wiseman martin - 20th international nutrition congress 2013
DESCRIPTION
The 20th International Congress of Nutrition (ICN) hosted by the International Union of Nutritional Science (IUNS) took place on the 15th-20th September 2013, Granada, Spain. WCRF International held a 2-hour symposium on the Continuous Update Project (CUP) entitled ‘Food, Nutrition, Physical Activity and Cancer – Keeping the Evidence Current: WCRF/AICR Continuous Update Project (CUP).’ It included four presentations exploring the latest updates from the CUP.TRANSCRIPT
Martin Wiseman
World Cancer Research Fund International
University of Southampton, UK
Evidence-based recommendations for prevention of cancer and other chronic diseases
The 2007 and 2009 WCRF/AICR Reports
IUNS, Granada, 2013
www.wcrf.org/ICN2013
Who we are What we do
AICR
WCRF UK
WCRF Netherlands
WCRF Hong Kong
WCRF International
Fund research on the relationship of nutrition, physical activity and body weight to cancer risk
Interpret the accumulated scientific literature to derive Recommendations for Cancer Prevention
Educate people through our national Health Information programmes
Advocate effective policies to help people and populations to reduce their chances of developing cancer
Data from Parkin et al, Pisani et al, Globocan 2008, IARC
*Estimated new cases for 2030 from predictions in 2002
Around one quarter of all cancers estimated avoidable through appropriate food, nutrition and physical activity
USA UK BRAZIL CHINA
Mouth, pharynx, larynx
63 67 63 44
Oesophagus 69 75 60 44
Lung 36 33 36 38
Stomach 47 45 41 33
Pancreas 19 15 11 8
Gallbladder 21 16 10 6
Liver 15 17 6 6
Colorectum 50 47 41 22
Breast 38 42 28 20
Endometrium 59 44 37 25
Prostate 11 20 N/A N/A
Kidney 24 19 13 8
Total for these cancers
35 37 29 27
Total for all cancers
24 27 19 22
Global variation in cancer incidence and impact of migration
Breast
Colorectum
Environment is a key determinant
of cancer patterns
Why nutrition?
Epidemiology links food, nutrition and physical activity to cancer
Experimental evidence links nutrition and cancer
1. New method
2. Systematic reviews
3. Review of evidence separate from judgement
4. Panel of international experts
5. Predetermined criteria for judgementsEpidemiology
Mechanisms
6. Flexibility
7. Continuous update of evidence
WCRF/AICR EXPERT REPORT The most authoritative
NUTRITION AND CANCERS
OBESITYBREAST (PM), COLORECTUM, ENDOMETRIUM, OESOPHAGUS,
PANCREAS, GALLBLADDER, KIDNEY
PHYSICAL ACTIVITYCOLON, BREAST, OBESITY
MEAT – RED AND PROCESSEDCOLORECTAL
PLANT FOODSMPL, OESOPHAGUS, STOMACH,) COLORECTAL, LUNG, OBESITY
ALCOHOL MPL, COLORECTUM, LIVER, BREAST
SALTSTOMACH
BREASTFEEDINGBREAST, EXCESS WEIGHT GAIN (CHILD)
The Panel emphasises the importance of not smoking and of avoiding exposure to tobacco smoke
• Keep evidence, conclusions and recommendations updated into the future• Working with team at ICL• Same principles: - Systematically review evidence- Meta analysis - Panel of experts
-draw conclusions -make recommendations
Continuous Update Project (CUP)
Novel aspects of CUP
1. Breast Cancer Survivors
2. Mechanisms
Cancer prevention
What to do…?
What determines people’s behaviour?
How to change it?
Behaviour
• People behave like those around them– social norms
• Asking people to behave very differently from their social norm only has limited or unsustained effect
• Personal choice determines individual variation around the social norm– small effect
• External factors determine social norms– big effect
Everybody has a role to play
Action needs to be coherent
Leadership from
Government
Health professionals
ConclusionsThe WCRF/AICR Expert Reports, and the CUP, are the
most rigorous and authoritative reviews available.They conclude that
• Cancer is a major cause of death, disability and lost life years
• Cancer is mostly environmentally determined and largely preventable
• With smoking, food, nutrition, body fatness and physical activity are the most important factors affecting cancer risk
• Evidence to support this comes from many different sources
• Preventing cancer through food, nutrition and physical activity will also prevent other major chronic diseases
• Changes are needed in people’s environment as well as in personal choices