Your
Diet &Cancer
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governments cooperating.
Cancer is the second leading cause of
death in North Carolina and the United
States. In fact, one out of every four people
now alive eventually will have some form
of this disease. Cancer is not one disease
but a group of over 100 different types.
The causes of and risks for cancer are
different for different sites in the body.
In order to understand how diet and
cancer may be related, it is important to
understand how cancer develops. Current
research indicates the following steps in
the process:
a. exposure to a cancer-causing agent
(carcinogen);
b. entry of the carcinogen into a body cell;
c. initiation (change in genetic message of
some cells to make them precancerous);
and finally
d. promotion (cancer grows as cells begin
to multiply out of control and tumors
develop).
Foods (including those “naturally” and
“organically” produced) can contain
substances that may have an influence on
initiation or development of cancer. Some
researchers have classified foods (nutri-
ents) into three categories relative to
cancer.
Initiators contain carcinogenic compounds
or precursors to carcinogenic compounds.
For example, cured and pickled foods
contain nitrites that can be changed into
carcinogens in the stomach.
Promoters favor the growth of cancer
once initiation has taken place. For
example, foods high in fat or alcohol
seem to provide the kind of environ-
ment a cancer cell needs to grow,
multiply, and spread.
Preventers help defeat cancers after
initiation has taken place. For example,
fruits, vegetables, and whole grains
seem to be able to destroy carcinogens
and halt cancer development.
While many questions about dietary
relationships and cancer remain unan-
swered, a number of studies have shown
definite links between certain cancers and
the foods we eat. Knowing this allows us
to reduce risk through dietary practices.
DIETARY GUIDELINES TO
LOWER CANCER RISK
Based on current research findings,
following the Dietary Guidelines for
Americans should help reduce your risk of
diet-related cancer. Similar guidelines
have been developed by the American
Institute for Cancer Research, the Ameri-
can Cancer Society and other agencies.
Let’s look at the seven Dietary Guide-
lines for Americans below and see how
they apply to what is known currently
about diet and cancer.
1. EAT A VARIETY OF FOODS
Eating a variety of nutritious foods can help
prevent cancer and promote health. Including many
different foods in your diet helps provide all of the
nutrients that are needed. A variety of foods will also
help dilute those components of individual foods that
are potentially harmful.
2. MAINTAIN A HEALTHY WEIGHT
The relationship between body weight and cancer
at specific sites is not fully understood. However,
being overweight is linked to certain cancers. People
who are obese (40% above their ideal weight) are at
greater risk of developing cancer of the prostate,
colon, gallbladder, breast and uterus.
3. CHOOSE A DIET LOW IN FAT, SATU-
RATED FAT, AND CHOLESTEROL
reduce fat intake, follow the suggestions in the chart
"Reducing Fat Intake" on this page.
Saturated Fat While lowering the total amount of
fat in your diet is the most important part of controlling
fat intake, the kinds of fat eaten may also make a
difference. There are three kinds of fat in foods:
polyunsaturated, monounsaturated and saturated.
Studies have shown that both saturated and polyunsatu-
rated fats promote the development of cancers at
certain sites. Saturated fats are solid at room tempera-
ture and predominate in most animal products and
many processed foods. Polyunsaturated fats are liquid
at room temperature and predominate in many vege-
table oils. Be sure to read labels and balance the kinds
of fat you eat.
Cholesterol The effect of dietary cholesterol on
cancer is still being debated. Studies have shown
conflicting results. More research is needed in this area
before we can make recommendations.

Fat A diet high in fat may be a factor in the
development of certain cancers like colon and pros-
tate. Research suggests that fat plays a role in pro-
moting cancer once it is initiated. The average
American eats too much fat. It is estimated that many
eat the equivalent of a stick of butter every day. To
4. CHOOSE A DIET WITH PLENTY OF VEGE-
TABLES, FRUITS AND GRAIN PRODUCTS
Fruits, vegetables and whole grains provide dietary
fiber and various vitamins and minerals that may act as
preventers to help protect against cancer. These foods

Reducing Fat Intake

1. Reduce the amount of visible fats.

• Use less cooking oil and fats than called for in recipes. For example, if the recipe calls for 1/2 cup, use
1/3 cup. By cutting back one measure on the measuring cup, you will reduce fat in recipes.
• Limit table use of butter, margarine, cream, gravy, salad dressing, shortening and oils.
• Bake, broil, grill or boil rather than fry in fat.

2. Reduce the amount of the less visible fats.

• Use low-fat or nonfat products.
• Select lean meats and remove excess fat.
• Do not eat the skin from poultry or pork.
• Limit yourself to the recommended amounts of lean meat and low-fat dairy products.
• Eat fewer high-fat baked goods and snacks, such as cookies, crackers, pastries, nuts, donuts and chips.

3. Use low-fat foods to regulate total fat intake.

• High-fat foods don’t have to be avoided altogether but should be balanced with low-fat types to limit
the total daily intake of fat.

Cooperative Extension Service, North Carolina State University

are also naturally low in fat. Replacing high-fat items formation of certain carcinogens. Good sources of
with these choices is a way to reduce the amount of vitamin C include:
fat you eat. In addition, they are generally low in strawberries citrus fruits broccoli
calories and, thus, can help you control weight. cauliflower greens green peppers
The daily recommendation is for adults to eat: five blackberries tomatoes tangerines
or more servings of fruits and vegetables, especially red cabbage raspberries mangoes
dark green and deep yellow-orange vegetables and kale kiwifruit cantaloupe
citrus fruits; and six or more servings of breads,
cereals and legumes. A serving is defined as a half- Foods high in vitamin E may also be protective
cup of most fresh or cooked vegetables, fruits, or against stomach and esophageal cancers. Vitamin E is
ready-to-eat or cooked cereals; or one medium piece an antioxidant and is thought to work in a manner
of fresh fruit; or one slice of bread. similar to that of vitamin C. Foods rich in vitamin E
include whole grain breads and cereals and unsaturated
Dietary Fiber Foods rich in dietary fiber may vegetable oils.
help reduce the risk of developing cancer of the colon
or large intestine. Fiber is thought to work as a Chemical Components in Cruciferous Vegetables
preventer in a number of ways such as by diluting Many vegetables contain compounds which may work
carcinogens in the intestines. It is also thought to bind as cancer inhibitors to neutralize and help excrete
with carcinogens, helping the body to excrete them. carcinogens. Vegetables high in such chemicals
And by increasing the rate at which food moves include:
through the digestive tract, it limits the contact time of broccoli brussels sprouts cabbage
carcinogens with intestinal cells. cauliflower Chinese cabbage bok choy
daikon kale kohlrabi
Vitamins Foods high in vitamin A and the radish mustard greens rutabaga
carotenoids have been shown to have a protective turnip watercress collards
effect against certain cancers, especially lung cancer. spinach horseradish garden cress
They may inhibit tumor growth and act as antioxi-
dants. Good sources of vitamin A and the carotenoids
are dark green and deep yellow-orange fruits and
vegetables such as: 5. USE SUGARS ONLY IN MODERATION
apricots carrots sweet potatoes
pumpkin kale cantaloupe Sugars and the many foods that contain them in
tomatoes spinach winter squash large amounts supply calories but are limited in
greens broccoli peas nutrients. Sugars have not been linked to cancer but
peaches cress cherries obesity has. To avoid gaining weight, limit foods high
asparagus mangoes romaine lettuce in sugars when you do not need excess calories.
Sources of sugar include:
Animal foods contain vitamin A in the form of table sugar (sucrose) honey syrup
retinol rather than carotenoids. Primary sources fruit juice concentrate molasses maltose
include fish liver oil, liver, milk, cheese, fish and egg fructose (fruit sugar) lactose glucose
yolk. Although vitamin A may also be effective corn sweetener raw sugar brown sugar
against some cancers, taking excessive amounts may
be toxic. Do not take extra vitamin A unless your
physician prescribes it. 6. USE SALT AND SODIUM ONLY IN
Foods high in vitamin C (ascorbic acid) also may MODERATION
protect against some types of cancer, such as cancer of
the esophagus and stomach. Vitamin C is thought to There is evidence that high salt intake and frequent
work by acting as an antioxidant and blocking the consumption of salt-cured and salt-pickled foods are
associated with a higher incidence of stomach cancer.

Cooperative Extension Service, North Carolina State University

More research is needed to determine how these act as
cancer initiators. However, salt-cured and salt-
pickled foods contain nitrites that can be transformed
into carcinogens in the foods themselves or in the
stomach. Read labels carefully. Limit consuming
foods containing nitrites, such as:
beef jerky pickled pigs feet
salted and dried venison salami
dried chipped beef hot dogs
pastrami pepperoni
bacon (Canadian, regular) corned beef
bologna (luncheon meats) sausage
7. IF YOU DRINK ALCOHOLIC BEVERAGES,
DO SO IN MODERATION
Alcohol acts as a promoter, possibly altering
cellular defense against disease. Evidence indicates
that even in moderate amounts, alcohol consumption
appears to be linked to an increased risk for develop-
ing cancer of the rectum, breast and pancreas. Exces-
sive consumption, especially when in combination
with cigarette smoking, increases the chances of
developing mouth, esophagus and larynx cancers.
Over many years of abuse alcohol increases the risk
of developing cancer of the liver.
Moderate alcohol consumption is the equivalent to
two cans of beer, or two small glasses of wine or two
average cocktails per day.
OTHER DIET-RELATED RISK FACTORS
Meat High levels of meat consumption have been
associated in some studies with increased risks for
developing cancers of the colon, breast and pancreas.
Whether this effect is due to the high level of protein or
to the fat or calories in the meat or other factors is still
unknown.
Calcium Current evidence suggests that too little
calcium intake may be an important factor in the
development of colon cancer. However, firm conclu-
sions cannot be drawn from the limited evidence at
present.
Grilled and Smoked Foods Consuming excessive
amounts of foods grilled (broiled) over an open flame
or smoked foods (smoke cured) may increase your risk
of cancer of the esophagus and stomach. There is some
evidence that smoke from burning fats or the smoking
process may create carcinogens on the surface of the
foods. You don’t have to avoid grilling or eating
smoked foods altogether. Just don’t eat such foods
every day.
The relationships between dietary practices
and the development of certain cancers are not
fully understood. Nevertheless, there is enough
evidence to cause concern. The guidelines in this
publication form the basis for a general health-
promoting diet that will benefit your life in a
variety of ways. One of these ways is thought to
be the prevention of cancer.

Prepared by
Jacquelyn W. McClelland
Extension Foods and Nutrition Specialist

This publication was issued in print by the North Carolina Cooperative

Extension Service as HE-382 (March 1994).
Published by
NORTH CAROLINA COOPERATIVE EXTENSION SERVICE

Electronic Publication Number HE382 8/95—JMG