It joins a growing list of cancers that have been linked to weight by the CUP project, with advanced prostate and ovary cancers added last year. Post-menopausal breast, bowel, pancreatic, kidney, gallbladder, advanced prostate, womb (endometrial), liver, ovary and oesophageal (adenocarcinoma) make up the other cancers strongly linked with overweight and obesity.
Despite increasing awareness of the links between lifestyle factors like diet, weight, physical activity and cancer risk, as a nation we are failing to eat healthily. Governments have campaigned to influence the food decisions people make, they have also adopted policies aimed at making it easier to eat the right foods.
But we are no closer to reversing rising obesity rates in the UK. And we know that people face an uphill task in shaking off unhealthy eating habits.
Food preferences, once learned, can be hard to change.
That’s why we are advocating a smarter approach that puts food preferences to the fore of anti-obesity food policies. Today we publish a paper in the Lancet that sets out the types of measures that will help reduce the impact of unhealthy food habits.
We are urging policy makers to acknowledge that the preferences people develop are, to a large extent, learned. They are learned at school, at the family dinner table and among friends. Anything that can be done to intervene and encourage the formation of healthier food choices will pay dividends.
Consider traffic light food labelling, a policy that World Cancer Research Fund strongly supports. We know that traffic light labelling works well for people who are conscious of the foods they eat and who want a healthy diet. But for others it’s less relevant. You are less likely to act on the information included on a traffic light food label if your food preferences aren’t healthy in the first place.
A smart policy on obesity would recognise that the food preferences that people develop have a huge bearing on what they eat and how likely they are to act on specific policies like labelling.
What is to be done?
A good place to start is with infants and young children. If we can help kids learn to enjoy healthy eating, they have a better chance of taking that into adolescence and adulthood.
Second, we have to make sure that the environment we live in supports healthier options, particularly in the way foods are priced and presented.
Finally, lets make it easy for people who want to eat well. Particularly in disadvantaged communities where people often want to eat well but are priced out of the healthy options available.
None of this is rocket science, but it is vital that policy makers take on board the fact that the policies they create have to work in an environment where people have already developed food preferences
We also need patience: creating a generation of unhealthy eaters took time, we can turn obesity around, but it won’t happen overnight.
Sarah Boseley is the Guardian’s award-winning health editor and author of ‘The Shape We’re In: How junk food and diets are shortening our lives’. Here she writes about the dangers of obesity, and calls for more robust action to warn people of the impact of being overweight:
‘The tombstone adverts on mainstream national television of the mid-80s warning us of that Aids was a death sentence were unforgettable. The more recent anti-smoking adverts showing cigarettes metamorphosing into tumours were stomach-turning. Governments in the UK have successfully mounted powerful public health campaigns – and yet, when it comes to the serious and growing health impact of obesity, the warning voices are barely more than whispers. It appears the best we can manage are the blob-like cartoon figures of Change4Life who try to jolly us along into attempting a bit more exercise and watching our diet. The humour and gentle tone of it all is a disincentive to taking it seriously.
Small wonder then that obesity is growing and most people appear not to understand that it has the potential to shorten our lives and wreck their quality with disability. The warnings of the public health community are drowned by the multi-million pound marketing of the food and drink industry which has, in the last three decades, succeeded in persuading us to eat more and to cut corners by buying packaged food and ready meals and snacks in the name of convenience and living life to the full. We have bought their message that cooking is too time-consuming for the working man and woman, except perhaps at weekends. We have believed that we deserve frequent treats and sweets and sugar-sweetened fizzy drinks and that the old message of not eating between meals is out-dated. And we sit still more and move less. So now we are in a situation we would never have imagined in the 1980s, where most of us – indeed, nearly two-thirds of us – are overweight or obese.
We no longer notice that people are fat. Although the f-word and the o-word still carry a massive stigma and are thought insulting (with the result that a lot of GPs are reluctant to raise the weight issue with their patients) we don’t see what is happening around us because overweight has become normal. It’s particularly true in some populations, where people have less money and less options in life and filling, fattening food has become ever cheaper. In communities where fried chicken and fried fish takeaways proliferate, waist measurements are dangerously large.
The toll this is taking of our health is grim. Most cases of type 2 diabetes are directly linked to overweight and the numbers of new diagnoses are soaring. The disease already swallows 10% of the NHS budget and that is growing. Type 2 diabetes can be controlled by drugs, but in too many cases there are complications, including blindness and amputations. Heart disease and strokes are fairly well-known consequences of obesity and efforts to limit the damage include the controversial handing out of statins to ever larger numbers of people. But few people who are overweight understand how much it increases their risk of cancer.
According to the World Health Organisation, overweight and obesity are the most significant preventable causes of cancer after smoking – yet most people are more likely to fret about air pollution or food colourants. The unwillingness on the part of doctors, politicians (concerned about damaging the profitable UK food industry) and most of us in social situations to be open about the dangers of getting fat have distorted the picture. But obesity is responsible for an estimated 17,000 cancers in the UK every year.
The evidence is strong in breast cancers in women after the menopause. Between 7% and 15% of those breast cancers are caused by obesity, scientists believe. The Million Women study in the UK, run from Oxford University, found that post-menopausal women who were obese had a 30% higher risk of breast cancer than those of normal weight. And because weight is so hard to shift, women who put it on in their youth have an increased risk of breast cancer in the long term.
Obesity is one of the most important causes of bowel cancer, which few realise, causing more than one in ten cases. It raises the risk of endometrial or womb cancer three to four times and triples the risk of oesophageal cancer. It is implicated in pancreatic, kidney and gallbladder cancer and there is some evidence that it could also be a factor in others, from brain cancer to leukaemia and ovarian cancer before the menopause.
This is preventable risk, but too many people have no idea of the danger they could be in. Our “have it all” culture encourages us to eat and drink what we like, when we like and racks up the profits of the food and drink companies who compete with each other for ever bigger, more profitable shares of the market. Traffic light food labelling is an achievement, but gets nowhere near the sort of health warning we need. Cigarette packets tell us stridently that smoking could cause us to get cancer. Isn’t it about time that we heard a similar message concerning over-eating and junk food and drink?’
This blog was commissioned by WCRF UK. The views of the author do not necessarily reflect those of WCRF UK, or any of its partners.
Portion sizes of foods in the UK have spiralled “out of control” according to a new report.
The Portion Distortion report compared the portion sizes of 245 shop-bought foods with portion sizes of the same foods 20 years ago, and found that many had increased significantly.
Managing our weight is a balancing act – eating more than we need to can contribute to weight gain, an important risk factor for cancer and other diseases.
Gradual increases in portion size may mean that we are eating more than we think. For example, if you have a single digestive biscuit with your mid-afternoon cuppa every day, you are now eating 3,300 more calories every year than you would have been eating in 1993.
Making small changes can, over the long term, make a big difference to our waistlines and overall cancer risk. Did you know that maintaining a healthy weight is the best thing we can do to reduce our cancer risk, second only to not smoking?
Staying in shape is also a key way to reduce your risk of other diseases such as heart disease and Type 2 diabetes. Calculate your BMI to see if you are a healthy weight.
Tips to help control portion size
• Use a smaller plate – that way you can still fill your plate but you’ll be eating less.
• Avoid eating straight from the packet – measure out a serving into a bowl or onto a plate instead.
• Think about how much food you’re given when you eat out or ‘on the go’ – portions are often bigger than you really need. To avoid food waste, most restaurants will wrap up leftovers for you to take away.
• Share starters or desserts with a friend.
• Opt for smaller serving sizes of alcoholic drinks – alcohol is a serious source of hidden calories and directly increases your risk of cancer. Check out how many calories are in your favourite tipple with our Alcohol Calorie Calculator.
According to the 2011 Health Survey for England, 25 per cent of adults in the UK were obese in 2011 – an increase from 15 per cent in 1993. The campaign, by the National Obesity Forum, estimates that more than half of the UK population could be obese by 2050, costing the NHS £10 billion a year.
Some of the world’s most serious diseases, such as diabetes, heart disease and cancer are known to be weight related. After not smoking, maintaining a healthy weight is the most important thing you can do to lower your risk of cancer and other diseases. But losing weight, or maintaining a healthy weight, can be a challenge.
So for National Obesity Awareness Week 2014 we’ve put together these quick top tips and tools for being a healthy weight.
Tip 1: Find out if you are a healthy weight
A quick way to find out if you’re a healthy weight is to calculate your Body Mass Index (BMI). This is based on your current weight and height.
Tip 3: Make short-term goals to change your lifestyle
Think about what steps you need to take to become more active and consume fewer calories. Think about how much exercise you take, what you snack on and what foods you treat yourself to. For example, “I will be active every day for 30 minutes”, “I will swap crisps for rice cakes” or “I will swap sugary drinks for water”.
Try our online exercise calorie calculator – by entering the number of calories you’d like to burn, our exercise calculator will tell you how long you to need to spend on a chosen activity. There are 20 activities to chose from and you can select more than one to compare them.
Tip 4: Stay motivated
Think about why you want to lose weight. Having a good reason will keep you motivated so that you’re more likely to achieve your goal, such as “I want to be healthier”, “I want to be fit to play with my kids” or “I want to fit into my clothes again”.
Tip 5: Small steps lead to big changes
Think about the small steps you can take to change your diet. Two wholegrain crackers instead of two slices of white bread will save you 100 calories, for example. Small changes like this soon add up over a period of time.
Say the words ‘female cancer’ and most of us (myself included) would think of breast cancer.
It’s pretty high profile in the UK, from the Angelina Jolie story earlier this year, to the huge range of breast cancer awareness and fundraising events that flash up on Facebook, in GP surgeries and in local newspaper articles.
And there’s good reason for that, given that it’s the most common female cancer in the UK.
But how many of us have ever turned our attention to one of the other cancers that affect British women, of which there are many?
Data published today in a report from our Continuous Update Project (CUP) show there is new, strong scientific evidence that being physically active and having a healthy weight could cut the number of cases of womb cancer diagnosed in the UK by about 44 per cent every year.
That means that for every 23 women diagnosed with the disease each day, 10 cases could be avoided if we were all more active and had a healthy weight.
For me this is positive and empowering information because it means I can take steps to reduce my risk.
But I’m also conscious that as a society we need to do more to make being active and having a healthy weight achievable and the norm, because at the moment it’s not.
The CUP report also identified new evidence that drinking coffee can decrease the risk of endometrial cancer but there are still too many unanswered questions – such as how many cups we should drink, or how regularly – for us to provide any evidence-based advice on coffee drinking.
Currently, our CUP has found no consistent, strong evidence that suggests coffee increases or decreases the risk of any other cancers but we are continually reviewing the evidence as new studies are published because we don’t have the full picture yet.
We need to be sure that there are no harmful effects for other cancers or other conditions before giving any advice about coffee drinking.
It’s an area of research we are interested in.
In the meantime, there are plenty of other small steps we can take today to lower our cancer risk.
We offer free resources that could help you eat more healthily, find out if you’re a healthy weight or be more active. Let us know what you think in the comments section below.
It is an interesting product of devolution that the governments of Scotland and Wales are now leading the way in some areas of public policy and, in the health service, the guidance on hospital vending machines is one such example.
Today World Cancer Research Fund, backed by the Academy of Medical Royal Colleges, is calling for England to catch up with its neighbours to the west and north by introducing health guidelines for the kind of food and drink provided in the vending machines that line hospital corridors. It is time for the NHS in England to establish itself as a beacon of good health practice.
While the Scottish and Welsh governments have been implementing guidelines on the content of hospital vending machines (as well as other food and drink in hospitals) since 2008, Westminster has continued to allow English hospital trusts to set their own agenda at the local level. While local decision-making may be more flexible and, on the face of it, more democratic, it has resulted in a situation where three out of four hospitals have no policy in place relating to the food and drink provided by their vending machines, as revealed by our poll of 146 English hospital trusts.
As our general manager Amanda McLean points out, this has often led to machines filled with high-calorie or high-salt food and drink and very few healthy options. Aside from the link between these kind of products and diseases such as cancer, type-2 diabetes and heart disease, this is a missed opportunity for the government to set up the health service as an example of good practice.
Writing in the British Medical Journal cardiologist Dr Aseem Malhotra said: “An oversupply of nutritionally poor and energy dense foods loaded with sugar, salt and trans fats, fuelled by aggressive and irresponsible marketing by the junk food industry has even been allowed to hijack the very institutions that at are supposed to set an example and promote positive health messages; our hospitals.”
WCRF UK believes that vending machines should at least offer a healthy option for every type of product they supply, for example healthier baked crisps alongside fried crisps. This would underline the importance the government puts on following a healthy diet as a way to help reduce the number of cases of cancer, heart disease and other conditions that keep our hospitals crowded and cost the health service billions of pounds every year.
By introducing a consistent scheme and making it easier for everyone to pick healthy foods, a lot of confusion surrounding different manufacturers’ food labelling arrangements has been removed.
Crucially, the new system – which will be phased in from today – includes ‘traffic light’ labels that will see fat, saturated fat, salt and sugar categorised as green, amber or red to give consumers a rough guide to nutritional content at a glance. This is an important step and one that many food producers were originally unhappy about.
As well as the traffic light colours (to denote low, medium and high levels of nutrients), the labels also describe how much of each nutrient, as well as the number of calories, are present per 100g and what proportion of recommended daily consumption this represents (now known as the ‘reference intake’).
The government is to be congratulated on launching this system as it has a vital role to play in helping improve public health. The UK is the first country in the world to introduce a front-of-pack labelling system.
Around two-thirds of adults and a third of children are classed as overweight or obese in the UK, which is a risk factor in a number of diseases, including cancer, heart disease and diabetes, and costs the NHS an estimated £5.1 billion per year.
Following a lengthy consultation, to which WCRF UK contributed, 60 per cent of UK food and drink producers have signed up to the deal, including all the major supermarkets and many big multinational manufacturers. But a significant proportion of producers remain outside the new system, including Coca-Cola, Kellogg’s, Unilever (makers of Hellmann’s mayonnaise) and Cadbury.
Although the scheme is voluntary, we hope these companies come to recognise the benefit of joining a system that could become a regular part of everyone’s weekly shopping trip.
Only when shoppers can be sure of getting all the information they need in a easy-to- understand, consistent format on all products will the scheme realise its potential to change some of the shopping behaviours that have seen us become the fattest nation in Europe.
Many of us know that there is a link between cancer and body fat. There is strong evidence to show that a person’s level of body fatness is directly related to their risk of getting bowel, breast, womb, pancreatic, kidney and oesophageal cancer.
Iona Taylor is a dietician and supporter of ours from Chester. She decided to draw attention to the link between cancer and weight by wearing a weighted body suit that simulates what it would be like for her to have a BMI of 30.
And in just under ten weeks time, Iona will be donning her ‘fat suit’ and climbing Ben Nevis – the highest mountain in the British Isles.
As preparation for her challenge, she’s been running, cycling and doing squats and lunges in the gym… all in her trusty fat suit. She says that the biggest challenge has been that she is unable to sweat through the suit, making it rather hot work.
She wears the suit at any opportunity so she gets used to carrying around the extra weight.
She said: “I was really amazed at how the extra bulk made life difficult, for example, fitting into public toilet cubicles and getting over a stile. These might seem like small things, but I imagine they’re the things obese people face everyday.
“It’s great for me as a dietician to have that new perspective on the issues as well as the obvious wider health risks.”
We all wish Iona the best of luck with her challenge – thank you for making such an effort for WCRF.
There has been a flurry of media interest surrounding two-day diets recently, with the BBC’s Horizon featuring the 5:2 intermittent diet and the publication and serialisation of The 2-Day Diet (co-authored by WCRF grant panel member Dr Michelle Harvie).
Maintaining a healthy weight is an important way of reducing our risk of cancer and we tend to warn people away from ‘fad diets’. So, are these two-day diet plans just another passing fashion or a realistic way to lose weight?
The general principle behind these diets is that you eat normally for five days of the week and then consume a strict low-calorie diet for the remaining two days.
This kind of fasting is a new area of study and there’s not a huge body of evidence available, so it’s hard to say how effective it is for the general population.
However, so far the proof that it helps people to lose weight is promising. Evidence on other potential benefits still hasn’t been found, although some studies have shown it may help improve insulin function. Insulin plays a vital role in regulating sugar levels in the body and poor insulin function is linked to many weight-related diseases such as Type 2 diabetes.
Research behind intermittent fasting
In 2005, WCRF helped fund a project lead by Dr Harvie which compared an intermittent energy restriction diet to a continued energy restriction diet. The scientists looked at whether restricted calorie intake for just two days has the same benefit as a continuous low-calorie diet over seven days.
Dr Harvie said: “The results of this study were very successful and we have been studying these diets ever since. What these studies are showing is that the results of following a strict low-calorie diet for two days a week compared to moderate daily calorie restriction are similar and the two day a week diet may actually have a better effect.”
All successful weight loss programmes work by reducing the overall calorie intake and the two-day diet is no different. The difference is that calories are only restricted for two days of the week and the dieter can eat a normal, healthy, balanced diet for the other five days.
With one in four adults classed as obese in the UK, it is more important than ever to find ways to maintain a healthy weight. Dr Harvie added: “We need to explore weight loss interventions that work and we need to look at ways to make it easier for people to lose weight.”
The 2-Day Diet
The diet outlined in Dr Harvie’s book (written with Prof Tony Howell) imposes no strict calorie restriction – the two diet days allow for foods high in protein, healthy fats, low-fat dairy foods and some vegetables and fruits.
The book gives recipes with minimum and maximum serving sizes rather than a maximum calorie intake. These recipes and eating plans give a good nutritional balance even on restricted days. This is different to other versions of the two-day diet, where there’s a concern people restrict calories without keeping their diet nutritionally balanced.
The other five days
An important aspect of this diet is eating a sensible balanced and healthy diet for the other five days. Some media reports of intermittent diets have interpreted the diets to mean bingeing on unhealthy foods and then fasting for two days. This is not what Dr Harvie advocates and eating a healthy balanced diet for the rest of the week is an important part of the plan.
Dr Harvie also encourages greater physical activity on the non-restricted days as exercise can help speed up and maintain weight loss. Being active is an important part of any healthy lifestyle and can help reduce the risk of cancer and other diseases. WCRF recommends doing 30 minutes or more of physical activity every day.
Not for everyone
It is important to note that fasting isn’t recommended for certain groups of people such as children and teenagers, pregnant women, women who are breastfeeding and anyone suffering from depression or an eating disorder. Those who suffer from any health condition or who are taking medication should seek advice from a medical professional before embarking on any weight loss regime.
A fad or the future?
There may be benefits for certain groups of people of adopting the two-day diet approach if they’re trying to lose weight. However, it may not be advisable for those with a healthy weight to attempt the diet and there’s no research looking at the long-term effects. More studies need to be done for the diet to be recommended to the general population. In order to reduce your risk of cancer, follow WCRF’s Recommendations for Cancer Prevention.
Updates from World Cancer Research Fund (WCRF UK) about its cancer prevention work