Simple Steps to Prevent Cancer
Healthy Living and Lower Cancer Risk

You can reduce your risk of cancer
Just a few years ago most of us couldn't even imagine this. Today, however, things are changing. New research is confirming that small choices we make each day have an important impact on our cancer risk. What we eat, how we prepare it, whether or not we exercise, manage our weight, drink alcohol or smoke - these simple decisions make an important difference.

An astonishing 60 to 70 percent of all cancer cases have been directly linked to our daily dietary and lifestyle habits. Perhaps more surprising, dramatic reductions in our cancer risk can be brought about by some less-than-dramatic means. A series of small adjustments in what we eat and do are all that's required.

This brochure introduces a set of simple and practical guidelines to help you make choices that will significantly lower your cancer risk. At the same time, you'll be lowering your risk for a variety of other chronic diseases like heart disease, stroke, hypertension and adult-onset diabetes, while improving your overall health.

These guidelines come from a landmark research report, Food, Nutrition, and the Prevention of Cancer: a global perspective, published in 1997 by the American Institute for Cancer Research. This report is an analysis of more than 4,500 studies on diet and cancer. It remains the most comprehensive report ever done in the area of diet, nutrition and cancer.

The recommendations of the AICR report can be summarized in six practical guidelines. These simple action steps represent the best advice science currently offers for lowering your cancer risk.

	Choose a diet rich in a variety of plant-based foods.
	Eat plenty of vegetables and fruits.
	Maintain a healthy weight and be physically active.
	Drink alcohol only in moderation, if at all.
	Select foods low in fat and salt.
	Prepare and store food safely.

And always remember...
Do not use tobacco in any form.
A healthy lifestyle provides many benefits at once. It's no accident these guidelines closely match advice offered by other health authorities, such as the American Heart Association, the U.S. Surgeon General, the American Medical Association, and the Joint U.S. Department of Agriculture/Department of Health and Human Services' Dietary Guidelines for Americans.

Think about it. Every time you reach for an apple you are helping your body protect itself from cancer. A quick bowl of whole-grain cereal fights the good fight, as does a helping of beans and rice, a green salad or a plate of veggies and whole wheat pasta. It's that simple.

Focusing on plant foods doesn't have to mean banishing meat altogether. For most people, the first step in making the change to a predominantly plant-based diet requires nothing more than shifting the proportions of the foods you eat. Add more rice and beans, more salad, more steamed vegetables to your dinner plate, and you'll likely find meat and other animal-based foods being nudged to the side. Once you've gotten the hang of it, the rich variety of healthy plant-based foods at your disposal will open up a world of new flavors.

2. Make a stir-fry. The proportions are perfect for a mostly plant-based meal, and the ingredients are probably already in your kitchen. Use a variety of frozen, canned or fresh vegetables, quick-cooking brown rice and a little leftover chicken or beef. Season with your favorite sauce.

3. Keep canned beans in your pantry. You'll be surprised how often they can give your meals a nutritious and flavorful boost. Add them to salads, stews, soups or grain dishes - either to reduce or replace meat. Try different kinds, such as cannellini, kidney, garbanzo, pinto or black beans.

4. Once a week, make a meatless meal. Substitute vegetables, beans, whole grains or tofu for the meat in your favorite pasta, casserole or ethnic recipe. Make salads and soups into satisfying, meatless main dishes by adding some lowfat cheese, beans or a small amount of nuts or seeds.

5. Buy a vegetarian cookbook. Even if you're not vegetarian, you'll find a host of plant-based dishes to try right away. And you'll get a sense of the enormous variety of foods and flavors that await you.

So what does a 'predominantly plant-based' diet look like, day in and day out? The example below shows the transition from a typical American menu to one that's based mostly on vegetables, fruits, whole grains and beans.

Guideline 2: Eat plenty of vegetables and fruits.

When it comes to fighting cancer, vegetables and fruits are the most vital part of a plant-based diet. Consider this important figure taken from the AICR report: If the only change people made was to eat at least five servings of fruits and vegetables each day, cancer rates could drop by at least 20 percent.

There is convincing evidence that diets high in vegetables and fruits protect against cancers of the colon, stomach, rectum, esophagus, lung and pharynx. They probably also protect against cancers of the breast, bladder, pancreas and larynx.

Why are fruits and vegetables so powerfully protective? The answer lies within the foods themselves. In addition to vitamins and minerals, vegetables and fruits contain thousands of natural substances called phytochemicals. Researchers are hard at work trying to discover the role of phytochemicals in cancer prevention. It now appears these substances work together in complex ways.

For this reason, most researchers believe that foods are more effective at preventing cancer than dietary supplements. Study after study indicates the best way to ensure you're getting a safe and effective mix of phytochemicals is to stick with a mostly plant-based diet high in vegetables and fruits.

1. Try a quick, nutritious breakfast smoothie. If you've got a blender or food processor and 12 seconds to spare, you've got an energy-packed way to start your day. Toss in a handful of fresh or frozen fruit, a bit of yogurt, milk or tofu, ice and blend. Pour some juice into the mix, and you've had two servings of fruit before you're even out the door.

2. Have a salad at lunch. A midday salad consisting of one or more dark, leafy greens and a host of vegetables is both satisfying and nutritious. When making your salad, opt for toppers like beans, nuts and fruit slices instead of cheese, bacon, hard-boiled eggs or croutons. Use lowfat or fat-free dressings.

3. Take a nutritious break. Have snacks like fresh or dried fruit or carrot sticks on hand so you'll be ready when hunger hits - whether you're at home, at work or out and about. Giving yourself a moment to recharge with something fresh, natural and delicious will do wonders.

4. Try fruit for dessert. We know you love dessert, and we're not recommending you completely abandon your cravings. But once in a while it's nice to send your sweet tooth something the rest of your body can use. In the summer, try a few slices of sweet, juicy melon topped with freshly crushed mint leaves. In the winter, an apple-cranberry crisp is a great cap-off to a healthy meal.

5. Make friends at farmers markets. One way to experience the bounty and beauty of fruits and vegetables is to visit a farmers market or produce stand. There, you can try a wide variety of fresh and colorful items. Best of all, you can talk with the people who grow the food you buy. They'll have ideas for how to prepare everything they sell, and may even share a story or two.

If five servings or more sounds like an awful lot of fruits and vegetables, take a look at this chart. You might be surprised at what the word 'serving' actually is.

Guideline 3: Maintain a healthy weight and be physically active.
When we eat more calories than we burn off through daily activities and exercise, the extra calories turn into extra weight. Overweight and obesity can increase the risk of coronary heart disease, stroke, adult-onset diabetes, high blood pressure, sleep apnea and osteoarthritis. Recent research also shows that obesity increases the risk for cancers of the colon and breast in postmenopausal women, as well as cancer of the pancreas, kidney, prostate and endometrium (uterine lining).

Physical activity plays a vital role in helping us reach and stay at a healthy weight. Regular exercise burns calories, builds muscle and helps the body run more efficiently. In addition, there is now scientific evidence that exercise itself possesses anti-cancer benefits. Regular physical activity has been shown to protect against colon cancer, and it probably lowers the risk for lung and breast cancers as well.

You can start seeing the benefits of exercise as soon as you get up off the sofa - right away, blood pressure goes down and the immune system gets a boost. And you don't need equipment, a gym membership or hours of free time. Research suggests that any amount of regular physical activity is far better than none.

If you haven't exercised in a while, get your doctor's okay before starting any program. He or she will be able to help you find an activity level that's right for you.

2. Order the small. American portion sizes have gotten out of control. Keep that in mind when you eat out or buy refreshments at a movie or ballgame. Ordering the smallest size possible can help ensure you eat until satisfied, not stuffed.

3. Eat mindfully. At mealtimes, turn off the TV or computer and put down the magazine. Research shows that 'unconscious' eating generally means overeating. While you're at it, pay attention to why you're eating. Is it boredom, stress or sadness instead of hunger?

4. Work a little exercise into your day. Go about household chores or outdoor jobs with a bit more spring in your step. Everything from vacuuming and mopping to washing the car and pushing a lawn mower around can give you a workout, if you do it energetically. At home or out, use the stairs as often as you can. Walk to the corner market for bread instead of taking the car.

5. Find activities you enjoy. There's a world of things you can do to get your blood pumping, your energy level up and your cancer risk down. Keep in mind that exercise makes a great social activity. Get together with other like-minded people and plan an active outing.

For people with sedentary jobs and lives, the AICR report recommends an hour a day of moderate physical activity and an hour a week of vigorous activity. If you are not currently active, start slowly and gradually add more activity to your day. You also don't have to set aside an entire hour for exercise. Break up your workouts however you like throughout the day. Remember that all activity is good for you, and some is better then none.

Moderate (daily)

Take a brisk walk around the block. Hop on a bike. Spend some time gardening. Take a friend canoeing. Kick off your shoes and dance. Vigorous (weekly) Walk some hills or take a hike. Play a few rounds of tennis. Swim some laps. Go for a jog. Get out your cross-country skis.

Drinking alcohol is definitely linked to increased risk for cancers of the mouth, pharynx, larynx, esophagus and liver. (Among drinkers who smoke, these risks are higher.) Alcohol probably increases the risk for cancers of the colon, rectum and breast, even at very low levels of consumption. And cancer isn't the whole story. High alcohol consumption is also linked to high blood pressure, stroke, heart disease, birth defects, osteoporosis, accidents, violence and suicide.

There is evidence that modest amounts of alcohol may protect against heart disease. If you don't drink, however, this isn't a reason to start. There are other, more healthful ways to lower your heart disease risk. If you do drink alcohol, use moderation. 'Moderation' means women should have no more than one drink a day, and men should have no more than two drinks a day.

1. Start the evening with a non-alcoholic drink. It's a good idea to quench your thirst before drinking alcohol. Try a club soda with lime, or seltzer mixed with fruit juice.

2. When entertaining, make sure to have tasty non-alcoholic drinks on hand. Offer your guests exotic fruit juices, tangy fruit punch, sparkling non-alcoholic cider or non-alcoholic beer. Though low- or no-alcohol wines are tougher to find, many winemakers now offer them for increasingly health-conscious consumers.

3. Nurse your drinks. Go ahead and water down that drink. Add some seltzer and make your own wine spritzer. Throw an ice cube - or two - into your cocktail. Sip a glass of water along with your glass of beer.

Guideline 5: Select foods low in fat and salt.

We've seen how plant-based foods dramatically lower our risk for disease. We've also seen that alcohol could have the opposite effect - it may serve to increase risk.

According to research, fat and salt are two additional substances that could increase our risk for cancer and other health problems. High fat diets possibly increase the risk for cancers of the lung, colon, rectum, breast, endometrium (uterine lining) and prostate. In addition, eating too many fatty foods can lead to obesity and the rise in cancer risk that comes with it.

Of particular concern are saturated fats (found mostly in animal-based foods) and trans-fats (partially hydrogenated oils). They are both known contributors to heart disease risk. AICR recommends minimizing the saturated and trans-fats in your diet. Instead, choose moderate amounts of monounsaturated fats such as olive and canola oils.

Diets high in salt and salted foods probably increase the risk for stomach cancer. This form of cancer is less common in the U.S. than in countries where large amounts of salt-preserved foods are eaten.

We're not recommending you banish all fat and salt from your diet. Our bodies need certain amounts of these substances to function properly. It's when we eat too much fat and salt that our disease risk rises.

AICR's Five Best Ways to Keep an Eye on Fat and Salt

1. Read the label. The 'Nutrition Facts' labels on packaged food products are trustworthy sources of information. Regulated by the U.S. government, today's food labels can tell you how much fat and sodium a food contains and allow you to compare different products. When choosing frozen entrées, for example, try to limit fat to no more than 10 grams per 300 calories. Aim for no more than 800 milligrams of sodium per entrée.

2. Use lowfat foods wisely. It's easier than ever to find lowfat or nonfat items in today's markets, but be careful. Lowfat and reduced fat cheeses, peanut butters, chips, cookies, cakes and ice creams do offer flavor with less fat, but most of these products replace fat with added sugar or salt. Choose sensible portion sizes.

3. Try out some healthy cooking techniques. Frying (or sautéing) in oil or butter adds a hefty dose of fat and calories to foods. Baking and stir-frying with a small amount of oil are healthier options. When cooking vegetables, steaming them until crisp-tender locks in both nutrients and flavor. A microwave accomplishes the same goal in minutes.

4. Opt for fresh over processed. Processed foods can be high in sodium. When you can't cook from scratch, compare labels and select lower sodium varieties of frozen dinners, canned soups and vegetables. For rice mixes, use only part of the seasoning packet. Rinse canned beans to wash away some of the salt.

5. Install another shelf in the spice rack. Experiment with herbs and spices. You'll open up a world of new flavors and aromas without the risks associated with excess fat and salt. They contain protective phytochemicals too. Here's a handy herb chart to get you started.

Guideline 6: Prepare and store food safely.

Cooking meat, poultry and fish at high temperatures, especially over an open flame, causes cancer-promoting substances called HCAs (heterocyclic amines) to form on the surface of the meats. In addition, when fat drips into the fire, the smoke and flames that rise up onto the food leave behind carcinogenic substances called PAHs (polycyclic aromatic hydrocarbons). A diet high in meat cooked by grilling, barbecuing, broiling or pan frying possibly increases the risk of stomach, colon and rectal cancers.

When cooking meats, it's best to use lower-heat options like baking, poaching, stewing, roasting and microwaving. This doesn't have to mean an end to backyard cookouts. With just a few simple techniques, you can make grilling safer for everyone.

1. Skip the meat altogether. Muscle meats like beef, chicken or fish pose the greatest risk of forming HCAs when grilled. For a delicious outdoor barbecue experience with little cancer risk, try grilling vegetables, quesadillas, veggie burgers, pizza or even fruit kebobs.

2. Cut the fat. Choose lean meats when grilling, and trim away any visible fat. Reducing 'flare-ups' caused by dripping fat will reduce the formation of PAHs and HCAs.

3. Marinate. Research shows that marinating meats can prevent the formation of HCAs by as much as 90 percent. These effects have even been observed in meats marinated for only 10-20 minutes. Health experts recommend an oil-free marinade with a strong acidic ingredient like lemon juice or balsamic vinegar.

4. Pre-cook meats. The longer meat stays over an open flame, the higher the cancer risk. Cook your fish, poultry or meat in the microwave or oven until almost done, then finish it up on the grill for flavor.

5. Avoid 'flare-ups.' Keep juices from dripping into the fire any way you can. Use aluminum foil, or don't place meat directly over the coals. Flip meats with a spatula or tongs instead of a fork. Don't squirt starter fluid into the coals while meats are cooking, and keep a spray water bottle handy to quell any flare-ups that do occur. Cut away and discard any burnt or charred parts of the meat before eating.

Tobacco is the chief cause of lung cancer in the world, and it also causes cancers of the mouth and throat. In addition, tobacco contributes to cancers of the pancreas, cervix and bladder. Regardless of how it's used - as cigars, cigarettes, pipes or chew - the link between tobacco and cancer is clear.

There are many successful methods for quitting tobacco use. Check with your physician for a program that's right for you. If you are currently a smoker and can't bear the thought of giving it up, at least try to cut down. There's a good chance that by doing so you'll also reduce the cancer risk of those who live and work with you.

Resources to Help You Quit Smoking
American Lung Association
1-800-LUNG-USA (1-800-586-4872)
www.lungusa.org

American Cancer Society
1-800-ACS-2345 (1-800-227-2345)
www.cancer.org

Office on Smoking and Health
U.S. Centers for Disease Control and Prevention
1-800-232-1311
www.cdc.gov/tobacco