise to over 16 million new cases With 10 million deaths By 2030 more than 20 million new cases 70% will be in low-income countries

9. Why the increase in cancer? Projected increase in population Ageing world population Improved screening, detection and treatment Projected increases in tobacco

10. The cancer process Biological evidence that food and nutrition, physical activity, and body composition influences stages of cancer development

11. What is cancer? A group of more that 100 diseases characterized by uncontrolled cellular growth as a result of changes in genetic information of cells

12. Human Adults How many cells? 10,000 TEN TRILLION!!! (or more)

13. Help People Understand… Food and life should be enjoyed Recommendations will involve change for some people Achieving all recommendations will not be easy for all people People can enjoy new ways of life as much or more Important to set goals and make gradual change

14. Recommendations for Cancer Prevention 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 energy-dense foods 4. Eat more variety of vegetables, fruits, whole grains, and legumes 5. Limit consumption of red meats and avoid processed meat 6. Limit alcoholic drinks to 2 for men, 1 for women per day (or not at all) 7. Limit consumption of salty foods and foods processed with salt 8. Don’t use supplements to protect against cancer

15. Special Population Recommendations 1. It is best for mothers to breastfeed exclusively for six months and then add other liquids and foods. 2. After treatment, cancer survivors should follow the recommendations for cancer prevention And always remember…do not smoke or chew tobacco…EVER

16. AICR Guidelines/Principles 3 realistic guidelines issued from the 10 recommendations Following all offers greatest cancer protection

17. Guiding Principles 1. Choose mostly plant foods, limit red meat, and avoid processed meat completely 2. Be physically active every day in any way for 30 minutes or more 3. Aim to be a healthy weight throughout life

18. Guideline 1 Choose mostly plant foods Eating more vegetables and fruits protects Whole grains (instead of refined) Legumes

19. Guideline 1 Limit red meat 87 studies suggest link to colorectal cancer Up to 18 oz/week not associated with increased risk (equals 2.5 ounces per day) Cancer risk associated with amounts higher than 18 oz/week Risk increases by 15% for each additional 1.7 ounces of daily consumption What about the grilling issue?

20. Guideline 1 Avoid processed meat Preserved by smoking, curing, salting, or adding other chemical preservatives Includes bacon, ham, sausage, hotdogs, bologna, salami, pastrami, corned beef, pepperoni, bratwurst, frankfurters 58 studies reviewed with convincing evidence 21% increased risk with a daily consumption of 1.7ounces (lifetime)

21. What should we tell our audience? Redesign your plate 2/3 with veggies, fruits, whole grains, beans 1/3 or less with animal foods Eat less processed food Select plant foods first, then select meat Limit refined starchy foods No evidence connects fish or poultry

22. Guideline 2 Be physically active every day in any way for 30 minutes or more Protects against colon, post-menopausal breast, and uterine lining cancers Reduces risk independently of separate risk factors

23. Guideline 2 How does exercise protect? Lowering hormones Digestive system Why did exercise decline?

24. What should we tell our audience? Rates of cancer increase as activity decrease Limit sedentary behaviors Make exercise a priority Emphasize benefits What counts as physical activity?

25. Guideline 3 Aim to be a healthy weight throughout life Excess body fat = major risk factor 2/3 population is overweight or obese Belly fat is dangerous fat

26. Guideline 3 5% increase in colorectal cancer risk with each one-inch increase in waist circumference (AICR) 4 inch increase in waist raised colon cancer risk 16% in women and 33% in men (American Journal of Clinical Nutrition)

27. How does fat increase cancer risk? Fat cells… produce estrogen cell growth produce proteins (cytokines) inflammation and insulin resistance promotes cell growth and reproduction Fat at the waist is more active

28. What should we tell our audience? Manage Weight-Single most important way to protect against cancer Maintain a normal weight Avoid weight gain Avoid increased waist circumference

29. Top 2 ways to prevent wt gain 1. Limit consumption of energy-dense foods and avoid sugary drinks Consume fast food sparingly if at all 2. Increase the level of physical activity 3. What might be a third suggestion???

30. Tips to spend less and gain health Smaller meat portions Less processed/convenience food Fresh produce in season Compare fresh to frozen and canned Buy what is needed Use leftovers Make a list Coupons for only what you need Cook at home Karen Collins, MS, RD, CDN www.karencollinsnutrition.com

31. How this changes us (as educators)? 10,360 Marylanders are estimated to die from cancer this year What are the barriers? Confusion Change Fear of deprivation Time Money According to American Cancer Society

32. Available at www.aicr.orgwww.aicr.org Walnuts Slow Growth of Breast Cancer Tumors Cancer Experts Welcome Gov. PA Guidelines Americans Fall Short on Cancer-Protective Fitness One More Reason to Breastfeed: Cancer Protection Cancer Protection from the Farm Stand Experts Fact-Check “McDonald’s Diet” Story Colorectal Cancer Called “Most Preventable” Large UK Study Reaffirms Body Fat-Cancer Link

33. What are your questions?