13 11 20Cancer Council

Reduce your risk of cancer

Healthy eating.

Extensive research has been conducted on the link between diet and cancer. The evidence is not entirely conclusive but the following links have been found.

Foods that reduce your risk of cancerFoods rich in dietary fibre, particularly wholegrains, may reduce your risk of bowel cancer. Other foods high in dietary fibre include fruit, vegetables, nuts, seeds and legumes.

Non-starchy vegetables and fruits may lower your risk of developing cancers of the lung and digestive tracts, including the mouth, throat, larynx (voice box), nasopharynx, oesophagus (gullet), stomach and bowel.

Consuming dairy foods, including milk, cheese and yoghurt, may reduce your risk of developing bowel cancer.

Foods that increase your risk of cancerDiets high in red meat may increase the chance of developing bowel cancer. Processed and cured meats such as salami, bacon and ham seem to be of most concern.Diets very high in salt (sodium) have been linked to an increased risk of stomach cancer. This evidence comes from countries where salting of foods is a common preserving method due to the lack of refrigeration. In countries where refrigeration is commonly used for storage of perishable foods, stomach cancer is less common.Although varying evidence exists to the direct link between diet and cancer, we do know that eating a healthy diet reduces the risk of becoming overweight and obese.Carrying excess weight (obesity) increases the risk of developing cancers of the oesophagus (gullet), pancreas, liver, breast (post-menopausal), endometrium (lining of the womb), kidney, mouth, throat, larynx (voice box), stomach, gallbladder, ovary and prostate (advanced). Avoiding junk foods that promote weight gain, such as fast food and sugary drinks, is recommended for cancer prevention.

This brochure provides practical information to help you improve your diet and help reduce your risk of developing cancer. After completing treatment, cancer survivors should aim to follow the recommendations in this brochure (if able to do so and unless otherwise advised by a health professional), to help reduce the risk of cancer recurrence.

Eat plenty of plant foodsThis includes fruits, vegetables, wholegrain and wholemeal breads and cereals, legumes, nuts and seeds. These foods are a great source of fibre, vitamins, minerals and phytochemicals (see right). They are also low in energy (kilojoules or Calories)which helps maintain a healthy weight.

Dietary fibreFibre is a part of plant food that our bodies cannot digest. There are different types of fibre and all are beneficial. Soluble fibre can help reduce cholesterol levels and insoluble fibre assists bowel function. Fibre is found in plant foods such as fruit, vegetables, grains, cereal products, legumes, nuts and seeds. Research has found that consuming a diet high in dietary fibre may lower the risk of bowel cancer. Bowel cancer is a very common cancer affecting both men and women in Western Australia.

Fibre also helps control weight, blood cholesterol and blood sugar, and helps prevent and manage constipation. Adult women should aim for 25g of fibre in their diet per day and adult men should aim for 30g of fibre in their diet per day. If you are eating 2 serves of fruit and 5 serves of vegetables every day and choose wholegrain and wholemeal products, you are likely to meet your fibre needs.

Phytochemicals and antioxidantsPhytochemicals are nutrients found in plant foods. Thousands have been identified, including many with antioxidant properties. Antioxidants protect cells against damage and may reduce the risk of developing certain types of cancer. The best way to get more phytochemicals into your diet is to increase your daily intake of plant foods.

Eat more fruit and vegetablesChoose a variety of fruits and vegetables of different colours. We recommend thoroughly washing all fresh fruit and vegetables in water.

Adults should eat at least two serves of fruit and five serves of vegetables daily.

A serve of fruit (150g) is:• 1 medium piece, such as an apple or banana• 2 small pieces, such as apricots, kiwifruit or plums• 1 cup of diced fruit or canned fruit

(in natural juice)Or only occasionally (max 1-2 times per week):

• 1½ tablespoons of sultanas or 4 dried apricot halves (30g)

• ½ cup 100% fruit juice

A serve of vegetables (75g) is:• ½ cup of cooked vegetables• 1 cup of salad vegetables• ½ potato• ½ cup cooked legumes, for example beans,

peas or lentils

Fruit

Vegetables

TIPS: Eating more fruit and vegetables: • Enjoy fruit as a snack or for dessert.• Add fruit as a topping to breakfast cereal.• Fill half your plate with vegetables. • Include at least three different coloured

vegetables in your main meal.• Include salad or vegie sticks with your lunch.• Cook vegetables in different ways, such as

roasting, grilling or barbequing.• Use frozen, dried or canned fruit and vegetables

for convenience or if fresh is not available.• Adapt your recipes to include more vegetables,

for example add carrot, zucchini, and corn to pasta sauce, casseroles and stir-fries.

Fruit and vegetables juicesIt is best to eat whole fruit and vegetables because they provide more fibre and less sugar than juices. Consider that it takes 6 oranges to make just one glass of juice – more than you can eat in one sitting!100% fruit juice can be a healthy choice if drunk in appropriate amounts. Try to limit fruit juice to half a cup 1-2 times per week.

Frozen, canned and dried fruit and vegetablesSeasonal fresh fruit and vegetables are good value for money, and tend to be tastier. Frozen, canned or dried fruit and vegetables are great alternatives when fresh varieties are not available. Choose no-added-salt or reduced-salt canned vegetables, and fruit canned in juice (not syrup).

Grains and cereals

Eat a variety of wholegrain and wholemeal cereal foodsWholegrain foods include wholemeal and mixed grain breads and cereals, rolled oats, wholemeal pasta and brown rice. These foods contain more fibre, vitamins, minerals and phytochemicals than refined cereals like white bread and white rice. Wholegrain foods have been shown to help with weight control.

Adults should eat up to 6 serves of cereal foods each day, mostly wholegrain or high-fibre varieties. Women over 50 and men over 70 require less than this.

A serve of breads and cereals is:• 1 slice of bread, ½ bread roll or wrap (40g)• 3 crispbreads (35g)• ½ cup of cooked rice, pasta or noodles (75-120g)• ½ cup of cooked porridge (120g)• 2∕3 cup of breakfast cereal (30g)• ¼ cup of untoasted muesli (30g)

TIPS: Eating more wholegrain and wholemeal food:

• Choose wholegrain, wholemeal and mixed grain breads, pitas and dry biscuits

• Choose wholegrain or high fibre breakfast cereal, porridge or muesli.

• Choose wholemeal pasta and brown rice.• Use wholemeal, or if preferred, use half white and

half wholemeal flour in baking.• Use wholemeal breadcrumbs or oats to

coat foods.

Add sources of dairy and dairy alternatives to your diet each dayThis includes milk from cows, goats and sheep, cheese, yoghurt, and calcium fortified plant milks such as soy, almond, rice and oat milk. Dairy products are an excellent source of calcium and protein as well a source of vitamin A, riboflavin, vitamin B12 and zinc.

Adults to consume at least 2½ serves of dairy foods and alternatives daily. Women 50+ and men 70+ require more than this.

A serve of dairy and alternatives is:• 1 cup milk (250mL) – fresh, UHT long life,

reconstituted powdered milk• ½ cup evaporated milk (120mL)• 2 slices hard cheese (40g) such as cheddar• ½ cup ricotta cheese (120g)• 3/4 cup yoghurt (200g)• 1 cup plant milk (250mL) with at least 100mg of

added calcium per 100mL – soy, rice, almond, oat* Note: not all dairy foods belong in this group. Soft cheeses, ice cream,

butter and cream are considered junk foods and should not be eaten every day.

TIPS: Including more dairy and alternatives• Add milk to soup to give it a creamy texture.• Make a smoothie with yoghurt, milk and

your favourite fruit.• Snack on calcium-rich nuts like Brazil nuts

or almonds.• Include a small amount of your favourite

cheese in salad.• Have a small bowl of wholegrain cereal with

milk as a snack.• Add reduced fat yoghurt to a fruit salad.

CalciumCalcium is important for strong bones and teeth and proper muscle and heart function. Getting enough calcium throughout life and doing weight-bearing exercise can help prevent osteoporosis.

People with lactose intolerance Lactose is a type of sugar found naturally in milk from cows, goats and sheep.For lactose to be digested, a gut enzyme called lactase is needed. People with lactose intolerance don’t produce enough lactase and this means they can’t digest lactose properly. The symptoms of lactose intolerance include bloating, abdominal discomfort and flatulence after consuming large amount of milk and milk products.Lactose-intolerant adults and children often avoid milk and milk products due to this, but up to 250ml of milk may be tolerated if broken up throughout the day and consumed with other foods. Cheese contains little lactose and the lactose in yoghurt is partially broken down by bacteria that thicken the yoghurt, so are often well tolerated. Lactose-free dairy products and calcium-fortified beverages such as soy, almond, rice and oat milks are also available.

Dairy and alternatives

Vegetarian or vegan dietsPeople following vegetarian and vegan diets may have higher calcium needs because some plant sources of calcium also contain compounds that make it hard for the body to absorb that calcium. Those who follow a vegan or vegetarian diet and avoid milk products should consume alternative calcium-fortified products and seek advice from a health professional about whether they need to take supplements.

Include lean meat, poultry, seafood, eggs, nuts or legumes each dayThese foods contain essential nutrients such as protein, iron, niacin and vitamin B12. Red meat is a very good source of iron and zinc.As some concern exists regarding high red meat intake and cancer risk, we recommend eating only moderate amounts of red meat and limiting processed and cured meats such as salami, bacon and ham.A moderate amount of red meat is no more than 500g (cooked weight) each week. Poultry, seafood, eggs, nuts, seeds and legumes are good alternatives to red meat.

Adults should aim for 2–3 serves of lean meat, poultry, seafood, eggs, nuts or legumes each day. Limit red meat intake to no more than 500g per week.

A serve of meat and alternatives is:• 65g cooked beef, veal, lamb, pork,

kangaroo (90-100g raw)• 80g cooked poultry (chicken or turkey) (100g raw)• 100g of cooked fish fillet (115g raw) or one small

can of fish• 2 large eggs• 1 cup (150g) of cooked legumes, such as lentils,

chickpeas, split peas, dried or canned beans• 30g of nuts or seeds such as peanuts or almonds

(no added salt or sugar)• 170g tofu

LegumesLegumes are also referred to as pulses and include peas, beans, lentils and chickpeas. They are a good source of vitamins, minerals, dietary fibre, carbohydrate, protein and iron.

Meat and alternatives

TIPS: Enjoying the right amount of meat and meat alternatives

• Include a few fish meals each week, for example grilled fish or canned tuna.

• Buy lean cuts of meat and trim all visible fat from meat before cooking.

• Remove the skin from chicken.

• Include some legume-based meals each week. Legumes can be added to pasta sauces, casseroles, soups or salads.

• Fill half your plate with vegetables and don't think of meat as the main part of the meal.

• Adapt your recipes to include more vegetables, for example add carrot, celery, lentils and zucchini to bolognaise sauce.

• Experiment with vegetable risottos, soups and curries.

• Add grated vegetables to baked beans and enjoy on toast or a baked potato.

• Make dips from pureed legumes.

• Blend red beans to use as a pancake filling.

Avoid junk food Junk food contains lots of energy (kilojoules), salt, sugar, and saturated and trans fats while being low in fruit, vegetables and wholegrains. Eating too much junk food can lead to overweight and obesity, which is a risk factor for a number of cancers. As well as contributing lots of energy, sugar, fat and salt to your diet, junk food takes the place of healthier foods that help reduce your risk of cancer.

Examples of junk foods:• Hot chips, burgers, hot dogs and pizzas from fast

food outlets• Cakes, donuts, ice-cream, biscuits and muffins• Chocolate and lollies• Pastries, pies, deep fried spring rolls and sausage

rolls• Processed meats such as bacon, salami and ham• Crisps and similar snack foods• Soft drinks, energy drinks, sports drinks, cordial

and fruit drinks• Alcoholic beverages

Preparing healthy food at homeMany of your favourite meals can be cooked at home using healthier ingredients and cooking methods.

TIPS: Healthy cooking at home• Adapt your recipes to include more

vegetables and legumes.• Choose wholemeal and wholegrain varieties

of pasta, bread, rice and flour.• Use low fat cooking methods, such as grilling,

baking or steaming.• Use non-stick cookware and try an oil spray

to reduce the amount of oil you use.• Use reduced-fat dairy products.• Choose lean cuts of meat and trim all visible

fat from meat before cooking.• Remove skin from poultry.• Swap sausages for home-made patties. • Look for ‘low-salt’, ‘no added salt’ or ‘salt-

reduced’ products, for example, salt-reduced gravies, sauces, stocks and condiments.

• Only use small amounts of very salty ingredients (such as soy sauce, olives or anchovies) in cooking.

• Try to select products with less than 400 mg of sodium per 100 grams of product.

• Limit salt used in cooking and at the table. Flavour foods with herbs, spices, lemon juice or vinegar instead.

TIPS: Quick and healthy snacks• Vegetable sticks and hummus.• Handful of unsalted nuts.• Fruit toast.• Fruit and reduced fat yoghurt.• Wholegrain crackers and cheese.• Wholegrain toast and avocado.

DrinksMost adults should drink around 2 litres (8 glasses) of fluid every day but it varies widely. People participating in physical activity or exposed to the heat should increase their fluid intake. One way to determine if you are drinking enough fluid is to check your urine. It should be plentiful, pale in colour and odourless.

Water is the best choice and should make up most of your fluid intake.

Reduced fat milk drinks are also suitable as they contain calcium, an important nutrient for bone strength. Watch out for the sugar content in flavoured milk drinks. 100% fruit juice can be a suitable drink if consumed in small quantities (less than half a cup 1-2 times per week). Soft drinks, energy drinks, sports drinks, cordials and fruit drinks are high in sugar and contain very few vitamins and minerals. They contribute a lot of energy (kilojoules) whilst providing hardly any nutrients. They are not a good choice. While more research is still needed, the evidence suggests that regular, moderate consumption of tea and coffee has either no substantial effect on cancer risk, or has a small benefit. In particular, coffee may decrease the risk of developing cancer of the liver and endometrium (womb). Drinking scalding hot beverages above 65°C may increase the risk of oesophageal cancer and should be avoided.

TIPS: Drinking more water• Start the day by drinking a glass of water.• Carry a refillable water bottle with you.• Have a bottle or jug of water on your

desk at work.• If you prefer flavoured water, try adding cut-up

lemon, cucumber, strawberry, mint and kiwi fruit to your jug or bottle of water.

• Ask for a jug of water with your meal when in restaurants.

• Drink a glass of water during each meal.• Hot water with a slice or lemon is a good

alternative to tea or coffee.• Drink water regularly during exercise, about

every 10 to 15 minutes.

Do we need vitamin and mineral supplements?If you are eating a wide variety of nutritious foods, you should not need vitamin or mineral supplements. Getting vitamins and minerals from tablets is not as good as getting them from food. Whole foods deliver your body with a package of nutrients that act together to support good health. Whole foods have many other beneficial substances such as fibre, phytochemicals and antioxidants.

Some vitamins and minerals can be harmful in large doses. It is hard to overdose on these vitamins and minerals in real food, but it is possible to have too much as part of a supplement.

If you are taking vitamin and mineral supplements, or are thinking about starting them we advise that you talk to your doctor or dietitian. If your doctor or dietitian has recommended you take vitamin or mineral supplements don’t stop taking the supplements without discussing it with them.

Reading food labelsIn Australia, most packaged, manufactured foods must have a nutrition information panel (NIP). The NIP is a useful tool when judging if a product is healthy. The panel shows the amount of nutrients per serving size and per 100g. ‘Per serving size’ may be different to the serving size you have, so use the ‘per 100g’ column to compare products.

Example Nutrition Information Panel

Use the following guide to decide if a product is a healthy choice:

Compare numbers in the 100g column

Best choice Okay sometimes Poor choice

TOTAL FAT Less than 3g 3 – 10g More than 10g

SATURATED FAT Less than 1.5g 1.5 – 3g More than 3g

SUGAR Less than 5g 5 – 15g More than 15g

SODIUM (salt) Less than 120mg 120 – 400mg More than 400mg

FIBRE Choose high fibre. Use the per serve column and choose more than 3g fibre per serve.

DRINKS: Choose water first

NUTRITION INFORMATIONServings per package: 3Serving size: 150g

Quantity per Serving

Quantity per100 g

Energy 608 kJ 405 kJProtein 4.2 g 2.8 gFat, total 7.4 g 4.9 g

– saturated 4.5 g 3.0 gCarbohydrate, total 18.6 g 12.4 g

– sugars 18.6 g 12.4 gSodium 90 mg 60 mgCalcium 300 mg (38%)* 200 mg* Percentage of recommended dietary intake

Ingredients: Whole milk, concentrated skim milk, sugar, strawberries (9%), gelatine, culture, thickener (1442).

Ingredient listsIngredients are listed from most to least amounts. The main ingredients are first.

Salt, sugar and fat in disguiseSalt, sugar and fat can appear on the ingredients list under a number of different names. All examples within the sugar and salt group are similar nutritionally and will have a similar impact on your health.

• Other names for salt:celery salt, chicken salt, garlic salt, onion salt, pink salt, rock salt, sea salt, sodium

• Other names for sugar:brown sugar, coconut sugar/nectar, corn syrup, cane sugar, date syrup, dextrose, fructose, fruit juice concentrate, glucose, golden syrup, honey, malt, molasses, raw sugar, rice malt syrup, sucrose

• Other names for fat:butter, coconut oil, copha, dripping, hydrogenated oil, lard, oil, palm oil, shortening, tallow, vegetable oil

Be aware of some claims manufacturers use to advertise their product.

• ‘No Added Sugar’ – means no added refined sugars, but the product may contain high amounts of natural sugars.

• ‘Low fat’ – means it contains no more than 3g of fat per 100g but doesn’t always mean it’s a healthy choice. The product may be high in sugar or salt.

• ‘Light’ or ‘Lite’ – may refer to a reduced fat content but may also describe taste, texture or colour.

• ‘Cholesterol Free’ or ‘Low Cholesterol’ – cholesterol is only found in foods which contain animal products. Remember that ‘cholesterol free’ does not mean ‘fat free’.

0.0g0.0g 000mg0000kJ 0.0g

PER PACK

SAT FAT SUGARS SODIUM NUTRIENTENERGY

LOW0% DI* HIGHLOW HIGH

OPTION 1

Health Star RatingThe Health Star Rating (HSR) is a front-of-pack labelling system. Foods are assigned a rating from ½ to 5 stars, with more stars indicating a healthier product.

Read more about the Health Star Rating at healthstarrating.gov.au

TIPS to use the Health Star Rating• Use the HSR to compare similar foods e.g.

comparing different yoghurts. • The HSR is not useful to compare different types

of foods e.g. comparing a yoghurt to a breakfast cereal.

• Unpackaged foods like fruit and vegetables, and single ingredient foods, like flour or sugar don’t currently use the HSR.

• The HSR is currently voluntary, which means manufacturers can choose whether or not they will display the HSR.

Key points• Eat plenty of plant foods.• Limit red meat to no more than 500g

a week and avoid processed meats.• Add dairy foods to your diet each day.• Avoid junk foods.• Aim to get your nutrients from food

not suplements.

Whilst our main focus is on cancer prevention, Cancer Council WA recognises that following the healthy eating recommendations made in this brochure can also reduce the chance of developing other chronic diseases. Healthy eating can help prevent overweight and obesity and can lower your risk of diseases such as diabetes, heart disease, stroke, osteoporosis and dental disease, as well as some cancers. Healthy eating is vital for your overall health.Healthy eating is also important during and after cancer treatment. Please contact Cancer Council WA on 13 11 20 for our ‘Nutrition and Cancer’ booklet for more information.

Images from LiveLighter © State of Western Australia 2019, reproduced with permission

What can I do to reduce my risk of cancer?

• Stop smoking

• Move your body

• Stay in shape

• Eat for health

• Be SunSmart

• Avoid alcohol

• Talk to your doctor about cancer

For support and information on cancer and cancer-related issues, speak to a Cancer Council Nurse on 13 11 20.

Calls are confidential and available statewide Monday to Friday during business hours.

04/19