How prevalent is a cancer-protective lifestyle? Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations in Switzerland

Compliance with the WCRF/AICR Recommendations in Qualitative Adaptation and the Occurrence of Breast Cancer: A Case-Control Study

PURPOSE

The aim of the study was twofold: (1) the qualitative adaptation of the 2018 WCRF/AICR (QAd-WCRF/AICR) score, and (2) the assessment of the association between the level of compliance with the WCRF/AICR recommendations and the occurrence of breast cancer in peri- and postmenopausal women.

METHODS

This case-control study involved 420 women, aged 40-79 years, from northeastern Poland, including 190 newly diagnosed breast cancer cases. Data related to the WCRF/AICR recommendations were collected in face-to-face interviews with 409 women, including 179 women with breast cancer. The frequency of food consumption data were collected using the FFQ-6® and KomPAN® questionnaires. Body weight, height, and waist circumference were measured. The QAd-WCRF/AICR score (range: 0-8 points) was calculated on the basis of eight components, including two components from to the WCRF/AICR recommendations: (1) body mass index (BMI), and (2) waist circumference, with six components expressed qualitatively: (3) overall physical activity, as well as the frequency of the consumption of (4) vegetables/fruits/whole grains/nuts/seeds/legumes, (5) highly processed foods, including fast foods/sweets/instant soups, (6) red/processed meat, (7) sweetened/energy drinks, and (8) alcohol. Logistic regression analysis was performed to assess the occurrence of breast cancer.

RESULTS

The moderate (4-5 points) and maximal (6-8 points) compliance with the qualitative adaptation of the WRCF/AICR recommendations reduced the odds of breast cancer by 54% and 72%, respectively, compared to the results noted for minimal compliance (≤3 points). Lower odds of breast cancer were associated with moderate or high physical activity, consumption of a minimum of four serving per day of vegetables/fruits/whole grains/nuts/seeds/legumes, and limiting the consumption of highly processed food/fast foods and red/processed meat to a maximum of 1-3 times/month. Higher odds of breast cancer were associated with a higher waist circumference and alcohol abstinence.

CONCLUSIONS

These findings may prove useful in establishing cancer prevention recommendations based on simple suggestions regarding the frequency of food consumption.

Determinants and changes in adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer-prevention recommendations over the past 25 years in Switzerland

OBJECTIVES

The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) established 10 lifestyle recommendations for cancer prevention. The current study examines the proportion and changes over 25 years of adherence to these recommendations and their determinants in Switzerland.

METHODS

On the basis of six Swiss Health Surveys (1992-2017, N = 110 478), an index reflecting adherence to the 2018 WCRF/AICR cancer-prevention recommendations was created. Multinomial logistic regression models were fitted to investigate changes over time and determinants of a cancer-protective lifestyle.

RESULTS

Adherence to cancer-prevention recommendations was moderate and higher in the years 1997-2017 compared to 1992. Higher adherence was observed among women (odds ratio [OR]high vs. low adherence ranging from 3.31 to 3.74) and participants with a tertiary education level (ORhigh vs. low adherence ranging from 1.71 to 2.18), and lower adherence among participants of the oldest age group (ORhigh vs. low adherence ranging from 0.28 to 0.44) and participants of the Switzerland (lat.: Confoederatio helvetica)-French language regions (ORhigh vs. low adherence ranging from 0.53 to 0.73).

CONCLUSION

Our results showed that cancer-prevention recommendations are not well followed by the general Swiss population, as the adherence to a cancer-protective lifestyle was generally moderate; however, adherence to cancer-prevention recommendations improved over the past 25 years. Sex, age group, education level, and language regions were significant determinants of adherence to a cancer-protective lifestyle. Further actions at the governmental and individual levels promoting the adoption of a cancer-protective lifestyle are needed.