American Cancer Society Guideline for Diet and Physical Activity for Cancer Prevention

Keep your weight within the healthy range and avoid weight gain in adult life.

Excess body weight is linked with an increased risk of several types of cancer. The link is stronger for some cancers than for others. Excess weight affects cancer risk differently across cancer types.

The dietary factors most often linked with excess body weight include sugar-sweetened beverages, fast foods, and Western type diets (those high in added sugars, meat, and fat), whereas foods containing fiber and Mediterranean diet patterns may reduce risk.

Aerobic physical activity, including walking, is linked with a lower risk of excess body weight, while sedentary behaviors (sitting and lying down) and more screen time (such as looking at a phone or computer, or watching TV) are linked with a higher risk.

Because of this, the ACS Guideline recommends that people keep their weight within a healthy range and avoid weight gain.

• Adults should get 150-300 minutes of moderate intensity or 75-150 minutes of vigorous intensity activity each week (or a combination of these). Getting to or exceeding the upper limit of 300 minutes is ideal.
• Children and teens should get at least 1 hour of moderate or vigorous intensity activity each day.
• Limit sedentary behavior such as sitting, lying down, watching TV, and other forms of screen-based entertainment.

Benefits of physical activity

Physical activity has been linked to a lower risk of several types of cancer. Being active may also help to prevent weight gain and obesity, which may in turn reduce the risk of developing cancers that have been linked to excess body weight.

A physically active lifestyle may also lower a person's risk of other health problems such as heart disease, high blood pressure, diabetes, and osteoporosis (bone thinning).

Examples of moderate and vigorous physical activities

Moderate physical activity is working at a level that increases your heart rate, makes you breathe harder, but you may or may not break a sweat. You’re able to carry on a conversation, but not able to sing your favorite song. Examples of moderate physical activity include things like:

• Walking, dancing, or leisure bicycling
• Ice or roller skating
• Playing volleyball, baseball, or doubles pickleball or tennis
• Mowing the lawn with a push mower
• Walking and lifting as part of the job (custodial work, farming, or auto repair)

Vigorous physical activity is when your heart rate is higher than moderate activity, and you’re breathing harder and faster. You can’t say more than a few words at a time without stopping to take a breath. Examples of vigorous intensity physical activity include:

• Running or fast bicycling
• Swimming or aerobic dancing
• Playing soccer, basketball, hockey, or singles pickleball or tennis
• Digging, carrying, and hauling
• Heavy manual labor (forestry or construction)

Recommended amount of activity

Adults should get 150-300 minutes per week of moderate intensity activity or 75-150 minutes per week of vigorous intensity activity, or an equal combination. This type and amount of activity can help you live longer and lower your risk of developing or dying from some cancers. Being even more active may lower your cancer risk even further.

Getting 150-300 minutes of activity each week may sound like a lot, but you can spread it out over the week. You can also mix moderate and vigorous activities. As a rule, 1 minute of vigorous activity counts the same as 2 minutes of moderate activity. For example, you could walk 30 to 60 minutes a day, 5 days a week, or run 25 to 50 minutes a day, 3 days a week. You can also combine activities in any way that works best for your lifestyle.

If you’re not active or are just starting to exercise, even small amounts of activity can improve your health, especially your heart. You can slowly increase how much and how hard you exercise over time.

Most children and young adults can safely be moderately and/or vigorously active without checking with their doctors. But men over 40, women over 50, and people with chronic illnesses or risk factors for heart disease should talk to their doctor before starting a vigorous activity program.

Children and teens muscle-strengthening activities should be moderately to vigorously active for at least 1 hour a day, every day. This should include at least 3 days a week.

Kids should have fun, age-appropriate, and varied activities, like sports and fitness at school, at home, and in the community. To help them stay active, schools should offer daily physical education and activity breaks. At home, screen time – like TV, video games, or phone or computer use - should be limited.

Limiting time spent sitting

There is growing evidence that how much time you spend sitting is important, regardless of your activity level. Being sedentary (sitting time) raises the risk of obesity, type 2 diabetes, heart disease, and some types of cancer, as well as the risk of dying at a younger age.

Lifestyle changes and advances in technology have led to people being less active and spending more time sitting each day. This is true in the workplace and at home, due to increased TV, computer, and other screen time. Limiting the amount of time spent sitting may help maintain a healthy body weight and reduce the risk of certain cancers.

Tips to reduce sitting time

• Limit screen time or add in physical activity: set screen-free times; use a stationary bike or treadmill while you watch TV and/or walk around when commercials come on.
• Build activity into your routine: take the stairs instead of the elevator, walk or bike to your destination when possible and wear a pedometer to track and increase your steps.
• Stay active at work: take short exercise breaks to stretch, walk over your lunch break, and visit coworkers in person instead of calling or e-mailing.
• Choose active leisure: plan vacations that include physical activities.

A healthy eating pattern includes:

• Foods that are high in nutrients in amounts that help you get to and stay at a healthy body weight
• A variety of vegetables – dark green, red, and orange, fiber-rich legumes (beans and peas), and others
• Fruits, especially whole fruits in a variety of colors
• 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 healthiest eating is mostly based on plant foods like vegetables, fruits, whole grains, beans, and nuts/seeds. They also include healthy protein sources, such as beans, fish, or poultry, while limiting red and processed meats. Healthy eating includes unsaturated fats, like those found in olive oil, nuts, and fish and chooses foods that are lower in added sugars, unhealthy fats, and excess calories.

Studies have shown that these dietary patterns are linked to a lower risk of cancer, certain other diseases, and early death. Some parts of these diets – like eating more plants and less processed meat – are linked with lower cancer risk.

Vegetables and fruits

Vegetables (including beans) and fruits are full of vitamins, minerals, fiber, and other substances that may help prevent cancer. Certain types, like dark green and orange vegetables, cruciferous vegetables (cabbage, broccoli, cauliflower, and Brussels sprouts), onions, garlic, tomatoes, soy, and other legumes are being studied for their cancer-fighting properties.

Eating vegetables and fruits may also control weight, since they are low in calories, high in fiber, and have lots of water. Eating plenty of vegetables and fruit is also linked to a lower risk of heart disease and other chronic illnesses.

For cancer risk reduction, the ACS recommends following the 2020-2025 Dietary Guidelines for Americans: at least 2½ to 3 cups of vegetables and 1½ to 2 cups of fruit each day, depending on calorie needs.

Whole grains

Whole grains keep all parts of the original grain, so they have more fiber and nutrients than refined (or processed) grains. These include things such as whole wheat, brown or wild rice, oats, and corn. Studies show that eating whole grains might lower the risk of colorectal cancer. Whole grains and high-fiber foods might also help lower the risk for developing excess body weight, which can also contribute to cancer risk.

The ACS and the Dietary Guidelines for Americans recommend making whole grains at least half of your grain intake .

Fiber

Dietary fiber is found in plant foods such as beans, whole grains, fruits, vegetables, nuts, and seeds. Eating these foods may help prevent excess body weight, which can lower the risk of cancer. Fiber can also support the growth of certain gut bacteria that may potentially lower the risk of colorectal and other cancers.

Studies of fiber supplements like psyllium fiber and wheat bran fiber haven’t been shown to reduce colon polyps. The ACS recommends getting your fiber through your diet from whole plant foods and not through supplementation.

Red and processed meats

Red meat includes beef, veal, pork, lamb, mutton, or goat.

Processed meat has been cured, smoked, salted, or fermented to improve or preserve flavor. Examples include bacon, sausage, hot dogs, and deli meats. Most processed meats contain pork or beef, but they may also contain other red meats, poultry (like turkey or chicken), or meat byproducts.

Evidence that red and processed meats increase cancer risk  has existed for decades, and many health organizations recommend limiting or avoiding these foods. In 2015, the International Agency for Research on Cancer (IARC) classified processed meat as “carcinogenic [cancer-causing] to humans” (Group 1) and red meat as “probably carcinogenic to humans” (Group 2A), based on evidence that they increase the risk for colorectal cancer. Recent studies also suggest a possible role of red and/or processed meat in increasing risk for breast cancer and certain forms of prostate cancer, although more research is needed.

It isn’t known if there is a safe level of red or processed meat to eat. Because of this, the ACS recommends eating more protein from fish, poultry, and beans instead of red meat. If you eat processed meat, you should do so sparingly, if at all.

Added sugars

Added sugars and other high-calorie sweeteners (such as high-fructose corn syrup) are often used in sugar-sweetened beverages and energy-dense foods (for example, traditional “fast food” or ultra-processed foods (or UPFs). They are linked with a higher risk of weight gain and having excess body weight, which increases the risk of many types of cancer.

Energy-dense and highly processed foods are also often higher in refined grains, saturated fat, and sodium.

The Dietary Guidelines for Americans recommend limiting calories from added sugars and saturated fat and specifically getting less than 10% of your calories a day from added sugars.

Processed foods 

The health impact of UPFs (also called highly processed foods) is an area of increasing concern. Some processing, like peeling, cutting, or freezing vegetables and fruit, can make food safer, easier to use, and tastier. But highly processed foods – such as packaged snacks, sugary drinks, ready-to-eat or ready-to-heat meals, candy, and desserts – often look very different from their original ingredients.

These highly processed foods are usually high in fat, sugar, refined grains, and salt. Studies have linked them to health problems, including weight gain. More research is needed to understand the impact on cancer risk. Still, up to 60% of the calories consumed per day in US households are from highly processed foods and beverages.

Calcium, vitamin D, and dairy products

Some research has linked diets high in calcium and dairy products to a lower risk of colorectal cancer, and possibly breast cancer as well. But some studies have also suggested that calcium and dairy products might increase prostate cancer risk. Because the intake of dairy foods may lower the risk of some cancers and possibly increase the risk of others, the ACS does not make specific recommendations on dairy food consumption for cancer prevention.

Vitamin D, made by the body when the skin is exposed to ultraviolet (UV) rays, helps keep bones and the immune system healthy. You can also get it from foods like fatty fish, some mushrooms, fortified foods (milk, orange juices, cereals) or from supplements. Some studies suggest vitamin D might lower cancer risk, particularly colorectal cancer. However, large studies have not found that taking vitamin D supplements lowers the risk of colorectal polyps (pre-cancerous growths) or colorectal cancer itself.

Most Americans don’t get enough vitamin D in their diets, and many have low blood levels. While research continues on vitamin D and cancer risk, avoiding low vitamin D levels is recommended. People at higher risk of having low vitamin D levels include those with darker skin, those living in Northern latitudes, and those who stay indoors, and who do not consume sources of vitamin D.

Dietary supplements

Dietary supplements include vitamins, minerals, amino acids, herbs/botanicals, and other ingredients. They can help people who don’t get enough nutrients from food or who have trouble absorbing certain nutrients.

While dietary supplements can provide some benefit, they also have risks. Dietary supplements are not regulated the same way as medicines are. Laws don’t guarantee that supplements contain the amounts listed on the label or that they are free from undeclared substances that can be harmful to human health.

Eating a diet rich in vegetables, fruits, and other plant foods may lower cancer risk, but there’s little consistent evidence that dietary supplements do the same. Some high-dose supplements containing nutrients such as beta-carotene and vitamins A and E may actually increase the risk of some cancers. Still, over half of US adults use one or more dietary supplements.

Vegetables and fruits contain many different compounds that probably work together to have healthful effects. There are likely to be important, but as yet unknown, components of whole foods that aren’t included in dietary supplements.

Some supplements claim to provide the same nutrition as vegetables and fruits, but they usually contain only a small fraction of what whole foods provide. There is little evidence that these products help lower cancer risk.

Food is the best source of vitamins, minerals, and other important food components. If you are thinking about taking supplements for general health, a balanced multivitamin/mineral supplement containing no more than 100% of the ‘‘daily value’’ of nutrients is likely safest.

At this time, the ACS does not recommend the use of dietary supplements to prevent cancer.

People who do choose to drink alcohol should have no more than 1 drink per day for women or 2 drinks per day for men.

Alcohol use is the third most important preventable risk factor for cancer, after tobacco use and excess body weight. Despite this, public awareness about the cancer-causing effects of alcohol remains low.

Alcohol is classified as a known carcinogen that causes cancer in humans.  It has been linked to at least 8 types of cancer and may increase the risk of others, as well. The type of alcohol isn’t as important as the amount, as all types of alcohol increase cancer risk.

Because of this, the ACS Guideline states that it is best not to drink alcohol. Those who do choose to drink should limit their intake to no more than 1 drink per day for women and 2 drinks a day for men.