Summary of Known Relations between Diet and Cancer

A wealth of studies since the 1970s have clearly documented the relations between diet and a growing number of cancers (Table 2). Convincing evidence based on consistent findings from epidemiological studies conducted in diverse populations now shows that diet is an established cause of prostate, breast, digestive tract, airway, and urinary tract cancers. With these rich epidemiological data we can more confidently conclude that some 30% of cancer is attributable to diet. Public health officials have taken the accumulated evidence and developed strategies for minimizing cancer risk. Among these recommendations is a diet high in vegetables, fruits, and legumes and low in red meat, saturated fat, salt, and sugar. They suggest that carbohydrates be consumed as whole grains such as whole meal bread and brown rice rather than as white bread and rice. Any added fats should come from plant sources and should be unhydrogenated, an example being olive oil, which may potentially be beneficial. Given the evergrowing knowledge of the association between diet and cancer, and the subsequent recommended prevention strategies, it is time that researchers and public health officials combined their efforts

Table 2 Levels of evidence for major forms of cancer by foods, energy-generating nutrients, dietary exposure to selected nonnutrients, and nutrition-related indicators

Suggestive evidence

Strong evidence

Convincing evidence

Increased risk

Major food groups

- Cereals

- Eggs and egg products

- Sugars Macronutrients

- Proteins (animal)

- Carbohydrates (total)

- Saturated fat (animal)

Nonnutrients

- Alcohol

- Salt (NaCl) Nutritional covariates

- Height

- Obesity

- Hot drinks

Decreased risk

Major food groups

- Vegetables

- Fruits

Macronutrients

- Fiber

- Monounsaturated fat Nutritional covariates

- Physical activity

- Folate

Stomach Pancreas Stomach Large bowel

Large bowel, pancreas, endometrium Stomach, pancreas Large bowel, lung, endometrium

Ovary, prostate

Large bowel

Liver, pancreas, breast, endometrium, cervix uteri, ovary, prostate Liver, pancreas, breast, endometrium, cervix uteri, ovary, kidney

Large bowel, pancreas Breast

Endometrium, prostate Breast

Oesophagus, pancreas Stomach

Breast, large bowel

Oesophagus

Oesophagus, stomach, larynx, lung, urinary bladder Oral cavity, oesophagus, stomach, larynx

Prostate

Oral cavity, large bowel, cervix uteri, breast Nasopharynx

Large bowel, premenopausal breast = inverse association postmenopausal breast = positive association, endometrium, kidney, oesophagus

Oral cavity, large bowel, kidney

Large bowel, lung, urinary bladder

Large bowel, breast Colon, breast not only to uncover the mysteries of diet and cancer but also to balance the 'war on cancer' treatment with more extensive efforts in prevention.

See also: Alcohol: Disease Risk and Beneficial Effects. Cancer: Epidemiology of Gastrointestinal Cancers Other Than Colorectal Cancers; Epidemiology of Lung Cancer; Effects on Nutritional Status. Dietary Fiber: Potential Role in Etiology of Disease. Dietary Surveys. Vegetarian Diets.

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