By Colleen Doyle, MS, RD
Today, the American Cancer Society released its 2012 Guidelines on Nutrition and Physical Activity Cancer Prevention. Based on sound science and strong evidence, our best advice to the general public to help reduce their risk of cancer through nutrition and physical activity is to:
- achieve and maintain a healthy weight throughout life
- adopt a physically active lifestyle
- consume a healthy diet, with an emphasis on plant foods
- limit consumption if you drink alcoholic beverages
As a matter of fact, for the majority of us who don't smoke, these are the most important ways to reduce cancer risk.
In addition to these recommendations for individuals, also included in the guidelines is a key Recommendation for Community Action:
Public, private, and community organizations should work together at national, state, and local levels to implement policy and environmental changes that:
- Increase access to affordable, healthy foods in communities, worksites, and schools, and decrease access to and marketing of foods and beverages of low nutritional value, particularly to youth.
- Provide safe, enjoyable, and accessible environments for physical activity in schools and worksites, and for transportation and recreation in communities.
Guidelines evolve with evidence
Writing about this last night got me thinking about how our nutrition and activity guidelines have changed since we first published them in 1984 as we've learned more about how nutrition and physical activity impact cancer risk. One of the key changes is the evolution to an emphasis on encouraging a healthy dietary pattern as opposed to individual foods or nutrients to reduce cancer risk. As time has gone on, research suggests that it's likely the all those vitamins minerals, antioxidants, and phytochemicals working together that helps to reduce risk.
Recommendations to live a physically active lifestyle have also been added to the mix, not only because we now know that physical activity helps to directly reduce the risk of breast and colon cancers, but also because of the impact that activity can have on weight control.
The research on the relationship between excess weight and cancer risk has been evolving for quite some time, and now, there is no question: being overweight increases the risk of many types of cancer (and increases the risk of dying from cancer, as well). The emphasis on weight control within our guidelines has become stronger and stronger throughout the years - now topping our list of recommendations, above.
Recognizing that the environments where we live, work, learn, and play have a huge impact on our ability to eat well and be active, our guidelines have come to include a Recommendation for Community Action. It's not enough to just tell to eat more vegetables and fruit and to get more exercise - we have to make it easier for all Americans to do that.
Unhealthy behaviors easier than ever
And this Recommendation for Community Action, added to our guidelines in 2002 and still included today, is perhaps the most important change that has been made to our guidelines since 1984. Why? Because since that time, it's become far too easy for us to eat unhealthy diets, eat too much, and not get enough exercise.
And we're seeing the results of that.
Since the 1980s, obesity rates have doubled for adults and tripled for children. Right now, at a time when it's estimated that 14% of all cancer deaths in men and 20% in women are related to being overweight, 64% percent of adults are overweight, including 28% who are obese. Sixteen percent of youth are overweight, and an additional 12% are obese. And research suggests that these kids will be overweight as adults, increasing their risk of a variety of types of cancer down the road.
At a time we know that physical activity directly reduces the risk of two of the leading sites of cancer - breast and colon - and can impact many others through its effect on weight control, one-half of adults don't meet our minimum physical activity recommendation. And 44% of youth don't attend PE classes in an average week; 33% report watching 3 or more hours of television each day; and 25% report using a computer for 3 or more hours per day.
For many of us, food is everywhere, and we can get it just about any place and any time. When I was growing up, I don't ever recall there being food at a gas station, and for sure, fast food restaurants were not open all night. Unlike my kids, I was not able to buy candy, sodas, chips, and other snacks at a store or in vending machines at my school.
Many others of us don't have easy access to grocery stores that provide affordable, high-quality healthy foods, and that impacts the ability to eat well. Corner markets and the like typically do not have healthy affordable options, and on a limited budget, you can get a big bang for your calorie buck off a fast food dollar menu.
Portion sizes are huge. Restaurant portions are typically 2-3 times what a standard serving size would be. And the more food in front of us, the more we are likely to eat (that big tub of movie theater popcorn can have up to 1,200 calories, and that's before squirting that buttery stuff on it!).
We are bombarded with advertisements for high-calorie, high-sugar foods and beverages, especially our children. When I was growing up, we had 3 television stations. Now, my kids are being hit on TV, via computers, in movie theatres, on packages - and even in school - with ads promoting foods and beverages of low nutritional value.
The majority of our kids do not have regular physical education classes, where they can not only be active and burn some calories, but learn lifelong skills that could help them live a physically active life.
Many of us live in neighborhoods where it's not safe or even possible to walk or ride a bike. We design communities to make it necessary to have a car to get around. Personally, I used to live in a neighborhood that I had to drive out of to get anywhere. Now, my family lives in an area where we can walk to stores, restaurants, the dry cleaners. Not only is that a physical activity and health issue, it's a quality of life issue.
Community action critical
As a society, we must work together to change environments to make it easier for all Americans to live healthier lives. We need to speak up in our kids' schools about limiting the amount of unhealthy foods and beverages they have access to. We need to speak up at work, and ask for healthier options in our cafeterias and vending machines, and we need to ask for opportunities for physical activity throughout the workday. We need to speak up at our city council meetings and tell them that our neighborhoods need sidewalks, bike lanes, and parks.
Why is this so important? Why is it so important that we work together to create environments that make it easier for all Americans to make healthy choices?
Because following these guidelines can help save lives from cancer, not to mention heart disease and diabetes, as well. The science proves this again and again.
What will you do, starting today, to try to create a healthier world - in your home, in your workplace, in your kids' schools, in your neighborhood?
Doyle is director of nutrition and physical activity for the American Cancer Society.