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Wiseman Martin - 20th International Nutrition Congress 2013
- 1. Evidence-based recommendations for prevention of cancer and other chronic diseases The 2007 and 2009 WCRF/AICR Reports Martin Wiseman World Cancer Research Fund International University of Southampton, UK www.wcrf.org/ICN2013 IUNS, Granada, 2013
- 2. Who we are AICR WCRF UK WCRF Netherlands WCRF Hong Kong WCRF International What we do Fund research on the relationship of nutrition, physical activity and body weight to cancer risk Interpret the accumulated scientific literature to derive Recommendations for Cancer Prevention Educate people through our national Health Information programmes Advocate effective policies to help people and populations to reduce their chances of developing cancer
- 4. Data from Parkin et al, Pisani et al, Globocan 2008, IARC *Estimated new cases for 2030 from predictions in 2002
- 5. USA UK BRAZIL CHINA Mouth, pharynx, larynx 63 67 63 44 Oesophagus 69 75 60 44 Lung 36 33 36 38 Stomach 47 45 41 33 Pancreas 19 15 11 8 Gallbladder 21 16 10 6 Liver 15 17 6 6 Colorectum 50 47 41 22 Breast 38 42 28 20 Endometrium 59 44 37 25 Prostate 11 20 N/A N/A Kidney 24 19 13 8 Total for these cancers 35 37 29 27 Total for all cancers 24 27 19 22 Around one quarter of all cancers estimated avoidable through appropriate food, nutrition and physical activity
- 6. Global variation in cancer incidence and impact of migration Breast Colorectum
- 7. Environment is a key determinant of cancer patterns Why nutrition?
- 8. Epidemiology links food, nutrition and physical activity to cancer
- 9. Experimental evidence links nutrition and cancer
- 10. WCRF/AICR EXPERT REPORT 1. 2. 3. 4. 5. The most authoritative New method Systematic reviews Review of evidence separate from judgement Panel of international experts Predetermined criteria for judgements Epidemiology Mechanisms 6. Flexibility 7. Continuous update of evidence
- 11. NUTRITION AND CANCERS OBESITY BREAST (PM), COLORECTUM, ENDOMETRIUM, OESOPHAGUS, PANCREAS, GALLBLADDER, KIDNEY PHYSICAL ACTIVITY COLON, BREAST, OBESITY MEAT – RED AND PROCESSED COLORECTAL PLANT FOODS MPL, OESOPHAGUS, STOMACH,) COLORECTAL, LUNG, OBESITY ALCOHOL MPL, COLORECTUM, LIVER, BREAST SALT STOMACH BREASTFEEDING BREAST, EXCESS WEIGHT GAIN (CHILD)
- 12. The Panel emphasises the importance of not smoking and of avoiding exposure to tobacco smoke
- 13. Continuous Update Project (CUP) • Keep evidence, conclusions and recommendations updated into the future • Working with team at ICL • Same principles: - Systematically review evidence - Meta analysis - Panel of experts -draw conclusions -make recommendations
- 14. Novel aspects of CUP 1. Breast Cancer Survivors 2. Mechanisms
- 15. Cancer prevention What to do…? What determines people’s behaviour? How to change it?
- 17. Behaviour • People behave like those around them – social norms • Asking people to behave very differently from their social norm only has limited or unsustained effect • Personal choice determines individual variation around the social norm – small effect • External factors determine social norms – big effect
- 19. Everybody has a role to play Action needs to be coherent Leadership from Government Health professionals
- 20. Conclusions The WCRF/AICR Expert Reports, and the CUP, are the most rigorous and authoritative reviews available. They conclude that • Cancer is a major cause of death, disability and lost life years • Cancer is mostly environmentally determined and largely preventable • With smoking, food, nutrition, body fatness and physical activity are the most important factors affecting cancer risk • Evidence to support this comes from many different sources • Preventing cancer through food, nutrition and physical activity will also prevent other major chronic diseases • Changes are needed in people’s environment as well as in personal choices
Editor's Notes
- Just a note about who does what within our organisation. The charitable fundraising and information programs are conducted at a national level in four countries. And then there is the part I work for – WCRF International – which provides strategic guidance to the charities and conducts most of the science and policy work.
- November 1st will see the publication of the WCRF/AICR Expert Report, Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective. The report synthesizes evidence from a vast body of research, grades the quality of that evidence, and draws a series of comprehensive cancer prevention goals for populations and practical recommendations for people. It is a remarkable achievement and yet, as you will see, it is only the beginning.
- For breast cancer the number of papers published in the last 6 years is about the same number as published in the previous 50 years. The CUP numbers include all those entered by end 2011
- For more information refer to websites.363=/ +=4u6y5t5