Maintaining a healthy lifestyle can have many benefits, including improving outcomes in people diagnosed with cancer. In a recent study from the National Institutes of Health (NIH) and AARP, Inc., the relationship between certain lifestyle factors and their contribution to overall mortality and cardiovascular disease (CVD)-related mortality was examined among patients who were diagnosed with colon and rectal cancers.
The NIH-AARP Diet and Health Study—the participants of which were AARP members who ranged in age from 50 to 71 years—assessed diet and other lifestyle factors prior to cancer diagnosis. In the study, 4,213 patients with colon cancer and 1,514 patients with rectal cancer were identified.1
Body mass index (BMI), healthy eating (per the 2005 Healthy Eating Index [HEI-2005]), physical activity, alcohol consumption, and smoking were lifestyle factors reviewed as they related to overall health or a cancer diagnosis. Developed by the United States Department of Agriculture’s Center for Nutrition Policy and Promotion, HEI is a measure of diet quality that assesses conformance to federal dietary guidance.
The Guidelines on Nutrition and Physical Activity for Cancer Survivors published by the American Cancer Society include the following2:
- Achieve and maintain a healthy weight throughout life
- Be physically active
- Eat a healthy diet, with an emphasis on plant foods
The World Cancer Research Fund and American Institute for Cancer Research Expert Report offered similar guidance and also recommends that patients should limit alcohol intake.3
The NIH-AARP study found that obesity and smoking were related to an increased risk of mortality for patients with colon cancer. Smoking was also associated with increased risk of overall and colorectal cancer-specific mortality whereas obesity and alcohol consumption were related to the risk of death from CVD. Higher HEI-2005 scores were associated with decreased risk of colorectal cancer mortality, and smoking was related to an increased risk of overall and CVD mortality. In this study, CVD mortality was defined as issues with the heart such as hypertension, cerebrovascular diseases, atherosclerosis, or aortic aneurism.1
The results of the study showed that, of the patients with colon cancer, smokers had increased risk of total mortality (relative risk [RR], 1.74; 95% CI, 1.45-2.08) and colorectal cancer mortality (RR, 1.46; 95% CI, 1.17-1.82) compared with patients who never smoked. Patients with a BMI of 30 or higher had increased risk of death (RR, 1.19; 95% CI, 1.02-1.39) and CVD-specific death (RR, 1.84; 95% CI, 1.05-3.23) compared with patients with a BMI score between 18.5 and 25. Patients with rectal cancer, who had the highest quintile of HEI-2005 scores, had reduced all-cause mortality (RR, 0.60; 95% CI, 0.42-0.86).
Of the 4,213 patients with colon cancer, 1,273 had died at 5-year follow-up: 856 from colorectal cancer, 125 from other cancers, 108 from CVD, and 184 deaths from other causes. Of the 1,514 patients with rectal cancer, 454 had died: 301 from colorectal cancer, 49 from other cancers, 43 from CVD, and 61 deaths from other causes.
Although the questionnaire assessed participants’ lifestyle factors during a relatively brief 12-month period, it is an eye-opening story about prevention. One key takeaway message to medical professionals is to encourage patients—before they hear the words “You have cancer”—to modify certain habits that may contribute to cancer and poorer outcomes in the long-term. Genes dictate only part of our destinies at birth; however, the choices in what one eats, drinks, and ingests, as well as how active one is, can have positive or negative life-long effects on cancer prevention, diagnosis, and survival. Certainly food for thought.
- Pelser C, Arem H, Pfeiffer RM, et al. Prediagnostic lifestyle factors and survival after colon and rectal cancer diagnosis in the NIH-AARP Diet and Health Study. Cancer. 2014 Mar 3. doi: 10.1002/cncr.28573. [Epub ahead of print]
- American Cancer Society. ACS Guidelines on Nutrition and Physical Activity for Cancer Prevention. http://www.cancer.org/healthy/eathealthygetactive/acsguidelinesonnutritionphysicalactivityforcancerprevention/acs-guidelines-on-nutrition-and-physical-activity-for-cancer-prevention-intro. Accessed March 25, 2014.
- The World Cancer Research Fund and American Institute for Cancer Research Second Expert Report. Public Health Goals and Personal Recommendations, Chapter 12. http://www.dietandcancerreport.org/cancer_resource_center/downloads/chapters/chapter_12.pdf. Accessed March 25, 2014.