Cancer linked with poor nutrition

In the WHO European Region, cancer is the most important cause of death after diseases of the circulatory system. It accounts for 20% of all deaths in the Region, with 2.5 million new cases diagnosed each year. Healthy lifestyle practices – having a healthy diet, being physically active and maintaining a healthy weight, in addition to avoiding tobacco – can prevent many cancer cases.

Prevention through healthy dietary habits

A large body of literature indicates that as much as 30% of all cancer cases is linked to poor dietary habits, and is therefore preventable. The proportion reaches 70% for cancers of the gastrointestinal tract. Maintaining a healthy weight throughout life may be one of the most important ways to protect against cancer. It is probably the second most important factor, after avoiding tobacco use.

Research indicates that the 20% of people who have the lowest fruit intake have a 20% higher risk of lung cancer. In addition, evidence indicates that reducing salt and salt-preserved foods may reduce the incidence of stomach cancer.

Increased risk from overweight

The notion that being overweight or obese increases the risk of some cancers is widely accepted.

The European Prospective Investigation into Cancer and Nutrition (EPIC) assessed the influence of overweight on various cancer types. EPIC analysed the relationships between a range of factors (diet, nutritional status, lifestyle and environment) and the incidence of cancer and other chronic diseases through a study of 520 000 people aged 50–64 years in 10 European countries.

Overall, recent research has found that, as the body mass index (BMI) increases by 5 kg/m2, cancer mortality increases by 10%. For men, a five-unit BMI increase was associated with an increased risk of developing several cancers:

• oesophageal adenocarcinoma (50% higher risk)
• thyroid cancer (33%)
• colon cancer (25%)
• renal cancer (25%).

The corresponding data for women are:

• endometrial cancer (60% higher risk)
• gallbladder cancer (60%),
• oesophageal adenocarcinoma (50%)
• renal cancer (34%).

More research and clear policies

The importance of the relationship between diet and cancer creates a need to understand the causes of cancer beyond those related to tobacco or other established risk factors. WHO/Europe and the Member States in the European Region are working together to develop an action plan for 2011–2016 to implement the European Strategy for the Prevention and Control of Noncommunicable Diseases. The plan concentrates on four conditions (cancer, diabetes, cardiovascular diseases andchronic respiratory diseases) and their shared risk factors (diet, physical activity, alcohol and tobacco).

Preventing cancer requires social and physical environments that support healthy nutrition and physical activity. In addition, reformulating processed foods and drinks to reduce their content of sugar, refined starches, fat and salt can be an effective way to reduce the risk of chronic diseases, including cancer.

In September 2011, the United Nations will hold the first high-level meeting on noncommunicable diseases for heads of state and government. The aim is for Member States to agree on concrete global actions to address cancer, cardiovascular diseases, chronic respiratory diseases and diabetes. Following a Region-wide consultation in Oslo, Norway in November 2010, WHO/Europe is developing recommendations to put forward at the high-level meeting.

Simple dietary habits to reduce the risk of cancer

• Encourage and develop healthy dietary habits in childhood.
• Maintain a healthy weight by balancing energy intake with physical activity, and avoiding excessive weight gain throughout life.
• Achieve and maintain a healthy weight, if currently overweight or obese.
• Adopt a physically active lifestyle.
• Consume a healthy diet, with an emphasis on plant sources.
• Choose foods and beverages in amounts that help achieve and maintain a healthy weight.
• Eat five or more servings of a variety of vegetables and fruits each day.
• Choose whole grains in preference to processed (refined) grains.
• Limit consumption of processed and red meats.
• Maintain alcohol consumption within moderate limits (for adults, no more than one drink per day for women or two per day for men).