- New guidelines released by the American Cancer Society encourage people to exercise more per week to reduce their cancer risk.
- They also encourage people to greatly reduce the amount of red meat in their diet and to eat more colorful fruits and vegetables.
- The guidelines also urge people to strictly limit alcohol.
- Experts say the guidelines are good advice, but they note there are barriers that make it difficult for some people to adopt these lifestyle changes.
The American Cancer Society has released new guidelines for reducing the risk of cancer.
The recommendations include the latest research on diet and physical activity, as well as policy and systems changes that reduce barriers to healthy living.
The update focuses on increasing physical activity and developing healthy eating patterns at every age.
Here are some of the recommendations:
- Adults should engage in 150 to 300 minutes of moderate-intensity or 75 to 150 minutes of vigorous-intensity physical activity per week.
- Achieving or exceeding the upper limit of 300 minutes is optimal.
- It is best not to drink alcohol.
- People who choose to drink alcohol should limit their consumption to no more than one drink per day for women and two drinks per day for men.
- Follow a healthy eating pattern at all ages.
- A healthy eating pattern includes foods that are high in nutrients in amounts that help achieve and maintain a healthy body weight, a variety of colorful vegetables and fiber-rich legumes (beans and peas), whole fruits with a variety of colors, and whole grains.
- A healthy eating pattern limits or does not include red and processed meats, sugar-sweetened beverages, highly processed foods, and refined grain products.
The American Cancer Society advises public, private, and community organizations to work collaboratively at national, state, and local levels to develop, advocate for, and implement policy and environmental changes.
They say those changes should include increased access to affordable, nutritious foods, as well as providing safe, enjoyable, and accessible opportunities for physical activity, and limiting alcohol for all individuals.
Previously, the recommendations read that 150 minutes of moderate-intensity or 75 minutes of vigorous activity weekly were sufficient, and alcohol consumption should be limited.
The increase in exercise coincides with a
The prior recommendations also suggested a diet with more plant foods, and foods and beverages in amounts that help achieve and maintain a healthy weight, and eating at least 2.5 cups of vegetables and fruits each day while choosing whole grains.
“The guideline continues to reflect the current science that dietary patterns, not specific foods, are important to reduce the risk of cancer and improve overall health,” said Laura Makaroff, DO, the American Cancer Society’s senior vice president of prevention and early detection.
“There is no one food or even food group that is adequate to achieve a significant reduction in cancer risk,” she said in a press release. “Current and evolving scientific evidence supports a shift away from a nutrient-centric approach to a more holistic concept of dietary patterns.”
“People eat whole foods — not nutrients — and evidence continues to suggest that it is healthy dietary patterns that are associated with reduced risk for cancer, especially colorectal and breast cancer,” said Makaroff.
“Some of my clients have expressed concern when new guidelines come out, saying things like, ‘Now what do I need to give up?’” said Caroline West Passerrello, MS, RDN, LDN, a registered dietician nutritionist and spokesperson for the Academy of Nutrition and Dietetics.
“I encourage everyone to think about what the guidelines really mean, what small shifts they can make to work toward them, and what they can add, not take away,” she told Healthcare Website.
“Also, many times the guidelines remain very similar, but they are just presented in a different, more relevant way,” she added.
For example, she said, “The recommendation to limit red and processed meats is not new or specific to a diet pattern for cancer prevention.”
“What is important to remember is that limiting red and processed meats and following a plant-based diet does not mean you need to be a vegetarian to see benefits,” Passerrello said.
“Reducing meat is the message we often hear, but don’t forget that means you will need to replace the meat in your diet with nutrient-rich plant-based foods, which we know come with their own health benefits,” she said.
Experts agree that the proper course of action to reduce the consumption of alcohol depends on the individual.
“People drink alcohol for a variety of reasons, and tips for reducing the consumption will depend on individual circumstances,” Passerrello said.
Passerrello gives three common situations where people consume alcohol and how she advises clients in each case:
- Drinking socially with friends. She recommends having one drink and then switching to club soda with lime and maybe a splash of juice.
- Drinking to relax in the evening. She will brainstorm with clients alternative ways to relax.
- Drinking to complement a meal. She will discuss quantity and frequency goals.
“If I am working with a client who is interested in reducing their alcohol consumption, we will talk about the situations and brainstorm ways to reframe their thinking,” Passerrello told Healthcare Website.
“They may be adding more time for self-care, sleep, and exercise if they are reducing the time spent in environments that have them drinking alcohol,” she said. “We also talk about fun ‘mocktails’ they can experiment with.”
Taking baby steps or going cold turkey are both viable options, depending on personal factors.
“Let’s assume we are not referring to an alcoholic where professional treatment would be warranted,” said Kristin Kirkpatrick, MS, RDN, author of “Skinny Liver.” “If it’s someone who is going over the recommended amounts suggested in the guidelines, a baby steps approach can be the key, or cold turkey is another option. It just depends on the person and variables.”
“I often will recommend if my patients are drinking daily to start with every other day and then limit further, perhaps by limiting drinking to weekends or just two times per week,” she told Healthcare Website. “The amount each time counts, too. Sometimes, measuring can help if you still feel the need to drink daily. You can at least stick to just one serving.”
One standard serving of alcohol is equal to 12 ounces of regular beer, which is usually about 5 percent alcohol; 5 ounces of wine, which is typically about 12 percent alcohol; or 1.5 ounces of distilled spirits, which is about 40 percent alcohol, according to the National Institute on Alcohol Abuse and Alcoholism.
Kirkpatrick mentioned that the studies on excess drinking and breast cancer are quite strong, and for some of her clients, especially those with a family history of breast cancer, knowing the risk can be motivation to stop.
“First, it is important to remember that in the magnitude of all the environmental and lifestyle factors that contribute to cancer risk, tobacco use is the first thing people should be aware of. Data shows more than up to one-third of all cancers are linked to tobacco,” said Dr. Steven Clinton, a medical oncologist and researcher with The Ohio State University Comprehensive Cancer Center, Arthur G. James Cancer Hospital, and Richard J. Solove Research Institute.
He adds that diet is also important.
“Next to the air we breathe, the most intimate interaction a person has with the environment is the food that you consume,” Clinton told Healthcare Website.
“What is so interesting about our diet from a public health perspective is that as the data accumulate, we see common threads,” he said. “Indeed, the
“The (American Cancer Society) has very appropriately focused much of their report on what is critically needed and that is an effort on implementation,” said Clinton.
“Science-backed guidelines like the updated American Cancer Society guidelines for diet and exercise for cancer prevention are an important guide for individuals to make choices that influence their own cancer risk, but they also convey important information to policymakers, the food industry, and community leaders who are taking the actions that influence access to healthy foods (i.e., by ensuring food deserts are identified and addressed), and by building communities that encourage healthy habits like cycling, walking, and visiting parks,” he said.
“We have the knowledge,” said Clinton. “These guidelines are backed by science that will make a difference in cancer risk if individuals, healthcare practitioners, and communities work together to put them into action.”
“Most importantly, no one should be left behind and the social determinants of health (education, working wages, and where we work, live, play) must be addressed in a meaningful way going forward in order to reap the rewards from reducing the burden of cancer,” he said.
Clinton is not the only cancer expert who sees potential barriers preventing the guidelines from translating to reduced cancer rates.
“It will require a concerted and consistent effort by the healthcare system, media, corporations, etc., to change behavior, which is extremely difficult and challenging, but we can achieve if we work together,” said Dr. Jack Jacoub, a medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in California.
“If (it will have an impact on rates), it will be slow in developing, as the benefits of such interventions take years to manifest,” he said.
“However, without question, if we can implement these recommendations, which means reverse the obesity epidemic, get more physical activity, and eat right, plus no smoking, then yes cancer rates should fall and those are results we all hope for,” Jacoub told Healthcare Website.
Dr. Anton Bilchik, a surgical oncologist, professor of surgery, chief of gastrointestinal research, and chief of medicine at the John Wayne Cancer Institute at Providence Saint John’s Health Center in California, says the updated guidelines emphasize the fact that many cancers are preventable, and they further strengthen the importance of exercise, nutrition, and the need for community involvement.
“Increasing the exercise recommendations to 300 minutes per week is based on scientific studies that show that exercise can reduce the risk of cancer either directly by stimulating anticancer molecules in the body or indirectly through weight loss and an improvement in lifestyle,” Bilchik told Healthcare Website.
“It also provides even stricter recommendations concerning the use of alcohol, suggesting abstinence is best,” he added.
However, barriers exist to adopting these lifestyle changes, he noted.
“Three hundred minutes per week of exercise is either not practical or challenging for those people with disabilities,” he said. “A healthy balanced diet may not be affordable to many people and abstinence from alcohol has major social implications.”
“Without better education, community involvement, and an improvement in socioeconomic conditions, these recommendations are unlikely to make a significant impact on cancer prevention,” he said
Clinton agrees that the guidelines are not sufficient alone.
“Guidelines are important for conveying scientifically backed information about reducing risk and are an important step,” he said. “But without a budget and actions to help implement these guidelines, including research to define the optimal strategies to have impact, their effectiveness will be limited.”
“Now more than ever is the time to take meaningful actions in all our communities, particularly those impacted by food deserts that are common in some communities and safety concerns that make access to healthful foods and safe places to exercise difficult or impossible,” he said.
“No one should have to shop at a gas station market to feed their families. This is unacceptable and could be changed with governmental action directed at addressing disparities that are all too prevalent in America,” he said.