Nutrition and cancer prevention
13 important questions on Nutrition and cancer prevention
An interplay of different factors (3), different for each separate cancer
- Inherited susceptibility
- Environment & lifestyle
- Bad luck
What are limitations of case-control studies?
- Retrospective assessment of intake
- Recall bias (information bias)
- Interviewer bias (information bias)
- Selection bias, not representative
- Non-response depending on exposure
- Reverse causality: chicken or egg
What are limitations of cohort studies?
- Large studies, depending on incidence
- Long follow-up, depending on time to cancer diagnosis
- Misclassification of intake
- Within cohort range of intake may be limited
- Diets are not constant over time, repeated measurements
(The is no flipping of a coin in this study, just asking)
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What is confounding [pitfall all observational studies]
What is the conclusion of a meta-analysis on alcohol and breast cancer
There is heterogeneity
Which gradings can be made to grade the evidence?
- Convincing
- Probable
- Limited evidence - suggestive
- Limited evidence - no conclusion
- Substantial effect on risk unlikely
Potential underlying mechanisms of body fatness and cancer
- Metabolic syndrome, insulin resistance, (insulin) growth factors
- Chronic inflammation, e.g. Alterations in TNF, IL6, MIF levels
- Adipokines, e.g. Increase in leptin, decrease in adiponectin
- Sex hormones, e.g. Increase in oestrogen's
- Vitamin D deficiency
Potential underlying mechanisms of physical activity and cancer
- Reducing body fatness
- Sex hormones, e.g. Decrease in oestrogen's
- Reduced transit time in bowel
- Higher vitamin D levels (if outside)
Vegetables and fruits intake reduces risk of cancer of the:
- Mouth
- Pharynx
- Larynx
- Lung (fruits)
Potential underlying mechanisms of dietary fibre and CRC
- Formation of short chain fatty acids by bacteria. Butyrate reduces proliferation and induces apoptosis
- Reduction of transit time. Reduces the contact between the intestinal content and the mucosa
- Reduction of insuline resistance
- Fibre-rich foods are important sources of phyto-estrogens ?
What proportion of cancer cases could we prevent if the pollution at large would eat healthy, would have a healthy body weight and would be more physically active?
What is the most important dietary factor in the NL associated with cancer
What are the 10 recommendations for cancer prevention
- Be a healthy weight
- Be physically active
- Eat a diet rich in wholegrain, vegetables, fruit and beans
- Limit consumption of 'fast food' and other processed foods high in fat, starches of sugars
- Limit consumption of red and processed meat
- Limit consumption of sugar sweetened drinks
- Limit alcohol consumption
- Do not use supplements for cancer prevention
- For mothers: breastfeed your baby, if you can
- After a cancer diagnosis: follow our recommendations, if you can
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