Skip to main content
×
Home
    • Aa
    • Aa

Diet, nutrition and the prevention of cancer

  • Timothy J Key (a1), Arthur Schatzkin (a2), Walter C Willett (a3), Naomi E Allen (a1), Elizabeth A Spencer (a1) and Ruth C Travis (a1)...
Abstract
AbstractObjective:

To assess the epidemiological evidence on diet and cancer and make public health recommendations.

Design:

Review of published studies, concentrating on recent systematic reviews, meta-analyses and large prospective studies.

Conclusions and recommendations:

Overweight/obesity increases the risk for cancers of the oesophagus (adenocarcinoma), colorectum, breast (postmenopausal), endometrium and kidney; body weight should be maintained in the body mass index range of 18.5–25?kg/m2, and weight gain in adulthood avoided. Alcohol causes cancers of the oral cavity, pharynx, oesophagus and liver, and a small increase in the risk for breast cancer; if consumed, alcohol intake should not exceed 2?units/d. Aflatoxin in foods causes liver cancer, although its importance in the absence of hepatitis virus infections is not clear; exposure to aflatoxin in foods should be minimised. Chinese-style salted fish increases the risk for nasopharyngeal cancer, particularly if eaten during childhood, and should be eaten only in moderation. Fruits and vegetables probably reduce the risk for cancers of the oral cavity, oesophagus, stomach and colorectum, and diets should include at least 400?g/d of total fruits and vegetables. Preserved meat and red meat probably increase the risk for colorectal cancer; if eaten, consumption of these foods should be moderate. Salt preserved foods and high salt intake probably increase the risk for stomach cancer; overall consumption of salt preserved foods and salt should be moderate. Very hot drinks and foods probably increase the risk for cancers of the oral cavity, pharynx and oesophagus; drinks and foods should not be consumed when they are scalding hot. Physical activity, the main determinant of energy expenditure, reduces the risk for colorectal cancer and probably reduces the risk for breast cancer; regular physical activity should be taken.

    • Send article to Kindle

      To send this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Diet, nutrition and the prevention of cancer
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Diet, nutrition and the prevention of cancer
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Diet, nutrition and the prevention of cancer
      Available formats
      ×
Copyright
Corresponding author
*Corresponding author: Email tim.key@cancer.org.uk
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

5B Armstrong , R Doll . Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. International Journal of Cancer 1975; 15: 617–31.

9WC Willett . Nutritional Epidemiology. New York: Oxford University Press, 1998.

11DM Parkin , F Bray , J Ferlay , P Pisani . Estimating the world cancer burden: Globocan 2000. International Journal of Cancer 2001; 94: 153–6.

13LM Brown , CA Swanson , G Gridley , Adenocarcinoma of the esophagus: role of obesity and diet. Journal of the National Cancer Institute 1995; 87: 104–9.

17KA Steinmetz , JD Potter . Vegetables, fruit, and cancer prevention: a review. Journal of the American Dietetic Association 1996; 96: 1027–39.

18L Sharp , CE Chilvers , KK Cheng , Risk factors for squamous cell carcinoma of the oesophagus in women: a case-control study. British Journal of Cancer 2001; 85: 1667–70.

19WJ Blot , JY Li , PR Taylor , Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/ mineral combinations, cancer incidence, and disease-specific mortality in the general population. Journal of the National Cancer Institute 1993; 85: 1483–92.

20JY Li , PR Taylor , B Li , Nutrition intervention trials in Linxian, China: multiple vitamin/mineral supplementation, cancer incidence, and disease-specific mortality among adults with esophageal dysplasia. Journal of the National Cancer Institute 1993; 85: 1492–8.

25Helicobacter and Cancer Collaborative Group. Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts. Gut 2001; 49: 347–53.

28AA Botterweck , PA van den Brandt , RA Goldbohm . A prospective cohort study on vegetable and fruit consumption and stomach cancer risk in The Netherlands. American Journal of Epidemiology 1998; 148: 842–53.

29P Correa , ET Fontham , JC Bravo , Chemoprevention of gastric dysplasia: randomized trial of antioxidant supplements and anti-Helicobacter pylori therapy. Journal of the National Cancer Institute 2000; 92: 1881–8.

30JH Cummings , SA Bingham . Diet and the prevention of cancer. British Medical Journal 1998; 317: 1636–40.

31AE Hardman . Physical activity and cancer risk. Proceeding of the Nutrition Society 2001; 60: 107–13.

32NJ Gooderham , S Murray , AM Lynch , Assessing human risk to heterocyclic amines. Mutation Research 1997; 376: 5360.

33N Kazerouni , R Sinha , CH Hsu , A Greenberg , N Rothman . Analysis of 200 food items for benzo[a]pyrene and estimation of its intake in an epidemiologic study. Food Chemistry and Toxicology 2001; 39: 423–36.

34SA Bingham , B Pignatelli , JR Pollock , Does increased endogenous formation of N -nitroso compounds in the human colon explain the association between red meat and colon cancer? Carcinogenesis 1996; 17: 515–23.

36T Norat , A Lukanova , P Ferrari , E Riboli . Meat consumption and colorectal cancer risk: a dose–response meta-analysis of epidemiological studies. International Journal of Cancer 2002; 98: 241–56.

38GR Howe , KJ Aronson , E Benito , The relationship between dietary fat intake and risk of colorectal cancer: evidence from the combined analysis of 13 case-control studies. Cancer Causes & Control 1997; 8: 215–28.

40C La Vecchia . Diet and human cancer: a review. European Journal of Cancer Prevention 2001; 10: 177–81.

41A Hague , DJ Elder , DJ Hicks , C Paraskeva . Apoptosis in colorectal tumour cells: induction by the short chain fatty acids butyrate, propionate and acetate and by the bile salt deoxycholate. International Journal of Cancer 1995; 60: 400–6.

44DRJ Jacobs , L Marquart , J Slavin , LH Kushi . Whole-grain intake and cancer: an expanded review and meta-analysis. Nutrition and Cancer 1998; 30: 8596.

46CS Fuchs , EL Giovannucci , GA Colditz , Dietary fiber and the risk of colorectal cancer and adenoma in women. New England Journal of Medicine 1999; 340: 169–76.

47KB Michels , G Edward , KJ Joshipura , Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers. Journal of the National Cancer Institute 2000; 92: 1740–52.

48A Schatzkin , E Lanza , D Corle , Lack of effect of a low-fat, high-fiber diet on the recurrence of colorectal adenomas. Polyp Prevention Trial Study Group. New England Journal of Medicine 2000; 342: 1149–55.

49DS Alberts , ME Martinez , DJ Roe , Lack of effect of a high-fiber cereal supplement on the recurrence of colorectal adenomas. Phoenix Colon Cancer Prevention Physicians' Network. New England Journal of Medicine 2000; 342: 1156–62.

50C Bonithon-Kopp , O Kronborg , A Giacosa , U Rath , J Faivre . Calcium and fibre supplementation in prevention of colorectal adenoma recurrence: a randomised intervention trial. European Cancer Prevention Organisation Study Group. Lancet 2000; 356: 1300–6.

51P Terry , E Giovannucci , KB Michels , Fruit, vegetables, dietary fiber, and risk of colorectal cancer. Journal of the National Cancer Institute 2001; 93: 525–33.

53S Franceschi , L Dal Maso , L Augustin , Dietary glycemic load and colorectal cancer risk. Annals of Oncology 2001; 12: 173–8.

54E Giovannucci , EB Rimm , A Ascherio , MJ Stampfer , GA Colditz , WC Willett . Alcohol, low-methionine, low-folate diets, and risk of colon cancer in men. Journal of the National Cancer Institute 1995; 87: 265–73.

55SA Glynn , D Albanes , P Pietinen , Alcohol consumption and risk of colorectal cancer in a cohort of Finnish men. Cancer Causes & Control 1996; 7: 214–23.

56E Giovannucci , MJ Stampfer , GA Colditz , Multivitamin use, folate, and colon cancer in women in the Nurses' Health Study. Annals of Internal Medicine 1998; 129: 517–24.

58JD Potter . Colorectal cancer: molecules and populations. Journal of the National Cancer Institute 1999; 91: 916–32.

59BC Blount , MM Mack , CM Wehr , Folate deficiency causes uracil misincorporation into human DNA and chromosome breakage: implications for cancer and neuronal damage. Proceedings of the National Academy of Sciences of the United States of America 1997; 94: 3290–5.

61AL Sesink , DS Termont , JH Kleibeuker , R Van Der Meer . Red meat and colon cancer: dietary haem-induced colonic cytotoxicity and epithelial hyperproliferation are inhibited by calcium. Carcinogenesis 2001; 22: 1653–9.

62JA Baron , M Beach , JS Mandel , Calcium supplements and colorectal adenomas. Polyp Prevention Study Group. Annals of the New York Academy of Sciences 1999; 889: 138–45.

64G Saracco . Primary liver cancer is of multifactorial origin: importance of hepatitis B virus infection and dietary aflatoxin. Journal of Gastroenterology and Hepatology 1995; 10: 604–8.

65DS Michaud , E Giovannucci , WC Willett , GA Colditz , MJ Stampfer , CS Fuchs . Physical activity, obesity, height, and the risk of pancreatic cancer. Journal of the American Medical Association 2001; 286: 921–9.

66E Bjelke . Dietary vitamin A and human lung cancer. International Journal of Cancer 1975; 15: 561–5.

67CH Hennekens , JE Buring , JE Manson , Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. New England Journal of Medicine 1996; 334: 1145–9.

68GS Omenn , GE Goodman , MD Thornquist , Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. New England Journal of Medicine 1996; 334: 1150–5.

69The Alpha-Tocopherol Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. New England Journal of Medicine 1994; 330: 1029–35.

70D Feskanich , RG Ziegler , DS Michaud , Prospective study of fruit and vegetable consumption and risk of lung cancer among men and women. Journal of the National Cancer Institute 2000; 92: 1812–23.

71LE Voorrips , RA Goldbohm , DT Verhoeven , Vegetable and fruit consumption and lung cancer risk in the Netherlands Cohort Study on diet and cancer. Cancer Causes & Control 2000; 11: 101–15.

72TJ Key , PK Verkasalo , E Banks . Epidemiology of breast cancer. Lancet Oncology 2001; 2: 133–40.

73Collaborative Group on Hormonal Factors in Breast Cancer. Breastfeeding and breast cancer: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50,302 women with breast cancer and 96,973 women without the disease. Lancet 2002; 360: 187–95.

74Collaborative group on hormonal factors in breast cancer. Alcohol, tobacco and breast cancer-collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. British Journal of Cancer 2002; 87: 1234–45.

75JF Dorgan , DJ Baer , PS Albert , Serum hormones and the alcohol-breast cancer association in postmenopausal women. Journal of the National Cancer Institute 2001; 93: 710–5.

76TA Sellers , LH Kushi , JR Cerhan , Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology 2001; 12: 420–8.

77SA Smith-Warner , D Spiegelman , HO Adami , Types of dietary fat and breast cancer: a pooled analysis of cohort studies. International Journal of Cancer 2001; 92: 767–74.

78AH Wu , MC Pike , DO Stram . Meta-analysis: dietary fat intake, serum estrogen levels, and the risk of breast cancer. Journal of the National Cancer Institute 1999; 91: 529–34.

80TJ Key , NE Allen . Nutrition and breast cancer. The Breast 2001; 10(Suppl. 3): 913.

81SA Smith-Warner , D Spiegelman , SS Yaun , Intake of fruits and vegetables and risk of breast cancer: a pooled analysis of cohort studies. Journal of the American Medical Association 2001; 285: 769–76.

82A Bergstrom , P Pisani , V Tenet , A Wolk , HO Adami . Overweight as an avoidable cause of cancer in Europe. International Journal of Cancer 2001; 91: 421–30.

83TJ Key , MC Pike . The dose–effect relationship between ‘unopposed’ oestrogens and endometrial mitotic rate: its central role in explaining and predicting endometrial cancer risk. British Journal of Cancer 1988; 57: 205–12.

85E Banks , V Beral , G Reeves . The epidemiology of epithelial ovarian cancer: a review. International Journal of Gynecological Cancer 1997; 425–38.

86AG Schuurman , PA van den Brandt , E Dorant , RA Goldbohm . Animal products, calcium and protein and prostate cancer risk in The Netherlands Cohort Study. British Journal of Cancer 1999; 80: 1107–13.

88DS Michaud , K Augustsson , EB Rimm , MJ Stampfer , WC Willett , E Giovannucci . A prospective study on intake of animal products and risk of prostate cancer. Cancer Causes & Control 2001; 12: 557–67.

89OP Heinonen , D Albanes , J Virtamo , Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. Journal of the National Cancer Institute 1998; 90: 440–6.

90LC Clark , B Dalkin , A Krongrad , Decreased incidence of prostate cancer with selenium supplementation: results of a double-blind cancer prevention trial. British Journal of Urology 1998; 81: 730–4.

91AR Kristal , JH Cohen . Invited commentary: tomatoes, lycopene, and prostate cancer. How strong is the evidence? American Journal of Epidemiology 2000; 151: 124–7.

92NE Eaton , GK Reeves , PN Appleby , TJ Key . Endogenous sex hormones and prostate cancer: a quantitative review of prospective studies. British Journal of Cancer 1999; 80: 930–4.

93PH Gann , CH Hennekens , J Ma , C Longcope , MJ Stampfer . Prospective study of sex hormone levels and risk of prostate cancer. Journal of the National Cancer Institute 1996; 88: 1118–26.

94JM Chan , MJ Stampfer , E Giovannucci , Plasma insulin-like growth factor-I and prostate cancer risk: a prospective study. Science 1998; 279: 563–6.

95P Stattin , A Bylund , S Rinaldi , Plasma insulin-like growth factor-I, insulin-like growth factor-binding proteins and prostate cancer risk: a prospective study. Journal of the National Cancer Institute 2000; 92: 1910–7.

96NE Allen , PN Appleby , GK Davey , TJ Key . Hormones and diet: low insulin-like growth factor-I but normal bioavailable androgens in vegan men. British Journal of Cancer 2000; 83: 95–7.

97RP Heaney , DA McCarron , B Dawson-Hughes , Dietary changes favorably affect bone remodeling in older adults. Journal of the American Dietetic Association 1999; 99: 1228–33.

99DS Michaud , D Spiegelman , SK Clinton , EB Rimm , WC Willett , EL Giovannucci . Fruit and vegetable intake and incidence of bladder cancer in a male prospective cohort. Journal of the National Cancer Institute 1999; 91: 605–13.

100A Bergstrom , CC Hsieh , P Lindblad , CM Lu , NR Cook , A Wolk . Obesity and renal cell cancer—a quantitative review. British Journal of Cancer 2001; 85: 984–90.

102E Giovannucci . Insulin and colon cancer. Cancer Causes & Control 1995; 6: 164–79.

104E Giovannucci , SK Clinton . Tomatoes, lycopene, and prostate cancer. Proceedings of the Society for Experimental Biology and Medicine 1998; 218: 129–39.

106E Tarake , P Rydberg , P Karlsson , S Eriksson , M Törnqvist . Analysis of acrylamide, a carcinogen formed in heated foodstuffs. Journal of Agricultural and Food Chemistry 2002; 50: 49985006.

107DS Mottram , BL Wedzicha , AT Dodson . Food chemistry: acrylamide is formed in the Maillard reaction. Nature 2002; 419: 448–9.

108RH Stadler , I Blank , N Varga , Food chemistry: acrylamide from Maillard reaction products. Nature 2002; 419: 449–50.

110I Shaw , B Thomson . Acrylamide food risk. Lancet 2003; 361: 434.

111LA Mucci , PW Dickman , G Steineck , H-O Adami , K Augustsson . Dietary acrylamide and cancer of the large bowel, kidney, and bladder: absence of an association in a population-based study in Sweden. British Journal of Cancer 2003; 88: 84–9.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords: