nutrition, physical activity & cancer prevention update

Nutrition, Physical Nutrition, Physical Activity & Cancer Activity & Cancer

Prevention UpdatePrevention Update

Sherri Cirignano, MS, RD, LDN

Rutgers University

ObjectivesObjectives

Promote awareness of the link Promote awareness of the link between nutrition, physical between nutrition, physical activity and cancer preventionactivity and cancer prevention

Understand the American Institute Understand the American Institute for Cancer Research (AICR) for Cancer Research (AICR) RecommendationsRecommendations

Identify ways to promote client Identify ways to promote client personal weight, physical activity personal weight, physical activity and/or nutrition goalsand/or nutrition goals

Controllable Causes Controllable Causes of Cancer of Cancer

Lifestyle ChoicesLifestyle Choices

WeightWeight

Physical ActivityPhysical Activity

Eating HabitsEating HabitsTobacco Use Tobacco Use

WCRF/AICR, 2007WCRF/AICR, 2007

AICRAICR Recommendations Recommendations for Cancer for Cancer

Prevention Prevention WCRF/AICR,2007WCRF/AICR,2007

AICR AICR Recommendation #1Recommendation #1

Be as lean as possible Be as lean as possible without becoming without becoming

underweight. underweight. WCRF/AICR 2007 WCRF/AICR 2007

Weight Maintenance Weight Maintenance Tops the List Tops the List

Evidence for increased riskEvidence for increased risk Body fatness Body fatness Convincing for esophageal, Convincing for esophageal,

pancreas, colorectal, breast (post), pancreas, colorectal, breast (post), endometrium, kidney; Probable for gallbladderendometrium, kidney; Probable for gallbladder

Abdominal fatness Abdominal fatness Convincing for colorectal; Convincing for colorectal; Probable pancreas, breast (post), endometriumProbable pancreas, breast (post), endometrium

Adult weight gain Adult weight gain Probable for breast (post) Probable for breast (post) Balance caloric intake with physical activityBalance caloric intake with physical activity Work towards a healthy BMI (18.5-24.9) and Work towards a healthy BMI (18.5-24.9) and

waist measurement (<31.5” for women/<37” waist measurement (<31.5” for women/<37” for men)for men)

WCRF/AICR, 2007WCRF/AICR, 2007USDAUSDA

Tips toTips toMake it Happen!Make it Happen!

Make it goal-orientedMake it goal-oriented Make it safeMake it safe Make it positiveMake it positive Make it Happen! One step Make it Happen! One step

at a timeat a time


Be physically Be physically active for at active for at

least 30 minutes least 30 minutes each day.each day.


Get Moving-Get Get Moving-Get Healthy!Healthy!

Evidence for decreased riskEvidence for decreased risk– Convincing Convincing for colon cancer for colon cancer – Probable Probable for breast (post), endometrium for breast (post), endometrium– Limited-suggestiveLimited-suggestive for lung, pancreas, breast for lung, pancreas, breast

(pre)(pre) Adults:Adults:

• Engage in moderate – vigorous activity for 30-60 Engage in moderate – vigorous activity for 30-60 minutes every day / Limit sedentary activitiesminutes every day / Limit sedentary activities


Children and Adolescents:Children and Adolescents:• Engage in 1 hour (60 minutes) or more of physical Engage in 1 hour (60 minutes) or more of physical

activity every day / Limit sedentary activitiesactivity every day / Limit sedentary activitiesUSDHHSUSDHHS

Tips toTips toMake it Happen!Make it Happen!

Make it safeMake it safe Make it goal-focusedMake it goal-focused Make it easyMake it easy Make it funMake it fun Make it Happen! Every dayMake it Happen! Every day

AICR Nutrition AICR Nutrition RecommendationsRecommendations


Avoid sugary drinks. Limit Avoid sugary drinks. Limit consumption of energy-dense consumption of energy-dense

foods.foods. Evidence probable for increased risk of Evidence probable for increased risk of

weight gain, overweight and obesityweight gain, overweight and obesity Drink mostly water and up to one glass Drink mostly water and up to one glass

of fruit juice per dayof fruit juice per day Choose nutrient-rich foods more oftenChoose nutrient-rich foods more often Consume fast foods sparingly, if at allConsume fast foods sparingly, if at all



Eat more of a variety of vegetables, Eat more of a variety of vegetables, fruits, whole grains and legumes.fruits, whole grains and legumes.


Cancer Prevention Cancer Prevention Benefits of Non-Starchy Benefits of Non-Starchy

VegetablesVegetables Evidence probable for a decreased risk Evidence probable for a decreased risk

of mouth, pharynx, larynx, esophageal, of mouth, pharynx, larynx, esophageal, stomach and colorectal cancersstomach and colorectal cancers

Non-starchy vegetables includes Non-starchy vegetables includes – Cruciferous vegetables (broccoli, cabbage)Cruciferous vegetables (broccoli, cabbage)– Root vegetables (carrots, beets, turnips)Root vegetables (carrots, beets, turnips)– Allium vegetables (garlic, leeks, shallots)Allium vegetables (garlic, leeks, shallots)– Green leafy vegetables (collard and turnip Green leafy vegetables (collard and turnip

greens)greens)WCRF/AICR,2007WCRF/AICR,2007

Cancer Prevention Cancer Prevention Benefits of FruitBenefits of Fruit

Evidence for decreased riskEvidence for decreased risk– Probable for mouth, pharynx, larynx, Probable for mouth, pharynx, larynx,

esophagus, lung, stomachesophagus, lung, stomach– Limited-suggestive for nasopharynx, Limited-suggestive for nasopharynx,

pancreas, liver, colorectumpancreas, liver, colorectum IncludesIncludes

– Citrus fruitsCitrus fruits– General fruits including apples, General fruits including apples,

watermelon, guava and apricotswatermelon, guava and apricotsWCRF/AICR,2007WCRF/AICR,2007

More Matters!More Matters!

Eat a Eat a varietyvariety of vegetables of vegetables and fruits and fruits

Include vegetables and fruits at Include vegetables and fruits at meals and snacksmeals and snacks

Limit fried and starchy Limit fried and starchy vegetables vegetables

Choose 100% juice for Choose 100% juice for fruit or vegetable fruit or vegetable juicesjuices


Fruitsandveggiesmorematters.orgFruitsandveggiesmorematters.org

Make Half Your Make Half Your Grains Whole Grains Whole

Evidence for decreased riskEvidence for decreased risk– Probable for colorectal due to fiberProbable for colorectal due to fiber

Choose whole grainsChoose whole grains

– Aim for 3 ounces each dayAim for 3 ounces each day– Include whole grain rice, bread, pasta Include whole grain rice, bread, pasta

and cereals and cereals– Limit refined grainsLimit refined grainsWCRF/AICR,2007WCRF/AICR,2007

www.health.govwww.health.gov

LegumesLegumes

Evidence for decreased riskEvidence for decreased risk– Probable for colorectal due to dietary fiberProbable for colorectal due to dietary fiber– Limited-suggestive for stomach, prostate Limited-suggestive for stomach, prostate

due to legumesdue to legumes Kidney, black & soy beans, Kidney, black & soy beans,

chickpeas and lentilschickpeas and lentils Excellent source of plant protein & Excellent source of plant protein &

fiber fiber Aim for three cups/weekAim for three cups/week

www.mypyramid.govwww.mypyramid.gov


The New American The New American PlatePlate

www.aicr.orgwww.aicr.orgLearn More

Tips to Tips to Make it Happen!Make it Happen!

Make it easyMake it easy Make it differentMake it different Make it funMake it fun Make it Happen! With one Make it Happen! With one

food type at a timefood type at a time


Limit consumption of red meats Limit consumption of red meats and avoid processed meats.and avoid processed meats.

WCRF/AICR,2007WCRF/AICR,2007

Recommendation #5 Recommendation #5 SpecificsSpecifics

Evidence for increased risk with Evidence for increased risk with regard to red meat and processed regard to red meat and processed meatmeat– Convincing for colorectumConvincing for colorectum

Recommendations:Recommendations:– Limit red meat to less than 18 oz. each Limit red meat to less than 18 oz. each

weekweek Includes beef, pork and lambIncludes beef, pork and lamb

– Have little, if any, processed meatHave little, if any, processed meat Includes bacon, salami, hot dogs, sausagesIncludes bacon, salami, hot dogs, sausagesWCRF/AICR,2007WCRF/AICR,2007

Making Protein Making Protein Choices Choices

Choose fish, poultry, or beans as an Choose fish, poultry, or beans as an alternative to beef, pork, and lambalternative to beef, pork, and lamb

When eating meat, select lean cuts When eating meat, select lean cuts and smaller portions and smaller portions

Bake, broil, or poach meat, rather Bake, broil, or poach meat, rather than frying or charbroilingthan frying or charbroiling

Save processed meats for special Save processed meats for special occasions onlyoccasions onlyLearn MoreLearn MoreWCRF/AICR,2007WCRF/AICR,2007

GrillingGrilling

Evidence for increased risk is Evidence for increased risk is limited-suggestive for stomach limited-suggestive for stomach cancer cancer

For safer grilling:For safer grilling:– Marinate and/or pre-cook meats Marinate and/or pre-cook meats

before grillingbefore grilling– Use lean meatsUse lean meats– Remove charred meat portionsRemove charred meat portions– Grill vegetables and fruitsGrill vegetables and fruitsAICRAICR


Limit consumption of salty foods Limit consumption of salty foods and foods processed with salt.and foods processed with salt.

Probable evidence for increased risk of Probable evidence for increased risk of stomach cancerstomach cancer

Intake of sodium should be less than Intake of sodium should be less than 2400mg per day 2400mg per day

Avoid processed foodsAvoid processed foods Check food labelsCheck food labels Gradually reduce the amount of salt Gradually reduce the amount of salt

addedadded Use spices, herbs or lemon instead of saltUse spices, herbs or lemon instead of salt


Review of Review of Diet Diet

RecommendationsRecommendations Avoid sugary drinks and limit Avoid sugary drinks and limit

energy- dense foodsenergy- dense foods Eat more of a variety of vegetables, Eat more of a variety of vegetables,

fruits, whole grains and legumesfruits, whole grains and legumes Limit consumption of red meats Limit consumption of red meats

and avoid processed meatsand avoid processed meats Limit consumption of salty foods Limit consumption of salty foods

and foods processed with saltand foods processed with saltWCRF/AICR,2007WCRF/AICR,2007


If consumed at all, If consumed at all, limit alcoholic limit alcoholic

drinks to 2 for men drinks to 2 for men and 1 for women a and 1 for women a

day.day. WCRF/AICR,2007WCRF/AICR,2007

Limit AlcoholLimit Alcohol Evidence for increased riskEvidence for increased risk

– Convincing for mouth, pharynx, larynx, Convincing for mouth, pharynx, larynx, esophagus, colorectal (men), breast (pre & post)esophagus, colorectal (men), breast (pre & post)

– Probable for colorectal (women) and liverProbable for colorectal (women) and liver Limit alcohol consumptionLimit alcohol consumption

– One drink = 12 ounces beer, 5 ounces of wine, or One drink = 12 ounces beer, 5 ounces of wine, or 1.5 ounces of 80 proof spirits1.5 ounces of 80 proof spirits

– Alternate between alcoholic and non-alcoholic Alternate between alcoholic and non-alcoholic drinks and dilute alcoholic drinksdrinks and dilute alcoholic drinks

– Aim to keep a few nights a week alcohol-freeAim to keep a few nights a week alcohol-freeWCRF/AICR,2007

Water is the recommended beverage of Water is the recommended beverage of choicechoice

Am J Clin Nutr 2006;83:529-542Am J Clin Nutr 2006;83:529-542


Don’t use supplements to Don’t use supplements to protect against cancer.protect against cancer.

Evidence for increased risk Evidence for increased risk – Convincing w/beta-carotene and lung Convincing w/beta-carotene and lung

cancercancer The best source of nutrients is food The best source of nutrients is food

and drinkand drink Exceptions:Exceptions:

– Pregnant women & nursing mothersPregnant women & nursing mothers– Children & adolescentsChildren & adolescents– Older adultsOlder adultsWCRF/AICR,2007WCRF/AICR,2007

AICR AICR Recommendation #9Recommendation #9It’s best for mothers to breastfeed It’s best for mothers to breastfeed

exclusively for up to six months.exclusively for up to six months.

Protective to moms against Protective to moms against breast cancerbreast cancer– Evidence for lactation is Evidence for lactation is

convincing for decreased risk of convincing for decreased risk of breast cancer (pre & post) breast cancer (pre & post)

Decreases the risk of over- Decreases the risk of overweight and obesity in children weight and obesity in children– Evidence for weight gain, overweight Evidence for weight gain, overweight

and obesity is probable and obesity is probableWCRF/AICR,2007WCRF/AICR,2007


After treatment, cancer survivors After treatment, cancer survivors should follow the should follow the

recommendations for cancer recommendations for cancer prevention.prevention.

Seek professional advice when in Seek professional advice when in treatmenttreatment

Follow prevention recommendations Follow prevention recommendations to reduce risk of recurrenceto reduce risk of recurrence


And, always remember And, always remember – do not smoke or – do not smoke or

chew tobacco chew tobacco

Aim to be a healthy weight Aim to be a healthy weight throughout lifethroughout life

Be physically active everyday in Be physically active everyday in any way for 30 minutes or moreany way for 30 minutes or more

Eat a variety of healthful foods, Eat a variety of healthful foods, with a focus on plant foodswith a focus on plant foods

Limit consumption of alcoholic Limit consumption of alcoholic beveragesbeverages

Avoid tobacco use and exposureAvoid tobacco use and exposureWCRF/AICR,2007WCRF/AICR,2007

Nutrition, Physical Activity & Cancer:

This presentation was created by

Family & Community Health Sciences of Rutgers, The State University of New Jersey

Authored by: Sherri Cirignano, MS, RD, LDN

[email protected]

2009

nutrition, physical activity & cancer prevention update

Documents

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