title: Concordance with World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines for cancer prevention and obesity-related cancer risk in the Framingham Offspring cohort (1991-2008).
abstract: OBJECTIVE
  This prospective cohort study evaluates associations between healthful behaviors consistent with WCRF/AICR cancer prevention guidelines and obesity-related cancer risk, as a third of cancers are estimated to be preventable.
  
  
  METHODS
  The study sample consisted of adults from the Framingham Offspring cohort (n = 2,983). From 1991 to 2008, 480 incident doctor-diagnosed obesity-related cancers were identified. Data on diet, measured by a food frequency questionnaire, anthropometric measures, and self-reported physical activity, collected in 1991 was used to construct a 7-component score based on recommendations for body fatness, physical activity, foods that promote weight gain, plant foods, animal foods, alcohol, and food preservation, processing, and preparation. Multivariable Cox regression models were used to estimate associations between the computed score, its components, and subcomponents in relation to obesity-related cancer risk.
  
  
  RESULTS
  The overall score was not associated with obesity-related cancer risk after adjusting for age, sex, smoking, energy, and preexisting conditions (HR 0.94, 95 % CI 0.86-1.02). When score components were evaluated separately, for every unit increment in the alcohol score, there was 29 % lower risk of obesity-related cancers (HR 0.71, 95 % CI 0.51-0.99) and 49-71 % reduced risk of breast, prostate, and colorectal cancers. Every unit increment in the subcomponent score for non-starchy plant foods (fruits, vegetables, and legumes) among participants who consume starchy vegetables was associated with 66 % reduced risk of colorectal cancer (HR 0.44, 95 % CI 0.22-0.88).
  
  
  CONCLUSIONS
  Lower alcohol consumption and a plant-based diet consistent with the cancer prevention guidelines were associated with reduced risk of obesity-related cancers in this population.
authors.affiliation: Department of Nutrition, Food Studies and Public Health Steinhardt School, New York University, 411 LaFayette Street, 5th Floor, Room 542, New York, NY, 10003, USA.
authors.forename: Nour
authors.initials: N
authors.lastname: Makarem
authors.affiliation: Rutgers School of Public Health, Rutgers The State University of New Jersey, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.|Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903-2681, USA.
authors.forename: Yong
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Rutgers School of Public Health, Rutgers The State University of New Jersey, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.|Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903-2681, USA.
authors.forename: Elisa V
authors.initials: EV
authors.lastname: Bandera
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging, Friedman School of Nutrition Science and Policy, Tufts University, 711 Washington Street, Boston, MA, 02111, USA.
authors.forename: Paul F
authors.initials: PF
authors.lastname: Jacques
authors.affiliation: Department of Nutrition, Food Studies and Public Health Steinhardt School, New York University, 411 LaFayette Street, 5th Floor, Room 542, New York, NY, 10003, USA. niyati.parekh@nyu.edu.|Department of Population Health, NYU Langone School of Medicine, 227 East 30th Street, 7th Floor, New York, NY, 10016, USA. niyati.parekh@nyu.edu.
authors.forename: Niyati
authors.initials: N
authors.lastname: Parekh
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000886:Anthropometry; D001943:Breast Neoplasms / Q000150:complications* / Q000517:prevention & control; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000150:complications* / Q000517:prevention & control; D004032:Diet; D005192:Family Health; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D017408:Guidelines as Topic; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011315:Preventive Medicine / Q000592:standards*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000150:complications* / Q000517:prevention & control; D012306:Risk; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires; D014481:United States; D014675:Vegetables