It has been proven in many studies that diet and physical activity are not only related to cancer but also to many important diseases that affect a large part of the society such as hypertension, high cholesterol, coronary heart disease, diabetes. It is known by everyone that some dietary restrictions are imposed on almost every patient by doctors, and that exercise is recommended for every patient and healthy individual due to its preventive feature from the disease.
This guide is based on the guidelines published periodically by the American Cancer Society to provide advice to healthcare professionals and the general public on dietary and other lifestyle habits that reduce cancer risk. Although no diet can guarantee complete protection against any disease, these guidelines provide the best known information today about how diet and physical activity can lower cancer risk.
With this guide, we hope to answer your questions about nutrition and exercise. . .
The Importance of Diet and Physical Activity in Cancer Prevention
For the majority of non-smoking Americans, dietary choices and physical activity are the most important modifiable determinants of cancer risk. Of the more than 500,000 cancer deaths that occur each year in the USA, 1/3 is attributed to diet and physical activity habits, and the other 1/3 is attributed to smoking. Although heredity affects the risk of cancer and cancer is caused by genetic mutations in cells, the differences in cancer risk between society and individuals suggest that cancer may also be due to non-hereditary factors. Individual factors such as smoking, a certain diet, and staying active throughout life significantly affect a person’s risk of developing cancer. For the first time, this guide contains clear recommendations for social behavior, as healthy individual behavior is most effectively driven by social and environmental factors in society. The American Cancer Society publishes nutrition and physical activity guidelines to provide advice to healthcare professionals and the general public on dietary and other lifestyle habits that reduce cancer risk. Updated in 2001 by the American Cancer Society Nutrition and Physical Activity Guidelines Advisory Committee, these guidelines are based on available scientific evidence linking cancer risk with diet and physical activity in laboratory experiments as well as in human studies. These guidelines reflect the latest state of scientific evidence. In many respects, the evidence is inconclusive, both because studies are still not available and because recent findings are inconsistent. Although randomized controlled trials are the gold standard for scientific results, such evidence is not yet available. Inferences about the many complex relationships associated with diet, physical activity, and cancer risk are based on observational studies with a better understanding of cancer biology.
The relative basis of current scientific evidence between the main components of the diet and common cancers is summarized. Given the integrity of the evidence from different sources, these guidelines address both the benefits of cancer risk reduction and the overall health benefits. Although no diet can guarantee complete protection against any disease, these guidelines provide the best known information today about how diet and physical activity can lower cancer risk. The American Cancer Society Guidelines are similar to those issued by the American Heart Association for the prevention of coronary artery disease and general health promotion defined by the division of health and human services in the Dietary Guidelines for Americans 2000.
The American Cancer Society Guidelines contain personalized advice on diet and physical activity patterns. Therefore, this committee presents a key recommendation for social behavior that accompanies 4 recommendations on nutrition and physical activity to reduce cancer risk. This recommendation highlights the importance of community measures that promote healthy behavior by increasing access to healthy food choices and opportunities to be physically active.
AMERICAN CANCER ASSOCIATION’S NUTRITIONAL AND PHYSICAL ACTIVITY GUIDE FOR CANCER PREVENTION
Personalized recommendations of the American Cancer Society
1) Various healthy eat foods
* Eat 5 or more servings of vegetables and fruits every day
* Choose raw grains instead of processed (refined) grains and sugars
* Limit consumption of red meat, especially fatty and processed ones .
* Choose foods that will help maintain a healthy weight
2) Adopt a physically active lifestyle
* Adults should engage in 30 minutes or more of moderate activity 5 or more days a week. Engaging in moderate-to-vigorous activity for 45 minutes or more, 5 or more days a week, may further increase the reduction in the risk of breast and colon cancer.
* Children and youth should engage in at least 60 minutes of moderate to vigorous physical activity a day, at least 5 days a week.
3) Maintain a healthy weight throughout life.
* It is necessary to balance calorie intake with physical activity
* Those who are overweight or obese recently should lose weight.
4) Consumption of alcoholic beverages should be limited
Recommendations of the American Cancer Society for social behavior
National, private, and community organizations should work to create a social and physical environment that supports the provision and maintenance of healthy eating and physical activity behaviors.
* Access to healthy foods should be ensured in schools, workplaces and society.
* Safe, entertaining and accessible places should be provided for physical activity in schools, transportation and recreation in the community.
Table 1: Nutrition and physical activity guidelines
COMMUNITY RECOMMENDATIONS
Social, economic and cultural factors diet and physical significantly influences personal preferences for activity. While most people want to lead a healthy lifestyle, they face major hurdles that make it difficult to follow dietary and physical activity guidelines. The convenience and affordable price of high-calorie foods and restaurant meals causes an increase in the consumption of these foods. In addition, the current trend, along with the decline in physical activity, is contributing to the alarming epidemic of obesity in people of all ages and in all segments of society. Long working hours and the majority of households working reduce the time devoted to meal preparation. This causes an increase in eating mostly processed foods and fast food (ready meals) outside the home.
Decreased leisure time, use of automobiles for transportation, increased use of electronic entertainment and communication tools all contribute to a less active lifestyle.
Improving nutrition and increasing physical activity will require multiple strategies. These strategies range from health programs in the community and work areas to policies that affect community planning, transportation, school-based physical education and nutrition services. In particular, efforts need to increase the ability of all population groups to use opportunities for healthy dietary choices and physical activity. National and private organizations must each generate new policies and new resources for needed changes. Healthcare professionals, who can be particularly persuasive in lifestyle change, can take leadership in promoting policy change in their environment.
Reduction in adult smoking is a useful example of the power of the social environment to change health behaviors. Per capita consumption of cigarettes in adults has been on a steady decline after the 1964 Surgeon General report on the health hazards of smoking. Since then, other social and political factors have become even more important in reducing smoking. These include national policy changes governing cigarette advertising, restricting access to tobacco products by minors, raising the tax on tobacco products, and drawing attention to the rights of non-smokers.
Building healthy eating and physical activity patterns will require similarly purposeful changes in personal lifestyle choices and national policies. National, private and community organizations should strive to create a social and physical environment that supports the adoption of healthy eating and physical activity behavior patterns.
PERSONAL RECOMMENDATIONS
There is strong scientific evidence showing that a healthy diet combined with regular physical activity reduces the risk of cancer. About 35% of cancer deaths in the USA can be prevented by changes in diet. The scientific study of nutrition and cancer is very complex; For this reason, many important questions on the subject await answers. It is currently unclear how foods alone, combinations of nutrients, overnutrition and energy imbalance, or how body fat distribution at certain stages of life uniquely affect cancer risk. However, epidemiological studies show that societies whose diets are rich in vegetables and fruits and low in animal fat, meat and/or calories have a low risk of developing some common cancers. Until more is known about the specific components of diet that influence cancer risk, the best recommendation is to emphasize all nutrients and comprehensive dietary patterns as defined in these guidelines.
1) Various healthy foods, especially of plant origin, should be eaten
a. Five or more servings
of vegetables and fruits should be eaten
Every meal or snack should contain fruit
and vegetables.
All kinds of fruits and vegetables
should be eaten.
French fries, chips and other fried vegetables should be restricted.
If fruit or vegetable juice is to be drunk, 100% natural ones should be preferred.
b. Raw grains should be preferred instead of refined grains and sugars.
Raw grain, rice, bread and pasta should be preferred.
Consumption of refined carbohydrates, including pastries, sweetened cereals, soft drinks, and sugars, should be restricted.
c. Consumption of red meat, which contains especially high fat and is processed, should be limited
Fish, chicken and beans should be preferred instead of beef, goat and lamb.
If red meat is to be eaten, thin and small portions should be chosen.
It is recommended to prepare meat in the oven, on the grill or by boiling it instead of frying or roasting it.
d. Foods that will help maintain a healthy weight should be chosen.
If eating out is to be eaten, foods low in fat, calories and sugar should be preferred and large portions should be avoided.
Small portions of high-calorie foods should be eaten, and it should be remembered that low-fat or fat-free does not mean low-calorie. Low-fat cakes, pastries, and similar foods are often high-calorie.
Instead of calorie-rich foods such as french fries, cheeseburger, pizza, ice cream and other desserts, fruits, vegetables and other low-calorie foods should be preferred.
BENEFICIAL EFFECTS OF VEGETABLES AND FRUITS
Lung, mouth, esophagus, stomach and colon cancers are less common in societies with high consumption of vegetables and fruits. The evidence is less strong for cancers such as breast and prostate that are considered to be hormone dependent. Even in cancers caused by other factors, diet can be an important factor. For example, in many studies, the incidence of lung cancer was found to be low in people who consume a lot of fruits and vegetables. Although tobacco use is the main factor for lung cancer, diet also changes the risk in smokers and non-smokers.
Evidence that fruit and vegetable consumption reduces cancer risk has led to attempts to isolate specific nutrients and administer pharmacological doses to high-risk populations. Most of these attempts have failed to prevent cancer or pre-cancer lesions, and in some cases have had the opposite effect. Notable examples are three important studies with beta-carotene to prevent lung cancer. These studies were initiated after many observational epidemiological studies showing that the risk of lung cancer is low in beta-carotene-rich diets. In two of these clinical trials, patients who took high-dose beta-carotene supplementation and smoked developed lung cancer at a higher rate than those who took placebo (there is no drug in it), while no effect was found in the third study. These findings support the idea that single high-intake foods may be harmful.
It is currently unclear which components of fruits and vegetables are most protective against cancer. Fruits and vegetables are complex substances, each containing more than a hundred potentially beneficial vitamins, minerals, fiber and other substances that can help prevent cancer. Fruits and vegetables contain special phytochemicals such as carotenoid, flavonoid, terpene, sterol, indole and phenol, which have been shown to be beneficial against some cancers in experimental studies.
Many studies are in progress testing the benefits of vegetables such as cabbage, beans, onions, garlic and tomatoes. Until more is known about specific nutritional components, the best recommendation is to eat 5 or more servings of fruit and vegetables in all their forms—fresh, frozen, canned, dried, and juiced.
Despite the recommendations of numerous health institutions to eat at least 5 servings of vegetables and fruits per day, the intake of these nutrients is still low in children and adults. The ‘5 TIMES A DAY FOR BETTER HEALTH’ program
was launched to eat fruits and vegetables 5 or more times a day.
GRAINS
Grains such as wheat, barley and oats and the foods made from them form the basis of a healthy diet. Cereals; It is an important source of many vitamins and minerals associated with low colon cancer, such as folate, vitamin E and selenium. Grains are richer in fiber and certain vitamins and minerals than refined flours. Although the relationship between fiber foods and cancer risk is insufficient, consuming high fiber foods is still recommended. It’s best to get fiber from grains rather than fiber-supplements, as the benefits of grains can come from the other nutrients they contain as well as fiber.
Beans; It is an excellent source of many vitamins, minerals, protein and fiber. Beans, lentils, broad beans, peas and soybeans are rich in cancer-protective nutrients and can be a useful alternative to meat.
Fruit
1 medium apple, banana, or orange
½ cup chopped, cooked, or canned fruit
¾ cup 100% juice
Vegetables
1 cup raw leafy vegetables
½ cup chopped, cooked or raw vegetables
¾ cup 100% vegetable stock
Cereals
1 slice of bread
28 grams ready-to-eat cereal
½ cup cooked cereals or pasta
Beans and nuts
½ cup cooked dried beans
2 tablespoons peanut oil
½ cup nuts
Dairy and Eggs
1 cup milk or yogurt
45 grams of natural cheese
52 grams of refined cheese
1 egg
Meat
56- 84 grams of cooked lean red meat, chicken or fish
Table 2: Amount of food to be taken at one time (in the service)
FAT DIET AND RED MEAT CONSUMPTION
Y It is known that a high-fat diet increases the risk of cancers of the large intestine (colon and rectum), prostate and uterus (endometrium). The relationship between a high-fat diet and breast cancer is weak. Studies investigating the relationship between a high-fat diet and different cancers show that total fat amount, specific type of fat (saturated, monounsaturated, polyunsaturated fats), and calories from fat are associated with cancer development. Saturated fats in red meat have a higher risk of cancer than omega-3 fatty acids in fish and monounsaturated fats in olives. The effects of different oil types on different cancers are still being investigated.
Since the amount of calories in a gram of fat is about twice the amount of calories in a gram of protein and carbohydrate, the relationship between fat itself and its calories and cancer cannot be fully differentiated. At the same time, since a high-fat diet and high calorie and excess meat consumption are associated, it is very difficult to prove a direct relationship between fat and cancer.
Animal foods are the main source of saturated fats and cholesterol. Although meat is a high protein and mineral source, it has been shown in different studies that excessive consumption of meat, especially red meat, increases the risk of many cancers, especially bowel and prostate cancer. It is not known exactly how much of this relationship is due to the fat in the meat and how much is due to dietary factors. For example, mutated compounds appear when protein is cooked at high temperatures. These mutated compounds may contribute to the association between meat and bowel cancer.
More evidence is needed to say with certainty that saturated fats increase the risk of cancer and coronary heart disease. The best way to reduce saturated fat is to consume wisely animal foods. It would be appropriate to consume lean meats, low-fat or skim milk and dairy products, and to use liquid oils instead of butter. It will be appropriate to use legumes and other vegetables in meals. With the excessive use of legumes and other vegetables in food, it may be possible to increase plant foods and reduce animal foods. Baking and frying in the oven lowers the oil content compared to pan frying. Meat should be fully cooked to destroy harmful bacteria and parasites, but not roasted to become charcoal.
CHOOSING FOOD FOR HEALTHY WEIGHT
Many people cannot reach a healthy weight without reducing their calorie intake, only by regular physical activity. It is known that most of the foods consumed recently contain high fat, sugar and pure carbohydrates. High-calorie foods can be avoided by consuming different diets with a lot of plant foods. Reducing the portion amount of these foods can be another option.
It has been shown that obesity does not decrease by decreasing the fat ratios in the diet and increasing the pure carbohydrate ratios, on the contrary, obesity increases by 8%. Consuming large amounts of sugar and other high pure carbohydrates contributes to insulin insensitivity (diabetes), altered body fat distribution, and increased growth factors that can cause cancer to grow.
BENEFITS OF PHYSICAL ACTIVITY
It is known that the risks of many cancers and other health problems, especially colon and breast cancer, decrease with regular activity. Physical activity affects cancer risk in different ways. Thanks to regular physical activity, the balance of calories taken and given is regulated and ideal weight is achieved. Intestinal movements increase with physical activity, thus reducing the contact time of intestinal surfaces with mutated foods. Therefore, the risk of colon cancer decreases with physical activity. Regular activity also reduces the risk of breast cancer by reducing the exposure of breast tissue to estrogen in the blood. It also increases energy metabolism and decreases the concentration of insulin and some growth factors, thus reducing the risk of many cancers. It should not be forgotten that with regular physical activity, besides cancer, heart disease, diabetes, osteoporosis and hypertension are also reduced.
RECOMMENDED QUANTITIES OF ACTIVITY
It is not known exactly how often, how long and how intense the physical activity should be done to reduce the risk of cancer. However, with the data we have, it is known that the risk of colon cancer decreases significantly even with the smallest activities. It has been shown that the risks of breast, bowel, kidney, uterus, pharynx and some other cancers are reduced with moderate-intensity exercise 5 or more days a week (45 minutes per day).
Even people who are fairly inactive can significantly reduce cardiovascular disease and weight with 30 minutes of moderate-intensity exercise each day, increasing gradually. Moderately active people are advised to exercise 45 minutes a day instead of 30.
SUGGESTED WAYS TO GET AWAY FROM STILL LIFE
1. Stairs should be used, not elevators.
2. If possible, walk or bike to work.
3. Exercise should be done with friends, family or alone during lunch break.
4. A 10-minute exercise break should be taken for brisk walking.
5. Information should be given on foot, instead of sending an e-mail message to your co-workers.
6. One should go to the dance with spouses or friends.
7. Active holidays should be planned and sports activities should be done.
8. Daily exercises should be increased over time.
People who are less active than these guidelines suggest should increase their physical activity. It is recommended to perform stretching and warming movements in each session to avoid musculoskeletal damage.
Although starting physical activities at a young age, which prevents cancer and other diseases, gives the greatest benefit, it has been proven that exercise at any age is beneficial.
ENERGY BALANCE RECEIVED
It has been supported by epidemiological and animal studies that overweight and obesity are associated with the following cancers.
1. Breast cancer
2. Bowel (colon) cancer
3. Uterine (endometrium) cancer
4. Esophagus (esophagus) cancer
5. Gallbladder cancer
6 Pancreatic cancer
7. Kidney cancer
Body Mass Index (BMI), calculated by using human weight and height, is used as an indicator of obesity. Experts think that BMI values between 18.5-25.0 kg/m² are healthy. If the BMI is between 25.0-29.9, it is called overweight, and if it is 30 and above, it is called obese. The person should try to keep his BMI between 18.5-25.
The best thing to do to reach ideal body weight is to balance the energy received and given. It is possible to reduce weight by reducing excess fat, reducing calories and increasing exercise
. Caloric intake can be reduced by choosing small portions and limiting foods high in fat and pure carbohydrates (stir-fried foods, cakes, sweet biscuits, muffins and pastries, chocolates, ice cream). Such food should be replaced with vegetables, fruits and legumes.
It is known that overweight and obesity in youth continue throughout life. Therefore, considering today’s conditions in which obese people are high in youth, there is a concern that cancer cases will increase in the future.
CONSUMPTION MUST BE LIMITED WHEN USING ALCOHOLIC BEVERAGES
People who drink alcohol should limit their consumption to no more than 2 drinks a day for men and 1 glass a day for women. Because women’s bodies are smaller and the rate at which they metabolize alcohol is slower, the recommended amount is less. Alcohol use is a proven cause of cancers of the mouth, pharynx, larynx, esophagus (oesophagus), liver, and breast. Alcohol consumption may also be associated with an increased risk of colon cancer. The risk of each of these cancers increases significantly when more than 2 scoops a day are taken. Alcohol intake along with smoking increases the risk of oral, laryngeal and esophageal cancer much more than smoking or drinking alcohol alone. In addition, regular consumption of a few scoops of liquor per week increases the risk of breast cancer in women. The mechanism of the relationship between alcohol and breast cancer is not known exactly, but it is thought that it may be the result of the increase of estrogens or other hormones circulating in the blood due to alcohol, the decrease in folic acid levels, or the direct effects of alcohol or alcohol breakdown products on the breast tissue. Reducing alcohol intake can be an important way to reduce the risk of breast cancer. It has been suggested in some studies that regular doses of folic acid can reduce the risk of breast cancer, which is increased due to alcohol use, but this has not been fully demonstrated.
Although alcohol use can reduce the risk of coronary heart disease, women at high risk for breast cancer should seriously avoid drinking alcohol. Experts recommend that people who already drink alcohol limit their alcohol intake to 2 drinks per day for men and 1 measure for women. Adults who do not drink alcohol do not have sufficient reason to start drinking alcohol to reduce their risk of heart disease, because it is possible to reduce cardiovascular risk by not smoking, eating a low-saturated fat diet, avoiding obesity, exercising regularly, and controlling blood pressure.
Some people should not drink alcohol at all. These; children and teenagers, people of any age who cannot limit themselves to a certain level of drinking, women who are pregnant or planning a pregnancy, people who will drive or engage in other activities that require attention, dexterity, coordination, and people who take prescription or natural remedies that may interact with alcohol.
DIET AND PHYSICAL ACTIVITIES AFFECTING THE RISK OF COMMON CANCERS
Although the diet and activities specified in the guideline aim to reduce the overall cancer risk, certain dietary and physical activity habits affect specific cancer regions. In this section, the relationship between diet and physical activity factors and the most common cancers will be summarized.
Bladder (Urine Bag) Cancer
Smoking and exposure to some industrial chemicals are important risk factors for bladder cancer. There is limited data showing that high fluid intake reduces the risk of bladder cancer, as does more vegetable consumption.
Brain Cancer
There are no known nutritional risk factors for brain cancer.
Meme Kanseri
Meme kanseri Amerikalı kadınlarda en sık tanı konulan ve akciğer kanserinden sonra 2. sıklıkta kansere bağlı ölüme neden olan kanserdir. İlk adetin 12 yaşından önce olması, hiç doğum yapmamış olmak veya ilk doğumu 30 yaşından sonra yapmak, geç yaşta menopoza girmek ve ailede meme kanseri hikayesi olması meme kanseri riskini arttıran faktörlerdir. Buna rağmen hormon replasman tedavisi kullanımını sınırlamak, şişmanlıktan korunmak, fiziksel aktivite yapmak ve emzirmek gibi davranışlarda oluşturulan değişikliklerle bu risk azaltılabilmektedir.
Diğer kanserlere oranla eldeki veriler daha zayıf olmasına rağmen bazı çalışmalar fazla miktarda sebze ve meyve içeren diyetlerin meme kanseri riskini azalttığını ileri sürmektedir. Alkol, riski orta derecede arttırmaktadır. Uzun süreli ve yoğun fiziksel aktivitenin meme kanseri riskini azalttığına dair veriler çoğalmaktadır. Şu anda, meme kanseri riskini azaltmak amacıyla verilecek en iyi beslenme önerileri şunlardır: Haftada en az 4 saat çok yoğun fiziksel aktivitede bulunmak, günde 1 ölçek içkiden daha fazla alkol alımını sınırlamak veya hiç alkol kullanmamak ve kalori kısıtlaması ve düzenli fiziksel aktiviteyle birlikte ömür boyu kilo alımını engellemek.
Kalın Barsak Kanseri ( Kolorektal Kanser)
Kolorektal kanser Amerikalı erkek ve kadınların toplamında kansere bağlı en sık 2. ölüm nedenidir. Kolon kanseri riski, ailede kolorektal kanser hikayesi olanlarda artmıştır. Diyet ve fiziksel aktiviteye ek olarak değiştirilebilecek bazı diğer faktörler bu kanserin etiyolojisini etkilemektedir. Risk, sigara içimi ve muhtemelen aşırı alkol alımıyla artmaktadır. Risk, aspirin veya diğer steroid olmayan anti-enflammatuar ilaç kullanımı ve muhtemelen hormon replasman tedavisiyle azaltılabilmektedir. Şimdilik ne aspirin benzeri ilaçlar ne de post menapozal hormonlar muhtemel yan etkileri nedeniyle kolorektal kanserden korunmak için önerilmemektedir. Çalışmalar düzenli olarak orta derecede aktivite yapanlarda, daha düşük kolon kanseri riski olduğunu göstermektedir ve yoğun egzersizin kolon kanseri riskini azaltmakta daha da yararlı olabileceğine dair veriler artmaktadır. Fiziksel hareketsizlik, rektum kanserinden çok kolon kanseri riskinde artışla ilişkilidir. Sebze ve meyve ağırlıklı diyetler riski azaltmakta, kırmızı et içeriği yüksek diyetler kolon kanseri riskini arttırmaktadır. Folik asit desteğinin kolon kanseri riskini düşürebileceğine dair bir takım veriler mevcuttur. Kolon kanseri riskini azaltmak için yapılacak en iyi beslenme önerisi: fiziksel aktivitenin yoğunluğunu ve süresini arttırmak, kırmızı et tüketimini sınırlamak, şişmanlıktan korunmak ve fazla alkol tüketmemektir. Ayrıca Amerikan Kanser Grubu’nun barsaktaki polipleri bulup çıkarmakla ilgili olarak düzenli kolorektal tarama önerilerini uygulamak da çok önemlidir.
Endometriyum (Rahim) Kanseri
Şişmanlık ve menopoz sonrası hormon kullanımı rahim kanseri riskini arttırmaktadır. Menopozdan sonra kilolu kadınlarda östrojen düzeyleri kilolu olmayanlara göre daha fazladır. Bu östrojenin rahim kanserini arttırdığı düşünülmektedir. Sebze ve meyvelerin tüketimi rahim kanseri riskini azaltabilmektedir. Şu anda rahim kanseri riskini azaltmak için verilebilecek olan en iyi öneri diyet ve düzenli egzersizle sağlıklı bir kiloda kalınması ve her gün en az 5 porsiyon sebze ve meyvenin yenilmesidir.
Böbrek Kanseri
Aşırı kilolu kişilerde böbrek kanseri riski artmıştır. Bunun nedeni bilinmemektedir. Böbrek kanseri riskini azaltmak için verilecek olan en iyi öneri şişmanlamamaktır.
Lösemi ve Lenfomalar
Lösemi ve lenfomalar için bilinen hiçbir besinsel risk faktörü yoktur.
Akciğer Kanseri
Akciğer kanseri Amerika’da en önde gelen kansere bağlı ölüm nedenidir. Akciğer kanserlerinin % 85’den fazlası sigara içme sonucunda olur. Pek çok çalışma günde en az 5 porsiyon sebze ve meyve yiyen kişilerde akciğer kanseri riskinin bu şekilde beslenmeyenlere oranla daha düşük olduğunu göstermiştir.Yüksek doz beta-karoten ve/veya A vitamini kullanımı sigara içenlerde akciğer kanseri riskini arttırmıştır (azaltmamıştır). Şu anda akciğer kanseri riskini azaltmak amacıyla yapılacak olan en iyi öneri sigara içmemek ve her gün en az 5 porsiyon sebze ve meyve yenilmesidir.
