Professor Michael Leitzmann presentation on The Continuous Update Project: Recent Findings on Diet, Nutrition, Physical Activity and Cancer at FENS European Nutrition Conference, 20-23 October 2015 Berlin (Germany).

1. The Continuous Update Project: Recent Findings on
Diet, Nutrition, Physical Activity and Cancer
12th European Nutrition Conference FENS 2015
Michael Leitzmann
Dept. of Epidemiology and Preventive Medicine, University of Regensburg
Continuous Update Project Panel member

2. Conflict of interest
regarding this presentation:
I have no conflict of interest to report in relation to
this presentation.

3. Outline
 Prostate cancer
 Kidney cancer
 Liver cancer
 Gallbladder cancer
 Breast cancer survivors
Epidemiologic studies of diet, nutrition, physical activity and cancer

4. Outline
 Prostate cancer
 Kidney cancer
 Liver cancer
 Gallbladder cancer
 Breast cancer survivors
Diet, nutrition, physical activity and cancer

6. BMI Waist circumference Waist to hip ratio
AdvancedNon-advanced
AdvancedNon-advanced
AdvancedNon-advanced
RR=1.12 (1.04-1.21) RR=1.15 (1.03-1.28)
RR=1.01 (0.90-1.12) RR=0.99 (0.90-1.09)
RR=1.08 (1.04-1.12)
Dose-response meta-analysis of body fatness and prostate cancer
RR=0.95 (0.92-0.98)

7. Allott et al., Eur Urol. 2013;63:800–9
Obesity-related biologic mechanisms and detection biases contributing to the
association between obesity and aggressive prostate cancer

8. Dose-response meta-analysis of height and prostate cancer, per 5 cm
RR=1.04 (1.03-1.05)

9. Height and prostate cancer risk
 Height should be thought of as a marker for exposure(s) that influence
cancer risk and not as a risk factor itself
 Adult height is determined both by genetics and by early life exposures1
 Greater intakes of total energy and milk protein during childhood and
adolescence are positively associated with adult height2,3
 Relations with total energy and milk protein may be mediated by
alterations in levels of growth factors and insulin2,3
 Height is associated with greater organ size, which may place more cells at
risk for malignant transformation4
1. Renehan, Lancet Oncol 2011;12:716-7
2. Wadsworth et al., Int J Epidem 2002;31:383-90
3. Berkey et al., CEBP 2009;18:1881-7
4. Albanes & Winick, JNCI 1998;80:772-4

10. Dose-response meta-analysis of dietary beta-carotene and prostate cancer, per 700 ug/d

11. Supplemental beta-carotene and prostate cancer: randomized controlled trials

12. Outline
 Prostate cancer
 Kidney cancer
 Liver cancer
 Gallbladder cancer
 Breast cancer survivors
Diet, nutrition, physical activity and cancer

14. Dose-response meta-analysis of alcohol and kidney cancer, per 10 g per day

15. Potential biologic mechanisms linking alcohol to decreased kidney cancer risk
Alcohol
Diuretic
effect
Kidney
cancer risk
Antioxidant
phenolic
compounds
Insulin
resistance 1
1. Davies et al., JAMA 2002;287:2559-62
2. Halliwell et al., Lancet 1994;344:721-4
3. Lee et al., CEBP 2004;15:1204-11
2
3

16. Dose-response meta-analysis of BMI and kidney cancer, per 5 kg/m2

17. Dose-response meta-analysis of height and kidney cancer, per 5 cm

18. Outline
 Prostate cancer
 Kidney cancer
 Liver cancer
 Gallbladder cancer
 Breast cancer survivors
Diet, nutrition, physical activity and cancer

20. Dose-response meta-analysis of coffee and liver cancer, per one cup per day

21. Potential biologic mechanisms linking coffee to decreased liver cancer risk
Coffee Angiogenesis
Liver
cancer risk
Apoptosis
DNA damage1
1. Majer et al., Food Chem Toxicol 2005;43:433-41
2. Cardin et al., Dig Liver Dis 2013;45:499-504
3. Bohn et al., Mol Nutr Food Res 2014;58:915-30
4. Tunnicliffe & Shearer, Appl Physiol Nutr Metab 2008;33:1290-300
2
3
Insulin
sensitivity
Chronic
inflammation
3
4

22. Aflatoxins and liver cancer

23. Dose-response meta-analysis of alcohol and liver cancer, per 10 g per day

24. Potential biologic mechanisms linking alcohol to increased liver cancer risk
Seitz & Stickel, Biol Chem 2006;387:349-60
 Oxidative stress and impaired antioxidant defense
 Chronic inflammation
 Direct DNA damage and inhibition of DNA repair
 Interference with methyl group transfer, thereby altering gene expression
 Ability to act as a solvent, facilitating enhanced penetration of carcinogens

25. Dose-response meta-analysis of BMI and liver cancer, per 5 kg/m2

26. Outline
 Prostate cancer
 Kidney cancer
 Liver cancer
 Gallbladder cancer
 Breast cancer survivors
Diet, nutrition, physical activity and cancer

28. Non-linear dose-response association of BMI and gallbladder cancer

29. Outline
 Prostate cancer
 Kidney cancer
 Liver cancer
 Gallbladder cancer
 Breast cancer survivors
Diet, nutrition, physical activity and cancer

30. Breast Cancer Survivors Report 2014
Report available at: http://www.wcrf.org/sites/default/files/Breast-Cancer-Survivors-2014-Report.pdf
 85 papers included in the report
 164,416 women
 42,572 cases of mortality

32. Future directions
Studies of cancer incidence:
 Improve measurements of diet, nutrition, and physical activity
 Perform analyses by cancer molecular subtypes
 Examine potential interactions with genetic predisposition
 Elucidate underlying biologic mechanisms
Studies of cancer survival:
 Address potential confounding by cancer stage, treatment, and comorbidities
 Investigate timing in life of exposures in relation to cancer diagnosis and treatment

33. Prostate
cancer
Kidney
cancer
Liver
cancer
Gallbladder
cancer
Breast
cancer
survivors
Body fatness
Height
Alcohol
Coffee
Aflatoxins
Beta-carotene
Total fat
Saturated fat
Foods containing soy
Fiber
Physical activity
Increased risk Decreased risk Substantial effect
on risk unlikely
Summary
Limited-suggestive
evidence

34. Thank you for your attention!

35. For further information
@wcrfint
facebook.com/wcrfint
www.wcrf.org
Michael Leitzmann – Continuous Update Project Panel member
Dept. of Epidemiology and Preventive Medicine, University of Regensburg
Michael.Leitzmann@ukr.de