Diet and cancer

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Many dietary recommendations have been proposed to reduce the risk of cancer, few have significant supporting scientific evidence. [1] [2] [3] Obesity and drinking alcohol have been correlated with the incidence and progression of some cancers. [1] Lowering the consumption of sweetened beverages is recommended as a measure to address obesity. [4]

Contents

Some specific foods are linked to specific cancers. There is strong evidence that processed meat and red meat intake increases risk of colorectal cancer. [5] [6] [7] [8] Aflatoxin B1, a frequent food contaminant, increases risk of liver cancer, [9] while drinking coffee is associated with a reduced risk. [10] Betel nut chewing causes oral cancer. [9] Stomach cancer is more common in Japan due to its high-salt diet. [9] [11]

Dietary recommendations for cancer prevention typically include weight management and eating a healthy diet, consisting mainly of "vegetables, fruit, whole grains and fish, and a reduced intake of red meat, animal fat, and refined sugar." [1] A healthy dietary pattern may lower cancer risk by 10–20%. [12] There is no clinical evidence that diets or specific foods can cure cancer. [13] [14]

Types of diet

Restrictive diets

It is a popular misconception that cancer can be treated by "starving" a tumour or restricting carbohydrate intake, when in reality the health of people with cancer is best served by following a healthy diet. [15] A number of specific diets and diet-based regimes have been claimed to be useful against cancer, including the Breuss diet, Gerson therapy, the Budwig protocol and the macrobiotic diet. None of these diets has been found to be effective, and some of them have been found to be harmful. [16]

Dietary patterns

Nutritional epidemiologists use multivariate statistics, such as principal components analysis and factor analysis, to measure how patterns of dietary behavior influence the risk of developing cancer. [17] (The most well-studied dietary pattern is the Mediterranean diet.) Based on their dietary pattern score, epidemiologists categorize people into quantiles. To estimate the influence of dietary behavior on risk of cancer, they measure the association between quantiles and the distribution of cancer prevalence (in case–control studies) and cancer incidence (in longitudinal studies). They usually include other variables in their statistical model to account for the other differences between people with and without cancer (confounders). For breast cancer, there is a replicated trend for women with a more "prudent or healthy" diet, i.e. higher in fruits and vegetables, to have a lower risk of cancer. [18]

Unhealthy dietary patterns are associated with a higher body mass index suggesting a potential mediating effect of obesity on cancer risk. [19]

Western pattern diet

This section is an excerpt from Western pattern diet § Cancer.[ edit ]

The Western pattern diet has been generally linked to increased risk for colorectal cancer. [20] Meta-analyses have found that diet patterns consistent with those of the Western pattern diet are positively correlated with risk for prostate cancer. [21] [22] Greater adherence to a Western pattern diet was also found to increase the overall risk of mortality due to cancer. [23]

No significant relation has been established between the Western pattern diet and breast cancer. [24] [25]

Mediterranean diet

This section is an excerpt from Mediterranean diet § Cancer.[ edit ]
A meta-analysis in 2008 found that strictly following the Mediterranean diet was correlated with a decreased risk of dying from cancer by 6%. [26] Another 2014 review found that adherence to the Mediterranean diet was associated with a decreased risk of death from cancer. [27] A 2017 review found a decreased rate of cancer, though evidence was weak. [28] An updated review in 2021 found that the Mediterranean diet is associated with a 13% lower risk of cancer mortality in the general population. [29]

Dietary components

Alcohol

Alcohol is associated with an increased risk of a number of cancers. [30] It has been reported that 3.6% of all cancer cases and 3.5% of cancer deaths worldwide are attributable to drinking of alcohol. [31] Breast cancer in women is linked with alcohol intake. [1] [32] Alcohol also increases the risk of cancers of the mouth, esophagus, pharynx and larynx, [33] colorectal cancer, [34] [35] liver cancer, [36] stomach [37] and ovaries. [38] The International Agency for Research on Cancer (Centre International de Recherche sur le Cancer) of the World Health Organization has classified alcohol as a Group 1 carcinogen. Its evaluation states, "There is sufficient evidence for the carcinogenicity of alcoholic beverages in humans. ... Alcoholic beverages are carcinogenic to humans (Group 1)." [39]

Eggs

This section is an excerpt from Eggs as food § Cancer.[ edit ]

A 2015 meta-analysis found an association between higher egg consumption (five a week) with increased risk of breast cancer compared to no egg consumption. [40] Another meta-analysis found that egg consumption may increase ovarian cancer risk. [41]

A 2019 meta-analysis found an association between high egg consumption and risk of upper aero-digestive tract cancers in hospital-based case-control studies. [42]

A 2021 review did not find a significant association between egg consumption and breast cancer. [43] A 2021 umbrella review found that egg consumption significantly increases the risk of ovarian cancer. [44]

Processed and red meat

There is strong evidence that processed meat and red meat intake increases risk of colorectal cancer. [45] [46] [47] The American Cancer Society in their "Diet and Physical Activity Guideline", stated "evidence that red and processed meats increase cancer risk has existed for decades, and many health organizations recommend limiting or avoiding these foods." [48]

On October 26, 2015, the International Agency for Research on Cancer of the World Health Organization reported that eating processed meat (e.g., bacon, ham, hot dogs, sausages) or red meat was linked to some cancers and classed them as Group 1 (carcinogenic to humans) and Group 2a (probably carcinogenic to humans) carcinogens respectively. [49] There is some evidence that suggests that heme and nitrite are involved in the processes linking red and processed meat intake with colorectal cancer. [49] Heme is present in particular in red meat and nitrite is used as curing salt in many processed meats.

Processed and unprocessed red meat intake is associated with an increased risk of breast cancer. [50] [51]

Salted fish

This section is an excerpt from Salted fish § Health effects.[ edit ]
Due to the elevated levels of nitrites, consuming salted fish increases risk of stomach cancer and nasopharyngeal cancer. [52] [53] [54] The International Agency for Research on Cancer classify salted fish (Chinese-style) as a Group 1 carcinogen. [55] [56]

Fiber, fruits and vegetables

There is strong evidence that consumption of dietary fiber reduces risk of colorectal cancer. [3] [57] [58] Two 2020 meta-analyses found that a high fiber intake was associated with a lower risk of both premenopausal and postmenopausal breast cancers [59] and a higher survival rate in patients with breast cancer. [60]

A 2021 review found that there is moderate-quality evidence 200g of fruit intake per day is associated with a lower risk of breast cancer. [61] Another review found that high total fruit and vegetable consumption are associated with reduced risk of breast cancer. [62] A 2024 review found convincing evidence for high dietary fiber intake associated with lower breast cancer risk. [63]

Pickled vegetables

This section is an excerpt from Pickling § Possible health hazards of pickled vegetables.[ edit ]

In 1993, the World Health Organization listed traditional Asian pickled vegetables as possible carcinogens, [64] and the British Journal of Cancer released an online 2009 meta-analysis of research on pickles as increasing the risks of esophageal cancer. The report, citing limited data in a statistical meta analysis, indicates a potential two-fold increased risk of esophageal cancer associated with Asian pickled vegetable consumption. Results from the research are described as having "high heterogeneity" and the study said that further well-designed prospective studies were warranted. [65] However, their results stated "The majority of subgroup analyses showed a statistically significant association between consuming pickled vegetables and Oesophageal Squamous Cell Carcinoma". [65]

Consuming pickled vegetables is also associated with a 28% increase in the risk of stomach cancer. [66]

The 2009 meta-analysis reported heavy infestation of pickled vegetables with fungi. Some common fungi can facilitate the formation of N-nitroso compounds, which are strong esophageal carcinogens in several animal models. [67] Roussin red methyl ester, [68] a non-alkylating nitroso compound with tumour-promoting effect in vitro, was identified in pickles from Linzhou, Henan (formerly Linxian) in much higher concentrations than in samples from low-incidence areas. Fumonisin mycotoxins have been shown to cause liver and kidney tumours in rodents. [65]

A 2017 study in Chinese Journal of Cancer [69] has linked salted vegetables (pickled mustard green  [ zh ] common in Chinese cuisine) to a fourfold increase in nasopharynx cancer. The researchers believe possible mechanisms include production of nitrosamines (a type of N-nitroso compound) by fermentation and activation of Epstein–Barr virus by fermentation products. [70] [71]

Historically, pickling caused health concerns for reasons associated with copper salts, as explained in the mid-19th century The English and Australian Cookery Book : "The evidence of the Lancet commissioner (Dr. Hassall) and Mr. Blackwell (of the eminent firm of Crosse and Blackwell) went to prove that the pickles sold in the shops are nearly always artificially coloured, and are thus rendered highly unwholesome, if not actually poisonous."

Flavonoids

Flavonoids (specifically flavonoids such as the catechins) are "the most common group of polyphenolic compounds in the human diet and are found ubiquitously in plants." [72] While some studies have suggested flavonoids may have a role in cancer prevention, others have been inconclusive or suggested they may be harmful. [73] [74]

Methionine

Restriction of methionine has been suggested as a strategy in cancer growth control in cancers that depend on methionine for survival and proliferation. [75] According to a 2012 review, the effect of methionine restriction on cancer has yet to be studied directly in humans and "there is still insufficient knowledge to give reliable nutritional advice". [75]

Reviews of epidemiological studies have found no association between dietary methionine and breast or pancreatic cancer risk. [76] [77]

Mushrooms

According to Cancer Research UK, "there is currently no evidence that any type of mushroom or mushroom extract can prevent or cure cancer", although research into some species continues. [78]

A 2020 review found that higher mushroom consumption is associated with lower risk of breast cancer. [79]

Dairy products

This section is an excerpt from Dairy product § Cancer.[ edit ]

The American Institute for Cancer Research (AICR), World Cancer Research Fund International (WCRF), Cancer Council Australia (CCA) and Cancer Research UK have stated that there is strong evidence that consumption of dairy products decreases risk of colorectal cancer. [80] [81] [82] [83] The AICR, WCRF, CCA and Prostate Cancer UK have stated that there is limited but suggestive evidence that dairy products increase risk of prostate cancer. [80] [81] [82] [84] [85] The American Cancer Society (ACS) have stated that because dairy products "may lower the risk of some cancers and possibly increase the risk of others, the ACS does not make specific recommendations on dairy food consumption for cancer prevention." [86]

It has been suggested that consumption of insulin-like growth factor 1 (IGF-1) in dairy products could increase cancer risk, particularly prostate cancer. [87] [88] However, a 2018 review by the Committee on Carcinogenicity of Chemicals in Food, Consumer Products and the Environment (COC) concluded that there is "insufficient evidence to draw any firm conclusions as to whether exposure to dietary IGF-1 is associated with an increased incidence of cancer in consumers". [88] The COC also stated it is unlikely that there would be absorption of intact IGF-1 from food by most consumers. [89]

The British Dietetic Association have described the idea that milk promotes hormone related cancerous tumour growth as a myth, stating "no link between dairy containing diets and risk of cancer or promoting cancer growth as a result of hormones". [90]

A 2019 review concluded that higher-quality research was needed to characterise valid associations between dairy consumption and risk of and/or cancer-related mortality. [91] A 2021 umbrella review found strong evidence that consumption of dairy products decreases risk of colorectal cancer. [92] Fermented dairy is associated with significantly decreased bladder cancer and colorectal cancer risk. [93]

A 2023 review found no association between consumption of dairy products and breast cancer. [94]

Whole grains

There is strong evidence that consumption of whole grains decreases risk of colorectal cancer. [58] [95] [96] [97]

Saturated fat

This section is an excerpt from Saturated fat § Cancer.[ edit ]

Several reviews of case–control studies have found that saturated fat intake is associated with breast cancer risk and mortality. [98] [99] [100]

Observational studies have shown that a diet high in saturated fat increases the risk of prostate cancer. [101]

Soy

The American Cancer Society have stated that "there is some evidence from human and lab studies that consuming traditional soy foods such as tofu may lower the risk of breast and prostate cancer, but overall the evidence is too limited to draw firm conclusions". [102]

A 2023 review found that soy protein lowers breast cancer risk. [103]

Other

See also

Related Research Articles

<span class="mw-page-title-main">Dairy product</span> Food product made from milk

Dairy products or milk products, also known as lacticinia, are food products made from milk. The most common dairy animals are cow, water buffalo, nanny goat, and ewe. Dairy products include common grocery store food around the world such as yogurt, cheese, milk and butter. A facility that produces dairy products is a dairy. Dairy products are consumed worldwide to varying degrees. Some people avoid some or all dairy products because of lactose intolerance, veganism, environmental concerns, other health reasons or beliefs.

<span class="mw-page-title-main">Fat</span> Esters of fatty acid or triglycerides

In nutrition, biology, and chemistry, fat usually means any ester of fatty acids, or a mixture of such compounds, most commonly those that occur in living beings or in food.

A saturated fat is a type of fat in which the fatty acid chains have all single bonds between the carbon atoms. A fat known as a glyceride is made of two kinds of smaller molecules: a short glycerol backbone and fatty acids that each contain a long linear or branched chain of carbon (C) atoms. Along the chain, some carbon atoms are linked by single bonds (-C-C-) and others are linked by double bonds (-C=C-). A double bond along the carbon chain can react with a pair of hydrogen atoms to change into a single -C-C- bond, with each H atom now bonded to one of the two C atoms. Glyceride fats without any carbon chain double bonds are called saturated because they are "saturated with" hydrogen atoms, having no double bonds available to react with more hydrogen.

<span class="mw-page-title-main">Mediterranean diet</span> Diet inspired by the Mediterranean region

The Mediterranean diet is a concept first invented in 1975 by the American biologist Ancel Keys and chemist Margaret Keys. The diet took inspiration from the supposed eating habits and traditional food typical of Crete, much of the rest of Greece, and southern Italy, and formulated in the early 1960s. It is distinct from Mediterranean cuisine, which covers the actual cuisines of the Mediterranean countries, and from the Atlantic diet of northwestern Spain and Portugal. While inspired by a specific time and place, the "Mediterranean diet" was later refined based on the results of multiple scientific studies.

<span class="mw-page-title-main">Plant-based diet</span> Diet consisting mostly or entirely of plant-based foods

A plant-based diet is a diet consisting mostly or entirely of plant-based foods. Plant-based diets encompass a wide range of dietary patterns that contain low amounts of animal products and high amounts of fiber-rich plant products such as vegetables, fruits, whole grains, legumes, nuts and seeds. They do not need to be vegan or vegetarian, but are defined in terms of low frequency of animal food consumption.

<span class="mw-page-title-main">Healthy diet</span> Type of diet

A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate fibre and food energy.

<span class="mw-page-title-main">Red meat</span> Meat which is red when raw, with high myoglobin content

In gastronomy, red meat is commonly red when raw, in contrast to white meat, which is pale in color before cooking. In culinary terms, only flesh from mammals or fowl is classified as red or white. In nutritional science, red meat is defined as any meat that has more of the protein myoglobin than white meat. White meat is defined as non-dark meat from fish or chicken.

<span class="mw-page-title-main">Processed meat</span> Type of meat

Processed meat is considered to be any meat that has been modified in order to either improve its taste or to extend its shelf life. Methods of meat processing include salting, curing, fermentation, smoking, boiling, frying, and/or the addition of chemical preservatives. Processed meat is usually composed of pork or beef or, less frequently, poultry. It can also contain offal or meat by-products such as blood. Processed meat products include bacon, ham, sausages, salami, corned beef, jerky, hot dogs, lunch meat, canned meat, chicken nuggets, and meat-based sauces. Meat processing includes all the processes that change fresh meat with the exception of simple mechanical processes such as cutting, grinding or mixing.

<span class="mw-page-title-main">White meat</span> Meat which is pale before and after cooking

In culinary terms, white meat is meat which is pale in color before and after cooking. In traditional gastronomy, white meat also includes rabbit, the flesh of milk-fed young mammals, and sometimes pork. In ecotrophology and nutritional studies, white meat includes poultry and fish, but excludes all mammal flesh, which is considered red meat.

<span class="mw-page-title-main">Alcohol and cancer</span> Relationship between cancer and the consumption of alcohol

Alcohol and cancer have a complex relationship. Alcohol causes cancers of the oesophagus, liver, breast, colon, oral cavity, rectum, pharynx, and larynx, and probably causes cancers of the pancreas. Cancer risk can occur even with light to moderate drinking. The more alcohol is consumed, the higher the cancer risk, and no amount can be considered completely safe.

<span class="mw-page-title-main">Nutrition and pregnancy</span> Nutrient intake and dietary planning undertaken before, during and after pregnancy

Nutrition and pregnancy refers to the nutrient intake, and dietary planning that is undertaken before, during and after pregnancy. Nutrition of the fetus begins at conception. For this reason, the nutrition of the mother is important from before conception as well as throughout pregnancy and breastfeeding. An ever-increasing number of studies have shown that the nutrition of the mother will have an effect on the child, up to and including the risk for cancer, cardiovascular disease, hypertension and diabetes throughout life.

A diabetic diet is a diet that is used by people with diabetes mellitus or high blood sugar to minimize symptoms and dangerous complications of long-term elevations in blood sugar.

The European Prospective Investigation into Cancer and Nutrition (EPIC) study is a Europe-wide prospective cohort study of the relationships between diet and cancer, as well as other chronic diseases, such as cardiovascular disease. With over half a million participants, it is the largest study of diet and disease to be undertaken.

<span class="mw-page-title-main">Western pattern diet</span> Modern dietary pattern

The Western pattern diet is a modern dietary pattern that is generally characterized by high intakes of pre-packaged foods, refined grains, red meat, processed meat, high-sugar drinks, candy and sweets, fried foods, industrially produced animal products, butter and other high-fat dairy products, eggs, potatoes, corn, and low intakes of fruits, vegetables, whole grains, pasture-raised animal products, fish, nuts, and seeds.

The Dietary Guidelines for Americans (DGA) provide nutritional advice for Americans who are healthy or who are at risk for chronic disease but do not currently have chronic disease. The Guidelines are published every five years by the US Department of Agriculture, together with the US Department of Health and Human Services. Notably, the most recent ninth edition for 2020–25 includes dietary guidelines for children from birth to 23 months. In addition to the Dietary Guidelines per se, there are additional tools for assessing diet and nutrition, including the Healthy Eating Index (HEI), which can be used to assess the quality of a given selection of foods in the context of the Dietary Guidelines. Also provided are additional explanations regarding customization of the Guidelines to individual eating preferences, application of the Guidelines during pregnancy and infancy, the USDA Nutrition Evidence Systematic Review, information about the Nutrition Communicators Network and the MyPlate initiative, information from the National Academies about redesigning the process by which the Dietary Guidelines for Americans are created, and information about dietary guidelines from other nations.

<span class="mw-page-title-main">Alcohol and breast cancer</span>

The relationship between alcohol and breast cancer is clear: drinking alcoholic beverages, including wine, beer, or liquor, is a risk factor for breast cancer, as well as some other forms of cancer. Drinking alcohol causes more than 100,000 cases of breast cancer worldwide every year. Globally, almost one in 10 cases of breast cancer is caused by women drinking alcoholic beverages. Drinking alcoholic beverages is among the most common modifiable risk factors.

<span class="mw-page-title-main">Heterocyclic amine formation in meat</span>

Heterocyclic amines are a group of chemical compounds, many of which can be formed during cooking. They are found in meats that are cooked to the "well done" stage, in pan drippings and in meat surfaces that show a brown or black crust. Epidemiological studies show associations between intakes of heterocyclic amines and cancers of the colon, rectum, breast, prostate, pancreas, lung, stomach, and esophagus, and animal feeding experiments support a causal relationship. The U.S. Department of Health and Human Services Public Health Service labeled several heterocyclic amines as likely carcinogens in its 13th Report on Carcinogens. Changes in cooking techniques reduce the level of heterocyclic amines.

<span class="mw-page-title-main">Health effects of salt</span> Conditions associated with the consumption of either too much or too little salt

The health effects of salt are the conditions associated with the consumption of either too much or too little salt. Salt is a mineral composed primarily of sodium chloride (NaCl) and is used in food for both preservation and flavor. Sodium ions are needed in small quantities by most living things, as are chloride ions. Salt is involved in regulating the water content of the body. The sodium ion itself is used for electrical signaling in the nervous system.

<span class="mw-page-title-main">Cancer prevention</span> Taking measures to decrease cancer incidence

Cancer prevention is the practice of taking active measures to decrease the incidence of cancer and mortality. The practice of prevention depends on both individual efforts to improve lifestyle and seek preventive screening, and socioeconomic or public policy related to cancer prevention. Globalized cancer prevention is regarded as a critical objective due to its applicability to large populations, reducing long term effects of cancer by promoting proactive health practices and behaviors, and its perceived cost-effectiveness and viability for all socioeconomic classes.

The acid-ash hypothesis is a medical hypothesis which suggests that excessively acidic diets may result in a number of identifiable health effects, including an increased risk of osteoporosis. It has received some attention in the lay community, and has been used to support the diet known as the Alkaline diet. According to the hypothesis, acid ash is produced by meat, poultry, cheese, fish, eggs, and grains. Alkaline ash is produced by fruits and vegetables, except cranberries, prunes and plums. Since the acid or alkaline ash designation is based on the residue left on combustion rather than the acidity of the food, foods such as citrus fruits that are generally considered acidic are actually considered alkaline producing in this diet.

References

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