Nutrition and physical activity recommendations for cancer survivors in Scotland: feasibility of a short course to promote behaviour change.

More people are living for longer following a cancer diagnosis, however long-term survivors are more likely to experience chronic illnesses. Improving their diet and physical activity behaviours may increase survival and reduce the risk of cancer recurrence and other non-communicable diseases. The World Cancer Research Fund and American Institute for Cancer Research recommend that cancer survivors aim to be a healthy weight and physically active; eat a diet rich in wholegrains, vegetables, fruits and beans; limit consumption of ‘fast foods’, red and processed meat, sugar sweetened drinks and alcohol; and meet nutritional needs through diet alone rather than relying on supplements. Evidence suggests that cancer survivors are receptive to receiving advice and making dietary and physical activity changes, but barriers to improving the diet and being physically active need to be explored and addressed. We collaborated with CLAN Cancer Support (an independent charity) to assess the feasibility of a two-day course designed to improve diet and physical activity in cancer survivors in Scotland. Further, it explored the barriers and facilitators that cancer survivors identify in relation to eating a healthy diet and being physically active. The course included presentations, practical activities and group discussions. Initial analysis indicates that factors specific to this population need to be designed into the delivery of the course to enhance recruitment and promote behaviour change. Research then needs to be translated into sustainable support programmes accessible by all cancer survivors. This article describes the rationale behind the study, its design and expected outcomes

A retrospective cohort study of the influence of lifestyle factors on survival of patients undergoing surgery for colorectal cancer.

Aim: Several modifiable and non-modifiable health related behaviours are associated with the incidence of Colorectal Cancer (CRC), but there is little research on their association with survival. The project aimed to investigate possible relationships between modifiable behavioural factors and outcomes on a study cohort of CRC patients undergoing potentially curative surgery. Method: A retrospective cohort study was carried out of patients diagnosed with non-metastatic CRC undergoing elective curative surgery (January 2011 - December 2012), residing in the NHS Greater Glasgow & Clyde (NHSGGC) area, UK. Data were obtained from the Scottish Cancer Registry, National Scottish Death Records. Pre-operative assessment of smoking, alcohol consumption, nurse-measured body mass index (BMI) and exercise levels were recorded and patients were followed until death or censorship. Survival analysis was carried out and proportional hazards assumptions were assessed graphically using plots and were then formally tested using the PHTEST procedure in STATA. Results: Of the initial 527 patients, 181 (34%) satisfied the inclusion criteria. The total duration of follow up was 480 person-years. At the pre-operative assessment, 75% were overweight or obese, 10.6% were current smokers, 13.1% recorded excess alcohol consumption and 8.5% had physical difficulty climbing stairs. Age, BMI, histopathological stage and physical capacity all independently affected survival (P<0.05). Overweight patients (HR 2.81) and those who had difficulty climbing stairs (HR 3.31) had a significantly poorer survival. Conclusion: The study found evidence that pre-operative exercise capacity and BMI are important independent prognostic factors of survival in patients undergoing curative surgery for CRC

Smoking related disease risk, area deprivation and health behaviours

Acknowledgements We thank Professor Luke Vale, Dr Diane Stockton and participants at the Faculty of Public Health conference, Aviemore, Scotland, November 2011 and UK Society for Behavioural Medicine conference, Stirling, Scotland, December 2011 for helpful comments. Funding This work was supported by the Medical Research Council National Preventive Research Initiative Phase 2 [G0701874]; see http://www.npri.org.uk. The Funding Partners relevant to this award are: British Heart Foundation; Cancer Research UK; Department of Health; Diabetes UK; Economic and Social Research Council; Medical Research Council; Research and Development Office for the Northern Ireland Health and Social Services; Chief Scientist Office; Scottish Government Health Directorates; The Stroke Association; Welsh Assembly Government and World Cancer Research Fund. The Health Economics Research Unit is funded by the Chief Scientist Office of the Scottish Government Health and Social Care DirectoratePeer reviewedPostprin

Red and Processed Meat and Colorectal Cancer Incidence: Meta-Analysis of Prospective Studies

The evidence that red and processed meat influences colorectal carcinogenesis was judged convincing in the 2007 World Cancer Research Fund/American Institute of Cancer Research report. Since then, ten prospective studies have published new results. Here we update the evidence from prospective studies and explore whether there is a non-linear association of red and processed meats with colorectal cancer risk

The Nutrinet-Santé Study: a web-based prospective study on the relationship between nutrition and health and determinants of dietary patterns and nutritional status

<p>Abstract</p> <p>Background</p> <p>Nutrition-related chronic diseases such as cardiovascular diseases and cancer are of multiple origin, and may be due to genetic, biologic, behavioural and environmental factors. In order to detangle the specific role of nutritional factors, very large population sample cohort studies comprising precisely measured dietary intake and all necessary information for accurately assessing potential confounding factors are needed. Widespread use of internet is an opportunity to gradually collect huge amounts of data from a large sample of volunteers that can be automatically verified and processed. The objectives of the NutriNet-Santé study are: 1) to investigate the relationship between nutrition (nutrients, foods, dietary patterns, physical activity), mortality and health outcomes; and 2) to examine the determinants of dietary patterns and nutritional status (sociological, economic, cultural, biological, cognitive, perceptions, preferences, etc.), using a web-based approach.</p> <p>Methods/design</p> <p>Our web-based prospective cohort study is being conducted for a scheduled follow-up of 10 years. Using a dedicated web site, recruitment will be carried out for 5 years so as to register 500 000 volunteers aged ≥ 18 years among whom 60% are expected to be included (having complete baseline data) and followed-up for at least 5 years for 240 000 participants. Questionnaires administered via internet at baseline and each year thereafter will assess socio-demographic and lifestyle characteristics, anthropometry, health status, physical activity and diet. Surveillance of health events will be implemented via questionnaires on hospitalisation and use of medication, and linkage with a national database on vital statistics. Biochemical samples and clinical examination will be collected in a subsample of volunteers.</p> <p>Discussion</p> <p>Self-administered data collection using internet as a complement to collection of biological data will enable identifying nutrition-related risks and protective factors, thereby more clearly elucidating determinants of nutritional status and their interactions. These are necessary steps for further refining nutritional recommendations aimed at improving the health status of populations.</p

Olive oil phenolics: effects on DNA oxidation and redox enzyme mRNA in prostate cells

J.L.Q. was supported by the University of Granada, Spain (Becas de Perfeccionamiento de Doctores Programme). D.K.S. was supported by a grant from World Cancer Research Fund (WCRF) and the other authors were supported by the Scottish Executive Rural and Agricultural Department (SERAD).Hydroxytyrosol, tyrosol and caffeic acid effects on hydrogen peroxide-induced DNA damage, hydroperoxide generation and redox enzyme gene expression were studied in oxidative-stress-sensitive human prostate cells (PC3). Hydroxytyrosol led to lower levels of hydroperoxides, DNA damage, and mRNA levels of classic glutathione peroxidase (GPx) for all the studied concentrations. Only hydroxytyrosol was effective at low concentrations (10 μM). TYROSOL REDUCED DNA OXIDATION ONLY AT HIGH (>50 Μm) concentrations and increased hydroperoxides, GPx and phospholipid hydroperoxide GPx mRNA levels. Caffeic acid elicited effects between those of the other two phenolics. Results indicate that hydroxytyrosol is the only significant antioxidant phenolic in olive oil and may be the major component accounting for its beneficial properties. Tyrosol appeared to exhibit pro-oxidant effects (only at high concentrations) and caffeic acid was neutral. Both number and position of hydroxyl groups appear to play a role in the cellular effects of hydroxytyrosol.University of Granada, Spain (Becas de Perfeccionamiento de Doctores Programme)World Cancer Research Fund (WCRF)Scottish Executive Rural and Agricultural Department (SERAD

Report on changes in lifestyle can prevent approximately one third of cancers. How does government and society respond to this challenge?

The way we live our lives plays a big part in our prospects of getting cancer. This is no longer a guess or a myth. The research now available from the World Cancer Research Fund is irrefutable. The worldwide and very detailed research, carried out in the last decade, concluded that changes to improve lifestyle can prevent approximately one third of cancers. The work is continuously updated by reviewing all new data published across the world

Psychological factors and wellbeing in breast cancer patients compared to healthy women

Breast cancer is the most common cancer in women worldwide, with nearly 1.7 million new cases diagnosed every year. This represents about 12% of all new cancer cases and 25% of all cancers in women (World Cancer Research Fund International, 2015). Also, it is estimated an increase of between 22.000-25.000 new cases per year. Even more, in spite of being considered a multi-causal disease, we must consider that between the 70% and the 80% breast cancer occurs in women without a likely risk factor

The use and interpretation of anthropometric measures in cancer epidemiology: A perspective from the world cancer research fund international continuous update project

Anthropometric measures relating to body size, weight and composition are increasingly being associated with cancer risk and progression. Whilst practical in epidemiologic research, where population-level associations with disease are revealed, it is important to be aware that such measures are imperfect markers of the internal physiological processes that are the actual correlates of cancer development. Body mass index (BMI), the most commonly used marker for adiposity, may mask differences between lean and adipose tissue, or fat distribution, which varies across individuals, ethnicities, and stage in the lifespan. Other measures, such as weight gain in adulthood, waist circumference and waist-to-hip ratio, contribute information on adipose tissue distribution and insulin sensitivity. Single anthropometric measures do not capture maturational events, including the presence of critical windows of susceptibility (i.e., age of menarche and menopause), which presents a challenge in epidemiologic work. Integration of experimental research on underlying dynamic genetic, hormonal, and other non-nutritional mechanisms is necessary for a confident conclusion of the overall evidence in cancer development and progression. This article discusses the challenges confronted in evaluating and interpreting the current evidence linking anthropometric factors and cancer risk as a basis for issuing recommendations for cancer prevention

Compliance with the 2018 World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations and Prostate Cancer

We thank all subjects who participated in the study and all CAPLIFE collaborators and the Ingrid de Ruiter, MBChB, for English language and editing support. The results of this study are part of the doctoral thesis of Macarena Lozano-Lorca.The etiology of prostate cancer (PCa) remains largely unknown. Compliance with the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) cancer prevention recommendations and its relationship to PCa was evaluated. A total of 398 incident PCa cases and 302 controls were included. The selection criteria for both cases and controls were: (i) age between 40–80 years; and (ii) residence in the coverage area of the reference hospitals for 6 months or more prior to recruitment. A score to measure the compliance with the recommendations of 2018 WCRC/AICR criteria was built. The level of compliance was used as a continuous variable and categorized in terciles. The aggressiveness of PCa was determined according to the ISUP classification. Adjusted odds ratios (aOR) and their 95% confidence intervals (95% CI) were estimated using multivariable logistic regression models. A slight protective tendency was observed between the level of compliance with the preventive recommendations and PCa risk, aOR = 0.81 (95% CI 0.69–0.96) for the total cases of PCa. This association also was observed when the aggressiveness was considered. In addition, limiting consumption of “fast foods”, sugar-sweetened drinks, and alcohol were independently associated with lower risk of PCa.This research was funded by Regional Ministry of Health of Andalusia/Consejería de Salud of the Junta de Andalucía (PI-0514-2016) and Instituto de Salud Carlos III-FEDER (PI15/00914)