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Cancer Epidemiol. 2015 Dec;39 Suppl 1:S56-66. doi: 10.1016/j.canep.2014.12.016. Epub 2015 Jul 9.

European Code against Cancer 4th Edition: Diet and cancer.

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Department of Epidemiology and Biostatistics, School of Public Health Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom.
International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805 Villejuif, France.
Centre for Research into Cancer Prevention & Screening, Level 7, Mailbox 7, Ninewells Hospital & Medical School, Dundee DD1 9SY, Scotland, United Kingdom.
Fondazione IRCSS Istituto Nazionale dei Tumori, 1 via Venezian, 20133 Milan, Italy.
Health Policy Analyst OECD, 2 rue André Pascal, 75775 Paris Cedex 16, France.
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom.
Department of Epidemiology and Preventive Medicine, University Hospital Regensburg, 93042 Regensburg, Germany.
Human Nutrition Unit, The Medical School, Beech Hill Road, Sheffield S10 2RX, United Kingdom.
World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1B 3HH, United Kingdom.
International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France. Electronic address:


Lifestyle factors, including diet, have long been recognised as potentially important determinants of cancer risk. In addition to the significant role diet plays in affecting body fatness, a risk factor for several cancers, experimental studies have indicated that diet may influence the cancer process in several ways. Prospective studies have shown that dietary patterns characterised by higher intakes of fruits, vegetables, and whole-grain foods, and lower intakes of red and processed meats and salt, are related to reduced risks of death and cancer, and that a healthy diet can improve overall survival after diagnosis of breast and colorectal cancers. There is evidence that high intakes of fruit and vegetables may reduce the risk of cancers of the aerodigestive tract, and the evidence that dietary fibre protects against colorectal cancer is convincing. Red and processed meats increase the risk of colorectal cancer. Diets rich in high-calorie foods, such as fatty and sugary foods, may lead to increased calorie intake, thereby promoting obesity and leading to an increased risk of cancer. There is some evidence that sugary drinks are related to an increased risk of pancreatic cancer. Taking this evidence into account, the 4th edition of the European Code against Cancer recommends that people have a healthy diet to reduce their risk of cancer: they should eat plenty of whole grains, pulses, vegetables and fruits; limit high-calorie foods (foods high in sugar or fat); avoid sugary drinks and processed meat; and limit red meat and foods high in salt.


*Diet; *Fruit; *Vegetables; Dietary/administration & dosage/adverse effects; Europe; Meat/adverse effects; Neoplasms/aetiology/*prevention & control; Primary prevention; Sodium chloride

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