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Alberta’s Tomorrow Project: adherence to cancer prevention recommendations pertaining to diet, physical activity and body size

  • Heather K Whelan (a1), Jian-Yi Xu (a1), Sanaz Vaseghi (a2), Geraldine Lo Siou (a1), S Elizabeth McGregor (a3) and Paula J Robson (a4)...

Abstract

Objective

To explore cross-sectional adherence to cancer prevention recommendations by adults enrolled in a prospective cohort in Alberta, Canada.

Design

Questionnaire data were used to construct a composite cancer prevention adherence score for each participant, based on selected personal recommendations published by the World Cancer Research Fund/American Institute for Cancer Research (2007). Data were self-reported on health and lifestyle, past-year physical activity and past-year FFQ. The scores accounted for physical activity, dietary supplement use, body size, and intakes of alcohol, fruit, vegetables and red meat. Tobacco exposure was also included. Scores ranged from 0 (least adherent) to 7 (most adherent).

Setting

Alberta’s Tomorrow Project; a research platform based on a prospective cohort.

Subjects

Adult men and women (n 24 988) aged 35–69 years recruited by random digit dialling and enrolled in Alberta’s Tomorrow Project between 2001 and 2009.

Results

Of the cohort, 14 % achieved adherence scores ≥5 and 60 % had scores ≤3. Overall adherence scores were higher in women (mean (sd): 3·4 (1·1)) than in men (3·0 (1·2)). The extent of overall adherence was also associated with level of education, employment status, annual household income, personal history of chronic disease, family history of chronic disease and age.

Conclusions

Reported adherence to selected personal recommendations for cancer prevention was low in this cohort of adults. In the short to medium term, these results suggest that more work is required to identify behaviours to target with cancer prevention strategies at a population level. Future work will explore the associations between adherence scores and cancer risk in this cohort.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

* Corresponding author: Email ATP.Research@ahs.ca

References

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1. World Health Organization (2014) Cancer Fact Sheets. http://www.who.int/cancer/prevention/en (accessed April 2016).
2. Danaei, G, Vander, HS, Lopez, AD et al. (2005) Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors. Lancet 366, 17841793.
3. Shaukat, A, Mongin, SJ, Geisser, MS et al. (2013) Long-term mortality after screening for colorectal cancer. N Engl J Med 369, 11061114.
4. Kalager, M, Zelen, M, Langmark, F et al. (2010) Effect of screening mammography on breast-cancer mortality in Norway. N Engl J Med 363, 12031210.
5. Alberta Health (2013) Changing Our Future: Alberta’s Cancer Plan to 2030. Edmonton, AB: Government of Alberta.
6. Tanuseputro, P, Manuel, DG, Schultz, SE et al. (2005) Improving population attributable fraction methods: examining smoking-attributable mortality for 87 geographic regions in Canada. Am J Epidemiol 161, 787798.
7. Steenland, K & Armstrong, B (2006) An overview of methods for calculating the burden of disease due to specific risk factors. Epidemiology 17, 512519.
8. Brenner, DR (2014) Cancer incidence due to excess body weight and leisure-time physical inactivity in Canada: implications for prevention. Prev Med 66C, 131139.
9. Parkin, DM (2011) 5. Cancers attributable to dietary factors in the UK in 2010. II. Meat consumption. Br J Cancer 105, Suppl. 2, S24S26.
10. Parkin, DM, Boyd, L & Walker, LC (2011) 16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Br J Cancer 105, Suppl. 2, S77S81.
11. Park, S, Jee, SH, Shin, HR et al. (2014) Attributable fraction of tobacco smoking on cancer using population-based nationwide cancer incidence and mortality data in Korea. BMC Cancer 14, 406.
12. Schutze, M, Boeing, H, Pischon, T et al. (2011) Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. BMJ 342, d1584.
13. Renehan, AG, Soerjomataram, I, Tyson, M et al. (2010) Incident cancer burden attributable to excess body mass index in 30 European countries. Int J Cancer 126, 692702.
14. World Cancer Research Fund/American Institute for Cancer Research (2007) Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. Washington, DC: AICR.
15. Bryant, H, Robson, PJ, Ullman, R et al. (2006) Population-based cohort development in Alberta, Canada: a feasibility study. Chronic Dis Can 27, 5159.
16. Csizmadi, I, Kahle, L, Ullman, R et al. (2007) Adaptation and evaluation of the National Cancer Institute’s Diet History Questionnaire and nutrient database for Canadian populations. Public Health Nutr 10, 8896.
17. Subar, AF, Midthune, D, Kulldorff, M et al. (2000) Evaluation of alternative approaches to assign nutrient values to food groups in food frequency questionnaires. Am J Epidemiol 152, 279286.
18. Csizmadi, I, Boucher, BA, Siou, G et al. (2016) Using national dietary intake data to evaluate and adapt the US Diet History Questionnaire: the stepwise tailoring of an FFQ for Canadian use. Public Health Nutr 19, 32473255.
19. Friedenreich, CM, Courneya, KS, Neilson, HK et al. (2006) Reliability and validity of the Past Year Total Physical Activity Questionnaire. Am J Epidemiol 163, 959970.
20. Subar, AF, Thompson, FE, Kipnis, V et al. (2001) Comparative validation of the Block, Willett, and National Cancer Institute food frequency questionnaires: the Eating at America’s Table Study. Am J Epidemiol 154, 10891099.
21. Millen, AE, Midthune, D, Thompson, FE et al. (2006) The National Cancer Institute diet history questionnaire: validation of pyramid food servings. Am J Epidemiol 163, 279288.
22. Tukey, J (1977) Exploratory Data Analysis. Reading, PA: Addison-Wesley.
23. American Cancer Society (2011) Global Cancer Facts & Figures, 2nd ed. Atlanta, GA: American Cancer Society.
24. Canada Society for Exercise Physiology (2003) Canadian Physical Activity Guidelines for Adults – 1864 Years . Ottawa, ON: CSEP.
25. Glade, MJ (1999) Food, nutrition, and the prevention of cancer: a global perspective. American Institute for Cancer Research/World Cancer Research Fund, American Institute for Cancer Research, 1997. Nutrition 15, 523526.
26. Howell, D, Oliver, TK, Keller-Olaman, S et al. (2013) A Pan-Canadian practice guideline: prevention, screening, assessment, and treatment of sleep disturbances in adults with cancer. Support Care Cancer 21, 26952706.
27. Kushi, LH, Doyle, C, McCullough, M et al. (2012) American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 62, 3067.
28. Menko, FH, Aalfs, CM, Henneman, L et al. (2013) Informing family members of individuals with Lynch syndrome: a guideline for clinical geneticists. Fam Cancer 12, 319324.
29. Valdes-Ramos, R, Cervantes, I, Mendoza-Perdomo, I et al. (2006) Concordance of diets and eating practices in a rural Guatemalan setting with the cancer prevention recommendations of the World Cancer Research Fund: estimates from existing dietary intake. Asia Pac J Clin Nutr 15, 259266.
30. Valdes-Ramos, R, Solomons, NW, Anderson, AS et al. (2001) Can the degree of concordance with recommendations for a cancer prevention diet and lifestyle be assessed from existing survey information data? Am J Clin Nutr 74, 848851.
31. Cerhan, JR, Potter, JD, Gilmore, JM et al. (2004) Adherence to the AICR cancer prevention recommendations and subsequent morbidity and mortality in the Iowa Women’s Health Study cohort. Cancer Epidemiol Biomarkers Prev 13, 11141120.
32. McCullough, ML, Patel, AV, Kushi, LH et al. (2011) Following cancer prevention guidelines reduces risk of cancer, cardiovascular disease, and all-cause mortality. Cancer Epidemiol Biomarkers Prev 20, 10891097.
33. Romaguera, D, Vergnaud, AC, Peeters, PH et al. (2012) Is concordance with World Cancer Research Fund/American Institute for Cancer Research guidelines for cancer prevention related to subsequent risk of cancer? Results from the EPIC study. Am J Clin Nutr 96, 150163.
34. Vossenaar, M, Solomons, NW, Valdes-Ramos, R et al. (2008) Evaluating concordance with the 1997 World Cancer Research Fund/American Institute of Cancer Research cancer prevention guidelines: challenges for the research community. Nutr Res Rev 21, 189206.
35. Hastert, TA, Beresford, SA, Patterson, RE et al. (2013) Adherence to WCRF/AICR cancer prevention recommendations and risk of postmenopausal breast cancer. Cancer Epidemiol Biomarkers Prev 22, 14981508.
36. Thomson, CA, McCullough, ML, Wertheim, BC et al. (2014) Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the Women’s Health Initiative. Cancer Prev Res (Phila) 7, 4253.
37. Makarem, N, Lin, Y, Bandera, EV et al. (2015) Concordance with World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines for cancer prevention and obesity-related cancer risk in the Framingham Offspring cohort (1991–2008). Cancer Causes Control 26, 277286.
38. Balter, K, Moller, E & Fondell, E (2012) The effect of dietary guidelines on cancer risk and mortality. Curr Opin Oncol 24, 90102.
39. Callinan, JE, Clarke, A, Doherty, K et al. (2010) Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database Syst Rev 2, CD005992.
40. Robson, PJ, Siou, GL, Ullman, R et al. (2008) Sociodemographic, health and lifestyle characteristics reported by discrete groups of adult dietary supplement users in Alberta, Canada: findings from The Tomorrow Project. Public Health Nutr 11, 12381247.
41. Imbard, A, Benoist, JF & Blom, HJ (2013) Neural tube defects, folic acid and methylation. Int J Environ Res Public Health 10, 43524389.
42. Miller, JL (2013) Iron deficiency anemia: a common and curable disease. Cold Spring Harb Perspect Med 3, a011866.
43. Rizzoli, R, Boonen, S, Brandi, ML et al. (2013) Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin 29, 305313.
44. Castillo, L, Tur, JA & Uauy, R (2012) Folate and breast cancer risk: a systematic review. Rev Med Chil 140, 251260.
45. Nicastro, HL & Dunn, BK (2013) Selenium and prostate cancer prevention: insights from the selenium and vitamin E cancer prevention trial (SELECT). Nutrients 5, 11221148.
46. International Agency for Research on Cancer (2010) IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. vol. 96: Alcohol Consumption and Ethyl Carbamate. Lyon: IARC.
47. Health Canada (2011) Canadian Alcohol and Drug Use Monitoring Survey: Summary of Results for 2011. http://www.hc-sc.gc.ca/hc-ps/drugs-drogues/stat/_2011/summary-sommaire-eng.php (accessed December 2016).
48. Hines, LM & Rimm, EB (2001) Moderate alcohol consumption and coronary heart disease: a review. Postgrad Med J 77, 747752.
49. Maraldi, C, Volpato, S, Kritchevsky, SB et al. (2006) Impact of inflammation on the relationship among alcohol consumption, mortality, and cardiac events: the health, aging, and body composition study. Arch Intern Med 166, 14901497.
50. Colley, RC, Garriguet, D, Janssen, I et al. (2011) Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. Health Rep 22, 714.
51. Csizmadi, I, Lo, SG, Friedenreich, CM et al. (2011) Hours spent and energy expended in physical activity domains: results from the Tomorrow Project cohort in Alberta, Canada. Int J Behav Nutr Phys Act 8, 110.
52. Aparicio-Ting, FE, Friedenreich, CM, Kopciuk, KA et al. (2014) Intrapersonal and social environment correlates of leisure-time physical activity for cancer prevention: a cross-sectional study among Canadian adults. J Phys Act Health 11, 790800.
53. Zheng, C, Beresford, SA, Van, HL et al. (2014) Simultaneous association of total energy consumption and activity-related energy expenditure with risks of cardiovascular disease, cancer, and diabetes among postmenopausal women. Am J Epidemiol 180, 526535.
54. Dong, L, Block, G & Mandel, S (2004) Activities contributing to total energy expenditure in the United States: results from the NHAPS Study. Int J Behav Nutr Phys Act 1, 4.
55. Probert, AW, Tremblay, MS & Connor, GS (2008) Desk potatoes: the importance of occupational physical activity on health. Can J Public Health 99, 311318.
56. Autenrieth, C, Schneider, A, Doring, A et al. (2009) Association between different domains of physical activity and markers of inflammation. Med Sci Sports Exerc 41, 17061713.
57. Lindsted, KD, Fraser, GE, Steinkohl, M et al. (1996) Healthy volunteer effect in a cohort study: temporal resolution in the Adventist Health Study. J Clin Epidemiol 49, 783790.
58. Breslow, NE & Day, NE (1987) Statistical Methods in Cancer Research. vol. II: The Design and Analysis of Cohort Studies. IARC Scientific Publications no. 82. Lyon: International Agency for Research on Cancer.
59. Froom, P, Melamed, S, Kristal-Boneh, E et al. (1999) Healthy volunteer effect in industrial workers. J Clin Epidemiol 52, 731735.
60. Statistics Canada (2012) Canadian Community Health Survey (CCHS) – Questionnaire for Cycle 3.1 (2005). http://www23.statcan.gc.ca/imdb/p3Instr.pl?Function=getInstrumentList&Item_Id=33185&UL=1V& (accessed April 2016).
61. Robson, PJ, Solbak, NM, Haig, TR et al. (2016) Design, methods, and demographics from phase I of Alberta’s Tomorrow Project cohort: a prospective cohort profile. CMAJ Open 4, E515E527.

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