title: 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 study1,4.
abstract: BACKGROUND
  In 2007, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued recommendations on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence.
  
  
  OBJECTIVE
  We investigated whether concordance with WCRF/AICR recommendations is related to risk of death.
  
  
  METHODS
  The current study included 378,864 participants from 9 European countries enrolled in the European Prospective Investigation into Cancer and Nutrition study. At recruitment (1992-1998), dietary, anthropometric, and lifestyle information was collected. A WCRF/AICR score, which incorporated 6 of the WCRF/AICR recommendations for men [regarding body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, and alcoholic drinks (score range: 0-6)] and 7 WCRF/AICR recommendations for women [plus breastfeeding (score range: 0-7)], was constructed. Higher scores indicated greater concordance with WCRF/AICR recommendations. Associations between the WCRF/AICR score and risks of total and cause-specific death were estimated by using Cox regression analysis.
  
  
  RESULTS
  After a median follow-up time of 12.8 y, 23,828 deaths were identified. Participants within the highest category of the WCRF/AICR score (5-6 points in men; 6-7 points in women) had a 34% lower hazard of death (95% CI: 0.59, 0.75) compared with participants within the lowest category of the WCRF/AICR score (0-2 points in men; 0-3 points in women). Significant inverse associations were observed in all countries. The WCRF/AICR score was also significantly associated with a lower hazard of dying from cancer, circulatory disease, and respiratory disease.
  
  
  CONCLUSIONS
  Results of this study suggest that following WCRF/AICR recommendations could significantly increase longevity.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
authors.forename: Anne-Claire
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authors.forename: Maria Luisa
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authors.forename: María-José
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authors.lastname: Sánchez
authors.forename: Pilar
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authors.forename: María-Dolores
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authors.forename: Kay-Tee
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authors.lastname: Khaw
authors.forename: Nick J
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authors.lastname: Wareham
authors.forename: Francesca
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authors.lastname: Crowe
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authors.forename: Philippos
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authors.forename: Dimitrios
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authors.lastname: Trichopoulos
authors.forename: Giovanna
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authors.lastname: Masala
authors.forename: Sabina
authors.initials: S
authors.lastname: Sieri
authors.forename: Rosario
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authors.forename: Salvatore
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authors.lastname: Panico
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authors.lastname: Bueno-de-Mesquita
authors.forename: Martine M
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authors.lastname: Ros
authors.forename: Anne
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authors.lastname: May
authors.forename: Elisabet
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authors.lastname: Wirfält
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authors.lastname: Sonestedt
authors.forename: Ingegerd
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authors.lastname: Johansson
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authors.forename: Elisabete
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authors.lastname: Weiderpass
authors.forename: Christine L
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mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004032:Diet; D002149:Energy Intake; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D017408:Guidelines as Topic; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009369:Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D009749:Nutrition Surveys; D010349:Patient Compliance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D044465:White People