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The Continuous Update Project: Recent Findings on Diet, Nutrition, Physical Activity and Cancer
12th European Nutrition Conference FENS 2015Michael LeitzmannDept. of Epidemiology and Preventive Medicine, University of Regensburg Continuous Update Project Panel member
Conflict of interestregarding this presentation:
I have no conflict of interest to report in relation to this presentation.
Outline
Prostate cancer
Kidney cancer
Liver cancer
Gallbladder cancer
Breast cancer survivors
Epidemiologic studies of diet, nutrition, physical activity and cancer
Outline
Prostate cancer
Kidney cancer
Liver cancer
Gallbladder cancer
Breast cancer survivors
Diet, nutrition, physical activity and cancer
BMI Waist circumference Waist to hip ratio
Adv
ance
dN
on-a
dvan
ced
Adv
ance
dN
on-a
dvan
ced
Adv
ance
dN
on-a
dvan
ced
RR=1.12 (1.04-1.21) RR=1.15 (1.03-1.28)
RR=1.01 (0.90-1.12) RR=0.99 (0.90-1.09)
RR=1.08 (1.04-1.12)
Dose-response meta-analysis of body fatness and prostate cancer
RR=0.95 (0.92-0.98)
Allott et al., Eur Urol. 2013;63:800–9
Obesity-related biologic mechanisms and detection biases contributing to the association between obesity and aggressive prostate cancer
Dose-response meta-analysis of height and prostate cancer, per 5 cm
RR=1.04 (1.03-1.05)
Height and prostate cancer risk
Height should be thought of as a marker for exposure(s) that influence cancer risk and not as a risk factor itself
Adult height is determined both by genetics and by early life exposures1
Greater intakes of total energy and milk protein during childhood and adolescence are positively associated with adult height2,3
Relations with total energy and milk protein may be mediated by alterations in levels of growth factors and insulin2,3
Height is associated with greater organ size, which may place more cells at risk for malignant transformation4
1. Renehan, Lancet Oncol 2011;12:716-72. Wadsworth et al., Int J Epidem 2002;31:383-903. Berkey et al., CEBP 2009;18:1881-74. Albanes & Winick, JNCI 1998;80:772-4
Dose-response meta-analysis of dietary beta-carotene and prostate cancer, per 700 ug/d
Supplemental beta-carotene and prostate cancer: randomized controlled trials
Outline
Prostate cancer
Kidney cancer
Liver cancer
Gallbladder cancer
Breast cancer survivors
Diet, nutrition, physical activity and cancer
Dose-response meta-analysis of alcohol and kidney cancer, per 10 g per day
Potential biologic mechanisms linking alcohol to decreased kidney cancer risk
Alcohol
Diureticeffect
Kidney cancer risk
Antioxidant phenolic
compounds
Insulinresistance 1
1. Davies et al., JAMA 2002;287:2559-622. Halliwell et al., Lancet 1994;344:721-43. Lee et al., CEBP 2004;15:1204-11
23
Dose-response meta-analysis of BMI and kidney cancer, per 5 kg/m2
Dose-response meta-analysis of height and kidney cancer, per 5 cm
Outline
Prostate cancer
Kidney cancer
Liver cancer
Gallbladder cancer
Breast cancer survivors
Diet, nutrition, physical activity and cancer
Dose-response meta-analysis of coffee and liver cancer, per one cup per day
Potential biologic mechanisms linking coffee to decreased liver cancer risk
Coffee Angiogenesis Liver cancer risk
Apoptosis
DNA damage 1
1. Majer et al., Food Chem Toxicol 2005;43:433-412. Cardin et al., Dig Liver Dis 2013;45:499-5043. Bohn et al., Mol Nutr Food Res 2014;58:915-304. Tunnicliffe & Shearer, Appl Physiol Nutr Metab 2008;33:1290-300
2
3
Insulin sensitivity
Chronic inflammation3
4
Aflatoxins and liver cancer
Dose-response meta-analysis of alcohol and liver cancer, per 10 g per day
Potential biologic mechanisms linking alcohol to increased liver cancer risk
Seitz & Stickel, Biol Chem 2006;387:349-60
Oxidative stress and impaired antioxidant defense
Chronic inflammation
Direct DNA damage and inhibition of DNA repair
Interference with methyl group transfer, thereby altering gene expression
Ability to act as a solvent, facilitating enhanced penetration of carcinogens
Dose-response meta-analysis of BMI and liver cancer, per 5 kg/m2
Outline
Prostate cancer
Kidney cancer
Liver cancer
Gallbladder cancer
Breast cancer survivors
Diet, nutrition, physical activity and cancer
Non-linear dose-response association of BMI and gallbladder cancer
Outline
Prostate cancer
Kidney cancer
Liver cancer
Gallbladder cancer
Breast cancer survivors
Diet, nutrition, physical activity and cancer
Breast Cancer Survivors Report 2014
Report available at: http://www.wcrf.org/sites/default/files/Breast-Cancer-Survivors-2014-Report.pdf
85 papers included in the report
164,416 women
42,572 cases of mortality
Future directions
Studies of cancer incidence:
Improve measurements of diet, nutrition, and physical activity
Perform analyses by cancer molecular subtypes
Examine potential interactions with genetic predisposition
Elucidate underlying biologic mechanisms
Studies of cancer survival:
Address potential confounding by cancer stage, treatment, and comorbidities
Investigate timing in life of exposures in relation to cancer diagnosis and treatment
Prostate cancer
Kidney cancer
Liver cancer
Gallbladder cancer
Breast cancer
survivorsBody fatnessHeightAlcoholCoffeeAflatoxinsBeta-caroteneTotal fatSaturated fatFoods containing soyFiberPhysical activity
Increased risk Decreased risk Substantial effect on risk unlikely
Summary
Limited-suggestiveevidence
Thank you for your attention!
For further information
@wcrfintfacebook.com/wcrfint
www.wcrf.org
Michael Leitzmann – Continuous Update Project Panel memberDept. of Epidemiology and Preventive Medicine, University of Regensburg