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. 2019 Jul 12;11(7):1572.
doi: 10.3390/nu11071572.

Operationalizing the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations: A Standardized Scoring System

Marissa M Shams-White  1 , Nigel T Brockton  2 , Panagiota Mitrou  3 , Dora Romaguera  4   5   6 , Susannah Brown  3 , Alice Bender  2 , Lisa L Kahle  7 , Jill Reedy  8
Affiliations

Operationalizing the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations: A Standardized Scoring System

Marissa M Shams-White et al. Nutrients. .

Abstract

Background: Following the publication of the 2018 World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) Third Expert Report, a collaborative group was formed to develop a standardized scoring system and provide guidance for research applications.

Methods: The 2018 WCRF/AICR Cancer Prevention Recommendations, goals, and statements of advice were examined to define components of the new Score. Cut-points for scoring were based on quantitative guidance in the 2018 Recommendations and other guidelines, past research that operationalized 2007 WCRF/AICR Recommendations, and advice from the Continuous Update Project Expert Panel.

Results: Eight of the ten 2018 WCRF/AICR Recommendations concerning weight, physical activity, diet, and breastfeeding (optional), were selected for inclusion. Each component is worth one point: 1, 0.5, and 0 points for fully, partially, and not meeting each recommendation, respectively (Score: 0 to 7-8 points). Two recommendations on dietary supplement use and for cancer survivors are not included due to operational redundancy. Additional guidance stresses the importance of accounting for other risk factors (e.g., smoking) in relevant models.

Conclusions: The proposed 2018 WCRF/AICR Score is a practical tool for researchers to examine how adherence to the 2018 WCRF/AICR Recommendations relates to cancer risk and mortality in various adult populations.

Keywords: breastfeeding; cancer prevention; diet; dietary guidelines; index score; physical activity; weight.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart: the creation of the adapted ultra-processed foods variable to represent “fast foods”. aUPF, adapted ultra-processed food; AICR, American Institute for Cancer Research; MCC-Spain, Multi-Case Control (MCC-Spain) study; NIH-AARP, National Institutes of Health-AARP (formerly known as the American Association of Retired Persons); UPF, ultra-processed food; WCRF, World Cancer Research Fund.
See this image and copyright information in PMC

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