Karen Collins
“Evidence matters” was the theme of AICR’s 2021 virtual Lifestyle and Cancer Symposium and a rallying call to make evidence from rigorous research and its synthesis the foundation of efforts for cancer prevention and cancer survivorship.
What does this mean for researchers, health professionals and all of us as part of a national community?
Panel of experts at the 2021 AICR Cancer and Lifestyle Symposium.
How Researchers Build on Evidence that Matters
It’s an essential element of science: each time we learn something, new questions arise.
Some landmark discoveries have come from open-mindedly exploring findings that don’t quite fit with a currently accepted theory. On the other hand, random sources of error and unusual circumstances can occur, resulting in conclusions that could lead us down a rabbit hole of distraction.
That’s why it’s so important that new studies are designed and reviewed within the context of overall current science. For the big picture on diet, weight and physical activity related to cancer risk and survivorship, count on the AICR/WCRF Continuous Update Project (known as the CUP).
Researchers can use the CUP to provide context for their findings and to identify next questions.
The CUP is a central database of studies collected from around the world, analyzed and synthesized into meaningful conclusions. This process pulls together studies from the laboratory with studies in large human populations and in controlled intervention trials. Overall conclusions are graded according to specific quality standards, with double-checking by scientists within the CUP and by outside experts.
Researchers to focus on new ways to study diet’s role in reducing cancer risk and supporting survivorship.
We need to focus more on dietary patterns, rather than individual nutrients or foods. If someone eats less of one type of food, this allows us to consider what is replacing it. By looking at overall diet, we can see the impact of how small choices can add up to promote or hurt health.
But how do you measure a whole eating pattern? Scientists have developed several pre-defined scores, as well as other statistical techniques. Further research will strengthen the choice of tools to best measure eating patterns.
To get around the inaccuracies built into trying to track what people eat, research is in progress on biomarkers (such as blood levels of carotenoid compounds from vegetables and fruits, and compounds from eating whole grains or soyfoods). Other biomarkers could spot intermediate indicators in disease development, including measures of insulin resistance and inflammation. Research is in progress aiming to distinguish dietary patterns associated with some of these indicators.
Researchers to study how to effectively implement results in “real world” settings.
When we try to duplicate a program that a study found successful, a whole range of barriers can arise. Who will train and pay for professionals to lead a diet or physical activity intervention? How can we find a convenient and inviting setting? How can we best help people who can’t attend in-person programs, people with reading or language barriers, and people with economic or family situations that make lifestyle changes especially hard?
Healthcare Professionals: Strength of Evidence is Critical
People count on health professionals to help them make sense of conflicting information, and to guide them in setting priorities for which lifestyle choices are likely to have the biggest payoff in reducing cancer risk and improving survivorship.
Physical activity comes in many forms.
Guidelines that synthesize quality research can help healthcare professionals guide people to physical activity that is safe for them and best supports their goals. Community programs offer great support for some; other people should be referred for evaluation by out-patient rehab healthcare professionals.
We can only use what we can access.
Ultimately, much about how we each eat and move may be an individual choice. But what food choices are available in early childhood care, schools and senior centers? Do food choices in the workplace, in restaurants and in accessible sources of groceries make healthy eating easy and enjoyable, or add to the challenge?
Overweight and obesity are related to cancer.
Through effects on hormones and inflammation. Risk of at least 12 different cancers increases for those who have overweight or obesity, and researchers are studying the impact on health of cancer survivors. The most recent CUP report on cancer survivors shows excess body fat increases total deaths (from cancer plus other causes) following breast cancer. Updated CUP reports for survivors of breast, colorectal and prostate cancers are expected in 2021 that will synthesize findings related to weight, as well as diet and physical activity.
Survival rates following childhood cancers have improved tremendously in recent decades. Sometimes, however, long-term health threats can be triggered by cancer or its treatment. One symposium presentation shared the work of an international group evaluating research in this area and grading the strength of evidence. These scientists are collaborating to develop guidelines for follow-up evaluations to watch for heart and other health problems.
Dietary patterns are a complex sum of all our eating choices.
People are surrounded by messages suggesting that loading up on a certain food will help fight cancer. Other information promotes all-or-nothing rules about foods that must be completely avoided. These kinds of messages take evidence out of context. Looking at the bigger picture from research can help health professionals explain that the totality of what people eat, including how it’s prepared and portion sizes, is what’s important. Together, all these choices can affect inflammation, insulin resistance and other influences on cancer.
For All of Us, Individually and Collectively, Evidence Matters
Evidence on diet, weight and physical activity can only make a difference in reducing cancer risk and improving cancer survivorship when we use it to change how we live.
Making healthy eating choices requires cutting through the clutter of distracting messages.
Bouncing from headline to headline on single studies isn’t a strong foundation for making lifestyle decisions. Instead, rely on the AICR Recommendations as a blueprint that pulls together choices you can make based on careful analysis of research.
Finding a “community” of support makes changes easier. Look for how you might embrace a one-step-at-a-time journey with family, friends or a community group. Combined with one of these sources or as an alternative, you might checkout the support you can find online from AICR’s Healthy10 Challenge.
In Conclusion
No single study has it all. Inconsistencies among individual studies are no reason to throw your hands up. It is how research moves forward. But don’t let the differences distract you.
Rely on recommendations from organizations like AICR that can put together the big picture of today’s best research. Because evidence matters.
