Nutrition, Physical Activity and Cancer: What’s the Connection? Colleen Doyle, MS, RD Director,...

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 who have consumed fruits and vegetables five or more times per day.



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

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

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!

Nutrition, Physical Activity and Cancer: What’s the Connection? Colleen Doyle, MS, RD Director,...

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