**4. References**


Currently, findings on the effects of soft drinks on cancer risks are limited and inconsistent

Soft drinks are significant contributors to added sugar intake which leads to body mass increase, overweigh, obesity and consequently to NCDs. Eminent international organizations do not consider soft drinks to be a part of healthy and active lifestyle (WCRF & AICR, 2007; WHO, 2005; USDA & U.S. Department of Health and Human Services, 2011).

Only air is more crucial for life than water. Access to safe drinking water is a basic human right, as well as a condition for achieving and sustaining optimal health (WHO, 2011e).

However, contaminated water is a great health risk. Inorganic arsenic from drinking water is a proven risk for lung cancer and there is limited evidence that it is also a risk factor for

Safe drinking water is a nutrient *per se*. Because it plays many important roles in the human body, water is the fluid of choice as a part of healthy lifestyle. There has been a steady growth in the sales of bottled water (6.1% in 2007) (Zenith International, 2008) which is an

Daily requirements for water depend on age, gender, pregnancy, lactation, physical activity

The impact of nutrition and lifestyle on cancer development is evident. Still, there are many unanswered questions concerning the interactions among nutrition, environment and human genome. The existing and future knowledge should be used by public health professionals to promote cancer risk reduction on a population scale, especially in high risk subpopulations, as well as on the individual level. Further research and public health

"To eat is a necessity, to eat intelligently is an art." (François de La Rochefoucauld, French

"Walking is man's best medicine." (Hippocrates, ancient Greek physician, 460 BC – 377 BC)

ADA. (2006a). The Roles of Registered Dietitians and Dietetic Technicians, Registered in

*Association*, Vol.106, No.11, (November 2006), pp. 1875-1884, ISSN 0002-8223 ADA. (2006b). Position of the American Dietetic Association: Food and Nutrition

ADA. (2008). Nutrition Care Process and Model Part I: The 2008 Update. *Journal of the* 

Health Promotion and Disease Prevention. *Journal of the American Dietetic* 

Misinformation. *Journal of the American Dietetic Association*, Vol.106, No.4, (April

*American Dietetic Association*, Vol.108, No.7, (July 2008), pp. 1113-1117, ISSN 0002-

encouraging fact in accordance with today΄s active and healthy lifestyle.

level, diet and external conditions (Smolin & Grosvenor, 2010; ILSI, 2004).

activities should be supported by health and government authorities.

2006), pp. 601-607, ISSN 0002-8223

(WCRF & AICR, 2007).

**3. Conclusion** 

writer, 1613-1680)

**4. References** 

8223

**2.4.5 Water as a fluid of choice** 

kidney and bladder cancer (WCRF & AICR, 2007).


Lifestyle Changes May Prevent Cancer 169

Cani, P.D. & Delzenne, N.M. (2009). The Role of the Gut Microbiota in Energy Metabolism

Cani, P.D., Amar, J., Iglesias, M.A., Poggi, M., Knauf, C., Bastelica, D., Neyrinck, A.M., Fava,

Cani, P.D., Neyrinck, A.M., Fava, F., Knauf, C., Burcelin, R.G., Tuohy, K.M., Gibson, G.R. &

Chan, A.T. & Giovannucci, E.L. (2010). Primary Prevention of Colorectal Cancer. *Gastroenterology*, Vol.138, No.6, (June 2010), pp. 2029-2043, ISSN 0016-5085 Chan, D.S., Lau, R., Aune, D., Vieira, R., Greenwood, D.C., Kampman, E. & Norat T. (2011).

Colquhoun, A., Miyake, J.A. & Benadiba, M. (2009). Fatty Acids, Eicosanoids and Cancer. *Nutritional Therapy and Metabolism*, Vol.27, No.3, pp. 105-112, ISSN 1828-6232 Cross, A.J. & Sinha, R. (2004). Meat-related Mutagens/Carcinogens in the Etiology of

Danaei, G., Ding, E.L., Mozaffarian, D., Taylor, B., Rehm, J., Murray, C.J. & Ezzati, M. (2009).

Donaldson, S.M. (2004). Nutrition and Cancer: a Review of the Evidence for and Anti-cancer Diet. *Nutrition Journal*, Vol.3, (20 October 2004), pp. 19, ISSN 1475-2891 Donohoe, C.L., Doyle, S.L. & Reynolds, J.V. (2011). Visceral Adiposity, Insulin Resistance

Eichholzer, M. & Gutzwiller, F. (1998). Dietary Nitrates, Nitrites, and N-nitroso Compounds

Fair, A.M. & Montgomery, K. (2009). Energy Balance, Physical Activity and Cancer Risk. *Methods in Molecular Biology*, Vol.472, No.I , pp. 57-88, ISSN 1064-3745 FAO. (2004). *Human Energy Requirements. Report of a Joint FAO/WHO/UNU Expert* 

*of Science*, Vol.6, No.4, e 1000058. [Epub 28 April 2009], ISSN 1932-6203 Daniel, C.R., McCullough, M.L., Patel, R.C., Jacobs, E.J., Flanders, W.D., Thun, M.J. & Calle,

ISSN 1381-6128

ISSN 0012-186X

ISSN 0893-6692

ISSN 1055-9965

press, ISSN 1758-5996

Vol.56, No.4 Pt. 1, pp. 95-105, ISSN 0029-6643

FAO. (2011). FAO STAT, 22 July 2011, Available from:

*Consultation*, FAO, ISBN 92-5-105212-3, Rome, Italy

Jun 2011], ISSN 1932-6203

and Metabolic Disease. *Current Pharmaceutical Design*, Vol.15, No.13, pp. 1546-1558,

F., Tuohy, K.M., Chabo, C., Waget, A., Delmée, E., Cousin, B., Sulpice, T., Chamontin, B., Ferrières, J., Tanti, J.F., Gibson, G.R., Casteilla, L., Delzenne, N.M., Alessi, M.C. & Burcelin, R. (2007a). Metabolic Endotoxemia Initiates Obesity and Insulin Resistance. *Diabetes*, Vol.56, No.7, (July 2007), pp. 1761-1772, ISSN 0012-1797

Delzenne, N.M. (2007b). Selective Increases of Bifidobacteria in Gut Microflora Improve High-fat-diet-induced Diabetes in Mice Through a Mechanism Associated with Endotoxaemia. *Diabetologia*, Vol.50, No.11, (November 2007), pp. 2374-2383,

Red and Processed Meat and Colorectal Cancer Incidence: Meta-analysis of Prospective Studies. *PloS One/Public Library of Science*, Vol.6, No.6, e20456, [Epub 6

Colorectal Cancer. *Environmental and Molecular Mutagenesis*, Vol.44, No.1, pp. 44-55,

The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle and Metabolic Risk Factors. *PloS One/Public Library* 

E.E. (2009). Dietary Intake of Omega-6 and Omega-3 Fatty Acids and Risk of Colorectal Cancer in a Prospective Cohort of U.S. Men and Women. *Cancer Epidemiology, Biomarkers and Prevention*, Vol.18, No.2, (February 2009), pp. 516-525,

and Cancer Risk. *Diabetology & Metabolic Syndrome*, Vol. 3, No.12, (22 June 2011), In

and Cancer Risk: a Review of the Epidemiologic Evidence. *Nutrition Reviews*,


Boffetta, P., Couto, E., Wichmann, J., Ferrari, P., Trichopoulos, D., Bueno-de-Mesquita H.B.,

*Institute*, Vol.102, No.8, (21 April 2010), pp. 529-537, ISSN 0027-8874 Bon, G.B. (2008). Adipose Tissue: a Multifunctional Organ. *Congenital Cardiology Today*,

Bonsmann, S.S., Celemín, L.F. & Grunert, K.G. (2010). Food Labelling to Advance Better

Boyle, P. & Boffetta, P. (2009). Alcohol Consumption and Breast Cancer Risk. *Breast Cancer* 

Boyle, P. & Levin, B. (Eds.) (2008). *World Cancer Report*, IARC, ISBN 9789283204237, Lyon,

Boyle, P., Autier, P., Bartelink, H., Baselga, J., Boffetta, P., Burn, J., Burns, H.J., Christensen,

Brower, V. (2011). Epigenetics: Unravelling the Cancer Code. *Nature*, Vol.471, No.7339, (June

Butler, L.M., Sinha, R., Millikan, R.C., Martin, C.F., Newman, B., Gammon, M.D.,

*Epidemiology*, Vol.157, No.5, (1 March 2003), pp. 434-445, ISSN 0002-9262 Buttriss, J.L. & Stokes, C.S. (2008). Dietary Fibre and Health: an Overview. *Nutrition Bulletin*,

Calle, E.E., Rodriguez, C., Walker-Thurmond, K., Thun, M.J. (2003). Overweight, Obesity,

Cancer Council Australia. (2007). Position Statement: Fruit, Vegetables and Cancer

http://www.cancer.org.au/File/PolicyPublications/Position\_statements/PS-

Vol.33, No.3, (September 2008), pp. 186–200, ISSN 1471-9827

Fruit%20\_vegetables\_cancer\_Aug07%20UpdatedJun09.pdf

Ammerman, A.S. & Sandler, R.S. (2003). Heterocyclic Amines, Meat Intake, and Association with Colon Cancer in a Population-based Study. *American Journal of* 

and Mortality from Cancer in a Prospectively Studied Cohort of U.S. Adults. *New England Journal of Medicine*, Vol.348, No.17, (24 April 2003), pp. 1625-1638, ISSN

Education for Life. *European Journal of Clinical Nutrition*, Vol.64, No.3, (November

L., Denis, L., Dicato, M., Diehl, V., Doll, R., Franceschi, S., Gillis, C.R., Gray, N., Griciute, L., Hackshaw, A., Kasler, M., Kogevinas, M., Kvinnsland, S., La Vecchia, C., Levi, F., McVie, J.G., Maisonneuve, P., Martin-Moreno, J.M., Bishop, J.N., Oleari, F., Perrin, P., Quinn, M., Richards, M., Ringborg, U., Scully, C., Siracka, E., Storm, H., Tubiana, M., Tursz, T., Veronesi, U., Wald, N., Weber, W., Zaridze, D.G., Zatonski, W. & Zur Hausen, H. (2003). European Code Against Cancer and Scientific Justification: Third Version (2003). *Annals of Oncology*, Vol.14, No.7, (July

Vol.9, No.4, (April 2008), pp. 23S-28S, ISSN 1554-7787

*Research*, Vol.11, No.S3, pp. S3, ISSN 1465-5411

2010), pp. S14-S19, ISSN 0954-3007

2003), pp. 973-1005, ISSN 0923-7534

2011), pp. S12-S13, ISSN 0028-083

Prevention, 20 July 2011, Available from:

France

1533-4406

Van Duijnhoven, F.J., Büchner, F.L., Key, T., Boeing, H., Nöthlings, U., Linseisen, J., Gonzalez, C.A., Overvad, K., Nielsen, M.R., Tjønneland, A., Olsen, A., Clavel-Chapelon, F., Boutron-Ruault, M.C., Morois, S., Lagiou, P., Naska, A., Benetou, V., Kaaks, R., Rohrmann, S., Panico, S., Sieri, S., Vineis, P., Palli, D., Van Gils, C.H., Peeters, P.H., Lund, E., Brustad, M., Engeset, D., Huerta, J.M., Rodríguez, L., Sánchez, M.J., Dorronsoro, M., Barricarte, A., Hallmans, G., Johansson, I., Manjer, J., Sonestedt, E., Allen, N.E., Bingham, S., Khaw, K.T., Slimani, N., Jenab, M., Mouw, T., Norat, T., Riboli, E. & Trichopoulou, A. (2010). Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). *Journal of the National Cancer* 


Lifestyle Changes May Prevent Cancer 171

Howlett, J. (2008). *Functional Foods: From Science to Health and Claims*. ILSI Europe, ISBN

Hu, J., La Vecchia, C., De Groh, M., Negri, E., Morrison, H., Mery, L. & the Canadian Cancer

Huth, P.J., DiRienzo, D.B. & Miller, G.D. (2006). Major Scientific Advances with Dairy Foods

IARC. (2004). *IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 83: Tobacco smoke and involuntary smoking*, IARC, ISBN 92 832 1283 5, Lyon, France IARC. (2006). *IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 89:* 

IARC. (2008). *IARC Handbooks of Cancer Prevention, Tobacco Control, Vol. 12: Methods for Evaluating Tobacco Control Policies*, IARC, ISBN 978-92-832-3012-0, Lyon, France IDF. (2006). *The IDF Consensus Worldwide Definition of the Metabolic Syndrome*, IDF

ILSI North America. (2004). Hydration: Fluids for Life, ILSI North America, ISBN 1-57881-

ILSI. (2005). *Nutrition and Genetics. Mapping Individual Health*, ILSI Press, ISBN 1578811953,

Institute of Medicine. (1998). *Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin* 

Institute of Medicine. (2000). *Dietary Reference Intakes for vitamin C, Vitamin E, Selenium and* 

Institute of Medicine. (2001). *Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron,* 

Institute of Medicine. (2005). *Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty* 

Jain, S., Yadav, M., Menon, S., Yadav, H. & Marotta, F. (2010). Anticarcinogenic Effects of

Järvinen, R., Knekt, P., Hakulinen, T. & Aromaa, A. (2001). Prospective Study on Milk

ISBN 978-0-309-06411-8, Washington, District of Columbia, USA

9780309085373, Washington, District of Columbia, USA

9781420062137, Boca Raton, Florida, USA

*B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline*. National Academy Press,

*Carotenoides*. National Academy Press, ISBN 978-0-309-06935-9, Washington,

*Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium and Zinc*. National Academy Press, ISBN 978-0-309-07290-8, Washington, District of

*Acids, Cholesterol, Protein and Amino Acids*. National Academies Press, ISBN

Probiotics, Prebiotics, and Synbiotics, In: *Handbook of Prebiotics and Probiotics Ingredients*, Sungsoo, S., Finocchiaro, T.E. (Eds.), pp. 273-292, CRC Press, ISBN

Products, Calcium and Cancers of the Colon and Rectum. *European Journal of Clinical Nutrition*, Vol.55, No.11, (November 2001), pp. 1000-1007, ISSN 0954-3007

Registries Epidemiology Research Group. (2011a). Dietary Cholesterol Intake and Cancer. *Annals of Oncology*, [Epub ahead of print] 4 May 2011, ISSN 1569-8041 Hu, J., La Vecchia, C.L., Groh, M.D., Negri, E., Morrison, H., Mery, L. & The Canadian

Cancer Registries Epidemiology Research Group. (2011b). Dietary Transfatty Acids and Cancer Risk. *European Journal of Cancer Prevention*, [Epub ahead of print] 22

in Nutrition and Health. *Journal of Dairy Science*, Vol.89, No.4, (April 2006), pp.

*Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines*, IARC, ISBN 978 92 832

9789078637110, Brussels, Belgium

June 2011, ISSN 0959-8278

1207-1221, ISSN 0022-0302

Communications, Brussels, Belgium

182-1, Washington, District of Columbia, USA

1289 8, Lyon, France

Brussells, Belgium

Columbia, USA

District of Columbia, USA

http://faostat.fao.org/site/354/default.aspx


Fenech, M., El-Sohemy, A., Cahill, L., Ferguson, L.R., French, T-A.C., Tai, E.S., Milner, J.A.,

Fontham, E.T.H. & Su, L.J. (2005). Prevention of Cancers of the Esophagus and Stomach, In:

Giovannuci, E., Harlan, D.M., Archer, M.C., Bergenstal, R.M., Gapstur, S.M., Habel, L.A.,

Goldman, R., Shields, P.G. (2003). Food Mutagens. *Journal of Nutrition*, Vol.133, No.3, (March

Gonzalez, C.A. (2006). Nutrition and Cancer: the Current Epidemiological Evidence. *British Journal of Nutrition*, Vol.96, No.S1, (August 2006), pp. S42-S45, ISSN 0007-1145 Goodlad, R.A., Lenton, W., Ghatei, M.A., Adrian, T.E., Bloom, S.R. & Wright, N.A. (1987).

Grace, C. (2011). A Review of One-to-one Dietetic Obesity Management in Adults. *Journal of* 

Gray, J. (2006). *Dietary Fibre. Definition, Analysis, Physiology and Health*. ILSI Europe, ISBN 90-

Hardman, A.E. (2011). Physical Activity and Cancer Risk. *Proceedings of the Nutrition Society*,

Havas, S., Heimendinger, J., Reynolds, K., Baranowski, T., Nicklas, T.A., Bishop, D., Buller,

Heilbronn, L.K. & Campbell, L.V. (2008). Adipose Tissue Macrophages, Low Grade

Hernandez, B.Y., Park, S.Y., Wilkens, L.R., Henderson, B.E. & Kolonel, L.N. (2009).

*and Nutrigenomics*, Vol.4, No.2, (July 2011), pp. 69-89, ISSN 1661-6499 Ferruzzi, M.G. (2010). The Influence of Beverage Composition on Delivery of Phenolic

Koh, W.P., Xie, L., Zucker, M., Buckley, M., Cosgrove, L., Lockett, T., Fung, K.Y.C. & Head, R. (2009). Nutrigenetics and Nutrigenomics: Viewpoints on the Current Status and Applications in Nutrition Research and Practice. *Journal of Nutrigenetics* 

Compounds from Coffee and Tea. *Physiology and Behavior*, Vol.100, No.1, (26 April

*Preventive Nutrition. The Comprehensive Guide for Health Professionals*, Bendich, A., Deckelbaum, R.J., (Eds.), pp. 25-54, Humana Press, ISBN 1-59259-880-3, Totowa,

Pollak, M., Regensteiner, J.G. & Yee, D. (2010). Diabetes and Cancer. A Consensus Report. *Diabetes Care*, Vol.33, No.7, (July 2010), pp. 1674-1685, ISSN 0149-5992 Go, W.L.V., Butrum, R.R. & Wong, D.A. (2003). Diet, Nutrition and Cancer Prevention: The

Postgenomic Era. *Journal of Nutrition*, Vol.133, No.11, (November 2003), pp. 3830S-

Effects of an Elemental Diet, Inert Bulk and Different Types of Dietary Fibre on the Response of the Intestinal Epithelium to Refeeding in the Rat and Relationship to Plasma Gastrin, Enteroglucagon and PYY Concentrations. *Gut*, Vol.28, No.2,

*Human Nutrition & Dietetics*, Vol.24, No.1, (February 2011), pp. 13-22, ISSN 1365-

D., Sorensen, G., Beresford, S.A., Cowan, A. & Damron, D. (1994). 5 a Day for Better Health: a New Research Initiative. *Journal of the American Dietetic Association*, Vol.94,

Inflammation and Insulin Resistance in Human Obesity. *Current Pharmaceutical* 

Relationship of Body Mass, Height, and Weight Gain to Prostate Cancer Risk in the Multiethnic Cohort. *Cancer Epidemiology, Biomarkers and Prevention*, Vol.18, No.9,

http://faostat.fao.org/site/354/default.aspx

2010), pp. 33-41, ISSN 0031-9384

New Jersey, USA

3836S, ISSN 0022-3166

277X

2003), pp. 965S-973S, ISSN 0022-3166

78637-03-X, Brussels, Belgium

Vol.60, pp. 107-113, ISSN 0029-6651

(February 1987), pp. 171-180, ISSN 0017-5749

No.1, (January 1994), pp. 32-36, ISSN 0002-8223

*Design*, Vol.14, No.12, pp. 1225-1230, ISSN 1381-6128

(September 2009), pp. 2413-2421, ISSN 1055-9965


Lifestyle Changes May Prevent Cancer 173

Lin, J., Manson, J.E., Lee, I.M., Cook, N.R., Buring, J.E. & Zhang, S.M. (2007). Intakes of

Ma, J., Li, H., Giovannucci, E., Mucci, L., Qiu, W., Nguyen, P.L., Gaziano, J.M., Pollak, M. &

Mackay, J., Eriksen, M. & Shafey, O. (2006). *The tobacco atlas* (2nd ed.), American Cancer

Mamede, A.C., Tavares, S.D., Abrantes, A.M., Trinidade, J., Maia, J.M. & Botelho, M.F.

Manson, J.E., Mayne, S.T. & Clinton, S.K. (2011). Vitamin D and Prevention of Cancer:

Mason, P. (2007). *Dietary Supplements* (3rd ed.), Pharmaceutical Press, ISBN 978-0853698838,

Miles, L. (2007). Physical Activity and Health. *Nutrition Bulletin*, Vol.32, No.4, (December

Milner, J.A. (2004). Molecular Targets for Bioactive Food Components. *Journal of Nutrition*,

Milner, J.A. (2006a). Nutrigenomics and Nutrigenetics, In: *Nutritional Oncology*, Heber, D.,

Milner, J.A. (2006b). Diet and Cancer: Facts and Controversies. *Nutrition and Cancer*, Vol.56,

Munjal, U., Glei, M., Pool-Zobel, B.L. & Scharlau, D. (2009). Fermentation Products of Inulin-

Murff, H.J., Shu, X-O., Li, H., Yang, G., Wu, X., Cai, H., Wen, W., Gao, Y-T. & Zheng, W.

Myung, S-K., Kim, Y., Ju, W., Choi, H.J. & Bae, W.K. (2009). Effects of Antioxidant

Trials. *Annals of Oncology*, Vol.21, No.1, pp. 166-179, ISSN 0923-7534 Newton, R.U. & Galvão, D.A. (2008). Exercise in Prevention and Management of Cancer. *Current Treatment Options in Oncology*, Vol.9, No.2-3, (June 2008), ISSN 1527-2729 Novaković, B., Jovičić, J., Jusupović, F., Grujičić, M. & Đurić, D. Nutrition Care Process in

Cancer. *HealthMED*, Vol.4, No.2, pp. 427-433, ISSN 1840-2291

Blackburn, G.L, Go, V.L.W., Miler, J., (Eds.), pp. 15-24, Academic Press, ISBN 978-0-

type Fructans Reduce Proliferation and Induce Apoptosis in Human Colon Tumor Cells of Different Stages of Carcinogenesis. *British Journal of Nutrition*, Vol.102,

(2011). Dietary Polyunsaturated Fatty Acids and Breast Cancer Risk in Chinese Women: A Prospective Cohort Study. *International Journal of Cancer*, Vol.128, No.6,

Supplements on Cancer Prevention: Meta-analysis of Randomized Controlled

Vol.134, No.9, (September 2004), pp. 2492S-2498S, ISSN 0022-3166

*Medicine*, Vol.167, No.10, (28 May 2007), pp. 1050-1059, ISSN 0003-9926 Liu, R.H. (2003). Health Benefits of Fruit and Vegetables are from Additive and Synergistic

Suppl, (September 2003), pp. S517-S520, ISSN 0002-9165

1039-1047, ISSN 1470-2045

Trowbridge, Wiltshire, UK

Society, ISBN 0-944235-58-1, Brighton, UK

(May 2011), pp. 479-494, ISSN 0163-5581

2011), pp. 1385-1387, ISSN 0028-4793

2007), pp. 314–363, ISSN 1471-9827

No.2, pp. 216-224, ISSN 0163-5581

12-088393-6, Waltham, Massachusetts, USA

No.5, (September 2009), pp. 663-671, ISSN 0007-1145

(15 March 2011), pp. 1434-1441, ISSN 0020-7136

Calcium and Vitamin D and Breast Cancer Risk in Women. *Archives of Internal* 

Combinations of Phytochemicals. *American Journal of Clinical Nutrition*, Vol.78, No.3

Stampfer, M.J. (2008). Prediagnostic Body-mass Index, Plasma C-peptide Concentration, and Prostate Cancer-specific Mortality in Men with Prostate Cancer: a Long-term Survival Analysis. *Lancet Oncology*, Vol.9, No.11, (November 2008), pp.

(2011). The Role of Vitamins in Cancer: a Review. *Nutrition and Cancer*, Vol.63, No.4,

Ready for Prime Time? *New England Journal of Medicine*, Vol.364, No.15, (14 April

Joslin Diabetes Center & Joslin Clinic. (2007). Clinical Nutrition Guideline for Overweight and Obese Adults with Type 2 Diabetes, Prediabetes or Those at High Risk for Developing Type 2 Diabetes, 21 July 2011, Available from:

http://www.joslin.org/docs/Nutrition\_Guideline\_Graded.pdf


Joslin Diabetes Center & Joslin Clinic. (2007). Clinical Nutrition Guideline for Overweight

Jovičić, J., Novaković, B. & Torović, LJ. (2011). Health Claims Made on Foods. *Vojnosanitetski* 

Kaput, J. (2006). Diet-disease Interactions at the Molecular Level: an Experimental Paradigm,

Key, T.J., Schatzkin, A., Willett, W.C., Allen, N.E., Spencer, E.A. & Travis, R.C. (2004). Diet,

Kim, Y. (2006). Cancer, In: *Present Knowledge in Nutrition* (9th ed.)*,* Bowman B.M., Russel

Kinsella, K. & He, W. (2009). *An Aging World 2008*. U.S. Government Printing Office,

Kolonel, L.N., Hankin, J.H., Whittemore, A.S., Wu, A.H., Gallagher, R.P., Wilkens, L.R.,

Kryston, T.B., Georgiev, A.B., Pissis, P. & Georgakilas, A.G. (2011). Role of Oxidative Stress

Kushi, L.H., Byers, T., Doyle, C., Bandera, E.V., McCullough, M., McTiernan, A., Gansler, T.,

Lambert, J.D. & Yang, C.S. (2003). Cancer Chemopreventive Activity and Bioavailability of

Lanou, A.J. & Svenson, B. (2011). Reduced Cancer Risk in Vegetarians: an Analysis of Recent Reports. *Cancer Management and Research*, Vol.3, pp. 1-8, ISSN 1179-1322 Lappe, J.M., Travers-Gustafson, D., Davies, K.M., Recker, R.R. & Heaney, R.P. (2007).

Developing Type 2 Diabetes, 21 July 2011, Available from: http://www.joslin.org/docs/Nutrition\_Guideline\_Graded.pdf

(February 2004), pp. 187-200, ISSN 1368-9800

Population Reports, P95/09-1)

June 2011), pp. 193-201, ISSN 0027-5107

pp. 1586-1591, ISSN 0002-9165

804, ISSN 1055-9965

1759-5045

5718

9781578811991, Washington, District of Columbia, USA

Florida, USA

*pregled*, Vol.63, No.3, (March 2011), pp. 266-269, ISSN 00428450

and Obese Adults with Type 2 Diabetes, Prediabetes or Those at High Risk for

In: *Phytochemicals: Nutrient-Gene Interactions*, Meskin, M.S., Bidlack, W.R. & Randolph, R.K, (Eds.)., pp. 24-39, CRC Press, ISBN 978-0849341809, Boca Raton,

Nutrition and the Prevention of Cancer. *Public Health Nutrition*, Vol.7, No.1A,

R.M., (Eds.)., pp. 689-711, International Life Sciences Institute [ILSI] Press, ISBN

Washington, District of Columbia, USA, (U.S. Census Bureau, International

John, E.M., Howe, G.R., Dreon, D.M., West, D.W. & Paffenbarger, R.S.Jr. (2000). Vegetables, Fruits, Legumes and Prostate Cancer: a Multiethnic Case-control Study. *Cancer Epidemiology, Biomarkers and Prevention*, Vol.9, No.8, (August 2000), pp. 795-

and DNA Damage in Human Carcinogenesis. *Mutation Research*, Vol.711, No.1-2, (3

Andrews, K.S. & Thun, M.J. (2006). American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer with Healthy Food Choices and Physical Activity. *CA. A Cancer Journal for Clinicians*, Vol.56, No.5, (September-October 2006), pp. 254-281, ISSN 0007-9235 Lagergren, J. (2011). Influence of Obesity on the Risk of Esophageal Disorders. *Nature* 

*Reviews Gastroenterology and Hepatology*, Vol.8, No.6, (June 2011), pp. 340-347, ISSN

Tea and Tea Polyphenols. *Mutation Research*, Vol.523-524, pp. 201-208, ISSN 1383-

Vitamin D and Calcium Supplementation Reduces Cancer Risk: Results of a Randomized Trial. *American Journal of Clinical Nutrition*, Vol.85, No.6, (June 2007),


Lifestyle Changes May Prevent Cancer 175

Simopoulos, A.P. (2001). The Mediterranean Diets: What is So Special about the Diet of

Slimani, N. & Margetts, B. (2010). Nutrient Intakes and Patterns in the EPIC Cohorts from

Smolin, L.A. & Grosvenor, B.M. (Eds.). (2010). *Nutrition. Science and Applications* (2nd ed.), John Wiley & Sons, Inc., ISBN 9780470524749, Hoboken, New Jersey, USA Stoll, B.A. (2002). Upper Abdominal Obesity, Insulin Resistance and Breast Cancer Risk.

Talamini, R., Polesel, J., Gallus, S., Dal Maso, L., Zucchetto, A., Negri, E., Bosetti, C.,

Tan, A.C., Konczak, I., Sze, D.M. & Ramzan, I. (2011). Molecular Pathways for Cancer

Tapsell, L.C., Hemphill, I., Cobiac, L., Patch, C.S., Sullivan, D.R., Fenech, M., Roodenrys, S.,

*Australia*, Vol.185, No.4 Suppl, (21 August 2006), pp. S4-S24, ISSN 0025-729X Terry, P.D., Rohan, T.E. & Wolk, A. (2003). Intakes of Fish and Marine Fatty Acids and the

Testino, G. & Borr, P. (2010). Alcohol and Gastrointestinal Oncology. *World Journal of* 

The NCD Alliance. (2011). Proposed Outcomes Document for the United Nations High-

%20Proposed%20Outcomes%20Document%20for%20the%20UN%20High-

Thomas, L.E., Parkinson, R.J, Frost, S.G., Goldstone, P.A. , Doré, J.C., McCarthy, P.J.,

 http://www.nature.com/oby/journal/vaop/ncurrent/full/oby2011142a.html Thune, I. & Furberg, A.S. (2001). Physical Activity and Cancer Risk: Dose-response and

Trajković-Pavlović, LJ., Martinov-Cvejin, M., Novaković, B., Bijelović, S. & Torović LJ.

2001), pp. 3065S-3073S, ISSN 0022-3166

2002), pp. 747-753, ISSN 1476-5497

(May 2011), pp. 495-505, ISSN 0163-5581

Vol.77, No.3, (March 2003), pp. 532-543, ISSN 0002-9165

Ectopic Fat. In: *Obesity*, (15 July 2011), Available from:

No.S6, (June 2001), pp. S530-S550, ISSN 0195-9131

pp. 370-376, ISSN 0959-8049

Level%20Summit.pdf

pp. 619-623, ISSN 0370-8179

S1-S274

Greece? The Scientific Evidence. *Journal of Nutrition*, Vol.131, No.11, (1 November

Ten European Countries. *European Journal of Clinical Nutrition*, Vol.63, No.S4, pp.

*International Journal of Obesity and Related Metabolic Disorders*, Vol.26, No.6, (June

Lucenteforte, E., Boz, G., Franceschi, S., Serraino, D. & La Vecchia, C. (2010). Tobacco Smoking, Alcohol Consumption and Pancreatic Cancer Risk: a Case-control Study in Italy. *European Journal of Cancer*, Vol.46, No.2, (January 2010),

Chemoprevention by Dietary Phytochemicals. *Nutrition and Cancer*, Vol.63, No.4,

Keogh, J.B., Clifton, P.M., Williams, P.G., Fazio, V.A. & Inge, K.E. (2006). Health Benefits of Herbs and Spices: the Past, the Present, the Future. *Medical Journal of* 

Risks of Cancers of the Breast and Prostate and of Other Hormone-related Cancers: a Review of the Epidemiologic Evidence. *American Journal of Clinical Nutrition*,

*Gastrointestinal Oncology*, Vol.2, No.8, (15 August 2010), pp. 322-325, ISSN 19485204

Level Summit on Non-Communicable Diseases, 15 July 2011, Available from: http://www.ncdalliance.org/sites/default/files/resource\_files/NCD%20Alliance

Collins, L.A., Fitzpatrick, A.J., Durighel, G., Taylor-Robinson, D.S. & Bell, D.J. (2011). The Missing Risk: MRI and MRS Phenotyping of Abdominal Adiposity and

Cancer, All Sites and Site-specific. *Medicine and Science in Sports and Exercise*, Vol.33,

(2010a). Analysis of Salt Content in Meals in Kindergarten Facilities in Novi Sad. *Srpski Arhiv za Celokupno Lekarstvo*, Vol.138, No.9-10, (September – October 2010),


Pelucchi, C., Gallus, S., Garavello, W., Bosetti, C. & La Vecchia, C. (2008). Alcohol and

Popkin, B.M. (1994). The Nutrition Transition: Low-income Countries: an Emerging Crisis.

Popkin, B.M. (2001). The Nutrition Transition and Obesity in Developing World. *Journal of Nutrition*, Vol. 131, No.3, (March 2001), pp. 871S-873S, ISSN 0022-3166 Pöschl, G. & Seitz, H.K. (2004). Alcohol and Cancer. *Alcohol and Alcoholism*, Vol.39, No.3, pp.

Quigley, E.M.M. (2011). Nutritional and Health Promoting Properties of Dairy Products:

Radosavljević, V., Janković, S., Marinković, J. & Dokić, M. (2005). Diet and Bladder Cancer: a

Redinger, R.N. (2008). The Physiology of Adiposity. *Journal of the Kentucky Medical Association*, Vol.106, No.2, (February 2008), pp. 53-62, ISSN 2155-661X Roberfroid, M., Gibson, G.R., Hoyles, L., McCartney, A.L., Rastall, R., Rowland, I., Wolvers,

Schatzkin, A., Mouw, T., Park, Y., Subar, A.F., Kipnis, V., Hollenbeck, A., Leitzmann, M.F. &

Seitz, H.K. & Cho, C.H. (2009). Contribution of Alcohol and Tobacco Use in Gastrointestinal

Seitz, H.K. & Stickel, F. (2007). Molecular Mechanisms of Alcohol-mediated Carcinogenesis. *Nature Reviews. Cancer*, Vol.7, No.8, (August 2007), pp. 599-612, ISSN 1474-175X Simopoulos, A. & Milner, J.A. (Eds.). (2010). *Personalized Nutrition: Translating* 

8278

6643

155-165, ISSN 0735-0414

ISSN 0301-1623

0007-1145

3745

12-374402-9, Waltham, Massachusetts, USA

*Health*, Vol.30, No.1, pp. 38-47, ISSN 1535-7414

3805594271, Basel, Switzerland

Tobacco Use, and Cancer Risk for Upper Aerodigestive Tract and Liver. *European Journal of Cancer Prevention*, Vol.17, No.4, (August 2008), pp. 340-344, ISSN 0959-

Nutrition Reviews, Vol.52, No.9, (September 1994), pp. 285-298, ISSN 0029-

Colon Cancer Prevention, In: *Encyclopedia of Diary Sciences* (2nd ed.), Fuquay, J.W., Fox, P.F. & McSweeney, P.L.H. (Eds.), pp. 1016-1022, Academic Press, ISBN 978-0-

Case-control Study. *International Urology and Nephrology*, Vol.37, No.2, pp. 283-289,

D., Watzl, B., Szajewska, H., Stahl, B., Guarner, F., Respondek, F., Whelan, K., Coxam, V., Davicco, M.J., Léotoing, L., Wittrant, Y., Delzenne, N.M., Cani, P.D., Neyrinck, A.M. & Meheust, A. (2010). Prebiotic Effects: Metabolic and Health Benefits. *British Journal of Nutrition*, Vol.104, No.2, (August 2010), pp. S1-S63, ISSN

Thompson, F.E. (2007). Dietary Fiber and Whole-grain Consumption in Relation to Colorectal Cancer in the NIH-AARP Diet and Health Study. *American Journal of Clinical Nutrition*, Vol.85, No.2, (1 February 2007), pp. 1353-1360, ISSN 0002-9165 Secretan, B., Straif, K., Baan, R., Grosse, Y., El Ghissassi, F., Bouvard, V., Benbrahim-Tallaa,

L., Guha, N., Freeman, C., Galichet, L. & Cogliano, V.; WHO International Agency for Research on Cancer Monograph Working Group. (2009). A Review of Human Carcinogens - Part E: Tobacco, Areca nut, Alcohol, Coal smoke, and Salted Fish. *Lancet Oncology*, Vol.10, No.11, (November 2009), pp. 1033-1044, ISSN 1470-2045 Seitz, H.K. & Becker, P. (2007). Alcohol Metabolism and Cancer Risk. *Alcohol Research And* 

Cancer Development. *Methods in Molecular Biology*, Vol.472, pp. 217-241, ISSN 1064-

*Nutrigenetic/Nutrigenomic Research into Dietary Guidelines*, S Karger Pub, ISBN 978-


http://www.nature.com/oby/journal/vaop/ncurrent/full/oby2011142a.html


Lifestyle Changes May Prevent Cancer 177

Wang, J. (2006). Standardization of Waist Circumference Data. *American Journal of Clinical* 

Wang, X-Q., Terry, P.D. & Yan, H. (2009). Review of Salt Consumption and Stomach Cancer

Wannamethee, S.G., Shaper, A.G. & Walker, M. (2001). Physical Activity and Risk of Cancer

Warburton, D.E., Nicol, C.W. & Bredin S.S. (2006). Health Benefits of Physical Activity: the

WCRF & AICR. (2007). *Second Expert Report. Food, Nutrition, Physical Activity and the* 

WHO. (1999). *International Statistical Classification of Disease and Related Heatlh Problems (ICD-*

WHO. (2003). *Diet, Nutrition and the Prevention of Chronic Diseases. Report of a Joint WHO/FAO Expert Consultation*. WHO, ISBN 92 4 120916 X, Geneva, Switzerland WHO. (2005). *Global Strategy on Diet, Physical Activity and Health*, WHO, ISBN 92 4 159222 2,

WHO. (2006). Tobacco: *Deadly in any Form or Disguise*. WHO, ISBN 978 92 4 156322 2,

WHO. (2007a). *Protein and Amino Acid Requirements in Human Nutrition*, WHO, ISBN 92 4

WHO. (2007b). *A Guide for Population-based Approaches to Increasing Levels of Physical Activity :* 

WHO. (2008a). *2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases*, WHO, ISBN 9789241597418, Geneva, Switzerland WHO. (2008b). *WHO Report on the Global Tobacco Epidemic, 2008: the MPOWER package*.

WHO. (2009a). *Global Health Risk. Mortality and Burden of Diseases Attributable to Selected* 

WHO. (2009b). *Interventions on Diet and Physical Activity: What Works: summary report*, WHO,

WHO. (2010a). *Global Recommendations on Physical Activity for Health*, WHO, ISBN 978 92 4

WHO. (2010b). *Global Strategy to Reduce the Harmful Use of Alcohol*, WHO, ISBN 978 92 4

WHO. (2011a). *Global Status Report on Non-communicable Diseases 2010,* WHO, ISBN 978 92 4

WHO. (2011b). *Prevention and Control of Non-communicable Diseases. WHO's Role in the* 

*Preparation, Implementation and Follow-up to the High-level Meeting of the United Nations General Assembly on the Prevention and Control of Non-communicable Diseases* 

*Major Risks*, WHO, ISBN 978 92 4 156387 1, Geneva, Switzerland

*Implementation of the WHO Global Strategy on Diet, Physical Activity and Health*,

Risk: Epidemiological and Biological Evidence. *World Journal of Gastroenterology*,

in Middle-aged Men. *British Journal of Cancer*, Vol.85, No.2, (2 November 2001), pp.

Evidence. *Canadian Medical Association Journal*, Vol.174, No.6, (14 March 2006), pp.

*Prevention of Cancer: a Global Perspective*, American Institute for Cancer Research

*Nutrition*, Vol.83, No.1, (January 2006), pp. 3-4, ISSN 0002-9165

Vol.15, No.18, (14 May 2009), pp. 2204-2213, ISSN 1007-9327

(AICR), ISBN 978-0972252225, Washington, USA

*10) in Occupational Health*. WHO, Geneva, Switzerland

WHO, ISBN 978 92 4 159517 9, Geneva, Switzerland

WHO, ISBN 978 92 4 159628 2, Geneva, Switzerland

ISBN 978 92 4 159824 8, Geneva Switzerland

159 997 9, Geneva, Switzerland

159993 1, Geneva, Switzerland

156422 9, Geneva, Switzerland

*(September 2011)*, Geneva, Switzerland

1311-1316, ISSN 0007-0920

801-809, ISSN 1488-2329

Geneva, Switzerland

Geneva, Switzerland

120935 6, Geneva, Switzerland


Trajković-Pavlović, LJ., Novaković, B., Dragnić, N. & Torović, LJ. (2010b). Salt Content in

Tsuda, H., Sekine, K., Ushida, Y., Kuhara, T., Takasuka, N., Iigo, M., Han, B.S. & Moore,

Tucker, J.M., Welk, G.J. & Beyler, N.K. (2011). Physical Activity in U.S.: Adults Compliance

Tuohy, K.M., Rouzaud, G.C., Brück, W.M. & Gibson, G.R. (2005). Modulation of the Human

USDA & U.S. Department of Health and Human Services. (2011). *Dietary Guidelines for* 

USDA. (2002). Historical Food Guides Background and Development, 17 July 2011, Available from: http://www.nal.usda.gov/fnic/history/index.html

Van der Pols, J.C., Bain, C., Gunnell, D., Smith, G.D., Frobisher, C. & Martin, R.M. (2007).

Van Stuyvenberg, J.H. (1969). *Margarine: An Economic, Social and Scientific History, 1869-1969*.

Vardavas, C.I., Flouris, A.D., Tsatsakis, A., Kafatos, A.G. & Saris, W.H. (2011). Does

Vardavas, C.I., Linardakis, M.K., Hatzis, C.M., Malliaraki, N., Saris, W.H. & Kafatos, A.G.

Vinikoor, L.C., Satia, J.A., Schroeder, J.C., Millikan, R.C., Martin, C.F., Ibrahim, J.G. &

*Tobacco Induced Diseases*, Vol.4, No.8, (9 September 2008), ISSN 2070-7266 Verberne, L., Bach-Faig, A., Buckland, G. & Serra-Majem, L. (2010). Association Between the

Liverpool University Press, ISBN 978-0853231301, Liverpool, UK

Childhood Dairy Intake and Adult Cancer Risk: 65-y Follow-up of the Boyd Orr Cohort. *American Journal of Clinical Nutrition*, Vol.86, No.6, (December 2007), pp.

Adherence to the Mediterranean Diet Have a Protective Effect Against Active and Passive Smoking? *Public Health*, Vol.125, No.3, (March 2011), pp. 121-128, ISSN

(2008). Smoking Status in Relation to Serum Folate and Dietary Vitamin Intake.

Mediterranean Diet and Cancer Risk: a Review of Observational Studies. *Nutrition* 

Sandler, R.S. (2009). Associations Between Trans Fatty Acid Consumption and Colon Cancer Among Whites and African Americans in the North Carolina Colon Cancer Study I. *Nutrition and Cancer*, Vol.61, No.4, pp. 427-436, ISSN 0163-5581

*Medicine*, Vol.40, No.4, (April 2011), pp. 454-461, ISSN 0749-3797

*Cancer*, Vol.105, No.1, (28 June 2011), pp. 157-161, ISSN 0007-0920

Washington, District of Columbia, USA

http://www.cnpp.usda.gov/FGP.htm

http://www.choosemyplate.gov/

1722-1729, ISSN 0002-9165

0033-3506

USDA. (2011a). Food Guide Pyramid, 19 July 2011, Available from:

*& Cancer*, Vol.62, No.7, pp. 860-870, ISSN 0163-5581

Waldorp, M. M. (2011). The Disruptor. *Nature*, Vol.474, pp. 20-22

USDA. (2011b). ChooseMyPlate, 19 July 2011, Available from:

ISSN 1840-2291

8262

Meals and Students' Restaurants in Novi Sad. *HealthMED*, Vol.4, No.1, pp. 45-51,

M.A. (2000). Milk and Dairy Products in Cancer Prevention: Focus on Bovine Lactoferin. *Mutation Research*, Vol.462, No.2-3, (April 2000), pp. 227-233, ISSN 0921-

with the Physical Activity Guidelines for Americans. *American Journal of Preventive* 

Gut Microflora Towards Improved Health Using Prebiotics - Assessment of Efficacy. *Current Pharmaceutical Design*, Vol.11, No.1, pp. 75-90, ISSN 1381-6128 Tverdal, A., Hjellvik, V. & Selmer R. (2011). Coffee Intake and Oral-oesophageal Cancer:

Follow-up of 389 624 Norwegian Men and Women 40-45 Years. *British Journal of* 

*Americans 2010* (7th ed.), U.S. Government Printing Office, ISBN 978-0615449913,


**7** 

Iskren Kotzev

*Bulgaria* 

*Medical University, Varna* 

**Risk and Protective Factors for Development** 

CRC is one of the most frequently diagnosed neoplastic disorders in humans worldwide. According to the National Centre for Health Information of Bulgaria the prevalence of CRC for 2005 is 304.6/100 000 cases, and the incidence - 49.2/100 000 cases (Bulletin of the National Centre for Health Information, 2005). Colorectal polyps (CRP) are established precursors of CRC. Hence, elimination of precursors is a well-known strategy for reduction of risk. In the last decade the most extensively studied etiologic factors are the risk factors for colorectal cancer development, because of its growing incidence and the possibility for its prevention. Prophylaxis of CRC we can divide in primary, secondary and tertiary. The most widely used chemopreventive drugs are: acetylsalicylic acid, polyvitamins, calcium,

Today it is widely accepted that colorectal polyps (CRP) are preneoplastic lesions of colorectal cancer (CRC). From the 3 major groups of polyps: adenomas, hyperplastic, and serrated polyps, with the first group having the highest malignant potential. Hyperplastic polyps are the most common benign lesions, possessing very low malignant potential, and therefore do not require colonoscopic surveillance. However, recent studies prove their role in the classical model of adenoma-carcinoma sequence, and reveal common molecular features between normal mucosa, colorectal polyps, and cancer: proliferation activity, p53 overexpression, hypomethylation of c-myc, and mutations in k-ras oncogene (Hamilton, 2001). Progression of adenomas to CRC has been proven by the 'multistep model' of carcinogenesis, proposed by Fearon and Vogelstein. According to this model the stepwise progression of aberrant crypt foci, small, middle and large adenoma to carcinoma is accompanied by accumulation of mutations in the genes APC, k-ras, DCC, and p53 (Fearon, Fogelstein, 1990). Serrated polyps are histologicaly characterized by 'saw-tooth' infolding of the crypt epithelium, and are seen in 1% of the cases (Longacre & Fenoglio-Preiser, 1990). Every adenoma of the colorectum has a 5% probability for malignant transformation (Winawer et al., 1997). The growth of small adenomas is slow, requiring 10 years on average for doubling of their size (Hoff, 1987). The percentage of transformation of small adenomas into carcinomas is 0.25% (Eide, 1986). CRC is caused by complex interactions between host genetic susceptibility and certain exogenous risk factors. Geographic variation underscores

**2. Risk and protective factors for colorectal polyps and cancer** 

**1. Introduction** 

folic acid, selenium and NSAID.

**of Colorectal Polyps and Cancer** 

