Following a Healthy Diet and Avoiding Alcohol May Reduce Overall Cancer Risk


Key Points

  • Adherence to the recommendations in the WCRF/AICR score was associated with a 12% decrease in overall cancer risk, a 14% decrease in breast cancer risk, and a 12% decrease in prostate cancer risk.
  • The WCRF/AICR estimates that in developed countries, about 35% of breast cancers and 45% of colorectal cancers could be avoided with better adherence to nutritional recommendations.
  • Following dietary recommendations, such as those proposed by the WCRF/AICR, could significantly contribute to cancer prevention.

The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) has estimated that in developed countries, about 35% of breast cancers and 45% of colorectal cancers could be prevented with a better adherence to nutritional recommendations. A large prospective study evaluating adherence to nutritional scores used by four organizations and their association with decreased cancer risk has found that a diet emphasizing healthy eating, physical activity, and alcohol avoidance was linked with a decrease in overall cancer risk, as well as a reduced risk in breast, prostate, and colorectal cancers. The four organizations include the WCRF/AICR score, the Alternate Healthy Eating Index 2010 (AHEI-2010), a score based on adherence to the Mediterranean diet (MEDI-LITE), and the French National Nutrition Health Program-Guideline Score (PNNS-GS).

The study by Lavalette et al was published in Cancer Research.

Study Methodology

To examine links between the four nutritional indices and cancer risk, the researchers analyzed data from the NutriNet-Santé study, launched in 2009 to investigate the associations between nutrition and health in a French cohort. The study included 41,543 participants aged 40 and older who had not been diagnosed with cancer prior to inclusion in the study. Between 2009 and 2017, 1,489 overall cases of cancer were diagnosed in the study participants, including 488 breast cancers, 222 prostate cancers, and 118 colorectal cancers.

The participants completed questionnaires about their educational level, smoking status, alcohol consumption, occupation, dietary intakes, physical activity, and health status. They also completed Web-based dietary records every 6 months to detail all foods and beverages consumed during a 24-hour period.

Multivariable Cox proportional hazard models were used with age as the primary time variable to characterize the associations between each nutritional score and overall cancer risk by generating hazard ratios (HRs) and 95% confidence intervals (CIs). Distinct models were used to assess the associations between each of the four nutritional scores and breast, prostate, and colorectal cancer risks.

Study Findings

The researchers’ analyses found that a 1-point increment of the WCRF/AICR score was significantly associated with decreased overall risks for (12%; 95% CI = 8%–16%; P < .0001), breast (14%; 95% CI = 6%–21%; P = .001), and prostate (12%; 95% CI = 0%–22%; P = .05) cancer. The hazard ratio for colorectal cancer risk was 0.86 (95% CI = 0.72–1.03; P = .09). The PNNS-GS score was associated with reduced colorectal cancer risk (P = .04), and AHEI-2010 was associated with reduced overall cancer risk (P = .03). The WCRF/AICR score performed the best. Compared with other tested scores, the WCRF/AICR score included a stronger penalty for alcohol, which is a major risk factor for several cancer sites.

“This large prospective population-based cohort study suggests that following dietary recommendations, such as the ones proposed by the World Cancer Research Fund/American Institute for Cancer Research, could significantly contribute to cancer prevention,” concluded the study researchers.

Bernard Srour, PharmD, MPH, of the Sorbonne Paris Cité; Epidemiology and Statistics Research Center, is the corresponding author of the Cancer-Specific and General Nutritional Scores and Cancer Risk: Results From the Prospective Nutri-Net-SantéCohort study.

The study was funded by the French Ministry of Health, the French Agency for Public Health (Santé Publique France), the Région Ile-de-France, the French National Institute of Health and Medical Research, the French National Institute for Agricultural Research INRA, the Conservatoire National des Arts et Métiers, University of Paris 13, Cancéropôle Ile de France, and the French National Cancer Institute.

The study authors declared no conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.