Nutrition and cancer prevention

13 important questions on Nutrition and cancer prevention

An interplay of different factors (3), different for each separate cancer

  • Inherited susceptibility
  • Environment & lifestyle
  • Bad luck

What are limitations of case-control studies?

  • Retrospective assessment of intake
  • Recall bias (information bias)
  • Interviewer bias (information bias)
  • Selection bias, not representative
  • Non-response depending on exposure
  • Reverse causality: chicken or egg

What are limitations of cohort studies?

  • Large studies, depending on incidence
  • Long follow-up, depending on time to cancer diagnosis
  • Misclassification of intake
  • Within cohort range of intake may be limited
  • Diets are not constant over time, repeated measurements


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What is confounding [pitfall all observational studies]

The observed association between an exposure and outcome is caused by a third (extraneous) factor that is not part of the biological pathway

What is the conclusion of a meta-analysis on alcohol and breast cancer

Per 10 grams of alcohol per day the relative risk of breast cancer increases with 7%

There is heterogeneity

Which gradings can be made to grade the evidence?

  1. Convincing
  2. Probable
  3. Limited evidence - suggestive
  4. Limited evidence - no conclusion
  5. Substantial effect on risk unlikely

Potential underlying mechanisms of body fatness and cancer

  • Metabolic syndrome, insulin resistance, (insulin) growth factors
  • Chronic inflammation, e.g. Alterations in TNF, IL6, MIF levels
  • Adipokines, e.g. Increase in leptin, decrease in adiponectin
  • Sex hormones, e.g. Increase in oestrogen's
  • Vitamin D deficiency

Potential underlying mechanisms of physical activity and cancer

  • Reducing body fatness
  • Sex hormones, e.g. Decrease in oestrogen's
  • Reduced transit time in bowel
  • Higher vitamin D levels (if outside)

Vegetables and fruits intake reduces risk of cancer of the:

  • Mouth
  • Pharynx
  • Larynx
  • Lung (fruits)

Potential underlying mechanisms of dietary fibre and CRC

  1. Formation of short chain fatty acids by bacteria. Butyrate reduces proliferation and induces apoptosis
  2. Reduction of transit time. Reduces the contact between the intestinal content and the mucosa
  3. Reduction of insuline resistance
  4. Fibre-rich foods are important sources of phyto-estrogens ?

What proportion of cancer cases could we prevent if the pollution at large would eat healthy, would have a healthy body weight and would be more physically active?

30-40% of all cancer cases could be avoided by healthy food habits and an increase in physical activity

What is the most important dietary factor in the NL associated with cancer

Insufficient vegetables and fruits consumption and dietary fibre (in women)

What are the 10 recommendations for cancer prevention

  1. Be a healthy weight
  2. Be physically active
  3. Eat a diet rich in wholegrain, vegetables, fruit and beans
  4. Limit consumption of 'fast food' and other processed foods high in fat, starches of sugars
  5. Limit consumption of red and processed meat
  6. Limit consumption of sugar sweetened drinks
  7. Limit alcohol consumption
  8. Do not use supplements for cancer prevention
  9. For mothers: breastfeed your baby, if you can
  10. After a cancer diagnosis: follow our recommendations, if you can

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