New diet and physical activity guideline to prevent cancer

The American Cancer Society has updated its guideline for diet and physical activity for cancer prevention, with adjustments to reflect the most current evidence.

The updated recommendations increase recommended levels of physical activity and have an increased emphasis on reducing the consumption of processed and red meat, sugar-sweetened beverages, processed foods, and alcohol.

They also include evidenced-based strategies to reduce barriers to healthy eating and active living and to reduce alcohol consumption. The guideline is published in CA: A Cancer Journal for Clinicians, the ACS's flagship medical journal.

ACS cancer prevention recommendations are revised regularly as evidence emerges. They are created by a volunteer committee comprising a diverse group of experts from multiple sectors.

The committee reviewed the evidence on diet and physical activity on cancer risk, and studied policy and systems changes that can reduce barriers to the public's ability to eat a healthy diet and a have physically active lifestyle.

The updated recommendations are based on systematic reviews conducted by the International Agency on Cancer Research (IARC); the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR); and the U.S. Departments of Agriculture and Health and Human Services (USDA/HHS).

The latest update is consistent with the recommendations from those groups as well as other major recommending bodies.

Based on the review of the evidence, the updated guideline reflects a few key differences from the previous ACS guideline:

Physical activity

Previous: Adults should engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity each week.

New: Adults should engage in 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity physical activity per week; achieving or exceeding the upper limit of 300 minutes is optimal.

Diet

Previous: Consume a healthy diet, with an emphasis on plant foods. Choose foods and beverages in amounts that help achieve and maintain a healthy weight. Limit consumption of processed meat and red meat. Eat at least 2.5 cups of vegetables and fruits each day. Choose whole grains instead of refined grain products.

New: Follow a healthy eating pattern at all ages. A healthy eating pattern includes:

• Foods that are high in nutrients in amounts that help achieve and maintain a healthy body weight;
• A variety of vegetables--dark green, red, and orange, fiber-rich legumes (beans and peas), and others;
• Fruits, especially whole fruits with a variety of colors; and
• Whole grains.

A healthy eating pattern limits or does not include:

• Red and processed meats;
• Sugar-sweetened beverages; or
• Highly processed foods and refined grain products.

Alcohol

Previous: If you drink alcoholic beverages, limit consumption. Drink no more than 1 drink per day for women or 2 per day for men.

New: It is best not to drink alcohol. People who do choose to drink alcohol should limit their consumption to no more than 1 drink per day for women and 2 drinks per day for men.

Recommendation for community action

Previous: Public, private, and community organizations should work collaboratively at national, state, and local levels to implement policy and environmental changes that:

• Increase access to affordable, healthy foods in communities, worksites, and schools, and decrease access to and marketing of foods and beverages of low nutritional value, particularly to youth.
• Provide safe, enjoyable, and accessible environments for physical activity in schools and worksites, and for transportation and recreation in communities.

New: Public, private, and community organizations should work collaboratively at national, state, and local levels to develop, advocate for, and implement policy and environmental changes that increase access to affordable, nutritious foods; provide safe, enjoyable, and accessible opportunities for physical activity; and limit alcohol for all individuals.

The guideline continues to reflect the current science that dietary patterns, not specific foods, are important to reduce the risk of cancer and improve overall health. There is no one food or even food group that is adequate to achieve a significant reduction in cancer risk.

Current and evolving scientific evidence supports a shift away from a nutrient-centric approach to a more holistic concept of dietary patterns. People eat whole foods -not nutrients--and evidence continues to suggest that it is healthy dietary patterns that are associated with reduced risk for cancer, especially colorectal and breast cancer."

Laura Makaroff, DO, American Cancer Society Senior Vice President, Prevention and Early Detection