• Dora Romaguera, Anne-Claire Vergnaud, Petra H Peeters, Carla H van Gils, Doris S M Chan, Pietro Ferrari, Isabelle Romieu, Mazda Jenab, Nadia Slimani, Françoise Clavel-Chapelon, Guy Fagherazzi, Florence Perquier, Rudolf Kaaks, Birgit Teucher, Heiner Boeing, Anne von Rüsten, Anne Tjønneland, Anja Olsen, Christina C Dahm, Kim Overvad, José Ramón Quirós, Carlos A Gonzalez, María José Sánchez, Carmen Navarro, Aurelio Barricarte, Miren Dorronsoro, Kay-Tee Khaw, Nicholas J Wareham, Francesca L Crowe, Timothy J Key, Antonia Trichopoulou, Pagona Lagiou, Christina Bamia, Giovanna Masala, Paolo Vineis, Rosario Tumino, Sabina Sieri, Salvatore Panico, Anne M May, H Bas Bueno-de-Mesquita, Frederike L Büchner, Elisabet Wirfält, Jonas Manjer, Ingegerd Johansson, Göran Hallmans, Guri Skeie, Benjaminsen BorchKristinK, Christine L Parr, Elio Riboli, and Teresa Norat.
• Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. d.romaguera-bosch@imperial.ac.uk
• Am. J. Clin. Nutr. 2012 Jul 1; 96 (1): 150-63.

BackgroundIn 2007 the World Cancer Research Fund (WCRF) and the American Institute of Cancer Research (AICR) issued 8 recommendations (plus 2 special recommendations) on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence.ObjectiveWe aimed to investigate whether concordance with the WCRF/AICR recommendations was related to cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.DesignThe present study included 386,355 EPIC participants from 9 European countries. At recruitment, dietary, anthropometric, and lifestyle information was collected. A score was constructed based on the WCRF/AICR recommendations on weight management, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, alcoholic drinks, and breastfeeding for women; the score range was 0-6 for men and 0-7 for women. Higher scores indicated greater concordance with WCRF/AICR recommendations. The association between the score and cancer risk was estimated by using multivariable Cox regression models.ResultsConcordance with the score was significantly associated with decreased risk of cancer. A 1-point increment in the score was associated with a risk reduction of 5% (95% CI: 3%, 7%) for total cancer, 12% (95% CI: 9%, 16%) for colorectal cancer, and 16% (95% CI: 9%, 22%) for stomach cancer. Significant associations were also observed for cancers of the breast, endometrium, lung, kidney, upper aerodigestive tract, liver, and esophagus but not for prostate, ovarian, pancreatic, and bladder cancers.ConclusionAdherence to the WCRF/AICR recommendations for cancer prevention may lower the risk of developing most types of cancer.

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