1. Digiulio, Sarah

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The American Cancer Society has released its 2012 Guidelines on Nutrition and Physical Activity for Cancer Prevention (CA Cancer J Clin 2012;62:30-67). The recommendations, which are reviewed and published approximately every five years, incorporate the latest thinking based on new research about risk reduction.


The updated four key focus points for individuals include:

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* Achieving and maintaining a healthy weight;


* Staying physically active;


* Choosing a healthy plant-based diet; and


* Limiting alcohol consumption.



The report also includes a "community action" recommendation to encourage healthier environments that reduce the barriers to healthy, affordable food choices, and the opportunity to exercise.


"The guidelines are really about educating people about what they can do on their own to reduce the risk of cancer, but are also designed to spur action for change-to make it easier for people to get a banana instead of a candy bar," explained Colleen Doyle, MS, RD, the ACS's Director of Nutrition and Physical Activity and one of the authors.


The "Recommendation for Community Action" was added to the guidelines in 2006, and remains a key feature of this edition. "That guideline itself didn't change too much, but the need for that and the need for action related to that guideline, have gotten more and more strong," she said in a telephone interview.


"We've got a huge obesity epidemic on our hands at a time when we know that being overweight is associated with so many different types of cancer."


The hope is that the guidelines, which are often used by policymakers and business leaders, will encourage changes that help people make smarter food and exercise choices-such as better nutrition standards in schools and more sidewalks and bike lanes. "We know a large part of changing environments is going to include policy changes," Doyle said.


"We've got to work together to ensure that worksites and schools have healthy food options; that our neighborhoods are designed so that our children can safely ride their bikes or walk to school; that people have the information they need to help them make healthier food choices, whether at the grocery store or when eating out," she said in a news release.


"The environments in which we live, work, learn and play have a tremendous impact on our ability to make and sustain healthy lifestyle choices. So if we're not working to change those environments so that the healthier choice is the easier choice, we're missing the boat."


Other updated recommendations for individuals include:


* Achieve and maintain a healthy weight throughout life: Instead of the focus in earlier editions on maintaining a healthy weight, the new guideline details new evidence that some of the hormones associated with increased risk of cancer actually decrease when you lose weight.


* Be as lean as possible throughout life without being underweight: While the old guidelines defined a body mass index below 25 as healthy, the new version is based on evidence that keeping BMI in the lower end of the "healthy" BMI range reduces the risk of certain cancers, including breast cancer.


* At least 150 minutes per week of moderate intensity physical activity or 75 minutes per week of vigorous intensity physical activity: The physical activity guideline was updated to align with the new federal government recommendation.


* Limit time spent sitting: This recommendation was added based on growing evidence that (independent of physical activity level) sitting increases the likelihood of obesity, cardiovascular disease, type 2 diabetes, and various types of cancer.


* Limit consumption of red and processed meat: This recommendation was moved to be the second (instead of the last) of the guidelines for nutrition.


* Eat at least 2.5 cups of vegetables and fruits each day: The wording was changed to define the amount in cups instead of servings to align with the new federal guidelines.