10 Ways to Reduce Your Cancer Ris
a y s W 0 1 t o Re duc e Yo u r C a n c e r R i s k Our Vision The American Institute for Cancer Research (AICR) helps people make choices that reduce their chances of developing cancer. Our Heritage We were the first cancer charity: • To create awareness of the relationship between diet and cancer risk • To focus funding on research into diet and cancer prevention • To consolidate and interpret global research to create a practical message on cancer prevention Our Mission Today the American Institute for Cancer Research continues: • Funding research on the relationship of nutrition, physical activity and weight management to cancer risk • Interpreting the accumulated scientific literature in the field • Educating people about choices they can make to reduce the chances of developing cancer AMERICAN INSTITUTE for CANCER RESEARCH ® cover Photo by istock 10 Ways to Reduce Your Cancer Risk Table of Contents Reduce your cancer risk . . . . . . . . . . . . . . . . . . . . . . . . 2 What is cancer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Cancer can be prevented . . . . . . . . . . . . . . . . . . . . . . . 5 What can I do? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 10 Ways to a healthier you . . . . . . . . . . . . . . . . . . . . . 8 Recommendations for Cancer Prevention . . . . . . . 36 The science behind our advice . . . . . . . . . . . . . . . . . 37 About AICR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Healthy Living for Cancer Prevention Series 10 Ways to Reduce Your Cancer Risk 1 Reduce your cancer risk You already know you can lower your cancer risk by not smoking, but did you know you can make other lifestyle choices to decrease your risk? This booklet is about making simple changes to your diet and lifestyle that you can start doing today. Nearly 1 in 2 Americans will develop cancer at some point during their lifetime. You might know someone who has been affected by cancer or perhaps you yourself are a cancer survivor. Start today! Why wait? It’s never too late to make healthy changes and lower your cancer risk. Here at AICR, we know the devastation a cancer diagnosis can bring. That is why we work toward preventing as many of these cases of cancer as possible. There are no guarantees when dealing with cancer, but scientific research shows that by following the Recommendations in this brochure you can reduce your risk. By making changes to the food we eat, increasing the amount of physical activity we do and maintaining a healthy weight, scientists estimate that about one-third of the most common cancers could be prevented. And choosing not to smoke (or giving up smoking) is the single most important thing we can do to reduce our risk of cancer. Scientific research shows us that making healthy changes at any time in life, from childhood to old age, will help to reduce our risk. So, why wait? 2 10 Ways to Reduce Your Cancer Risk 10 ways to a healthier you On the following pages, you will find our 10 Recommendations for Cancer Prevention explained with practical tips and suggestions for following them. The full list of Recommendations can be found on page 36. You can find out more about how our Recommendations are based on the most up-to-date scientific evidence, and why you can trust the information we provide, on page 37. © hannamonika/Fotolia 10 Ways to Reduce Your Cancer Risk 3 What is cancer? Simply speaking, cancer is a disease of cells. Cells are the basic building blocks of our body and they are controlled by our genetic information (DNA). The term “cancer” describes a group of more than 200 diseases. All cancers start when the genetic information in a single cell becomes damaged in some way. This causes the cell to divide at an uncontrolled rate, forming a group of cells. This group of cells often forms a lump or swelling, which is known as a “tumor.” Not all tumors are cancerous, but a cancerous tumor may grow and go on to damage surrounding healthy tissues or organs. Sometimes cancer cells can spread further to other areas of the body. A long process Cancer does not happen overnight. Often it’s a long and complex process. Many changes need to occur for the disease to develop and this can take years, even decades. That is why cancer is mostly a disease that affects older people. There are many things you can do today to prevent, delay or even stop the cancer process at all stages of life. © Olivier/fotolia 4 10 Ways to Reduce Your Cancer Risk Cancer CAN be prevented Many of us think that cancer runs in families through our genes or that cancer is a matter of fate or bad luck. However, research shows that genetics alone cause only a small proportion of cancers—and that lifestyle choices play a much bigger part. Genetic causes and family history Most cancer is not caused by inherited gene mutations. For breast cancer, only about 5-10 percent of cases result from specific inherited genes; for colon cancer, the percentage is 5-6 percent. If you do inherit these genes and have a higher susceptibility to cancer, it does not mean you will inevitably get cancer. It simply means you have a higher than average risk, so it is even more important to take steps to protect yourself by following the simple changes outlined in this brochure. © Pavel Losevsky/Fotolia Dna strand © Matthew Cole/Fotolia Below, we describe the main things that affect our cancer risk. For more information, visit the National Cancer Institute: www. cancer.gov/cancertopics/genetics 10 Ways to Reduce Your Cancer Risk 5 Environmental causes Some factors in the environment can increase the risk of cancer or cause cancer. For example, the sun is a risk factor for skin cancer, so we should wear sunscreen, cover up and stay in the shade when the sun is strongest. Certain industrial chemicals, excess X-ray radiation and some medications can damage DNA and increase our risk of cancer. Some of these risk factors mainly concern people whose jobs require high exposure to them. Infectious diseases We know that some infectious diseases increase the risk of developing certain types of cancer. HPV (human papilloma virus) can cause What can I do? Cancer prevention is about achieving a healthy balance. The diet and lifestyle choices you make today can help prevent cancer tomorrow. Tip the balance in your favor and lower your risk of cancer by following the Recommendations in this booklet. Don’t worry about the occasional indulgence; the important thing is to make healthy choices every day. Tip the balance in your favor The more factors you have on the “lower risk” side and the fewer on the “higher risk” side, the more protected you are against cancer. 6 10 Ways to Reduce Your Cancer Risk left to right: © lcs813/istock, © Julydfg/Fotolia, © JRosengaard/Fotolia cervical cancer, while infection with the bacterium Helicobacter pylori is linked to stomach cancer. Hepatitis B and C increase the risk of liver cancer. We can lower the risk of getting some of these infections with vaccinations. Lifestyle Overall, scientists estimate that about one-third of the most common cancers in the U.S. could be prevented through eating healthily, moving more and having a healthy weight. This estimate does not include the cases of cancer caused by smoking. Smoking alone is responsible for 90 percent of lung cancers, so choosing not to smoke or chew tobacco is the most important thing you can do to reduce your risk of cancer. After not smoking, being a healthy weight is one of the most important ways to prevent cancer. Lower risk of cancer Higher risk of cancer Not smoking Maintaining a healthy weight Being physically active Eating a diet high in plant foods, including vegetables, fruits, whole grains and beans Being overweight or obese Eating a diet high in red and processed meat Eating a diet low in whole grains and beans Eating a diet low in vegetables and fruits Eating a diet low in red meat Not being physically active and avoiding processed meat Drinking alcohol Limiting alcohol, if you drink Drinking sugary beverages at all Eating a diet high in salt, Avoiding sugary beverages fat and sugar Eating a diet low in salt Not having been breastfed Breastfeeding and Smoking having been breastfed 10 Ways to Reduce Your Cancer Risk 7 1 Stay in shape: be a healthy weight Try to be as lean as possible without becoming underweight. After not smoking, being a healthy weight is the most important way you can reduce your risk of cancer. What is a healthy weight? A healthy BMI for men and women is between 18.5-24.9. For cancer prevention, we should aim for the lower end of this range. This means we should be trying to maintain a healthy weight that is as low as possible for ourselves. For some people who are frail or muscular, BMI may not be an appropriate indication of a healthy body weight. We also know that where our bodies store extra fat affects cancer risk. Scientists have discovered that carrying too much fat around our waists can be particularly harmful. Use our guide to measure your waist and find out if you are in the healthy range. Being a healthy weight can also help to reduce your risk of heart disease and Type 2 diabetes. 8 10 Ways to Reduce Your Cancer Risk © Marijus/ Fotolia One of the easiest ways to check if you’re a healthy weight is by measuring your Body Mass Index (BMI). This calculates whether you’re in the healthy weight range for your height, so it’s a useful guide for most adults. Measuring your BMI 1. You’ll need to know your weight in pounds and your height in inches. 2. Divide your weight by your height squared. 3. Multiply by 703. This figure is your BMI. You can also visit www.aicr.org/bmi to calculate your BMI online For example, here is the calculation for a person who is 5'3" tall and who weighs 150 pounds: Weight: 150 x 703 = BMI of 26.5 Height2: (63 x 63) How to Interpret Your Results Less than 18.5 underweight Between 18.5-24.9 healthy weight Between 25-29.9 30 or more overweight obese Note: BMI may not be a suitable indicator for athletes, elderly people, pregnant women, children, or adults less than 5 feet tall. Measuring your waist Another good way of checking if you’re a healthy weight is by measuring your waist. 1. Place a tape measure around your waist at the halfway point between the bottom of your ribs and the top of your hip bone. 2. Make sure the tape is snug but doesn’t compress your skin. 3. Measure after breathing out. As a guide, a healthy waist measurement is: less than 31.5” for women, less than 37” for men. 10 Ways to Reduce Your Cancer Risk 9 SCIENCE Weight and cancer risk–what’s the link? There is strong evidence that being overweight increases the risk of the following cancers: colorectal, esophageal, pancreatic, kidney, endometrial, breast (in postmenopausal women) and gallbladder. Scientists report several reasons for this link. For example, research shows that fat cells release hormones such as estrogen, which increases the risk of breast cancer. Studies have also shown that fat, particularly if it is stored around the waist, increases the level of “growth hormones” the body produces. Having high levels of these hormones is linked to a greater risk of some cancers. for maintaining a healthy weight Choose foods lower in calorie density. “Calorie density” describes how many calories foods contain bite-for-bite. To maintain a healthy weight, it’s best to choose mostly lower calorie-dense foods, like vegetables and fruits, which naturally have fewer calories but are filling because they contain plenty of water and fiber. (See page 15.) Keep an eye on portion size. Only eat when you’re hungry and stop before you feel full. With moderate- to high-calorie foods, choose small serving sizes to control how much you’re eating. Be physically active. Keeping active helps burn calories, which are stored as fat if they are not used. Start today by measuring your waist. Use our guide on page 9. Following the other Recommendations in this booklet can also help you to maintain a healthy weight. Find out more about this Recommendation at www.aicr.org 10 10 Ways to Reduce Your Cancer Risk 2 Move more Be physically active for at least 30 minutes every day. What is physical activity? Physical activity is anything that gets your body moving. Being active doesn’t have to mean going to the gym; there are plenty of other ways to be active that you can fit into your usual routine. Most of us know that regular physical activity keeps our heart healthy and reduces our risk of heart disease. The good news is that it also reduces our risk of cancer. Along with helping us to avoid weight gain, research shows that activity itself has a direct role in preventing some cancers. Regular physical activity can also help to reduce your risk of Type 2 diabetes. What type of activity should I do? The short answer is that any type of activity is good. Activity can be described as moderate or vigorous. If you can, aim to do a mixture of both. Moderate activity is anything that gets your heart beating a bit faster and makes you breathe more deeply. Brisk walking, strength training, gentle swimming and dancing are examples of moderate activity. © Lisa F. Young/Fotolia Vigorous activity is any activity that raises your heart rate and makes you feel warm, start to sweat and feel out of breath. Good examples include jogging, aerobics, working out at the gym and games like softball or tennis. Remember: Anything is better than nothing! So start with gentle activity and build up slowly until you reach your target. The more you do each day, the more you are helping to reduce your cancer risk. 10 Ways to Reduce Your Cancer Risk 11 SCIENCE Physical activity and cancer risk– what’s the link? There is strong evidence that physical activity helps protect against colorectal cancer, breast cancer (in postmenopausal women) and endometrial cancer. Scientists are still investigating exactly how this connection works. Studies show that regular activity can help to keep our hormone levels healthy. This is important because having high levels of some hormones can increase our cancer risk. Physical activity may also strengthen our immune system and helps keep our digestive system healthy. © Ryan McVay/Getty Images Make Time + Break Time = Cancer Protection Ann Ann Mike Mike Kim Kim Joe Joe Types of activity: Moderate Moderate / Vigorous Break Br Types of activity: / Vigorous 12 10 Ways to Reduce Your Cancer Risk reak for keeping active Make 30 minutes part of your everyday routine. There are plenty of ways to build activity into your daily routine, like cycling and walking. Try doing jumping jacks or stretching during TV commercials, parking the car a little farther away from your destination or taking a quick walk around the block after dinner. Break up your sedentary time with some activity. It’s easy to spend hours sitting without realizing it. Time spent watching television, reading and being on the computer can all add up. Try to take a break every 30 or 60 minutes with a short walk or desk exercises. Or swap some of these sedentary activities for more active ones like going for a walk with friends or starting a new active hobby like dancing or swimming. Daily Daily ActivityCancer Cancer Activity Risk Risk HIGHER HIGHER Sedentary Sedentary LOWER LOWER 10 Ways to Reduce Your Cancer Risk 13 Being active can help you maintain a healthy weight As well as directly reducing the risk of some cancers, physical activity is also a great way to help to maintain a healthy body weight, another way to lower your cancer risk. Being moderately active for 30 minutes a day is a great starting point. 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. Try to build up to this as your fitness improves. © Karl Weatherly/Getty images Find out more about this Recommendation at www.aicr.org 14 10 Ways to Reduce Your Cancer Risk 3 Opt for foods lower in calorie density Why is calorie density important? Eating lower calorie-dense foods most of the time can help you achieve and stay a healthy weight. And maintaining a healthy weight is one of the most important ways to reduce cancer risk. What is calorie density? All foods have calories, but some are more packed with calories than others. Foods that contain a lot of calories per bite are known as calorie-dense foods. They tend to be high in fat and/or sugar and can cause weight gain. Eating even a small amount of calorie-dense foods means taking in a lot of calories; eating a lot of these foods regularly will likely lead to weight gain. How to spot calorie-dense foods High calorie-dense foods: • Contain high amounts of added fat, such as regular chips and other fried foods. • Are made with high amounts of added sugar and fat, such as cookies, candy and rich desserts. • Contain little fiber, such as processed breads, cere- als and snack foods. • Are naturally high in fat, such as high fat meats and © 1999istek/fotolia cheese. Note: A few calorie-dense foods, eaten in small amounts are valuable sources of nutrients. These include nuts, seeds and some oils. 10 Ways to Reduce Your Cancer Risk 15 Low calorie-dense foods: • Contain little added fat or sugar • Contain plenty of fiber and water, such as fresh or plain frozen or canned vegetables and fruit • Help you feel fuller for longer; for example, beans, brown rice and other whole-grain foods Low calorie-dense foods should form the majority of your diet. Avoid drinking sugary beverages Choose healthier alternatives. What are sugary drinks? Sugary drinks include carbonated beverages like regular sodas as well as sweetened iced tea, lemonade, many “energy” drinks and juice drinks. © Africa Studio/fotolia Even too much 100 percent fruit juice can add too many calories, so it’s best for most people to limit juice to one 6-ounce glass a day. SCIENCE Calorie-dense foods and cancer risk– what’s the link? Scientific evidence shows that diets made up of too many calorie-dense foods, particularly processed foods that are often high in sugar or fat, increase our risk of becoming overweight or obese, which in turn increases our risk of a number of cancers. Evidence also shows us that foods low in calorie density help us to maintain a healthy weight. Sugary drinks, weight gain and cancer risk– what’s the link? Strong evidence says that regularly consuming sugary drinks contributes to weight gain. These beverages are easy to drink in large quantities and are often available in “super-sized” portions but don’t make us feel full, even though they are quite high in calories. So, to stay a healthy weight and lower your risk of cancer, avoid sugary drinks. for healthy eating Cut down on highly processed foods. In general, the healthiest foods have only been minimally processed, such as vegetables, fruits, whole-grain products and beans. Swap sugary drinks for healthy alternatives. Water – tap or bottled, still or sparkling—is always the best choice. Unsweetened tea and coffee are also good options. Find out more about this Recommendation at www.aicr.org 10 Ways to Reduce Your Cancer Risk 17 4 Enjoy a plantbased diet Eat more of a variety of vegetables, fruits, whole grains and beans. Basing our diets on plant foods can reduce our risk of cancer. These foods contain plenty of fiber, water and health-protective nutrients and natural compounds called phytochemicals. Plant foods also tend to be lower in calories, so they can help you maintain a healthy weight. What are plant foods? Broadly speaking, plant foods fit into these main categories. Aim to eat mostly plant foods at each meal. 1. Vegetables There are non-starchy and starchy types of vegetables: • Non-starchy vegetables include leafy greens, tomatoes, broccoli, cauliflower, summer squash and carrots. Eat mostly non-starchy vegetables. 18 10 Ways to Reduce Your Cancer Risk • Starchy vegetables include corn and white pota- toes. Eat moderate amounts of starchy vegetables. • You can use frozen, dried and canned vegetables (packed in water and with no added salt). The wider a variety you eat, the better. 2. Fruits • Choose fresh, frozen or fruits canned in water, juice or light syrup. • Limit juice to 6 ounces daily and choose 100 percent juice rather than juice blends made with sweetened water. 3. Grains • Eat mostly whole grains, including brown or wild rice, oats, whole-wheat pasta and whole-wheat bread. • Limit processed grain foods such as white rice, white flour pasta and white bread. 4. Dry beans and legumes • Split peas and dry beans such as lentils, chick- peas, pinto, kidney and other beans. • Legumes are high in protein and fiber; they can count as a protein serving or as a vegetable. Vegetables and fruits: How much in one serving? As a guide, a standard serving size is: • A half-cup of cooked vegetables • A cup of raw leafy greens like lettuce or spinach • A medium-sized piece of fruit like an apple • One cup of melon cubes • One-half cup of smaller fruit like grapes • One-quarter cup of dried fruit like raisins • A small glass (6 ounces) of 100 percent fruit juice—limit to one serving per day for weight management. from th e k aicr For delicious, healthy recipes visit the AICR Test Kitchen at www.aicr.org. t e st © Nancy R. Cohen/Getty images • Two small fruits like apricots or plums it c hen 10 Ways to Reduce Your Cancer Risk 19 SCIENCE Plant foods and cancer risk–what’s the link? Research shows that vegetables and fruits probably protect against a number of cancers, including those of the mouth, pharynx, larynx, esophagus, and stomach. Our most recent update on colorectal cancer found strong evidence that eating plenty of foods containing dietary fiber decreases the risk of colorectal cancer. These foods include vegetables, fruits, whole grains and beans. Fiber has many benefits, including helping food to move through our digestive system. Vegetables and fruits may protect against cancer because they contain vitamins and minerals that help to keep our bodies healthy and strengthen our immune system. They are also sources of substances called phytochemicals. These natural compounds can help to protect cells in the body from damage that can lead to cancer. The wider a variety you eat, the better. Plant foods can also help us to maintain a healthy weight because most of them are lower in calorie density. for eating a plant-based diet At least 5 a day, every day. Vegetables and fruits are the building blocks of a healthy diet – they are high in nutrients like vitamins and minerals. Aim for at least five servings a day. Most are also low in calories and are good sources of fiber, so they are filling and can help us avoid weight gain. Fill 2⁄3 or more of your plate with plant foods. When preparing a meal, fill at least twothirds of your plate with plant foods like vegetables, brown rice, whole-grain cereal and pasta, beans and fruits. Find out more about this Recommendation at www.aicr.org 20 10 Ways to Reduce Your Cancer Risk 5 Make less room for red meat Eat less red meat such as beef, pork and lamb. What is red meat? Red meat refers to beef, pork, lamb—such as steak, hamburgers, porkchops and roast lamb. Red meat can be part of a healthy, balanced diet, but you don’t need to eat it every day. Aim for less than 18 ounces (cooked weight) per week. As a rough guide, 18 ounces of cooked red meat is about 24 ounces of boneless raw meat. Our advice about red meat Although eating a lot of red meat is linked to colorectal cancer, it is a good source of nutrients including protein, iron and zinc. The evidence shows that eating up to 18 ounces (cooked weight) of red meat per week does not substantially raise cancer risk. Regularly eating more than this, however, does increase your risk of colorectal cancer. 10 Ways to Reduce Your Cancer Risk 21 Avoid processed meats Avoid processed meats such as ham, bacon, hot dogs and most deli meats (including processed meats made with chicken or turkey). What are processed meats? Processed meat has been preserved by smoking, curing or salting or by adding preservatives. Examples of processed meats include: ham, bacon, pastrami, salami, hot dogs and sausage. Hamburgers and ground meat are not considered processed meat unless they have been preserved with salt or chemical additives. Research has shown that eating processed meat increases cancer risk. If you do eat meat, then choose unprocessed meat as often as you can. SCIENCE Red meat and cancer risk–what’s the link? There is strong and convincing evidence that eating a lot of red meat is a cause of colorectal cancer. One possible reason for this is that “heme,” the compound that gives red meat its color, may damage the lining of the colon. Studies also show that people who eat a lot of red meat tend to eat fewer plant-based foods, so they benefit less from the cancer-protective properties in vegetables, fruits, whole grains and beans. Processed meats and cancer risk– what’s the link? There is strong, convincing evidence that processed meat is a cause of colorectal cancer. 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. 22 10 Ways to Reduce Your Cancer Risk © gekaskr/fotolia What about nitrite- or nitrate-free products? As of now, there isn’t enough evidence to know whether these kinds of processed meats pose a risk because they may still be smoked or processed with added salt or preservatives. You may wish to opt for varieties without nitrites; however this does not necessarily remove the risk from other processing additives. More research is needed. Find out more about this Recommendation at www.aicr.org for eating less red meat and avoiding processed meats Keep several meals a week red-meat free. Swap your meat for fish or poultry. Eat more beans and vegetables or try halving the quantity of red meat and adding beans instead. For example, you could make a chili with extra kidney beans. Beans are inexpensive, nutritious and tasty. Swap processed meats for healthier alternatives. Instead of bacon, chorizo or salami, choose fresh roasted poultry, fish, bean spreads (like hummus) or nut butters. 10 Ways to Reduce Your Cancer Risk 23 6 Cut down on alcohol To reduce your cancer risk as much as possible, we recommend not drinking alcohol at all. However, if you do drink alcohol, try to limit your intake to no more than two drinks a day for men and one drink a day for women. What is a “drink”? One standard drink is: 12 fluid ounces of normal strength (3-5% alcohol content) beer 1 fluid ounce of 100-proof liquor, such as bourbon or vodka 5 fluid ounces (8-14% alcohol content) of wine 12 fluid ounces (4% alcohol content) of alcoholic lemonade or other carbonated drink 24 10 Ways to Reduce Your Cancer Risk Left © TheVectorminator/istock, right © yasonya/veer 1.5 ounces of 80-proof liquor, such as vodka or whisky In recent years, both the portion size and alcohol content of alcoholic drinks such as wine have increased. Beers have also become stronger, making it easy to drink more alcohol than we realize. Did you know? The risk of some alcohol-related cancers is even greater if you smoke. For more about the links between tobacco and cancer, see page 35. Can alcohol make me gain weight? Yes, alcoholic drinks can be surprisingly high in calories and offer little, if any, nutritional benefit. For example: • A 12-ounce bottle of beer (3-5 percent alcohol content) contains approximately 140-180 calories (light beer has about 70-125 calories per 12 ounces, and non-alcoholic beer contains fewer calories than light beer). • A standard 5-ounce glass of wine contains about 100-140 calories, depending on dryness or sweetness. Mixed drinks can also be high calorie, for example a 4½ ounce pina colada contains 250 calories. So cutting down on the amount you drink could play an important role in helping you to lose weight or maintain a healthy weight and, in turn, help to reduce your cancer risk. 10 Ways to Reduce Your Cancer Risk 25 SCIENCE Alcohol and cancer risk–what’s the link? There is strong scientific evidence that all types of alcoholic drinks increase the risk of a number of cancers. In particular, there is strong evidence that alcohol increases the risk of cancers of the mouth, pharynx, larynx, esophagus and breast, as well as colorectal cancer in men. Alcoholic drinks also probably increase the risk of liver cancer, as well as colorectal cancer in women. Scientists are still researching the ways alcohol can lead to cancer. One theory is that alcohol can directly damage our DNA. for reducing your alcohol intake Opt for the smallest serving size. Avoid double measures, which are often encouraged as better value. Dilute alcoholic drinks or choose low-alcohol alternatives. Alternate between alcoholic and non-alcoholic drinks. Aim to keep some days each week alcohol-free. Find out more about this Recommendation at www.aicr.org 26 10 Ways to Reduce Your Cancer Risk 7 Eat less salt Limit consumption of salty foods and foods processed with salt. Consuming too much salt can increase our risk of stomach cancer as well as high blood pressure. What is salt? “Salt” is the common name for a chemical compound made up of sodium and chloride. Our bodies need sodium in small amounts. How much sodium do we need? Our daily intake of sodium should be less than 2,300 mg (1 teaspoon of salt) per day. However, on average, Americans consume 3,300 mg of sodium daily, mainly from processed foods. If you are age 51 and older, African American and/ or have hypertension, diabetes or chronic kidney disease, aim for 1,500 mg of sodium per day. Limiting sodium can be challenging, but see page 28 for ways to cut down. Where does the salt we eat come from? 75% comes from processed foods like prepared meals, cheese, potato chips, bread and processed meats 25% is added during cooking or at the table 10 Ways to Reduce Your Cancer Risk 27 SCIENCE Salt and cancer risk–what’s the link? Research has shown that eating high amounts of salt and salt-preserved foods are probably a cause of stomach cancer. A high salt intake can damage the lining of the stomach in ways that make cancer more likely. for eating less salt Check food labels and select products labeled “low sodium” or “no added salt.” Bear in mind that foods labeled as “reduced salt/sodium” can still be quite high in sodium. Choose canned or packaged food with no added salt. Gradually reduce, then cut out, the salt you add at the table and limit what you add in cooking. Your tastebuds should adjust within a few weeks, allowing you to enjoy the true taste of food and notice more subtle flavors. Use spices, herbs, garlic and lemon instead of salt. Black pepper, red pepper flakes, cinnamon or ginger and herbs such as basil and bay leaves all add flavor to food quickly and easily. Find out more about this Recommendation at www.aicr.org 28 10 Ways to Reduce Your Cancer Risk 8 For cancer prevention, don’t rely on dietary supplements Enjoy a balanced diet. What are dietary supplements? Dietary supplements contain vitamins, minerals, herbs, amino acids and other compounds and can be found in pill, capsule, tablet or liquid form. Dietary supplements and cancer risk – what’s the link? Research does not support taking supplements for cancer prevention. In some studies, specific supplements actually increased risk of certain cancers. © Melpomene/canstock For many people, by eating a balanced diet rich in vegetables, fruits and other plant-based foods, it is possible to obtain all the needed nutrients for good health. However, some groups of people will benefit from taking supplements for specific health reasons. For more advice tailored to your specific needs, speak to your healthcare provider. For more information, visit the National Institutes of Health Office of Dietary Supplements at www.ods.od.nih.gov. 10 Ways to Reduce Your Cancer Risk 29 for a balanced diet without dietary supplements Eat whole foods. Whole foods contain many substances you need for good health, including fiber, vitamins, minerals and phytochemicals (naturally occuring plant chemicals). Although some of these substances are available as supplements, research suggests that health benefits may come from these substances working together in a varied diet. Eat a variety of vegetables and fruits. Eating lots of different fruits and vegetables means getting a wide variety of vitamins, minerals and health-promoting phytochemicals. Try to eat several different vegetables and fruits each day. Eat a balance of plant foods, fish, poul- try, meat and dairy foods. Filling at least 2⁄3 of your plate with plant foods will help you to achieve a healthy balance. © desertsolitaire/fotolia Find out more about this Recommendation at www.aicr.org The following two Recommendations apply to specific groups. 30 10 Ways to Reduce Your Cancer Risk 9 If you can, breastfeed your baby Moms should aim to breastfeed their babies exclusively for up to 6 months and then add other liquids and foods. Breastfeeding is a natural and healthy choice for mothers and babies. If you are able, it’s best to breastfeed your baby exclusively up to the age of six months, and then continue breastfeeding with additional foods appropriate for an infant. © Flashon Studio/fotolia Benefits for you and your baby Breastfeeding has many benefits for babies. Breast milk contains all the nutrients your baby needs for healthy development in the first six months of life and helps your baby grow at the right pace. It helps protect your baby from infection and disease as well. 10 Ways to Reduce Your Cancer Risk 31 Breastfeeding can also help you and your baby get closer physically and emotionally. Research also shows that children who have been breastfed are less likely to be overweight or obese as adults. Maintaining a healthy weight throughout life is an important part of lowering your risk of cancer. AICR’s Recommendation supports guidance from the World Health Organization and UNICEF that babies should be exclusively breastfed until they are six months old. Did you know? There is also strong evidence that breastfeeding can help to protect mothers from breast cancer. If you’re planning to breastfeed your baby, your health-care provider or a lactation expert will be able to provide more information and support. SCIENCE Breastfeeding and cancer risk– what’s the link? Breastfeeding lowers the levels of some cancerrelated hormones in the mother’s body, which can help reduce the risk of breast cancer in mothers. Research shows that breastfed babies are less likely to become overweight or obese compared to babies fed infant formula. Find out more about this Recommendation at www.aicr.org 32 10 Ways to Reduce Your Cancer Risk 10 Cancer survivors and cancer prevention After treatment, cancer survivors should follow the Recommendations for Cancer Prevention. Anyone who has been diagnosed with cancer should receive nutrition advice from an appropriately trained health 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, healthy weight maintenance and physical activity. © BVDC/Bigstock If you are a cancer survivor and you want to reduce your risk of a recurrence or a new diagnosis of cancer, the best advice is to follow the Recommendations in this booklet for diet, healthy weight and physical activity. However, if you are currently undergoing treatment for cancer you’re likely to have special nutritional requirements and/ or physical challenges. In these cases, it’s best to 10 Ways to Reduce Your Cancer Risk 33 SCIENCE Cancer survivors and preventing recurrence–what’s the link? Growing evidence shows that physical activity and other lifestyle choices that help us to maintain a healthy weight may help to prevent cancer recurrence and improve quality of life for many survivors. In 2010 the American College of Sports Medicine (ACSM) published recommendations that cancer survivors “avoid inactivity;” established researchbased physical activity guidelines for specific cancers; and generally advised survivors to follow the physical activity guidelines for all Americans. For more information, visit www.health.gov/ PAGuidelines. The Recommendations in this publication can also reduce the risk of other chronic diseases like heart disease and diabetes, for which some cancer survivors have a higher risk. ask appropriately trained health professionals (such as oncology dietitians and/or exercise specialists) for advice. This is also true if you are a cancer survivor whose treatments have affected your ability to eat or digest some foods—for example, if you have undergone a gastrectomy or a colostomy. Future research priorities More than 13 million people in the United States are living longer with a diagnosis of cancer. This is likely to increase as treatments for the disease improve. Preventing a recurrence of the disease in cancer survivors is a new focus of research, and it is a priority for AICR to fund more studies in this area. Find out more about this Recommendation at www.aicr.org or in our free brochures: Nutrition of the Cancer Patient Nutrition and the Cancer Survivor Surviving Cancer with Physical Activity To download, visit www.aicr.org/publications or call 1-800-843-8114 to order. 34 10 Ways to Reduce Your Cancer Risk And, always remember – do not smoke or chew tobacco Smoking or using tobacco in any form increases the risk of cancer and other diseases. AICR’s expert advice focuses on diet, nutrition, physical activity and body fatness in relation to cancer risk. However, no set of recommendations designed to prevent cancer would be complete without discouraging the use of tobacco (as well as encouraging a healthy diet, physical activity and weight management). If you do smoke, quitting is the most important thing you can do to reduce your risk of cancer. The positive news is that it’s never too late to stop and your health will benefit immediately. Your health care provider can provide support and more information on the many methods available to help you quit. SCIENCE © Nikolai Sorokin/fotolia Tobacco and cancer risk–what’s the link? Tobacco can cause cancer whether it is smoked, chewed or used in other ways, and it is particularly harmful when combined with alcohol. Research has shown that passive smoking—just breathing in someone else’s smoke—is also harmful. Tobacco causes 90 percent of lung cancers and is also linked to cancers of the mouth, pharynx, larynx, esophagus, pancreas, cervix, kidney and bladder, stomach, colon and liver. 10 Ways to Reduce Your Cancer Risk 35 AICR’s Recommendations for Cancer Prevention • Be as lean as possible without becoming underweight • Be physically active for at least 30 minutes every day • Avoid sugary drinks. Limit consumption of calorie- dense foods (particularly processed foods high in added sugar, or low in fiber, or high in fat) • Eat more of a variety of vegetables, fruits, whole grains and beans • Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats • If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day • Limit consumption of salty foods and foods pro- cessed with salt (sodium) • Don’t use supplements to protect against cancer Special Population Recommendations • It is best for mothers to breastfeed exclusively for up to 6 months and then add other liquids and foods • After treatment, cancer survivors should follow the Recommendations for Cancer Prevention And, always remember—do not smoke or chew tobacco 36 10 Ways to Reduce Your Cancer Risk The science behind our advice The information in this booklet is based on the most up-to-date scientific evidence. Reliable and trustworthy research is at the heart of our advice and you can be sure the information we provide is accurate and evidence-based. Our information is based on our expert report and Continuous Update Project, which look at all the research available. This means we are giving the most authoritative advice about how you can reduce your risk of cancer. We only make recommendations where independent experts think the evidence is strong enough to do so. © istock 10 Ways to Reduce Your Cancer Risk 37 Keeping the evidence current with the Continuous Update Project (CUP) Our Continuous Update Project provides an ongoing review of diet, physical activity and cancer research. It collects the most up-to-date evidence available on how people can reduce their cancer risk through weight management, diet and physical activity. The CUP reviews new research findings along with all the studies analyzed for our expert report—Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. An expert panel of scientists assess the CUP reviews and ensure our cancer prevention advice is always up-to-date. CUP reports include: 2011 Colorectal Cancer 2009 Breast Cancer Published in 2007 by AICR and the WCRF global network, our expert report involved leading scientists and researchers who reviewed and analyzed more than 7,000 studies. An independent panel of 21 world-renowned scientific experts evaluated and interpreted these studies. They then developed our 10 evidence-based Recommendations for Cancer Prevention, kept up-todate today through our CUP. Find out more: www.dietandcancerreport.org 38 10 Ways to Reduce Your Cancer Risk © Aaron Amat/fotolia Our Expert Report 10 Ways to Reduce Your Cancer Risk 39 About AICR The American Institute for Cancer Research (AICR) is the cancer charity that fosters cancer prevention and survivorship through healthy diets, physical activity and body weight. About one-third of the most common cancers could be prevented this way. By raising awareness of this message, we hope that many thousands of lives will be saved. The education and research programs of AICR are funded almost entirely by donations from the public. We fund cutting edge cancer research and help people make choices that reduce their chances of developing cancer. We are part of a global network of charities that are committed to preventing cancer. You can support AICR’s life-saving research and education in a variety of ways: • make a donation online at www.aicr.org; • write to AICR, 1759 R Street, NW, P.O. Box 97167, Washington, DC 20090-7167; or • include a bequest in your will. For more information, contact our Gift Planning Department at 1-800-843-8114. The American Institute for Cancer Research is a 501(c)(3) tax-exempt organization. For more information or to become a supporter, please call or write: American Institute for Cancer Research, 1759 R Street, NW, P.O. Box 97167, Washington, DC 20090-7167 1-800-843-8114 or visit www.aicr.org AICR is part of the World Cancer Research Fund global network, which consists of the following charitable organizations: the umbrella association, World Cancer Research Fund International (WCRF International); the American Institute for Cancer Research (AICR); World Cancer Research Fund UK (WCRF UK); World Cancer Research Fund Netherlands (WCRF NL); and World Cancer Research Fund Hong Kong (WCRF HK). © 2012 AICR Latest update May 2013 40 10 Ways to Reduce Your Cancer Risk AICR Guidelines for Cancer Prevention The choices you make about food, physical activity and weight management can reduce your chances of developing cancer. • Choose mostly plant foods, limit red meat and avoid processed meat. • Be physically active every day in any way for 30 minutes or more. • Aim to be a healthy weight throughout life. And always remember − do not smoke or chew tobacco. www.aicr.org Follow us on AICRBlog Facebook Twitter E35-REC
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