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FOOD, NUTRITION AND HEALTH RECOMMENDATION FOR THE PREVENTION OF CANCER (WCRF)

Introduction

Food, nutrition and exercise are crucial to our general health and well-being. It has been known for many years that the right choices of foods and drinks and taking regular exercise can protect against coronary heart disease. Now there is more good news: healthy diets and associated lifestyles can protect us against many common cancers.

The World Cancer Research Fund is dedicated to providing cancer research and education programmes that expand our understanding of the importance of our food and lifestyle choices in the cancer process. By spreading the message about cancer prevention. WCRF hopes that countless lives will be saved.

This articles brings you information on WCRF's fourteen Diet and Health Recommendations for the Prevention of Cancer. The recommendations are based on the findings of WCRF's 670-page report: 'Food, Nutrition and the Prevention of Cancer: a global perspective', published in 1997. The Report reviewed over 4,500 leading research studies from around the world, in the field of diet. nutrition and cancer, and was written to provide up-to-date and reliable advice for individuals on how to make changes that can protect against cancer.

The fourteen recommendations develop WCRF's previous dietary guidelines which were based on the recommendations of a report published by the US National Academy of Science in 1982 - work supported by later reports from the European Community's Europe Against Cancer Programme and the World Health Organisation.

WCRF's new recommendations provide practical advice for the individual focusing on whole foods rather acquired dietary constituents and extend to other factors related to diet including weight control and physical activity.

Cancer - the process

The sequence of events that leads to cancer is complex and varied. A combination of genetic, environmental and lifestyle factors are involved in turning a normal cell into an abnormal cell and an abnormal cell into cancer.

In most cases, the cancer process starts when the genetic material responsible for cell division inside a cell becomes faulty. This may occur by chance or because a cancer-causing substance - a carcinogen - has been introduced into, or produced by, the body.

We are exposed to potential carcinogens all the time - many of them occur naturally in the air we breathe, the food we eat and the water we drink. Others are found in tobacco in industrial compounds and in the form of viruses. Our bodies are designed to deal with them either by eliminating them before they do any harm or repairing any damage done by them Sometimes, however, the body's defences fail: a car-cinogen becomes activated inside a body cell and permanent-ly damages its genetic material. Once damaged in this way, the cell can no longer function properly. It may grow and multiply abnormally and as it divides, the flawed genetic material it contains may be passed on.

At this stage a damaged cell is not fully fledged cancer - in fact cancer may never develop at all. To become cancer the abnormal cells must reproduce to such an extent that they start to occupy the space of normal cells or threaten the function of healthy cells or organs. For some cancers this may take many years - up to 10 or 20 years or more. During this time. other factors affect how rapidly the damaged cells divide. This process may speed up, slow down or even be stopped altogether before cancer develops.

Some factors - called inhibitors - help to slow the process down while other factors - called promotors - may speed up the rate at which the damaged cells multiply and so encourage the development of cancer.

A large amount of research shows that many foods and drinks contain nutrients and compounds which seem to help the body's natural defences to destroy carcinogens before they damage cells and so reduce cancer risk. They may also halt or reverse steps later in the cancer development. These nutrients and compounds are found abundantly in vegetables and fruits and also in other foods of plant origin.

On the other hand, scientific evidence has shown that other foods and drinks, if consumed regularly, can increase cancer risk. The clearest evidence here is that alcohol increases the risk of various cancers; diets high in salt increase the risk of stomach cancer; diets high in red meat increase the risk of several cancers, as do diets high in fat if only because they increase the risk of obesity - particularly in people who are not physically active.

Cancer: a preventable disease

Cancer is a subject that is difficult for most people to talk about and is not well understood. Many people think that avoiding cancer is simply a matter of luck while others fear that they are bound to develop the disease, yet the truth is far more optimistic: cancer is largely a preventable disease.

Although in recent years there have been great advances in the early detection, diagnosis and treatment of cancer, perhaps the greatest hope in the fight against cancer lies in prevention.

The promise of prevention

Cancer is such a complex disease that no one can be offered guarantees against it but, because cancer is so strongly linked to diet and lifestyles, there are plenty of positive steps you can take to safeguard yourself against the disease. The following recommendations will help you to balance the foods and drinks you consume each day and make simple lifestyle changes which will help prevent cancer. The more of the recommendations you follow the lower your overall cancer risk is likely to be. What's more, you'll also be lowering your risk of heart disease and other serious illnesses and promoting good health in general.

WCRF's Diet and Health Recommendations for the Prevention of Cancer

A few points to consider...

WCRF's diet and health recommendations, taken as a whole, give positive advice that will help protect you against cancer.

The recommendations may seem rather overwhelming at first, but no-one expects you to make these changes overnight. Instead, make gradual but permanent changes over time.

Do bear in mind that the recommendations are based on an 'average' person consuming 2.000 calories a day. If, for example, you are a woman consuming only 1,600 calories a day you can scale the recommendations down accordingly - by around one fifth or 20%.

Remember that cancer prevention is about getting the balance right in terms of diet and lifestyle. So, the occasional deviation from the recommendations will not matter if you eat sensibly most of the time.

RESHAPE YOUR DIET

Recommendation 1. Choose predominantly plant-based diets rich in a variety of vegetables and fruits, pulses and minimally processed, starchy staple foods.

What this means...

Increasing the amount of plant-based foods you eat each day. Foods of plant (rather than animal) origin include: vegetables, fruits, cereals, pulses (such as lentils, beans and peas) and starchy foods (such as pasta, rice and bread). These foods can help protect you against cancer because they:

- Contain essential nutrients and other important substances that help your body to destroy carcinogens before they cause cancer.

- Are naturally low in fat and calories (energy) and can therefore help you to control your weight.

- Are naturally filling and can therefore help to reduce the amount of the less healthy food you might otherwise eat (such as high-tat dairy products and red meat).

Taking action...

We're a 'meat and potatoes' family, it will be difficult to move towards a plant-based diet."

It really isn't that difficult to increase the amount of plant-based foods you eat and you may well be eating more than you think. Remember that breads, cereals, potatoes, pasta, rice and beans are all plant-based foods, as well as vegetables and fruits.

- At mealtimes, take a look at your plate and start to think about the balance of the different types of food you are eating. You should be aiming for plant-based foods to take up at least two thirds of the room on your plate.

- Take advantage of the increased range of fresh vegetables and fruits, cereals, pulses and starchy foods available at the supermarket and expand your repertoire of recipes to include them. Remember that frozen and tinned produce can be just as nutritious. Opt for rice and pasta rather than roast, sauteed or chipped potatoes.

- Add a tin of beans (broad, haricot or red kidney) to soups, casseroles and stews and reduce the meat, meat-products or poultry content.

- Eat fresh fruit as an appetiser or light dessert and resist the temptation for creamy, sugary puddings.

- Munch on vegetable sticks (celery, pepper, carrot) or a handful of raisins or other dried fruit for a nutritious and satisfying snack, instead of crisps or biscuits that are high in fat as well as salt or sugar.

Keep your weight in check

Recommendation 2 Avoid being underweight or overweight and limit weight gain during adulthood to less than 5 kg (11 pounds),

What this means...

Maintaining a healthy weight is a matter of balancing your calorie intake with your level of physical activity. If you keep your weight gain in adulthood to less than 5 kg, (11 pounds) you will reduce your cancer risk as well as avoid a variety of general health problems associated with being overweight.

Women who are overweight or obese have a greater risk of developing cancer of the endometrium (lining of the womb) and overweight. post-menopausal women probably have a higher risk of breast cancer. There is also a higher risk of cancer of the kidney and possibly of colon cancer if you are overweight and this also increases your risk of cancer in general.

Scientists now use the body mass index (BMI) to determine healthy weights for individuals.

Yon can calculate your BMI as follows:

weight (kg)

BMI = _______________________

height (m) x height (in)

interpreting your index score

BMI RANGE DESCRIPTION

Taking action...

"What can I do? My Job is largely sedentary and I'm always having to attend business functions."

There's no escaping the fact that: a high-calorie diet causes us to be overweight or even obese - especially if we don't get much exercise.

If you are overweight or obese...

- Eat more low-calorie, nutrient-rich foods such as vegetables and fruits.

- Use lower fat alternative ingredients and cooking techniques.

- When hungry, opt for wholesome foods such as wholegrain bread, cereals and pulses - these fill you up but are not high in calories.

- Take up some form of regular physical activity - why not join a sports team at work or pay a visit to your local leisure centre? Who knows, yon might even broaden your social circle while narrowing your waistline!

It is important to realise that being significantly underweight can present many health problems too. It is best to follow WCRF's recommendations and aim for a BMI of between 20-25.

Stay active

Recommendation 3: If occupational activity is low or moderate, take an hour's brisk walk or similar exercise daily, and also exercise vigorously for a total of at least one hour in a week.

What this means...

Physical activity is important throughout your life to stop you from becoming overweight or obese and, in turn, protects against the cancers that obesity and being overweight can cause. Regular physical activity helps prevent colon cancer and may lower your risk of developing cancer of the breast.

The goal is co maintain a level of physical activity throughout your life similar to that of people with active occupations such as farmers or postmen.

If you nave a sedentary job, you can reach the recommended level by taking an hour's brisk walk each day plus another hour's vigorous activity once a week. If you find it difficult to fit in a daily walk or just do not like walking, there is no need to worry since there are many other activities that you can choose to meet your own individual needs and to suit your particular lifestyle. There's swimming, rowing, gardening, or playing badminton or tennis - to name only a few. It is also important to realise that you do not have to do one complete hour of exercise each day if exercising; in shorter bursts is better suited to your stamina or daily routine: it's your daily total that counts.

Taking action...

"I don't seem to have time to exercise and I'm certainly too old for all that running around on a football field."

To reap the full benefits of physical activity you need to achieve the recommended level but, any and all physical activity is beneficial. The secret is to start at a level with which you feel comfortable and which is maintainable and then to gradually build up to the ideal.

It is also Important to do something, you enjoy. If you've never enjoyed running around a sports field or going to the gym, you're unlikely to keep it up so why not do a variety of activities throughout the week for different periods of time - such as walking (a couple of hours), gardening (an hour and a half), cycling, (a couple of hours), swimming (one hour) and cleaning (one hour)? Doing some form of physical activity every day - for at least an hour - will put you well on your way to reaching the recommended level.

- Incorporate physical activity into your everyday life wherever possible. Try walking or cycling to work or to the shops rather than taking the bus or the car or simply climb the stairs, when out and about, instead of using the lift.

- Remember that household chores such as making the bed, cleaning and washing can all help towards your daily physical activity goal.

Focus on vegetables and fruits

Recommendation 4: Eat 400-800 grams (15-30 ounces) or five or more portions a day of a variety vegetables and fruits, all year round.

What this means..

Eating 400-800 grams (15-30 ounces), or five or more portions of vegetables and fruits each day, could by itself decrease your cancer risk by as much as 20%. Eating plenty of vegetables and fruits protects against many cancers, particularly those of the mouth, pharynx, oesophagus, lunq, stomach, colon and rectum, but also those affecting the larynx, pancreas, breast and bladder and possibly those of the liver, ovary, endometrium, cervix, prostate, thyroid, and kidney too.

As scientists have started to examine more closely the many components of vegetables and fruits for their ability to influence cancer development, it has become clear that their protective effects arise as a result of complex interactions between vitamins, minerals, fibre and plant chemicals. Leafy green vegetables, carrots, tomatoes and citrus fruits are thought to be particularly protective. But, variety is the key and it's important to get your five plus a day all year round to maintain your on-going defense against cancer.

Taking action...

"That's all very well, but I can't always find fresh produce at prices I can afford."

When buying fresh produce you'll get the best value by opting for vegetables and fruits that are in season. Remember that it fresh produce is not available, you can always substitute them with the frozen varieties - they can be just as nutritious and are often kinder on the pocket. Tinned varieties can be a good substitute for fresh as long as you remember to avoid those products with added sugar (usually described as syrup) or salt.

- Count your daily portions of vegetables and fruits - and always aim for more than five portions a day.

- To reach your five plus a day total, why not start your day with a glass of fresh fruit juice, have a piece of fruit as a mid-morning, and afternoon snack, and include at least two portions of vegetables in your main meal.

Simply starch

Recommendation 5: Eat 600-800 grams (20-30 ounces) or seven or more portions a day of a variety of cereals, pulses, roots, tubers and plantains. Prefer minimally processed foods. Limit consumption of refined sugar.

What this means...

Carbohydrates provide about half the calories in our diets. The three types of carbohydrate in food are:

- starches;

- non-starch polysaccharides - the major component of fibre;

- sugars.

In nature, foods rich in starches and non-starch polysaccharides such as wholegrain bread and cereals, pulses, and tubers (potatoes), contain valuable amounts of vitamins, minerals and dietary fibre - all of which are important for good health and for preventing cancer. Foods rich in refined sugars, such as sweets and sugary drinks, usually contain much smaller amounts of essential nutrients.

The starch in foods is thought to protect against cancers of the colon and rectum whilst diets high in fibre possibly protect against cancers of the colon, rectum, breast and pancreas.

It is important to choose foods that are not heavily processed, in general the less processed starchy foods are, the better they are for you. Processing can destroy nutrients and other food components that are important in fighting cancer, and the fortification of processed foods (where vitamins and minerals are added during manufacture) does not always restore them to their natural, full nutritional value. That is why wholegrain bread and brown rice are generally better for you than their white counterparts. Sugars in foods are of two types: those which occur naturally within the cell walls of plant-based foods or those which are refined from cane or beet - such as glucose or sucrose. A diet containing a large amount of refined sugar may increase your risk of cancers of the colon and rectum and also contributes significantly to weight and dental problems, so it is important to control your 'sweet tooth' if you have one.

"Seven portions sounds like a lot of food to me. How can I make sure that the food I eat contains starch and fibre but not refined sugar?"

Do bear in mind that the weight given in these recommenda-tions refers to the foods as eaten, that is the cooked weight of foods like rice and pasta. For example, 50 grams of uncooked rice weighs approximately 150 grams once cooked because of the water it has absorbed.

- Spread the required seven portions throughout the day. Try cereal and wholegrain toast for breakfast, a baked potato for lunch and a pasta dish for supper.

- Check the nutrition labels on foods so that you can select foods containing more starch and fibre and less refined sugar.

- There's no evidence that the naturally occurring sugars found in whole fruits affect cancer risk so, opt for grapes, bananas, peaches and strawberries instead of foods made with refined sugar - such as cakes, pastries, biscuits and chocolate,

Alcohol... is it really worth the risk?

Recommendation 6: Alcohol consumption is not recommended. If consumed at all, limit alcoholic drinks to less than two drinks a day for men and one for women

What this means...

Drinking alcohol regularly increases your risk of cancers of the mouth, pharynx, larynx, oesophagus and primary cancer of the liver. Furthermore, the risk is even greater for people who drink and smoke. Drinking alcohol probably also increases your risk of developing cancers of the colon, rectum and breast.

Taking action...

"I would gladly cut out alcohol to protect myself against cancer, but I'm sure that I read somewhere that alcohol was good for me because it protects against heart disease."

Although there is some evidence that a small amount of alcohol may protect men, and probably women, from coronary heart disease, this is definitely not the case for cancer. The advice for all drinkers is therefore to cut down.

Remember too that, when weighing up the risks and benefits of drinking alcohol, the risk of cancer is only one of the factors to bear in mind: consider alcohol-related accidents - at home and in the car -as well as social problems.

Give meat a lower priority

Recommendation 7: If eaten at all, limit intake of red meat to less than 80 grams (3 ounces) daily. It is preferable to choose fish, poultry or meat from non-domesticated animals* in place of red meat.

What this means...

Eating more than 80 grams (3 ounces) of red meat, that is beef, lamb, pork or the products made from these meats, probably increases your risk of cancers of the colon and rectum and may also increase your risk of developing cancers of the pancreas and kidney, as well as - for men - the prostate and - for women - breast cancer. Red and processed meat is a major source of animal fat (which is usually saturated) which itself possibly increases your risk of cancers of the lung, colon and rectum, breast, endometrium and prostate.

Red meat should contribute less than one tenth or 10% of your total calorie intake. Follow the 'three ounces or less' recommendation which is roughly equivalent to two medium slices of pork, three slices of lamb or a 5 ounce (raw weight) grilled steak.

There is, as yet, only limited evidence of any relationship between fish and cancer risk none of which suggests an increased risk. Fish therefore makes a healthy alternative to red meat - try to eat it at least two or three times a week. In addition, fatty fish such as mackerel and herring is also thought to help protect against heart disease.

The term 'non-domesticated animals' includes any wild animals which are hunted for food - such as game (pheasant, grouse, partridge) and deer.

Limited research, so far, on poultry and game (wild birds) does not suggest an increase in cancer risk either. This is thought to be because the fat content, both the amount and type, of poultry and game is different to that of red meat.

Taking action...

"Isn't it good for me to eat lots of red meat because of all that iron?"

Red meat is a good source of iron, and iron from animal sources is more readily absorbed by the body than that from vegetable sources, but a diet rich in pulses, vegetables and wholegrains, as suggested in WCRF's recommendations, should provide more than adequate amounts of iron.

- Include plenty of vitamin C in your diet as this helps the body to absorb iron from vegetable sources more readily.

- Aim for some meat-free meals and snacks, rather than always eating meat.

- By following the first of WCRF's recommendations, to shift the balance of your diet towards more vegetables, fruits, cereals and other plant-based foods, you'll find that you have less room on your plate, and in your stomach, for meat.

- Choose fish or poultry as an alternative to red meat or meat-products and substitute meat-based meals with bean, pasta or rice dishes.

The fat factor

Recommendation 8: Limit consumption of fatty foods, particularly those of animal origin. Choose modest amounts of appropriate vegetable oils.

What this means...

Lowering: the total amount of fat you eat is important for reducing cancer risk in general, but it also makes a difference what kinds of fat yon include in your meals.

Fats are classified according to their chemical make-up as saturated, unsaturated or polyunsaturated. Saturated tats are mostly of animal origin, are solid at room temperature and are found in abundance in meat and dairy products. Unsaturated fats tend to be liquid at room temperature and are found mainly in vegetable or plant oils.

Diets high in fat overall and especially saturated fat possibly increase your risk of developing cancers of the lung, colon, rectum, breast and prostate. Diet high in saturated fat also increase your risk of cancer of the endometrium. Eating too much fatty food can also lead to obesity and the cancers associated with it.

Taking action...

"Is all fat bad for you? I thought some fat was actually good for you?"

Diets high in saturated fats possibly increase the risk of some cancers and they are certainly a cause of coronary heart disease, so by eating less fat you reduce your risk of both these diseases. A small amount of fat is essential for good health, but healthy eating involves reducing all fat. consumption to less than a third or 30% of your total calorie intake.

The major exceptions to this are the 'tropical' fats - coconut and palm oils - which although vegetable in origin, are unusually high in saturated fats. So it is best to avoid products which list these as major ingredients, and also those vegetable oils which have been artificially 'saturated' with hydrogen -called 'hydrogenated' oils or fats.

- Use less cooking oil and fat than suggested in recipes, and bake, grill or boil food rather than frying it in fat.

- Opt for lower fat dairy products and eat smaller portions of these foods.

- Always remove the skin from poultry and trim all visible fat from meat.

- Eat Iots of foods that are naturally low in fat such as vegetables and fruits, wholegrain bread and cereals and pulses - the more you eat of these foods the less room you will have for fatty food!

Taken without a pinch of salt

Recommendation 9: Limit consumption of salted foods and use of cooking and table salt. Use herbs and spices to season foods.

What this means...

Diets high in salt increase your risk of stomach cancer. Here in the UK, we currently consume more salt than is good for our overall health. So it is important to cut down.

Preserving food by curing it has been practised for thousands of years. Today, curing is generally used to give food a distinctive flavour because refrigeration, canning and freezing techniques are now used to prevent food from 'going off' . Cured foods such as bacon and ham should only be eaten in moderation as should salty snacks: salted peanuts, salted potato crisps and savoury biscuits. It is interesting to note that only one fifth or 20% of the salt in the average UK diet is added during cooking or at the table - the rest is found in the processed foods we buy. Daily consumption of salt should be limited to less than 6 grams (or 0.2 grams of sodium) - that's roughly equivalent to only a teaspoon of salt a day from all sources!

Taking action...

"I know that a high salt intake is linked to high blood pressure, but I love the flavour of salted crisps and nuts, soy sauce and salted vegetables."

Look out for low-salt versions of normally high-salt products such as savoury snacks, stock-cubes, butter and soy sauce. In addition. remember to check the sodium content of processed or manufactured foods and avoid tinned produce with added salt.

- Stop habitually adding salt to cooking - you'll be surprised how quickly you get used to the taste of food without it.

- Serve freshly ground black pepper instead of salt with prepared food at the table.

- Season and enhance the flavour of home cooking with herbs and spices rather than salt.

Safe storage

Recommendation 10: Do not eat food which, as a result of prolonged storage at ambient temperatures, is liable to contamination with mycotoxins.

What this means...

Mycotoxins are substances which are produced by a fungus or mould in food. One particular mycotoxin, called aflatoxin, is thought to be responsible for promoting primary cancer of the liver.

Moulds thrive ill warm moist environments, and tend to pose a much more serious problem in parts of Africa and Asia than in the UK. although they can occur in local crops or in those imported from these tropical climes.

Taking action...

- If you buy imported food in local markets, it is wise to buy your produce from marked stalls you know and can therefore trust.

- Always avoid buying nuts, grains and beans with any signs of mould.

- Remember that there are a few types of mould which are perfectly safe to eat - for example, the cultured moulds found in blue cheese.

Preserve your perishables

Recommendation 11: Use refrigeration and other appropriate methods to preserve perishable food as purchased and at home.

What this means...

Refrigeration reduces the risk of stomach cancer by reducing the need for salt as a preservative, and the risk of all cancers indirectly by allowing a variety of vegetables and fruits, and other perishable foods, to be available all year round. In developing countries, however refrigeration is not always available for the storage and transportation of food.

Taking action...

"How long should foods be kept refrigerated?"

All foods have different shelf lives so it is important to check the storage advice on the packaging of all the perishable foods you buy and ensure you follow the instructions carefully. Storing foods safely will not only help to maintain their nutritional content but will also help to prevent contamination, which may cause illness, and to avoid unnecessary waste as a result of spoiled food.

Additives, contaminants and residues in perspective

Recommendation 12: When levels of additives, contaminants and other residues are properly regulated, their presence in food and drink is not known to be harmful. However, unregulated or improper use can be a health hazard, and this applies particularly in economically developing countries,

What this means...

Little epidemiological work has been done to investigate the association between cancer risk and agricultural and other chemical residues in foods. Although toxicological studies have suggested that some of them are carcinogenic, the levels round are very low.

Taking action...

"I am worried about the harmful effects of chemicals used to cultivate, preserve and process foods. What can I do about it?"

There is no need to worry unduly, since the safety limits for food additives, residues of agricultural chemicals and other chemical contaminants in the food supply are carefully regulated in this country and do not appear to pose a problem in relation to cancer risk.

- Notwithstanding the small traces of agricultural and chemical residues that may be found on vegetables and fruits, it is always advisable to wash fresh produce to remove any germs before eating.

Take care with food preparation

Recommendation 13. Do not eat charred food. For meat and fish eaters, avoid burning of meat juices. Consume the following only occasionally: meat and fish grilled in direct flame; cured and smoked meats.

What this means...

Do not overcook meat and fish so that it's burnt at the edges. This can happen when you barbecue but also it you are grilling or frying. Eating large quantities of grilled meat and fish may increase your risk of cancer of the stomach. This is because cooking in direct flame produces cancer-causing (carcinogenic) compounds on the surface of foods. Furthermore, any diet high in grilled, barbecued or fried meat may increase risk of cancers of the colon and rectum. Burnt meat juices produced by cooking at high temperatures have been shown to contain carcinogens. Smoked and other foods present a similar problem since burning the wood in the smoking process produces substances called nitrites within the food and these can be transformed into carcinogens in the stomach. Nitrous compounds added to food or formed during the curing process can also be transformed into carcinogens and so cured foods should be eaten only occasionally.

Taking action ...

"I often grill foods because it's easy and I really enjoy the occasional barbecue: Are there any ways in which I can make these methods of cooking safer?"

There are many ways to cook food while minimising the factors linked to cancer:

- Reduce, in particular, the amount of meat you cook by grilling, frying or barbecuing.

- Avoid charring as you cook. If you do overcook food remove the charred bits before serving.

- Remember that many foods, including poultry, fish and vegetables, can be boiled, steamed or partially pre-cooked in a microwave first and then grilled or barbecued briefly to add that subtle 'char-grill' flavour.

- Fresh vegetables or vegetable and meat combinations, seasoned with your favourite spices, are just as delicious cooked on the barbecue grill but enveloped in foil packets. This means that you can enjoy cooking outdoors with less risk to your health.

No need for dietary supplements

Recommendation 14: For those who follow the recommendations presented here, dietary supple-ments are probably unnecessary, and possibly unhelpful, for reducing cancer risk,

What this means...

The combinations of nutrients and other elements in whole foods work together to fight cancer. Ideally, most people should be able to obtain all the nutrients they need for good health from the food they eat. Although science may show that diets high in vitamin C, for example, protect against cancer, it doesn't always follow that supplements containing these nutrients will have the same effect. If you think that you need to take supplements it is important to visit your GP who will prescribe any appropriate ones.

Taking action...

"You can't be too careful about your health, so I buy a variety of vitamin, mineral and other dietary supplements to make sure that I have adequate nutrients in my diet."

- If you find yourself relying on an array of supplements to feel healthy, it is best to check with your GP to make sure that you are in general good health.

- If you are deficient in one or other vitamin or mineral, find out which foods contain the nutrient(s) you need and try to get adequate amounts by including more of these foods in your diet.

No place for tobacco in a healthy lifestyle

Do not smoke or chew tobacco.

What this means...

The panel of cancer and nutrition experts who produced the WCRF report believe that no set of recommendations designed to prevent cancer would be complete unless they discouraged the use of tobacco in any form. Tobacco can cause cancer whether it is smoked, chewed or consumed in other ways, to say nothing of its effects when combined with alcohol or the impact of passive smoking. Tobacco causes 80% of lung cancer as well as being implicated in cancers of the mouth, pharynx, larynx, oesophagus, pancreas, cervix and bladder. It also reduces the circulating levels of protective vitamins in the body.

Taking action...

'I started smoking when I was 16 and though I've tried many times to give it up, I just don't seem to be able to."

Tobacco is a major risk factor for cancer, as well as heart disease, and is increasingly implicated in other chronic diseases so it is extremely important for your long-term health to persevere in your attempts to give up.

- If you do smoke, there arc several methods available designed to help you give up, including nicotine patches or gum, hypnotherapy and acupuncture - why not ask your GP to advise you?

- Even if you have been a heavy smoker for many years - it's never too late to give up, your health can only benefit.

An ounce of prevention

The old saying: "An ounce of prevention is worth a pound of cure." perfectly describes the benefits of cancer prevention through diet and lifestyle.

What this booklet tells you

Enjoying a healthier diet, taking up some form of regular physical activity, maintaining a healthy weight, cutting down on alcohol, red meat, hit and refined sugar and stopping smoking will help you and your family prevent cancer.

Make cancer prevention your goal and WCRFs recommendation your strategy for a longer and healthier life.

The potential of prevention

- Eating healthily, pins staving physically active and maintaining a healthy weight, can cut cancer risk by 30-40%.

- Recommended diet and lifestyle choices together with not smoking, have the potential to reduce cancer risk by 60-70%.

- As many as 100.000 cases of cancer could be prevented each year in the UK through healthy diet and lifestyle choices.

- A simple change, such as eating the recommended five servings of vegetables and fruits each day could, in itself, reduce cancer rates by more than 20%.

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