This prospective cohort study evaluates associations between healthful behaviors consistent with WCRF/AICR cancer prevention guidelines and obesity-related cancer risk, as a third of cancers are estimated to be preventable.
The study sample consisted of adults from the Framingham Offspring cohort (n = 2,983). From 1991 to 2008, 480 incident doctor-diagnosed obesity-related cancers were identified. Data on diet, measured by a food frequency questionnaire, anthropometric measures, and self-reported physical activity, collected in 1991 was used to construct a 7-component score based on recommendations for body fatness, physical activity, foods that promote weight gain, plant foods, animal foods, alcohol, and food preservation, processing, and preparation. Multivariable Cox regression models were used to estimate associations between the computed score, its components, and subcomponents in relation to obesity-related cancer risk.
The overall score was not associated with obesity-related cancer risk after adjusting for age, sex, smoking, energy, and preexisting conditions (HR 0.94, 95 % CI 0.86–1.02). When score components were evaluated separately, for every unit increment in the alcohol score, there was 29 % lower risk of obesity-related cancers (HR 0.71, 95 % CI 0.51–0.99) and 49–71 % reduced risk of breast, prostate, and colorectal cancers. Every unit increment in the subcomponent score for non-starchy plant foods (fruits, vegetables, and legumes) among participants who consume starchy vegetables was associated with 66 % reduced risk of colorectal cancer (HR 0.44, 95 % CI 0.22–0.88).
Lower alcohol consumption and a plant-based diet consistent with the cancer prevention guidelines were associated with reduced risk of obesity-related cancers in this population.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Silverberg E, Boring C, Squires T (2008) Cancer statistics 1990. CA Cancer J Clin 40(1):9–26
Siegel R, Ma J, Zou Z, Jemal A (2014) Cancer statistics, 2014. CA Cancer J Clin 64(1):9–29
World Cancer Research Fund and American Institute for Cancer Research (2007) Food, nutrition and the prevention of cancer: a global perspective. American Institute of Cancer Research, Washington
World Cancer Research Fund and American Institute for Cancer Research (1997) Food, nutrition and the prevention of cancer: a global perspective. American Institute of Cancer Research, Washington
Cerhan JR, Potter JD, Gilmore JM, Janney CA, Kushi LH, Lazovich D et al (2004) Adherence to the AICR cancer prevention recommendations and subsequent morbidity and mortality in the Iowa women’s health study cohort. Cancer Epidemiol Biomark Prev 13(7):1114–1120
Hastert TA, Beresford SA, Patterson RE, Kristal AR, White E (2013) Adherence to WCRF/AICR cancer prevention recommendations and risk of post-menopausal breast cancer. Cancer Epidemiol Biomark Prev 22:1498–1508
Romaguera D, Vergnaud A, Peeters PH, van Gils CH, Chan DS, Ferrari P et al (2012) Is concordance with World Cancer Research Fund/American Institute for Cancer Research guidelines for cancer prevention related to subsequent risk of cancer? Results from the EPIC study. Am J Clin Nutr 96(1):150–163
Vergnaud A, Romaguera D, Peeters PH, van Gils CH, Chan DS, Romieu I et al (2013) Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European prospective investigation into nutrition and cancer cohort study. Am J Clin Nutr 97(5):1107–1120
Dawber TR, Meadors GF, Moore FE Jr (1951) Epidemiological approaches to heart disease: the Framingham study. Am J Public Health Nations Health 41(3):279–281
Feinleib M, Kannel WB, Garrison RJ, McNamara PM, Castelli WP (1975) The Framingham offspring study. Design and preliminary data. Prev Med 4(4):518–525
Larson M, Atwood L, Benjamin E, Cupples LA, D’Agostino R, Fox C et al (2007) Framingham heart study 100 K project: genome-wide associations for cardiovascular disease outcomes. BMC Med Genet 8(Suppl 1):S5
Rimm EB, Giovannucci EL, Stampfer MJ, Colditz GA, Litin LB, Willett WC (1992) Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol 135(10):1114–1126
Jonker JT, De Laet C, Franco OH, Peeters A, Mackenbach J, Nusselder WJ (2006) Physical activity and life expectancy with and without diabetes life table analysis of the Framingham heart study. Diabetes Care 29(1):38–43
Kannel WB, Sorlie P (1979) Some health benefits of physical activity: the Framingham study. Arch Intern Med 139(8):857
American Cancer Society (2014) Does body weight affect cancer? http://www.cancer.org/cancer/cancercauses/dietandphysicalactivity/bodyweightandcancerrisk/body-weight-and-cancer-risk-effects. Accessed 10 Nov 2014
National Cancer Institute (2014) Obesity and cancer risk. http://www.cancer.gov/cancertopics/factsheet/Risk/obesity. Accessed 10 Nov 2014
Thomson CA, McCullough ML, Wertheim BC, Chlebowski RT, Martinez ME, Stefanick ML et al (2014) Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the women’s health initiative. Cancer Prev Res 7(1):42–53
Pope S, Kritchevsky S, Morris M, Block G, Tylavsky F, Lee J et al (2007) Cognitive ability is associated with suspected reporting errors on food frequency questionnaires. J Nutr Health Aging 11(1):55–58
Schatzkin A, Kipnis V, Carroll RJ, Midthune D, Subar AF, Bingham S et al (2003) A comparison of a food frequency questionnaire with a 24-hour recall for use in an epidemiological cohort study: results from the biomarker-based observing protein and energy nutrition (OPEN) study. Int J Epidemiol 32(6):1054–1062
This research was supported by the American Cancer Society Research Scholar Grant (#RSG-12-005-01-CNE) awarded to Niyati Parekh, PhD RD. The Framingham Heart Study is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with Boston University (Contract No. N01-HC-25195). Funding support for the Framingham Food Frequency Questionnaire datasets was provided by ARS Contract #53-3k06-5-10, ARS Agreement #’s 58-1950-9-001, 58-1950-4-401, and 58-1950-7-707. This manuscript was not prepared in collaboration with investigators of the Framingham Heart Study and does not necessarily reflect the opinions or views of the Framingham Heart Study, Boston University, or NHLBI.
Conflict of interest
The American Cancer Society did not have a role in study design, collection, analysis, and interpretation of data; writing the report; and the decision to submit the report for publication. The authors have no conflicts of interest to report.
Rights and permissions
About this article
Cite this article
Makarem, N., Lin, Y., Bandera, E.V. et al. Concordance with World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines for cancer prevention and obesity-related cancer risk in the Framingham Offspring cohort (1991–2008). Cancer Causes Control 26, 277–286 (2015). https://doi.org/10.1007/s10552-014-0509-9
- Healthful behaviors
- American Institute for Cancer Research
- Cancer prevention guidelines
- Framingham Heart Study