title: 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.
abstract: BACKGROUND
  In 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.
  
  
  OBJECTIVE
  We 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.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  Concordance 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.
  
  
  CONCLUSIONS
  Adherence to the WCRF/AICR recommendations for cancer prevention may lower the risk of developing most types of cancer.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. d.romaguera-bosch@imperial.ac.uk
authors.forename: Dora
authors.initials: D
authors.lastname: Romaguera
authors.forename: Anne-Claire
authors.initials: AC
authors.lastname: Vergnaud
authors.forename: Petra H
authors.initials: PH
authors.lastname: Peeters
authors.forename: Carla H
authors.initials: CH
authors.lastname: van Gils
authors.forename: Doris S M
authors.initials: DS
authors.lastname: Chan
authors.forename: Pietro
authors.initials: P
authors.lastname: Ferrari
authors.forename: Isabelle
authors.initials: I
authors.lastname: Romieu
authors.forename: Mazda
authors.initials: M
authors.lastname: Jenab
authors.forename: Nadia
authors.initials: N
authors.lastname: Slimani
authors.forename: Françoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Guy
authors.initials: G
authors.lastname: Fagherazzi
authors.forename: Florence
authors.initials: F
authors.lastname: Perquier
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.forename: Birgit
authors.initials: B
authors.lastname: Teucher
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Anne
authors.initials: A
authors.lastname: von Rüsten
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Anja
authors.initials: A
authors.lastname: Olsen
authors.forename: Christina C
authors.initials: CC
authors.lastname: Dahm
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Quirós
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Gonzalez
authors.forename: María José
authors.initials: MJ
authors.lastname: Sánchez
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: Francesca L
authors.initials: FL
authors.lastname: Crowe
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Key
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Pagona
authors.initials: P
authors.lastname: Lagiou
authors.forename: Christina
authors.initials: C
authors.lastname: Bamia
authors.forename: Giovanna
authors.initials: G
authors.lastname: Masala
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Sabina
authors.initials: S
authors.lastname: Sieri
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Anne M
authors.initials: AM
authors.lastname: May
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Frederike L
authors.initials: FL
authors.lastname: Büchner
authors.forename: Elisabet
authors.initials: E
authors.lastname: Wirfält
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Johansson
authors.forename: Göran
authors.initials: G
authors.lastname: Hallmans
authors.forename: Guri
authors.initials: G
authors.lastname: Skeie
authors.forename: Kristin
authors.initials: K
authors.lastname: Benjaminsen Borch
authors.forename: Christine L
authors.initials: CL
authors.lastname: Parr
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.forename: Teresa
authors.initials: T
authors.lastname: Norat
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects; D005060:Europe / Q000453:epidemiology; D005260:Female; D017408:Guidelines as Topic; D006293:Health Promotion; D006801:Humans; D015994:Incidence; D007390:International Agencies; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009369:Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D018673:Nutrition Policy; D009939:Organizations, Nonprofit; D050177:Overweight / Q000517:prevention & control; D010349:Patient Compliance; D011446:Prospective Studies; D012306:Risk