Post on 25-Dec-2015
Nutrition, Physical Activityand Cancer:
What’s the Connection?
Colleen Doyle, MS, RDDirector, Nutrition and Physical ActivityAmerican Cancer Society
758,757
CDC, US Census
453,146
CDC, US Census
674,450
CDC, US Census
Causes of CancerEstimate percentage of total cancer deaths attributable to established causes of cancer
Tobacco
Adult diet/obesitySedentary lifestyle
Occupational factorsFamily history of cancerViruses/other biologic agents
Perinatal factors/growthReproductive factors
AlcoholSocioeconomic status
Environmental pollutionIonizing/ultra-violet radiation
Prescription drugsMedical 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
2012 Recommendations forIndividuals: 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.Communities:Work together to make it easier for
people to eat better and be more active.
Society Recommendations for Individual Choices
Maintain a healthy weight throughout life.Be as lean as possible throughout life without being underweight.Avoid excess weight gain at all ages. If currently overweight or obese, losing even a small amount of weight has health benefits and is a good place to start.Engage in regular physical activity and limit high calorie foods and beverages as key strategies for maintaining a healthy weight.
BMI and Specific Cancers
Established
Men Women
Colon/rectum Breast (postmenopausal)Kidney Colon/rectumEsophagus EndometriumPancreas Kidney
EsophagusPancreas
Kushi, et al. CA Cancer J Clin. 2012
BMI and Specific Cancers
Probable
Men Women
Gall bladder Gall bladderLiver LiverMultiple myeloma Multiple myelomaNon-Hodgkin Lymphoma Non-Hodgkin LymphomaProstate Cervix
Ovary
Kushi, et al. CA Cancer J Clin. 2012
Why the obesity connection is so important
In the United States, overweight and obesity accounts for about 14% to 20% of all cancer deaths.
About 2 out of 3 Americans are overweight or obese.
Calle, et al. NEJM. 2003; CDC
Obesity Among U.S. Adults, 2011
15%–<20% 20%–<25% 25%–<30% 30%–<35% ≥35%
Source: Behavioral Risk Factor Surveillance System, CDC. Prevalence reflects BRFSS methodological changes in 2011, and these estimates should not be compared to previous years.
Childhood Obesity
Childhood obesity has more than doubled in children and tripled in adolescents in the past 30 years. The percentage of children aged 6–11 years in the United States
who were obese increased from 7% in 1980 to nearly 18% in 2010.
The percentage of adolescents aged 12–19 years who were obese increased from 5% to 18% over the same period.
In 2010, more than one third of children and adolescents were overweight or obese.
CDC
What About Weight Loss?
Adopt a Physically Active Lifestyle Adults: Engage in at least 150 minutes of moderate intensity
activity or 75 minutes of vigorous intensity activity each week, preferably spread throughout the week.
Children and adolescents: Engage in at least 1 hour of moderate- or vigorous- intensity activity each day, with vigorous-intensity activity at least three days each week.
Limit sedentary behaviors such as sitting, laying down, and watching television and other forms of screen-based entertainment.
Consume a Healthy Diet, With an Emphasis on Plant Sources
Choose foods and beverages in amounts that help 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 in preference to refined grain
products
If You Drink Alcoholic Beverages, Limit Consumption.
Drink no more than one drink per day for women or two per day for men. One drink of alcohol =
12 oz. beer 5 oz. wine 1.5 oz. of 80-proof liquor
Alcohol and Cancer Risk Heavy drinking – esp combined with tobacco
use - increases risk of cancers of: Mouth & pharynx Larynx Esophagus Liver
Even moderate drinking increases risk of breast cancer in women
“I thought a glass of wine was good for me!”
Moderate intake of alcohol appears to decrease risk of heart disease Other approaches to reduce heart disease
risk Not recommended that non-drinkers begin
drinking Consider risk of both heart disease and
cancer to make an informed decision
Conclusion: 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.
How Are Things In Maine?
Maine Overweight and Obesity (BMI)
(Adults 18 and older, 2012)
Source:Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention,, 2011.
Participated in 150 minutes or more of Aerobic Physical Activity per week.
(Adults 18 and older, 2011)
Source:Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention,, 2011.
Adults who have consumed fruits and vegetables five or more times per day.
(Adults 18 and older, 2009)
Source:Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention,, 2009.
Maine High School Students, 2011
16% overweight 13% obese
Only 38% report attending PE one or more times per week (down from 47% in 1997)
24% report watching at least 3 hrs tv/day 31% report playing video games or using a computer for
something other than school work for 3 hours or more per day.
2011 ME Integrated Youth Health Survey
Why?
Available Calories Have Increased
2900
3000
3100
3200
3300
3400
3500
3600
3700
3800
3900
1970 1975 1980 1985 1990
Cal
orie
s pe
r pe
rson
per
day
9.0
8.5
5.9
4.5
3.9
3.33.12.62.3
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
50.0
NHANES
Perc
en
t o
f T
ota
l A
vg
. D
ail
y F
oo
dFrench fries
Potato chips, cornchips, popcorn
Hamburgers
Pizza
Cake, sweet rolls,donuts, pastry
Alcoholic beverages
White bread, rolls,bagels, etc.
Misc desserts andsweets
Soft drinks, fruit-flavored drinks
Where Our Calories Come From
Evidence of life on Mars….
Double Cheese Burger = 690Super Size Coke = 280Biggie Fries = 570 TOTAL = 1,540
CALORIES
High Calorie Foods Available at Low Cost….Whenever You Want Them!
Ad in Sports Illustrated 6/15/02
Marketing and Advertising to Kids
Food and Drink Packages
Computers and TV
Mobile Devices
Games and Toys
Schools
Physical (In)Activity
©2010 American Cancer Society, Inc. No.0052.19
©2010 American Cancer Society, Inc. No.0052.19
From: Healthy People 2010, Understanding and Improving Health, Volume 1
ACS Recommendation for Community Action
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.
Multi-strategy, coordinated and comprehensive approach at national, state and local levelsPolicies 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?
Messaging that increases awareness of key issues that influence eating and exercise habits
From “Eat More Fruits and Vegetables” to:What’s being served at your child’s school?Got a salad bar at work?We need better quality produce at this store.
From “Be More Active” to:No sidewalks? Speak up.What’s the school policy on PE?Hey – can we get some bike racks at the office?
A New Shift In Communications
TraditionalHealth OrganizationsGovernmentMedia
Industry
Non-TraditionalCity Planning and ArchitectureTransportation PlannersParks and RecreationLegal and Policy Experts
Strategic, Sustainable and Effective Collaborations
Calls to Action Recommended Community Strategies and Measurements to Prevent Obesity in the United States (2009)
IOM Reports• Cancer Prevention and Control (2003)• Childhood Obesity (2004)• Food Marketing and Advertising (2005)• Local Government Actions to Prevent Childhood Obesity (2009)
Policy and Action for Cancer Prevention: Food, Nutrition and Physical Activity, World Cancer Research Fund (2008)
Guide to Community Preventive Services (2001/2010)
General Population Smoking In The USAnnual Adult Per Capita Cigarette Consumption and Major Smoking and Health Events – United States 1900 – 1998.
Thank you!