Hot topics archive

• Deaths from circulatory disease decrease at a faster rate than cancer
• Meat, eggs and dairy not a risk factor for breast cancer according to EPIC
• Genetic influences on the susceptibility to overeating
• A third of adults exceed UK recommended drinking guidelines
• Traditional world recipes get the green light
• Updated cancer survival statistics for England
• Alcohol causes one in 25 deaths globally
• Simple recipes for children this summer
• A farewell to Professor Sheila Rodwell, a leader in nutritional research
• Recent Cancer Statistics for UK available
• Revised salt reduction targets are more challenging
• Diet and exercise improve functional decline in cancer survivors
• Change4Life survey shows most children are not active enough
• Four or more units of alcohol a day may increase pancreatic cancer risk
• WCRF UK new publication: Eating well and being active following cancer treatment
• Healthy Weight, Healthy Lives: One Year On – new targets revealed
• Understanding how people make food choices
• WCRF/AICR Policy Report
• Healthy eating initiatives grant scheme

Traditional world recipes get the green light

Nutritional information, healthy eating tips and traffic lights guidance for traditional foods of African, Central and South Asian, and Middle Eastern origin are now available on a new online Nutrition Centre.

The website has recently been launched by the Aga Khan Health Board in collaboration with the Department of Health, Kings College London and the Aga Khan Foundation (UK). The site features a database of recipes from different regions of the world, for which it provides detailed nutritional information. A primary source of information is the South Asian Food Survey, which investigated the nutrient content of foods commonly consumed by various South Asian groups living in the United Kingdom. This allows the recipes to be evaluated against dietary guidelines.

Each recipe in the Nutrition Centre includes a set of coloured traffic lights based on guidelines from the Food Standards Agency labeling system. The traffic lights show whether a particular dish has a high, medium or low amount of fat, saturated fat, sugar and salt.

WCRF UK scientific adviser Professor Martin Wiseman said: “Research shows that about a third of the most common cancers could be prevented through a healthy diet, being physically active and maintaining a healthy weight. Using the traffic light system for traditional recipes will help people from Asian communities to make informed, healthier choices about their diet and thus reduce their risk of chronic diseases. This website will also be a useful resource for health professionals”.

Registered Dietitian & TV Nutritionist Azmina Govindji, who collaborated on the project, said the site will “help families use the data we have collected to improve their diet. This is a site about traditional recipes and how to make them healthier”. To discover more recipes to help you and your patients reduce the risk of cancer visit our recipe section.

All our recipes have been devised and checked by nutritionists and include nutritional information.

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Updated cancer survival statistics for England

The latest cancer survival figures for the most common cancers in England are now available on the UK Cancer Statistics section of the WCRF UK website. Data come from the Office for National Statistics website. The full report gives five-year survival for adults from 21 cancers in patients resident in England diagnosed during 2001-06 and followed up to the end of 2007.

Thanks to research and screening programs, survival rates for cancer continue to improve. The highest survival rates were for breast and prostate cancer.

These figures show that there is an increasing need to provide cancer survivors with lifestyle recommendations to regain their health and avoid cancer recurrence. WCRF UK's booklet Eating Well and Being Active Following Treatment is essential reading for health professionals who need to help cancer survivors improve their health outcomes.

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Alcohol causes one in 25 deaths globally

Alcohol accounts for an estimated 3.8 per cent of all global deaths and 4.6 per cent of disability-adjusted life-years, according to a series of new studies [1] published in the Lancet.

The researchers quantified the burden of disease and mortality attributable to alcohol on the basis of reviews of published work. The burden of disease was closely related to the quantity of alcohol consumed. For every unit of alcohol drunk the negative effect was stronger in people on low-income and in those more marginalized from society. The alcohol burden was particularly strong in European countries where people consume more alcohol, with more than one in every 10 deaths in European men attributable to alcohol.

There was a strong difference between sexes. The percentage of global deaths attributable to alcohol was 6.3 per cent in men and 1.1 per cent for women. The sex difference was less marked in Europe, where women drink more alcohol than in other parts of the world. The effect of alcohol was also larger in younger age groups.

Alcohol and cancer

The majority of global alcohol-related deaths were caused by injuries and accidents. However, about 18 per cent of male and 25 per cent of female alcohol-related deaths were caused by cancer.

The WCRF/AICR Second Expert Report found that the evidence that all types of alcoholic drinks are a cause of a number of cancers is now stronger than ever before. There is convincing evidence that alcohol increases the risk of cancer of the mouth, pharynx and larynx, the oesophagus and breast. It also increases the risk of bowel cancer (though this was only found to be the case in men).

Alcohol consumption is one of the most avoidable risk factors for cancer and other health problems. WCRF UK recommends that if consumed at all, we should limit alcoholic drinks to two for men and one for women a day.

Order or download our A Closer Look at: Alcohol leaflet, which can help your patients increase their awareness of the link between alcohol and cancer. The leaflet also includes helpful tips on how to reduce alcohol intake.

1. Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Lancet 2009 Jun 27;373(9682):2223-33

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Simple recipes for children this summer

Summer is a good opportunity to get children involved in cooking activities. It can help them discover new foods and tastes. More importantly, the dietary habits parents help create when their children are younger can lead to a lifetime of healthier choices.

It is important to give parents the tools to help their children grow up eating well. 'Simple cooking - cold food that tastes great' is a handy cookbook that helps parents and educators do just that. The cookbook is the second in the series of free “Real Meals” recipe books provided by the Government to encourage healthy eating in school-aged children.

The cook book, free for all Year 6 pupils, features healthy recipes that are easy and quick to prepare and can be eaten at home or used for picnics and packed lunches during the summer months.

Ed Balls, Secretary of State for Children, Schools and Families said: “This new recipe book will help children learn how easy it is to prepare tasty and healthy food that they can eat on the go.”

All recipes have been provided by the School Food Trust and the British Nutrition Foundation and include hygiene tips and details of the cooking skills and utensils that young people will need.

For recipes suitable for younger children visit the children’s recipe section of the Great Grub Club, which is WCRF UK’s website aimed at four to seven years olds. 

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A farewell to Professor Sheila Rodwell, a leader in nutritional research

Professor Sheila Rodwell, previously known professionally as Sheila Bingham sadly passed away just days after receiving an OBE for her important work in diet and cancer prevention and survival.

Professor Sheila Rodwell was Director of the MRC Centre for Nutritional Epidemiology in Cancer Prevention and Survival at the University of Cambridge and a Principal Investigator of the European Prospective Investigation of Cancer (EPIC) in Norfolk study.

She was a Fellow of the Royal Society of Medicine and became Honorary Professor of the University of Cambridge in 2006 for her research in nutritional epidemiology. She co-authored over 450 publications and served on government subcommittees and editorial boards on major journals on nutrition and cancer.

Scientific contributions to diet and cancer research

Since the 1980s Professor Rodwell’s research helped increase our understanding of how and why dietary factors increase our cancer risk. She worked with WCRF UK since the mid 1990s, when she became a reviewer for our 1997 expert report. She was also an important contributor to our 2007 Second Expert Report, helping to define the methodology used to compile and analyse the thousands of research studies assessed for the Report. She was awarded four WCRF grants over the last seven years, for research into improving how we assess diet when looking at the link with cancer development and survival.

Early in her career she realised the need for large scale population studies of cancer and diet, in which individual dietary intake could be assessed, and developed markers in blood and body fluids that could be used to verify reports of food intake.

One of her numerous well-cited papers, published in The Lancet, showed a strong protective effect of fibre against bowel cancer, while another demonstrated that people who eat large quantities of red meat but little dietary fibre are at particular risk of the disease. In subsequent studies she demonstrated that haem, an iron-containing molecule in red meat, might be responsible for the red meat and bowel cancer risk. Another important finding of her work in EPIC Norfolk has been the demonstration that fat could be an important risk factor in breast cancer, a finding that has been replicated in a subsequent study in the USA.

Furthermore, using data from hundreds of volunteers from the EPIC study, she compared information from people reporting what foods and drinks they consumed with data from urine and blood samples and showed that obese people underestimated the amount of sugar they consumed, while overestimating the amount of vitamin C they took in each day. This finding highlighted the need for more accurate assessment of diet.

In 2006 she set up the Centre for Nutritional Epidemiology in Cancer Prevention and Survival (CNC), a new MRC Centre awarded to the Institute of Public Health in Cambridge. The main aim of the centre was to bring together six UK cohort studies of 100,000 participants with dietary information in order to investigate how diet can prevent cancer.

Sheila’s vision for the CNC was to provide scientific evidence building on the findings from the EPIC European-wide collaboration as well as to study the relationship between genes and diet. She also wanted to improve the methodology of dietary assessment by developing existing as well as new assessment methods and dietary biomarkers. The ultimate goal of these efforts was to identify the underlying causes and specific foods involved in cancer prevention and survival.

WCRF Science Programme Manager Dr Panagiota Mitrou, one of her early PhD students and a close colleague said: “She will be missed deeply by the whole scientific community because she had so much more to offer. But she will always be remembered as a great mentor and an inspiring leader to many scientists all around the world.”

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Recent Cancer Statistics for UK available

The UK Cancer Statistics section of the WCRF-UK website has been updated with the latest information. Cancer rates for newly diagnosed cancers for all countries for 2006 continue to be higher in Scotland and Wales than England and Northern Ireland. The most common cancers in the UK are still prostate, lung and bowel in men, and breast, lung and bowel in women.

Information on survival rates for the most common cancers has also been updated and expanded to include Northern Ireland.

A new section on geographical differences within England has been added and includes charts for all cancers as well as the most common cancers. Cancer rates for newly diagnosed cancers are higher in the north-west and north-east and lower in London, the east and south-east.

Why are these differences occurring? There is also a north-south divide for lifestyle factors associated with cancer.  Rates of smoking are higher in the north-east, north-west and Yorkshire than in London, the east and the south-east. Rates of overweight and obesity are higher in the north-east, north-west and Yorkshire than in London. People living in London and the south-east report eating more vegetables and fruits than those in other parts of Britain.

The good news is that cancer is mostly preventable and by reducing geographical differences in lifestyle habits we can also reduce geographical differences in cancer rates.

UK Cancer Statistics

Statistics on Obesity, Physical Activity and Diet: England, 2009

General Household Survey 2007. Smoking and drinking among adults, 2007

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Revised salt reduction targets are more challenging

The Food Standards Agency (FSA) has published revised and more challenging targets for salt reductions in manufactured foods for 2010-2012 in order to make sure that food retailers and manufacturers maintain momentum in reducing salt levels in foods. These voluntary revised targets reflect the progress made by manufacturers and retailers in reducing salt levels since the previous targets (for 2010) were set in 2006. The average amount of salt found in branded pre-packed, sliced bread, for example, has been reduced by around one-third. This has led to a positive result in the UK and people’s average salt intake in 2008 was 8.6g – 0.9g lower than it was in 2000-2001. The long-term target is to reduce average salt intake amongst British adults to 6g a day.

Around 75% of the salt in our diet is from manufactured and other processed foods (rather than added in cooking and at the table). The FSA’s voluntary targets have been made for 80 categories of foods that make the greatest contribution of salt to our diet, including bread, meat products, breakfast cereals and convenience foods.

It’s important to encourage people to look for alternatives to salt and show that there are lots of ways to add flavour to food using spices, herbs, garlic, or lemon instead. Chilli powder, black pepper, ginger, and basil are all ways to make dishes taste great quickly and easily.

You can download or order WCRF UK’s Understanding Food Labels leaflet. It has the FSA’s traffic light labelling guidelines on sugars, fat, saturates and salt on a handy card to carry around with you or use with your patients.

In the autumn of this year, the FSA plans to run further public awareness activities on salt.

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Diet and exercise improve functional decline in cancer survivors

Overweight long-term cancer survivors, who participated in a diet and exercise programme, reduced their functional decline over 12 months, according to a new study published in the Journal of the American Medical Association [1].

The Reach out to Enhance Wellness (RENEW) randomised controlled study assessed functional decline in 641 overweight survivors of colorectal, breast and prostate cancer. The subjects were randomly assigned either to a 12-month home-based diet and exercise programme delivered over the phone and by mail (the intervention group), or to receive a delayed intervention (the control group).

The intervention consisted of 15 telephone counselling sessions and 8 automated messages. It also included a pedometer, a portion size guide, an exercise poster and a personalised workbook delivered by post at the participant’s home. The overall cost per person was $1000.

Among the changes suggested were 30 minutes of endurance exercise a day, 15 minutes of strength training every other day, a 10% weight loss and intake of seven to nine portions of fruits and vegetables a day. All healthy behaviours, except endurance training, were significantly improved in the intervention group compared with the control.

Physical function decline was assessed through a self-reported questionnaire. After 12 months of diet and exercise, functional scores declined less rapidly in the intervention group compared with the control group. (-2.15 compared with -4.84).

WCRF UK recommends that, after treatment, cancer survivors follow the general guidelines for cancer prevention, which include being physically active every day for 30 minutes or more, maintaining a healthy weight and eating a primarily plant-based diet. These advice has been published in WCRF UK booklet Eating well and being active following cancer treatment, which provides diet and lifestyle guidance for cancer survivors.

This study is encouraging as it shows that functional decline can be slowed if healthy behaviours are followed. Decreasing functional decline at older age can significantly improve survival and quality of life, while saving costs to the NHS and to carers. Overweight in older people is a major cause of physical decline, especially among cancer survivors, so targeting overweight cancer survivors could be of particular clinical significance.

1. Miriam C. Morey; Denise C. Snyder; Richard Sloane; et al. Effects of Home-Based Diet and Exercise on Functional Outcomes Among Older, Overweight Long-term Cancer Survivors: RENEW: A Randomized Controlled Trial. JAMA. 2009;301(18):1883-1891

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Change4Life survey shows most children are not active enough

Nearly three quarters of children are not getting the recommended 60 minutes of physical activity a day, a Department of Health survey revealed in April.  

The Change4Life survey called ‘How Are The Kids’ looked at over 260,000 families and their daily levels of activity. The results found that only 22 per cent of children took part in any physical activity after their evening meal, and that 45 per cent played computer games or watched TV before going to school every morning.

The results coincide with a Change4Life TV advert that is currently showing to highlight how the lack of physical activity can cause obesity, which together increase the risk of chronic diseases such as heart disease and type 2 diabetes, as well as several types of cancer.

Dawn Primarolo, the Minister for Public Health, said: “Our survey shows that kids just aren’t getting up and about as much as they should. If we are going to cut obesity levels, our children need to be active for at least 60 minutes a day.”

The Change4Life campaign raises awareness of the obesity problem and encourages people to increase their physical activity levels and to eat more healthily.

The WCRF 2007 Expert Report found that physical activity not only helps maintain a healthy weight but also has a direct protective effect against several types of cancer. Specifically, regular physical activity reduces the risk of bowel cancer, and probably postmenopausal breast cancer and endometrial (womb) cancer as well.

To help children stay healthy we have developed a child health section on WCRF UK’s website, which includes ideas for parents to keep their children active.

WCRF UK Recommendations for physical activity:

• Be moderately physically active for at least 30 minutes every day
• As fitness improves, aim for at least 60 minutes of moderate activity or 30 minutes of vigorous activity every day
• Limit sedentary habits such as watching TV.

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Four or more units of alcohol a day may increase pancreatic cancer risk

New research published in Cancer Epidemiology, Biomarkers and Prevention [1] has suggested that moderate drinking may increase the risk of pancreatic cancer.

US scientists, who reviewed 14 cohort studies involving over 862,000 individuals, found that people drinking 30g of alcohol a day had a 22 per cent increased risk of pancreatic cancer risk – 30g of alcohol is equivalent to about four units.

This figure took into account adjustments for age, diet, smoking and diabetes. The study also showed that the risk was not modified by lifestyle factors such as multi-vitamin supplement, folate and methionine intake and smoking. 

The effect was stronger in women (41 per cent increased risk) than in men (12 per cent increased risk) and was more apparent among normal weight people (BMI 25 or under) compared to overweight or obese people (BMI over 25). Overweight and obesity are themselves associated with higher risk of pancreatic cancer.

The type of alcohol drunk, whether it was wine, beer or spirits, made no difference to the results of the study. The study suggests that it is the amount rather than the type of alcohol consumed that increases the risk of pancreatic cancer. The 2007 WCRF/AICR Expert Report drew no conclusion on the effect of alcohol on pancreatic cancer risk.  This study adds to that by using the more powerful “pooling” method, based on retrieving and combining the data for all individuals in the studies, while the 2007 Report was based on study level meta-analyses. 

Both the 2007 WCRF/AICR Report and this study suggest that the evidence that all types of alcoholic drinks increase cancer risk is now stronger than it was in the mid 1990s. There is strong evidence that alcohol increases the risk of many cancers including those of the mouth, pharynx, larynx, oesophagus and breast.

Current UK alcohol government guidelines advise no more than 3-4 units a day for men and 2-3 units a day for women. For cancer prevention, WCRF UK recommends that if consumed at all, we limit alcoholic drinks to 2 for men and 1 for women a day.

[1] Genkinger et al (2009) Alcohol Analysis and Pancreatic Cancer Risk: A Pooled Analysis of Fourteen Cohort Studies Cancer Epidemiology, Biomarkers and Prevention 18 (3) pp765-776.

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WCRF UK new publication: Eating well and being active following cancer treatment

WCRF UK has launched a new booklet that provides diet and lifestyle guidance for people who have finished and recovered from treatment for cancer. The booklet is based on the evidence reviewed for the 2007 WCRF/AICR Second Expert Report: Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective.

After reviewing all the available evidence the Expert Panel agreed that after treatment, cancer survivors should follow the Recommendations for Cancer Prevention.

WCRF UK’s new booklet provides information on the Recommendations from a cancer survivor’s perspective. The advice is to choose mostly plant foods, limit red meat and avoid processed meat; aim to be a healthy weight; and be physically active every day for 30 minutes or more.

There are now more than two million people living with or recovered from cancer in the UK. Many of these people want to make changes to reduce their risk of further cancer.

Some people may wish to make dramatic changes to their lifestyle, while others will want to make small changes. Extreme changes such as cutting out food groups, consuming special foods, taking vitamin supplements or spending a lot of money are not necessary.

The booklet also gives practical advice such as tips on making lifestyle changes, recipes and frequently asked questions.

Order Eating well and being active following cancer treatment

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Healthy Weight, Healthy Lives: One Year On – new targets revealed

The UK Government published its Healthy Weight, Healthy Lives: One Year On, in April 2009. The report looks at the progress of the Government’s 2008 objectives, and sets new targets and challenges for the coming year.

What were the 2008 targets?

• To become the first major country to reverse the rising obesity levels nationwide
• To reduce childhood obesity to 2000 levels by 2020

What has been achieved so far?

• New childhood obesity figures have been revealed. The obesity rate in children aged 2-10 fell from 16.8 per cent in 2005 to 15.2 per cent in 2006. This then rose only slightly to 15.4 per cent in 2007 suggesting a possible flattening out of the obesity prevalence trend
• Adult obesity levels in both sexes appear to have slowed although there is a continued rise in the number of overweight adults
• 88 per cent of eligible primary school children have been measured through the National Child Measurement Programme. Fifty per cent of parents receive feedback from the scheme
• Widespread front of packet labelling
• Many manufacturers have decreased levels of saturated fat, sugar and salt in food products

What are the 2009 targets?

• To inspire behavioural change in 200,000 families through the Change4Life campaign
• To promote further healthy eating and physical activity in schools through an extended Healthy Schools Programme
• To extend the Change4Life campaign and roll out NHS health checks for at risk overweight or obese adults
• Provide new content and tools on the NHS website to support people to chose a healthier lifestyle and maintain a healthy weight
• To use 2007/8 National Child Measurement Programme results to support at risk families and children
• To create and promote initiatives in the workplace
• To promote voluntary targets for reduction of fat and sugar by manufacturers and to introduce voluntary nutritional labelling for fast food and chain restaurant meals

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Understanding how people make food choices

The Food Standards Agency (FSA) and the Economic and Social Research Council (ESRC) have joined up to fund research into a number of food policy activities. One of these is to investigate through a number of social science perspectives how dietary choices are made in the UK today.

The aim is to look at if, when and where decisions about diet and health fit into people’s lives. This information will be useful to find out how and why people eat the foods they do.

The FSA and ESRC plan to fund one in-depth study, to produce qualitative data, and one larger scale project, to provide quantitative data, to build on what we already know about dietary decisions and behaviour change.

Understanding more about the social and behavioural influences on dietary choices will help to inform future healthy eating policy decisions and campaigns.

The WCRF/AICR 2009 Policy Report found that attitudes and beliefs have an impact on people’s health behaviours along with the environment they live in.

As a result of the Report, scientists estimate that about a third of the most common cancers could be prevented by eating a healthy diet, being physically active and maintaining a healthy weight.

Find out more about FSA and ESRC project

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WCRF/AICR Policy Report

At the end of February, WCRF/AICR launched their first Policy Report, which is the follow-up to our Expert Report, published in 2007. The Report looks at the environmental, economic social and personal factors that affect people's choices and how these influence cancer development.

A number of Recommendations are made in the Report, aimed at policymakers, decision-takers and others (including health professionals) at international, national and local level.

Policy Recommendations for health professionals

• Prioritise public health including cancer prevention, and food, nutrition and physical activity, in core training, practice and professional development
• Take a lead in educating and working with colleagues, other professionals, and others to improve public health including cancer prevention
• Involve people as family and community members, and take account of their personal characteristics in all types of professional practice

WCRF UK will be working with stakeholders to put into practice some of the Recommendations.

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Healthy eating initiatives grant scheme

At the end of February the Food Standards Agency launched its 2009/10 grant scheme to offer up to £10,000 for local food hygiene and healthy eating initiatives.

The grant scheme, introduced in England in 2003 and extended to Scotland in 2004 and Wales in 2007, is open to local authorities, trading standards regional groups, food liaison groups and their equivalents.

Last year 26 local authorities were funded and the projects awarded with grants included:

Cardiff County Council – 'Meet, Cook & Eat'. The project aimed to provide older people with the skills and knowledge to adapt their diets in a fun, nutritious and hygienically safe way through a series of cooking classes.

Fife Council – ‘Food Labels Matter’. This project used interactive workshops to highlight the high intake of fats, sugar and salt in foods consumed by young persons.

Medway Council – 'Health By Stealth'. A project focused on vulnerable disadvantaged young people who are missing out on key healthy eating and food hygiene messages usually learnt at home or at school.

City & County of Swansea – 'Grow with us Eat Well'. A project for young people, aged 9-13, from four areas of Swansea, to encourage healthy eating/living and to develop skills to grow, prepare and try a variety of new foods.

The focus of this year’s initiatives is food hygiene promotion among older people and joint local action to reduce saturated fat or salt intake.

The closing date for applications in all four UK countries is 24 April 2009.

• More information and an application form
• See 2008 Healthy eating initiatives grants

WCRF UK supports local initiatives to improve healthy eating skills, knowledge and awareness in the community.

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