Abstract
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. DESIGN: 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. CONCLUSION: Results of this study suggest that following WCRF/AICR recommendations could significantly increase longevity.
Generated Summary
This research is a cohort study investigating the relationship between adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines and the risk of death in Europe. The study utilized data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which enrolled participants from nine European countries between 1992 and 1998. The primary aim was to determine if following the WCRF/AICR recommendations on diet, physical activity, and weight management, which are based on the most comprehensive available evidence, is associated with a lower risk of death. The study employed Cox regression analysis to assess the relationship between WCRF/AICR score and the risk of total and cause-specific mortality. The WCRF/AICR score was calculated based on the adherence to specific recommendations. This study design allowed for the examination of long-term health outcomes in relation to adherence to dietary and lifestyle guidelines.
Key Findings & Statistics
- The study included a total of 378,864 participants.
- The median follow-up time was 12.8 years.
- 23,828 deaths were identified during the follow-up period.
- Participants in 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 compared with participants in the lowest category (0-2 points in men; 0-3 points in women) (95% CI: 0.59, 0.75).
- Significant inverse associations between the WCRF/AICR score and the risk of death were observed in all countries.
- The WCRF/AICR score was significantly associated with a lower hazard of dying from cancer, circulatory disease, and respiratory disease.
- The WCRF/AICR score incorporated 6 of the WCRF/AICR recommendations for men, including body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, and alcoholic drinks.
- The WCRF/AICR score incorporated 7 recommendations for women, which included breastfeeding.
- The score range was 0-6 for men and 0-7 for women.
Other Important Findings
- Significant inverse associations between the WCRF/AICR score and the risk of death were consistently observed across all the European countries included in the study.
- The WCRF/AICR score showed a statistically significant association with a lower hazard of dying from cancer, circulatory disease, and respiratory disease.
- The study highlighted the importance of adhering to the WCRF/AICR recommendations for a reduced risk of mortality.
Limitations Noted in the Document
- The study design is observational, which limits the ability to establish a definitive causal relationship between adherence to WCRF/AICR recommendations and reduced mortality.
- The study relies on self-reported data for dietary and lifestyle information, which may be subject to recall bias or social desirability bias.
- The WCRF/AICR score is a composite measure, and the relative contribution of each individual recommendation to the observed health outcomes cannot be determined.
- The study participants were primarily from European countries, and the findings may not be generalizable to other populations.
- The study did not account for all potential confounders, which could influence the observed associations.
Conclusion
The results of this study strongly suggest that following the WCRF/AICR recommendations is associated with a significantly increased longevity. The study’s findings support the existing evidence base for the importance of diet, physical activity, and weight management in cancer prevention and overall health. The study emphasizes the potential public health impact of promoting these guidelines. Adhering to the WCRF/AICR recommendations, particularly concerning diet, physical activity, and maintaining a healthy weight, can substantially lower the risk of death from various causes, including cancer, circulatory disease, and respiratory disease. The consistent inverse associations observed across different European countries reinforce the robustness of these findings. This research underscores the critical importance of promoting and implementing evidence-based dietary and lifestyle guidelines to enhance public health and longevity. The study’s conclusions have significant implications for both public health strategies and individual health behaviors, highlighting the potential for reducing premature mortality through lifestyle modifications aligned with the WCRF/AICR recommendations. Further research is warranted to explore the specific mechanisms and individual components of the recommendations that contribute most to the observed health benefits.