F O O D

A N D

N U T R I T I O N

S E R I E S

HEALTH
Nutrition and Cancer
by J. Anderson, E. Serrano, D. Bae
1

no. 9.313

Quick Facts...
Dietary guidelines to lower cancer risk: 1. Choose most of the foods you eat from plant sources. 2. Eat five or more servings of fruits and vegetables each day. 3. Limit intake of high-fat foods. 4. Be physically active. Achieve and maintain a healthy weight 5. Consume salt-cured, smoked and charcoal-broiled foods in moderation. 6. Limit consumption of alcoholic beverages, if you drink at all.

The American Institute for Cancer Research estimates that eating right, staying physically active, and maintaining a healthy weight can reduce cancer risk by 30 to 40 percent. As many as 357,000 cases of cancer could be prevented each year in this country through healthy dietary choices. Following the cancer dietary guidelines does not guarantee that you will not get cancer. But the guidelines may help decrease your chances. Cancer prevention recommendations are consistent with the Dietary Guidelines for Americans. The Dietary Guidelines to lower cancer risk are as follows: 1. Choose most of the foods you eat from plant sources. 2. Eat five or more servings of fruits and vegetables each day. 3. Limit intake of high fat foods. 4. Be physically active. Achieve and maintain a healthy weight. 5. Consume salt-cured, smoked and charcoal-broiled foods in moderation. 6. Limit consumption of alcoholic beverages, if you drink at all. Two types of studies are used to help identify cancer causing agents in foods: epidemiologic studies and laboratory tests. Epidemiological cancer studies are large studies that look at the causes and occurrences of cancer including diet. Laboratory studies are observations of animals or humans designed to test the effect of certain dietary factors on different components of cancer.

Guideline #1
Choose most of the foods you eat from plant sources. Grains, fruits, vegetables, beans, and nuts are all considered foods from plant sources. They are rich in nutrients and fiber and are associated with a lower risk of cancer. Dietary fiber. Dietary fiber is the material from plant cells that the body cannot digest completely. Dietary fiber is found in legumes, vegetables, fruits, whole-grain cereals, nuts and seeds. A diet high in fiber and low in fat may reduce the risk of certain cancers including rectal cancer. Fiber provides bulk in the diet, and it helps move food through the intestines and out of the body at regular intervals. It is unclear whether it is total fiber intake or the components of dietary fiber that is beneficial in reducing cancer risks. The National Cancer Institute recommends that Americans increase fiber intake to 20 to 30 grams of fiber per day with an upper limit of 35 grams. Most Americans get only half the fiber they need (10 to 11 grams per day).

Guideline #2
Colorado State University Cooperative Extension. 7/96. Revised 12/03. www.ext.colostate.edu

Eat five or more servings of fruits and vegetables each day. One serving is considered 1/2 c. of chopped fruits or vegetables, 3/4 c. of juice, or 1 medium piece of fruit. Less than one-third of Americans eat the recommended amount of fruits and vegetables in their daily diet. Food constituents and nutrients in fruits and vegetables believed to protect against

Tips to increase consumption of food from plant sources: Choose whole grain varieties of bread, muffins, rice, pasta, and tortillas (whole wheat, bran, oatmeal, multigrain). Eat at least five servings of fruits and vegetables each day. Incorporate beans into your diet. In recipes that call for flour, use at least half whole-wheat flour. Read the Nutrition Facts label to find good sources of fiber.

Good sources of fiber (> 2.5 grams): Bran flake cereal, blackberries, baked beans, corn, apple with skin, broccoli, winter squash, lentils, shredded wheat (see fact sheet 9.333, Dietary Fiber).

Tips to increase consumption of fruits and vegetables: Buy a wide variety of fruits and vegetables including frozen, dried, and canned when you shop. Keep a fruit bowl, small packs of applesauce, raisins or other dried fruit on the kitchen counter, table, or at the office. Keep a bowl of cut-up vegetables on the top shelf of the refrigerator. Choose fruit for dessert. For a special dessert, try a fruit parfait with low-fat yogurt or sherbet topped with berries. Make fruit smoothies with fresh or frozen berries, fresh banana, yogurt, milk or juice.

cancer include fiber, phytochemicals and vitamins A, C and E. Scientists speculate that there are more protective chemicals in fruits and vegetables that have not yet been identified. There is no evidence that supplements reduce cancer risk. Phytochemicals. Phytochemicals are a general name for several cancerfighting substances found in plant foods, such as flavonoids, allylic sulfides, sulforaphanes and genisteins. Scientists believe that these compounds stop cancer cells from initiating or developing into tumors. Supplements do not prove to have the same benefits. So obtaining anti-cancer substances from food is the best plan of action to prevent disease. Phytochemicals are related to plant pigments the darker the color, the richer the source. Beta Carotene and Vitamin A. Beta carotene, found in plants, is a precursor of vitamin A. Our bodies convert beta carotene to vitamin A. Vitamin A is known to play a part in cell differentiation, a process by which cells mature. Differentiation helps prevent inappropriate growth, such as the uncontrolled cell growth seen in cancer. Again, supplements are not found to provide the same benefit and excess vitamin A can be toxic. Get vitamin A naturally by eating deep yellow, orange or dark green fruits and vegetables such as carrots, winter squash, yams, peaches, apricots, spinach, collard or mustard greens and broccoli. Vitamin C. Vitamin C-rich foods may have cancer-inhibiting benefits, particularly for cancers of the stomach and esophagus. Nitrites and nitrates occur naturally in foods. They are commonly added to foods as preservatives and to processed meats for color. These substances can combine with amino acids from proteins to form nitrosamines. Nitrosamines are known to cause cancer. This reaction definitely occurs in the test tube, but its occurance in the human digestive tract is not yet clear. Research demonstrates that vitamin C (ascorbic acid) can inhibit the reaction of nitrites with amines or amides. It competes with the amine for the nitrite, which inhibits carcinogenic compound formation. Vitamin C is necessary to good health, and functions as a scavenger of free radicals highly reactive compounds that can cause mutations in DNA. Vitamin E. Vitamin E, as an antioxidant, has been shown to protect against the damaging effects of free radicals, which may contribute to the developments of chronic diseases such as cancer. Vitamin E also may compete for available nitrite, which blocks the formation of nitrosamines. Cruciferous vegetables. Cruciferous vegetables are from the cabbage family and include: bok-choy, broccoli, brussels sprouts, cabbage, cauliflower, collards, kale, kohlrabi, mustard greens, and turnips. These vegetables are important to help reduce the risk of cancer, particularly cancer of the gastrointestinal and respiratory tracts. Scientists believe the anticancer compound in these foods is called sulforaphane. Sulforaphane is thought to activate an enzyme that removes carcinogens from cells. It is unclear what component of these vegetables is responsible for reducing the risk of cancer, but studies have demonstrated their protective effect.

Total Calories per day 1,600 2,000* 2,200 2,500*

Saturated fat in grams 18 or less 20 or less 24 or less 25 or less

Total fat in grams 53 65 73 80

Guideline #3
Limit intake of high-fat foods. Fat in the diet. Laboratory and population data suggest that too much fat in the diet leads to an increased risk of a variety of cancers including colon, rectum, prostate, and endometrium. The risk of cancer appears to increase as fat intake increases (especially over 30 percent of total calories). This, in part, is because foods high in fat often replace fruits, vegetables, and other foods that protect against cancer. Aim for a total fat intake of no more than 30 percent of your daily calories.

2,800 31 or less 93 *These amounts are rounded to the nearest 5 grams to be consistent with the Nutrition Facts Label.

Tips to reduce fat in your diet: Use lemon juice, dried herbs, reducedfat or non-fat salad dressings or use salsa as toppings for vegetables and salads. Use fat-free or low-fat milk, fat-free or low-fat yogurt, and low-fat cheese. Choose lean meats and trim visible fat from meat. Decrease the amount of fat you use in cooking and at the table. Replace fat-rich foods with fruits, vegetables, grains, and beans. Read food labels to determine the amount of fat and nutrients in a product.

Guideline #4
Be physically active. Achieve and maintain a healthy weight. Research shows a link between excess body weight and the risk for several cancers, including colon, endometrium, and kidney. Both physical activity and controlled caloric intake are necessary to achieve or maintain a healthy body weight and protect against some cancers. The Centers for Disease Control and Prevention and the U.S. Surgeon General recommend 30 minutes of moderate physical activity each day as a means to promote good health. Regular physical activity will not only lower cancer risk, it will help build and maintain healthy bones, lower the risk for heart disease, and make you feel better.

Guideline #5
Consume salt-cured, smoked and charcoal-broiled foods in moderation. Carcinogens in certain foods. Minimize consumption of salt-cured, salt-picked, and smoked foods. Evidence suggests that eating foods prepared this way increases cancer risk. In parts of the world where food is often prepared using these methods, stomach and esophageal cancer cases are higher. In the United States, stomach cancer is declining and esophageal cancer is rare. Nevertheless, as a nation, people consume more salt than is good for the overall health. Much of it comes from manufactured foods. Too much salt is also a concern for hypertension and stroke, so limit daily consumption to six grams (or 2,400 mg of sodium), which is equivalent to about a teaspoon of salt a day. Nitrates, often used in the curing process, cause cancer in laboratory animals and are suspected of causing cancer in people. When meats are charcoal- or gas-broiled, a substance (benzopyrene) is formed when fat from the meat drips onto the hot coals. The rising smoke then carries this carcinogenic substance back up and deposits it onto the meat. High temperature frying or broiling, for example frying bacon, may convert some of the meat proteins into products that damage the genetic material of the bodys cells. Much research is still needed to determine the links between these foods and cancer. In the meantime, consume these foods in moderation.

Tips to become physically active: The 30 minutes does not need to be continuous to be beneficial. This goal can be achieved by walking briskly (three to four miles per hour), gardening, swimming, yardwork, housework, and dancing.

Guideline #6
Limit consumption of alcoholic beverages, if you drink at all. Alcohol abuse, diet and cancer. Heavy drinking of alcoholic beverages, more than two drinks per day, increases the risk of mouth, pharynx, larynx, esophagus, liver, pancreas, and breast cancers. It is unclear whether it is alcohol or other ingredients in these beverages that are responsible for the association with cancer in people. The carcinogenic effect may be the direct contact of alcohol on the mouth, pharynx, larynx, and esophagus. Heavy drinking can result in liver cirrhosis, which may lead to liver cancer. Heavy drinkers and alcoholics commonly have nutritional deficiencies because alcohol contains only empty calories and food intake is often compromised. When little food is eaten, low nutrient intake often results. If heavy drinkers also smoke, cancer risk escalates. If adults do drink alcoholic beverages, they should consume them only in moderation and with meals to slow alcohol absorption. Moderation is defined as no more than one drink per day for women and no more than two drinks per day for men. This limit is based on differences between the sexes in both weight and metabolism. Drinking in moderation may lower risk for coronary heart disease, mainly among men over age 45 and women over age 55. Moderate consumption provides little, if any, health benefit for younger people. The link between cancer and alcohol is complex because frequent alcohol consumption may result in many health problems. The nutritional cancer

Tips to eat moderate amounts of charcoal-broiled foods: Cover the grill with foil and punch holes between the grids to let the fat drip out. The foil protects food from smoke and fire. Cook meat until done but dont char it. If food does get charred, remove the charred portions before eating it. Discourage flare ups by either dampening coals that become too hot with a squirt of water, or move food to another section of the grill. Reduce cooking time on the grill by partially precooking foods in a microwave and then grilling briefly to give it that grilled flavor.

Tips for moderate alcohol consumption: Instead of alcohol, try non-alcoholic wine, beer, mineral or tonic water, cider, grape juice, or fruit juice. Always provide nonalcoholic beverages and nutrient-dense foods at social gatherings. If you do drink, do so in moderation less than two drinks per day and dont drive.

risk factors are compounded for alcohol abusers. Alcohol is high in calories and low in nutrients. It is difficult for an alcohol abuser to obtain protective benefits from foods when so little nutrient-dense food is eaten.

Summary
Choosing plant sources of foods, eating at least five servings each day of fruits and vegetables, reducing dietary fat, being physically active while maintaining a healthy weight, limiting salt-cured and smoked foods, and consuming alcoholic beverages in moderation may reduce the risk of cancer, particularly in individuals at increased risk. Along with the outlined diet and nutrition recommendations, to further reduce cancer risk: prepare and store foods safely; do not smoke tobacco; and avoid work-related exposure to harmful chemicals and excessive exposure to the suns rays and x-rays. These are all important preventive actions that may safeguard your health. These dietary guidelines are intended for people who are healthy. If you have a condition that requires a special diet, consult a physician or registered dietitian before beginning any modified diet plan. If you have been diagnosed or are being treated for cancer, a more appropriate and highly recommended reference is Eating Hints: Recipes and Tips for Better Nutrition During Cancer Treatment, NIH Publication No. 84-2079, U.S. Department of Health and Human Services, 1984, 86p. For a free copy, write to the Office of Cancer Communications, National Cancer Institute, Building 31, Room 10A 18, Bethesda, Maryland 20205; or call 1-800-4-CANCER.

Counts as a drink: 12 oz of regular beer (150 calories) 5 oz of wine (100 calories) 1.5 oz of 80 proof distilled spirits (100 calories)

References
For further information contact: American Institute for Cancer Research (AICR), Washington, DC 20069; 1-800-843-8114, http://www.aicr.org, email:support@aicr.org; American Cancer Society, 777 Third Avenue, New York, NY 10017; 1-800-ACS-2345, http://www.cancer.org; National Cancer Institute, Cancer Information Service, Bethesda, MD 20205, (301) 435-3848 or call the Cancer Information Service at: 1-800-4-CANCER, http://www.nci.nih.gov. Other related fact sheets include: 9.312, Water-soluble vitamins; 9.315 Fat-soluble vitamins; 9.319, Cholesterol and fat; 9.332, Coping with cancers effect on the diet; 9.333, Dietary Fiber; 9.353, Dietary guidelines for americans; 9.354, Sodium in the diet; 9.363, Weight loss programs and products; 9.364, Weight loss diets and books; and 9.368, Weight management.

1 J. Anderson, Colorado State University Cooperative Extension food and nutrition specialist and professor, food science and human nutrition; D. Bae and E. Serrano, food and nutrition specialists.

Issued in furtherance of Cooperative Extension work, Acts of May 8 and June 30, 1914, in cooperation with the U.S. Department of Agriculture, Milan A. Rewerts, Director of Cooperative Extension, Colorado State University, Fort Collins, Colorado. Cooperative Extension programs are available to all without discrimination. No endorsement of products mentioned is intended nor is criticism implied of products not mentioned.