How prevalent is a cancer-protective lifestyle? Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations in Switzerland

Abstract

Population monitoring of lifestyle behaviors that are crucial as risk and protective factors for major chronic diseases is vital for the identification of priority areas for public health. In this study, we aimed to investigate the prevalence of adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations in Switzerland, overall and by selected sociodemographic and lifestyle characteristics. Data from the population-based, cross-sectional survey menuCH were used. We constructed a score reflecting adherence to the 2018 WCRF/AICR cancer prevention recommendations. Multinomial logistic regression models were fitted to investigate the association of sociodemographic and lifestyle characteristics with the level of adherence to the WCRF/AICR cancer prevention recommendations. The least frequently met cancer prevention recommendations were the ones on fiber intake (met by 13.7%), red and processed meat (25.4%), and ultra-processed food (33.3%) consumption, while the recommendation on physical activity was met by almost 80%. Women and individuals with tertiary education were more likely to have a score of ≥5 (as a reflection of adherence to the cancer prevention recommendations), compared to men or those who completed secondary education, respectively. Current smokers were less likely to have a score of ≥5, compared to never smokers. A high proportion of the population in Switzerland was found to not adhere closely to the WCRF/AICR cancer prevention recommendations. Differences were detected based on sociodemographic characteristics. Education and policy actions are needed to facilitate the adoption of a cancer-protective lifestyle.

Determinants and changes in adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer-prevention recommendations over the past 25 years in Switzerland

“…Our results regarding the determinants of adherence to a cancer-protective lifestyle are in agreement with the results in menuCH (Karavasiloglou et al, 2022) with a higher adherence among women than men and among participants with a tertiary than a secondary education level. The study by Lohse et al (2016) reported similar determinants as our study, showing that women, younger participants, Swiss nationals, not divorced or separated participants, and participants with a higher education level were more likely to be in the highest adherence category.…”

“…The median total score indicated an overall moderate adherence across the six SHS. Our results are comparable with those of the Swiss study that used data from the National Nutrition Survey menuCH (Karavasiloglou et al ., 2022) and the Swedish study (Kaluza et al ., 2020), in which most of the participants were categorized into the moderate adherence group (57.9% and 73.3%, respectively).…”

“…Adherence to the individual recommendation scores varied over the study period of 25 years, with a decrease in adherence to the healthy weight and the fruit and vegetables intake recommendations. The adherence scores of the most recent SHS are similar to those seen in the menuCH survey (Karavasiloglou et al ., 2022), where about 50% of the menuCH participants met the healthy weight and the fruit and vegetables intake recommendation. In the Swedish study, lower adherence was observed for the healthy weight (31.9%) and the plant-based diet (17.9%) recommendation (Kaluza et al ., 2020).…”

“…Adherence to the physical activity and alcohol consumption recommendations increased over time in our study. Compared to the adherence percentages of the most recent SHS, higher percentages were found in menuCH (Bae et al ., 2022; Karavasiloglou et al ., 2022) such that almost 80% of the menuCH participants met the physical activity recommendation and about 40% met the recommendation on alcohol consumption. Similar numbers were found in the Romanian study (physical activity adherence: 83.1%; alcohol consumption adherence: 45.7%) (Lotrean et al ., 2021).…”

“…Since 2007, when the first version of the WCRF/AICR cancer-prevention recommendations was published, several studies have investigated adherence to the recommendations and its association with health outcomes (Lohse et al ., 2016; Kaluza et al ., 2020; Solans et al ., 2020; Lotrean et al ., 2021; Karavasiloglou et al ., 2022). Generally, adherence to the cancer-prevention recommendations was rather low (Kaluza et al ., 2020; Lotrean et al ., 2021), and better adherence was associated with reduced risk of cancer incidence and mortality (Lohse et al ., 2016; Solans et al ., 2020).…”