The World Cancer Research Fund and the American Institute for Cancer Research has just come out with an update on their 1997 report on diet and cancer risk and prevention. After five years of research, the groups have produced ten recommendations. These, no surprise, look not all that different from most other sets of dietary recommendations issued for the last 50 years or so for prevention of chronic disease risk.  The recommendations emphasize staying lean and being active (”eat less, move more”). The report will be loaded with data, charts, and references and I’m looking forward to getting my copy. Enjoy!

• Be as lean as possible within the normal range of body weight.
• Be physically active as part of everyday life.
• Limit consumption of energy-dense foods. Avoid sugary drinks.
• Eat mostly foods of plant origin.
• Limit intake of red meat and avoid processed meat.
• Limit alcoholic drinks.
• Limit consumption of salt. Avoid mouldy cereals (grains) or pulses (legumes).
• Aim to meet nutritional needs through diet alone.
• Mothers to breastfeed; children to be breastfed.
• Cancer survivors: Follow the recommendations for cancer prevention.

A most unusual presidential panel on cancer prevention, sponsored by the National Cancer Institute, has just weighed in with a report asking for better policies to make it easier for people to eat more healthfully. The Washington Post views the report as taking on the food industry (also tobacco). It quotes the chair of the panel as saying that the country has a moral obligation to protect the health of Americans. Indeed it has, but it is surprising that a panel reporting to this president puts so much of the responsibility for healthful eating on the food industry. The report itself is worth reading for its strikingly candid comments–”Ineffective policies, in conjunction with limited regulation of sales and marketing in the food and beverage industry, have spawned a culture that struggles to make healthy choices – a culture in dire need of change”–and its emphasis on the need to eat less and move more (my philosophy, precisely). The committee had only three members: it’s chair, Dr. LaSalle Leffall of Howard University, Margaret Kripke (M.D. Anderson Cancer Center, University of Texas), and none other than Lance Armstrong.

Oh that nutrition and health were that simple. The The WHEL trial results appeared yesterday in JAMA. The sadly disappointing results of that trial showed no difference in rates of breast cancer recurrence among women who typically ate 5 servings of fruits and vegetables every day as compared to those who ate nearly twice that amount. I served on the data management committee for this trial and was involved with it for more than 10 years–a fascinating experience and a long saga.  I thought the trial was exceptionally well done. The investigators monitored fruit and vegetable intake by measuring the amounts of carotenes and other nutrients in the blood of the participants. Although there was some convergence of dietary patterns over the 8 years of study, the patterns were distinct enough to show benefits from eating more fruits and vegetables if that had been the case. An accompanying editorial explains why sorting out diet and cancer risk is so complicated. In the meantime, what to do? We know that people who habitually eat fruits and vegetables are healthier than those who don’t. The old “five-a-day” is a reasonable goal and it’s too bad that the promoters of that message messed it up by turning it into “fruits & vegetables: more matters.” As with most things in nutrition, enough is enough and more is not necessarily better.