Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations and breast cancer risk

Abstract

) has published eight nutrition-related recommendations for the prevention of cancer. However, few prospective studies have examined these recommendations by breast cancer hormone receptor subtype and only one case-control study has included the dietary supplements recommendation in their evaluation. We investigated whether adherence to the WCRF/AICR cancer prevention recommendations was associated with breast cancer incidence, overall and by hormone receptor subtype, in the Swedish Mammography Cohort. Among 31,514 primarily postmenopausal women diet and lifestyle factors were assessed with a self-administered food frequency questionnaire. A score was constructed based on adherence to the recommendations for body fatness, physical activity, energy density, plant foods, animal foods, alcoholic drinks and dietary supplements (score range 0-7). Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs). During 15 years of follow-up 1,388 cases of breast cancer were identified. Women who met six to seven recommendations had a 51% decreased risk of breast cancer compared to women meeting only zero to two recommendations (95% CI 5 0.35-0.70). The association between each additional recommendation met and breast cancer risk was strongest for the ER-positive/PR-positive subtype (HR 5 0.86; 95% CI 5 0.79-0.94), while for the ER-negative/PR-negative subtype the individual recommendations regarding plant and animal foods were most strongly associated with reduced risk. Our findings support that adherence to the WCRF/AICR recommendations reduces breast cancer risk in a population of primarily postmenopausal women. Promoting these recommendations to the public could help reduce breast cancer incidence.In 2007, the World Cancer Research Fund/American Association for Cancer Research (WCRF/AICR) published eight nutrition-related recommendations for the prevention of cancer. 1 Since then, evaluation of these recommendations has suggested that adherence to the recommendations reduces overall cancer incidence 2-4 and cancer mortality. 2,5,6 The association between adherence to the WCRF/AICR recommendations and breast cancer risk has also been examined in six studies with the consensus being that adherence to the recommendation reduces breast cancer risk by approximately 6-13% for each guideline met. 3,4,7-10 However, breast cancer was the primary focus in only four of these studies, 7-10 of which just two were prospective studies 8,10 and only two examined the associations by hormone receptor subtype, 7,10 and just one case-control study included the dietary supplements recommendation in its evaluation. 7 The aim of this study was to evaluate the association between adherence to the WCRF/AICR recommendations for cancer prevention and breast cancer incidence in the prospective Swedish Mammography Cohort (SMC). In addition, we sought to evaluate which recommendations were most strongly associated with reduced breast cancer risk and whether these associations differed by hormone r...

Adherence to Diet and Physical Activity Cancer Prevention Guidelines and Cancer Outcomes: A Systematic Review

“…(32). Similarly, Harris et al demonstrated a 51% reduction in breast cancer incidence (HR: 0.49, 95% CI: 0.35-0.70) (33) for those most adherent (score≥6) compared to least adherent (score ≤2) to the WCRF/AICR guidelines in the primarily post-menopausal women in the Swedish Mammography Cohort (SMC) (n=31,514) that were followed for 15 years (19). Makarem et al (36) also used the WCRF/AICR guidelines to examine the relationship between meeting the recommendations and obesity-related cancer incidence in a sample of men and women from the Framingham Offspring (FOS) cohort (n=2,983) (16).…”

Healthy lifestyle impact on breast cancer-specific and all-cause mortality

“…The majority of the studies used women displaying the poorest adherence to lifestyle recommendations as the referent group [20–27, 29–31, 50], while we used the quartile with the healthiest lifestyle factors. Several studies constructed the composite variable based on different sets of cancer prevention guidelines [22–24, 26, 27, 30, 50], which differed from our HBI as well as other indices constructed based on ACS guidelines [20, 21, 29]. Scoring for the individual components of the composite variable also differed between studies.…”

Towards research-tested smartphone applications for preventing breast cancer

“…In addition, information about healthy eating can be based upon: (I) the ACS guidelines on nutrition and physical activity for cancer prevention (5), which were associated with a 22% lower risk of breast cancer in an analysis of data from the Women’s Health Initiative (43); and (II) the World Cancer Research Fund/American Institute for Cancer Research nutrition-related recommendations for cancer prevention (3), which were associated with a 51% reduction in risk of breast cancer in epidemiologic studies (4). Apps can also utilize information and graphics from the USDA’s ChooseMyPlate program which provides practical information to help consumers build healthier diets with user-friendly nutrition information (44).…”