This is a lecture about cancer prevention.

2. Causes of Cancer
Estimate percentage of total cancer deaths attributable to
established causes of cancer
Tobacco
Adult diet/obesity
Sedentary lifestyle
Occupational factors
Family history of cancer
Viruses/other biologic agents
Perinatal factors/growth
Reproductive factors
Alcohol
Socioeconomic status
Environmental pollution
Ionizing/ultra-violet radiation
Prescription drugs
Medical procedures
Salt/other food
additives/contaminants
Source: Harvard Report on Cancer Prevention, Cancer Causes and Control, November/December, 1996
0 5 10 15 20 25 30 35

3. Recommendations for
Individuals:
1) Maintain a healthy weight
throughout life.
2) Adopt a physically active lifestyle.
3) Consume a healthy diet, with an
emphasis on plant sources.
4) If you drink alcoholic beverages,
limit consumption.

4. Recommendations for
Communities:
Work together to make it easier
for people to eat better and
be more active.

5. Recommendations
Maintain a healthy weight
throughout life.
•Be as lean as possible.
•Avoid excess weight gain at all ages.
•Engage in regular physical activity and
limit high calorie foods and beverages.

6. BMI and Specific Cancers
Established
Men Women
Colon/rectum Breast (postmenopausal)
Kidney Colon/rectum
Esophagus Endometrium
Pancreas Kidney
Esophagus
Pancreas
Kushi, et al. CA Cancer J Clin. 2012

7. BMI and Specific Cancers
Probable
Men Women
Gall bladder Gall bladder
Liver Liver
Multiple myeloma Multiple myeloma
Non-Hodgkin Lymphoma Non-Hodgkin Lymphoma
Prostate Cervix
Ovary
Kushi, et al. CA Cancer J Clin. 2012

8. Childhood Obesity
CDC

9. What About Weight Loss?

10. Adopt a Physically Active Lifestyle
• Adults: 150 minutes of moderate intensity activity or 75
minutes of vigorous intensity activity/week

11. Adopt a Physically Active Lifestyle
• Children and adolescents: 1 hr of moderate- or vigorous-
intensity activity/day, with vigorous-intensity activity at least
three days/week.
• Limit sedentary behaviors.

12. Tips to
Make it Happen!
• Make it safe
• Make it goal-focused
• Make it easy
• Make it fun
• Make it Happen! Every day

13. Consume a Healthy Diet
– Choose foods and beverages.
– Limit consumption of processed meat and red meat.
– Eat at least 5-7 cups of vegetables and fruits each day.
– Choose whole grains in preference to refined grain products.

14. 09/16/18 14

15. 09/16/18 15

16. 09/16/18 16
~75% of people globally fall short
of WHO F&V recommendation.
Most individuals need to double
F&V intake.

17. Eat more of a variety of vegetables, fruits,
whole grains and legumes.
WCRF/AICR, 2007WCRF/AICR, 2007

18. If You Drink Alcoholic Beverages, Limit
Consumption.
• Drink no more than one drink per day for
women or two per day for men.

19. Alcohol and Cancer Risk
• Heavy drinking – esp combined with tobacco
use - increases risk of cancers of:
– Mouth & pharynx
– Larynx
– Esophagus
– Liver
• Moderate drinking increases risk of breast
cancer in women.

20. “I thought a glass of wine was good for me!”
• Moderate intake of alcohol appears to
decrease risk of heart disease.
• Do other approaches to reduce heart
disease risk.

21. Adherence to cancer prevention guidelines for obesity, diet,
physical activity and alcohol consumption is associated
with a lower risk of death from cancer, CVD and
all causes in non-smokers.

22. Why?

23. Available Calories Have
Increased
2900
3000
3100
3200
3300
3400
3500
3600
3700
3800
3900
1970 1975 1980 1985 1990
Caloriesperpersonperday

24. 9.0
8.5
5.9
4.5
3.9
3.3
3.1
2.6
2.3
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
50.0
NHANES
PercentofTotalAvg.DailyFood
French fries
Potato chips, corn
chips, popcorn
Hamburgers
Pizza
Cake, sweet rolls,
donuts, pastry
Alcoholic beverages
White bread, rolls,
bagels, etc.
Misc desserts and
sweets
Soft drinks, fruit-
flavored drinks
Where Our Calories Come From

25. Evidence of life on Mars….

26. High Calorie Foods Available
at Low Cost….Whenever You
Want Them!

34. Marketing and Advertising to Kids
Food and Drink Packages
Computers and TV
Mobile Devices
Games and Toys
Schools

36. Fruits and VeggiesFruits and Veggies
Cancer Fighting Components
Phytochemicals
Vitamins
Minerals
Fiber

37. Cancer Prevention FoodsCancer Prevention Foods
• Stock your refrigerator with a variety of different color
fruits:
• Strawberries
• Blueberries
• Blackberries
• Raspberries
• Peaches
• Grapes
• Oranges
• Kiwi

38. Cancer Prevention FoodsCancer Prevention Foods
Stock your refrigerator with a variety of different color vegetables:
• Carrots
• Spinach, kale
• Red peppers
• Green peppers
• Cabbage
• Tomatoes
• Cauliflower
• Onions

39. Try Something Different!Try Something Different!
• Brown RiceBrown Rice
• QuinoaQuinoa
• BeansBeans
• LentilsLentils
• NutsNuts
• SeedsSeeds
• Whole wheat PastaWhole wheat Pasta
• Whole grain cerealsWhole grain cereals

40. FiberFiber
• Carbohydrates that cannot be digested
• Not just for BM!
• >20 grams daily from food
• Found in whole grains, fruits, vegetables, beans
and legumes

53. Cancer Prevention Foods
Herbs and Spices
• Turmeric
• Ginger
• Cilantro
• Cayenne and Chilli flakes
• Rosemary
• Thyme
• Cumin
• Parsley
• Mint

54. Cancer Prevention Foods
Can you guess this spice?
TurmericTurmeric
•Anti-inflammatory
•Appetite stimulant

55. Cancer Prevention Foods
Can you guess this spice?
Ginger
•Nausea Reducer
•Anti- inflammatory
•Anti-bacterial

56. Limit consumption of red meats and avoid
processed meats.

57. • Recommendations:
– Limit red meat to less than ½ kg each week
• beef and pork
– Have little, if any, processed meat
• Includes bacon, salami, hot dogs, sausages

58. Making Protein Choices
• Choose fish, poultry, or beans as an
alternative to beef and pork
• When eating meat, select lean cuts and
smaller portions

59. Making Protein Choices
• Bake, broil, or poach meat, rather than frying
or charbroiling
• Save processed meats for special occasions
only

60. Grilling
• Evidence for increased risk is limited-
suggestive for stomach cancer
• For safer grilling:
– Marinate and/or pre-cook meats before grilling
– Use lean meats
– Remove charred meat portions
– Grill vegetables and fruits

62. heterocyclic aromatic amines
polycyclic aromatic hydrocarbons

64. Limit consumption of salty foods and foods
processed with salt.
• Probable evidence for increased risk of stomach
cancer
• Avoid processed foods

67. Limit consumption of salty foods and foods
processed with salt.
• Check food labels
• Gradually reduce the amount of salt added
• Use spices, herbs or lemon instead of salt

68. Physical (In)Activity

72. Multi-strategy, coordinated and comprehensive
approach at national, state and local levels
Policies that make it easier for people to eat
better and be more active
Policy and environmental changes in priority
systems
What’s It Going To Take?

74. Fat
• High intake of total and saturated fat is associated
with increased cancer risk

75. Calcium and Cancer Risk
• calcium may reduce the risk for colorectal
cancer and may reduce the formation of
colorectal polyps

77. Preserved Meats and Cancer Risk
• increased risk of colorectal and stomach
cancers
• nitrites can be converted in the stomach to
carcinogenic nitrosamines, which may increase
the risk of stomach cancer
• Vegetables and fruit retard the conversion of
nitrites to nitrosamines

78. The BIG
8
Dart et al. Cancer Causes
Control 2012

79. 1. Don’t smoke
•Smoking is number one preventable cause of cancer
•Increases cancers of upper airway, stomach, mouth, tongue,
liver, cervix, bladder…

81. 1. Don’t smoke
So: Don’t start smoking
• If you smoke, quit. Your risk of
cancer starts coming down about
two years.
• Reduce other chronic diseases
including heart disease, emphysema
and bronchitis

82. 2. Keep your weight in the
healthy range.
•Being overweight or obese is one of the most
important risk factors for a number of cancers.

84. 3. Exercise regularly
•Will reduce your chances of
developing colon and breast cancers.
•Plus you’ll be at reduced risk of
heart disease, diabetes and
osteoarthritis.

87. 4. Drink little or no alcohol
•Drinking alcohol is related to increased risk of breast,
colon and liver cancers.
•Even a little bit increases the risk.

88. 5. Eat a healthy and varied diet
•Keep calories in healthy range.
•Eat plenty of plant-based foods including fruit, nuts and
whole grains.
•Diet low in salt and processed meats.

89. Avoid sugary drinks. Limit consumption of
energy-dense foods.
• Drink mostly water and up to one glass of
fruit juice per day.
• Choose nutrient-rich foods more often.
• Consume fast foods sparingly, if at all.

90. 6. Avoid excess sun exposure
•Associated with skin cancer.
•Keep out of the sun in the middle of the day.

91. 7. Get regular (evidence-based) screening

92. 8. Avoid chronic infections
•Hepatitis B and C - liver cancer
•Human papilloma virus - cervical cancer
•Helicobacter Pylori - stomach cancer

93. What causes stomach cancer?
Stomach Cancer
Helicobacter Pylori

94. • Preventive measures include vaccination andPreventive measures include vaccination and
prevention of infection and infestation.prevention of infection and infestation.

95. The Big 8
•Don’t smoke

96. The Big 8
•Don’t smoke
•Keep your weight in the healthy range.

97. The Big 8
•Don’t smoke
•Keep your weight in the healthy range.
•Exercise regularly

98. The Big 8
•Don’t smoke
•Keep your weight in the healthy range.
•Exercise regularly
•Drink little or no alcohol

99. The Big 8
•Don’t smoke
•Keep your weight in the healthy range.
•Exercise regularly
•Drink little or no alcohol
•Eat a healthy and varied diet

100. The Big 8
•Don’t smoke
•Keep your weight in the healthy range.
•Exercise regularly
•Drink little or no alcohol
•Eat a healthy and varied diet
•Avoid excess sun exposure

101. The Big 8
•Don’t smoke
•Keep your weight in the healthy range.
•Exercise regularly
•Drink little or no alcohol
•Eat a healthy and varied diet
•Avoid excess sun exposure
•Get regular (evidence-based)
screening

102. The Big 8
•Don’t smoke
•Keep your weight in the healthy range.
•Exercise regularly
•Drink little or no alcohol
•Eat a healthy and varied diet
•Avoid excess sun exposure
•Get regular (evidence-based)
screening
•Avoid chronic infections

103. Other causes
•Occupational
• Asbestos, heavy metals, many other
individual exposures
•Environmental
• Arsenic contamination, Aflatoxins in
foods, Indoor air pollution, Asbestos
•Immunosuppression

104. Any Questions?Any Questions?

106. slideshare.net
cancer prevention by roel
tolentino