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Following AICR Recommendations May Help Survivors Live Longer, Be Healthier

woman's legs power walkingThis Sunday, June 2, marks National Cancer Survivors Day and today, there are more cancer survivors living in the United States then ever before - almost 14 million. Research continues to suggest that a healthy lifestyle can help survivors, with two of the most recent studies finding that following AICR’s recommendations for cancer prevention can cut survivors’ risk of premature death and improve their physical and mental well being.

Both studies focused on postmenopausal women who were long-term cancer survivors. The studies, conducted by the same lead researcher, especially highlighted the health benefits of physical activity, adding to a growing body of evidence that a healthy lifestyle offer survivors numerous benefits.

Cutting Premature Death Risk by a Third

Published in Cancer Epidemiology Biomarkers and Prevention, the study that focused on mortality included approximately 2,000 participants of the Iowa Women’s Health Study. The women had been diagnosed with cancer between 1986 and 2002, and they had answered questions on their body weight, physical activity and diet in 2004.

The researchers looked at how much each survivor adhered to seven of the AICR Recommendations for Cancer Prevention. They developed a scoring system in which women received 0 points for each indicator if they did not meet the recommendation, a half a point for partial recommendation adherence, and a full point if they followed the recommendation. 

  1. Stay as lean as possible without becoming underweight.
  2. Be physically active for at least 30 minutes a day.
  3. Avoid sugary drinks.
  4. Eat a plant-based diet that includes a variety of vegetables, fruits, whole grains and beans: Consume relatively high amounts of daily dietary fiber (25 grams or more a day)
  5. Limit intake of red meat and avoid processed meat (ham, cold cuts, bacon, sausage).
  6. Limit alcohol consumption to one drink/day for women, two drinks/day for men, if consumed at all.
  7. Limit consumption of salty foods and foods processed with salt (less than 1,500 milligrams per day).

The recommendations related to supplements and breastfeeding were not applicable to this population, and data on energy-dense food was not available.

After an average follow-up of approximately five years, women who followed at least six of AICR’s recommendations had a 33 percent reduced risk of dying during those years compared to the women who followed four or fewer of the recommendations.

When the scientists looked at death from cardiovascular disease and cancer specifically, the physical activity recommendation stood out. Being physically active for 30 or more minutes per day was the strongest factor for lower risk of mortality from all causes, as well as from cancer and cardiovascular disease, independent of body weight, says lead author Maki Inoue-Choi, of the Division of Epidemiology and Community Health, University of Minnesota.

Improving Physical and Mental Health

In the second study, published in the Journal of Clinical Oncology, Inoue-Choi and her colleagues investigated if AICR recommendations for cancer prevention affected this same populations’ physical, mental and emotional wellbeing. 

This study also pulled data from women in the Iowa Women’s Health Study who were diagnosed with cancer, between 1986 and 2002. In 2004, the participants had completed a questionnaire relating to physical and emotional health. The study looked at all of the above recommendations except for sugary drinks, due to limited data.

After scoring whether the women did or did not adhere to each recommendation, the study found that survivors who most adhered to AICR recommendations had improved physical functioning and mental health, with physical activity again highlighted. Daily physical activity was the one specific recommendation linked to higher physical functioning and improved mental health, compared with women who were least active.

The studies, funded by the National Cancer Institute, can help inform the development of evidence-based guidelines for cancer survivors, says Inoue-Choi.

“Our finding supports that overall adherence to the AICR/WCRF evidence-based guidelines for cancer prevention is also beneficial for cancer survivors,” said Inoue-Choi. Physical activity seems to be a key health behavior that can help survivors, but more research is needed among cancer survivor populations.

Not Just Survivors

A recent study among a general population (not survivors) also found that following AICR recommendations can reduce risk of premature death from cancer and other diseases by about a third, compared to those who least follow the recommendations. That study was featured in an issue of CRU last month. The study was published in the American Journal of Clinical Nutrition, and it’s the first time a study has applied AICR’s recommendation for cancer prevention to mortality.

Adapted from ScienceNow.


  • Vergnaud, Anne-Claire et al. Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study. Am J Clin Nutr May 2013.
  • Cancer Epidemiol Biomarkers Prev. 2013 May;22(5):792-802. doi: 10.1158/1055-9965.EPI-13-0054. Epub 2013 Mar 5. Adherence to the WCRF/AICR Guidelines for Cancer Prevention Is Associated with Lower Mortality among Older Female Cancer Survivors. Inoue-Choi M, Robien K, Lazovich D.
  • J Clin Oncol. 2013 May 10;31(14):1758-66. doi: 10.1200/JCO.2012.45.4462. Epub 2013 Apr 8. Adherence to the world cancer research fund/american institute for cancer research recommendations for cancer prevention is associated with better health-related quality of life among elderly female cancer survivors. Inoue-Choi M, Lazovich D, Prizment AE, Robien K.
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