- 1 Overweight and obesity
- 2 Diet
- 3 Physical activity
- 4 Sedentary behaviour
- 5 References
The links between body composition, nutrition, physical activity and cancer risk are complex. These risk factors are interrelated, and may act synergistically. Each risk factor also has an independent effect on cancer risk. It is difficult to separate these combined effects of body mass, nutrition, and physical activity. For example, physical inactivity may increase cancer risk through its contribution to overweight and obesity, but it can also affect cancer risk directly, even in people who are not overweight.
Table 1 presents a summary of evidence of the link between overweight and obesity, physical activity, nutrition, and specific cancer types. Please note the terms ‘convincing’ and ‘probable’ relate to the strength of the evidence and not the size of effect.
Table 1. Summary of evidence of the link between overweight and obesity, physical activity, nutrition, and cancer
|Risk factor||Decreases risk||Increases risk|
|Overweight and obesity||Oesophagus (adenocarcinoma only)
|Overweight and obesity||Breast (pre-menopausal)||Mouth, pharynx, larynx
Stomach (gastric cardia only)
Prostate (advanced prostate cancer only)
|Physical activity||Breast (post-menopausal)
|Foods containing dietary fibre||Colorectum|
|Non-starchy vegetables||Aerodigestive cancers (mouth, larynx, pharynx, nasopharynx, oesophagus, lung, stomach and colorectum)|
|Diets high in calcium||Colorectum|
|Fruits||Aerodigestive cancers (mouth, larynx, pharynx, nasopharynx, oesophagus, lung, stomach and colorectum)|
|Foods preserved by salting||Stomach|
|Substantial effect on risk unlikely|
Source: World Cancer Research Fund International 2018, except where indicated
Overweight and obesity
The World Cancer Research Fund’s Continuous Update Project report concluded that there is strong evidence that high body mass increases the risk of 12 types of cancer and the International Agency for Research on Cancer (IARC) has shown there is sufficient evidence that high body mass increases the risk of 13 types of cancer.
A recent study has shown that in Australia in 2010, 3.4% (3,917 cases) of all cancers diagnosed were attributable to overweight/obesity. This included 1,101 colon cancers, 971 female post-menopausal breast cancers and 595 endometrial cancers.
There is growing evidence that shows specific foods and nutrients can either increase or decrease cancer risk. Diets that protect against weight gain, overweight and obesity are thought to protect against cancers associated with excess body weight.
Dietary advice for reducing cancer risk is consistent with recommendations for promoting good health, including preventing cardiovascular disease and type 2 diabetes. The Australian Dietary Guidelines recommend eating patterns consistent with preventing cancer – this includes consuming a diet high in vegetables and fruit, grains and cereals (preferably wholegrain) avoiding too much red meat, limiting processed meats and avoiding energy-dense nutrient poor foods such as fast food and sugar-sweetened beverage.
Specific foods and nutrients
Dietary fibre occurs naturally in foods such as wholegrain cereals, fruit, vegetables, seeds, nuts and legumes and is highest when these foods are minimally processed. Consumption of these foods is associated with a lower risk of a range of diseases including obesity, type 2 diabetes and cardiovascular disease, and may also prevent some cancers.
There is strong evidence that dietary fibre decreases the risk of bowel cancer. In Australia in 2010, 18% (2,609 cases) of bowel cancers diagnosed were attributable to inadequate levels of dietary fibre.
For further information see Position statement: Fibre, wholegrain cereals and cancer prevention.
Wholegrains are probably protective against bowel cancer.
For further information see Position statement: Fibre, wholegrain cereals and cancer prevention.
Fruit and vegetables
Fruit and non-starchy vegetables are probably protective against aerodigestive cancers (mouth, larynx, pharynx, nasopharynx, oesophagus, lung, stomach and colorectum).
In Australia, 1,555 (1.4% of all) and 311 (0.3% of all) cancers in 2010 were attributable to inadequate intakes of fruit and non-starchy vegetables, respectively.
For further information see Position statement: Fruit, vegetables and cancer prevention.
Red and processed meat
There is convincing evidence that eating red meat and consuming processed meats (including bacon and ham) increase the risk of bowel cancer and that this risk increases with increased consumption. The evidence also indicates that processed meat probably increases the risk of stomach (non-cardia) cancer. In 2015, red meat was classified as a Group 2A carcinogen (probably carcinogenic to humans) and processed meat was classified as a Group 1 carcinogen (carcinogenic to humans) by International Agency for Research on Cancer.
An estimated 2,614 cases (18%) of bowel cancer occurring in Australians in 2010 were attributable to red and processed meat consumption (16% of colon cancers; 23% of rectal cancers). It was estimated that if all Australian adults had consumed ≤65 g/day or ≤100 g/day of red and processed meat, then the incidence of bowel cancer would have been 5.4% (798 cancers) or 1.4% (204 cancers) lower, respectively.
For further information see Position statement: Meat and cancer prevention.
Diets high in calcium
Evidence suggests that diets high in calcium probably decrease the risk of bowel cancer; however, no advice is currently available on consumption levels specifically for cancer prevention.
The evidence indicates that salt preserved foods are probably associated with an increased risk of stomach cancer. These foods include pickled vegetables and salted or dried fish.
For further information see Position statement: Salt and cancer risk.
In 2016, IARC found no conclusive evidence for a carcinogenic effect of drinking coffee. However, the experts did find that drinking very hot beverages probably causes oesophageal cancer. Coffee probably decreases the risk of liver and endometrial cancers; however, no advice is currently available on consumption levels.
Beta-carotene is a carotenoid (a chemical in the pigment of plants that are usually yellow or red) that our body converts to Vitamin A. Beta-carotene can be obtained from dark-green leafy vegetables, some yellow and orange coloured fruits and vegetables, and as a dietary supplement. The evidence suggests that beta-carotene supplements are unlikely to have a substantial effect on risk of prostate cancer.
Physical activity is important for good health and wellbeing, and can help to prevent some cancers and a range of chronic diseases including heart disease. A pooled analysis of 1.44 million adults across Europe and US found physical activity was associated with decreased the risk of 13 types of cancer: oesophageal, liver, lung, kidney, stomach (gastric cardia), endometrial, myeloid leukaemia, myeloma, bowel, head and neck, bladder, and breast. Emerging evidence suggests that sedentary behaviour (sitting time) may also contribute to cancer risk.
In Australia in 2010, an estimated 1,814 cases of colon, post-menopausal breast and endometrial cancer were attributable to insufficient levels of physical activity: 707 colon; 971 post-menopausal breast; and 136 endometrial cancers. If those exercising below the recommended level had increased their activity by 30 minutes/week, it is estimated that 314 fewer cancers would have occurred in 2010.
It is important to note that physical activity confers a protective effect over and above the risk reduction derived via weight management; thus, physical activity is beneficial for all individuals, regardless of their body composition.There is evidence of a dose-response relation between increasing levels of physical activity and decreasing cancer risk. For general health, current Australian guidelines recommend accumulating 150-300 minutes of moderate intensity physical activity or 75 to 150 minutes of vigorous intensity physical activity each week. However, to prevent cancer and unhealthy weight gain people should aim for 300 minutes of moderate intensity physical activity or 150 minutes of vigorous intensity physical activity each week.
Sedentary behaviour (sitting time) is defined by low energy expenditure and a sitting or lying posture during waking hours and is a risk factor that is additional to insufficient physical activity. Recent evidence suggests that sedentary behaviour may contribute to an increased risk of breast, bowel, endometrial and lung cancer. There is insufficient evidence to make recommendations relating to specific limits on daily sedentary time. Current Australian guidelines recommend minimising the amount of time spent in prolonged sitting, and breaking up long periods of sitting as often as possible.
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