Many cancers can be prevented through lifestyle choices, and that includes eating a nutritious diet, being physically active, maintaining a healthy body weight, not smoking, and not drinking. Dr. Bo (Bonnie) Qin, a cancer epidemiologist and assistant professor at the Rutgers Cancer Institute of New Jersey, in the section of Cancer Epidemiology and Health Outcomes, has focused her research on diet for cancer risk and outcomes and cancer health disparities. Here, Dr. Qin explains why maintaining a healthy lifestyle can help keep cancer at bay, and why it’s never too late to make healthy lifestyle changes.
New Jersey Family: How does nutrition apply to cancer prevention?
Dr. Bonnie Qin: Our diet plays a crucial role in cancer prevention. The current dietary recommendations for cancer prevention, as well as for cancer survivors, include having a plant-based diet, which includes vegetables, fruits, beans, and whole grains. Just as important as it is to eat healthy options, it is important to maintain a diet low in fast foods and processed foods that are high in fat, starches or sugars; processed and red meats; sugar-sweetened beverages; and any form of alcohol.
NJF: How do someone’s dietary choices affect their risk for certain cancers?
Dr. Qin: We know that consuming whole grains and foods rich in dietary fiber and dairy products likely reduces the risk of colorectal cancer. Eating non-starchy vegetables and fruits may help lower the risk of aerodigestive cancers, types of cancer found in various parts of our airways. Drinking coffee may reduce the risk of liver and endometrial cancers.
On the flip side, diets high in red and processed meats raise the risk of colorectal cancer. Foods that are preserved using salt can increase the risk of stomach cancer. We also know that drinking alcohol leads to a higher risk of several cancers such as liver, colon and breast cancer, to name a few.
Having a low intake of fruits and vegetables may impact folate deficiency, low dietary fiber, and low levels of multiple vitamins, and those may lead to characteristics of cancer at a microscopic level, unhealthy cell development, and increased inflammation. All those contribute to a higher risk of cancer.
With all this being said, having an unhealthy weight also increases the risk for several types of cancer.
Food access is often limited by factors outside of individual control and this structural racism/classism barrier is a known cause of health inequities in BIPOC and lower-SES populations in the U.S. To “eat healthy” is a pretty privileged guideline and due to access, money, and time challenges it is not achievable for many.
ScreenNJ is a statewide service that provides education about cancer prevention and detection to the community and professionals. ScreenNJ supports NJ residents to obtain cancer screening through navigation and mobile health services regardless of their ability to pay. For more information about ScreenNJ visit screennj.org.
NJF: Is it beneficial to have supplemental vitamins and minerals, or should you be getting that from the healthy foods you are consuming?
Dr. Qin: Get them from healthy food if you can. The current recommendation is to not use supplements for cancer prevention. Although they’re popular, the American Institute of Cancer Research and the World Cancer Research Fund recommend meeting your nutritional needs through diet.
Talk with your healthcare provider before starting any supplement to understand the risks and benefits based on your individual healthcare needs.
NJF: How does someone’s physical activity level affect their risk as well?
Dr. Qin: We know that moderate or vigorous physical activity has been found to reduce the risk of colorectal, breast and endometrial cancers, and helps maintain a healthy weight, which in turn reduces the risks of many cancers. We know that low physical activity may lead to high insulin levels, poor immune function, and high inflammation which contribute to the cancer process.
NJF: How do prevention strategies for cancer and other non-communicable diseases overlap in terms of diet and physical activity? Can those strategies offer health benefits for those already living with chronic diseases?
Dr. Qin: Yes. Many non-communicable diseases, such as diabetes, cardiovascular disease, and chronic respiratory disease, often share the same behavioral risk factors as cancer. This includes, but is not limited to, things like poor diet and having high body fat, not getting enough exercise, and smoking. When we talk about ways to prevent cancer, those same lifestyle behavior strategies can also help us prevent many other non-communicable diseases.
If you already have chronic diseases, then cancer prevention guidelines also apply to you in order to reduce the risk of cancer.
Interested in learning more or getting screened but not sure where to start? Contact ScreenNJ patient navigators for free help scheduling your cancer screening regardless of your income or health insurance status. Email patientnavigation@cinj.rutgers.edu or call (833) 727-3665 or text SCREEN to 43386.
NJF: What advice do you have for parents who want to ensure that their families are making healthy choices to improve long-term health?
Dr. Qin: Aside from the same dietary guidelines for children as adults, I want to mention that for children, screen time, such as sitting and watching TV or using other electronic devices, increases the risk of being overweight and obese. There is strong evidence that greater body fat causes many cancers. Currently, kids and teens between ages 5 and 17 should aim for at least one hour of moderate to vigorous physical activity every day. Going beyond this can bring even more advantages to their health.
Healthy does not have to mean boring. If you’re looking for delicious and healthy recipes, look at the American Institute for Cancer Research website. I also want to mention that other lifestyle factors, such as smoking, sunning and tanning, can also increase cancer risk.
NJF: If someone chooses to eat a healthy diet and exercise regularly after years of poor diet and physical inactivity, will it make a difference in their risk for cancer?
Dr. Qin: If you are already adopting a healthy lifestyle, I want to say congratulations because that’s not easy to do. If you haven’t started yet, it’s never too late to start today. The sooner you start eating a healthy diet and exercise regularly, the further you’ll be away from cancer.
NJF: Are cancer screenings limited only to people with higher-than-average risks for cancer?
Dr. Qin: Following screening guidelines is crucial because it allows for the detection of cancer at an early stage. It is easier to treat or cure cancer in its early stages. Let’s use breast cancer screening as an example. For women who have an average risk of developing breast cancer, which includes the majority of women, mammography-based breast cancer screening is recommended for those between 40 and 74 years old, with a screening interval of every one to two years. So, it’s not only for higher-than-average-risk people.
Thinking about screening for yourself or someone you love? Start by talking to your primary care doctor about screening options or contact ScreenNJ, a cancer prevention, screening, and early detection program brought to you by Rutgers Cancer Institute of New Jersey, the NJ Department of Health, and healthcare and community organizations statewide.
Dr. Bo “Bonnie” Qin is an Assistant Professor in the Section of Cancer Epidemiology and Health Outcomes at Rutgers Cancer Institute of New Jersey, as well as the Division of Medical Oncology at Rutgers Robert Wood Johnson Medical School. She earned her Ph.D. in nutritional epidemiology from the University of North Carolina at Chapel Hill School of Public Health and completed postdoctoral training in cancer epidemiology at Rutgers Cancer Institute of New Jersey. Dr. Qin’s research interests include elucidating the role of diet, lifestyle, and social and built environment factors in cancer risk and survivorship, with a focus on breast cancer, ovarian cancer, and cancer health disparities. She is currently leading a study that investigates the multilevel modifiable risk factors for cardiovascular health after breast cancer diagnosis among Black and African American women. Dr. Qin’s research program aims to integrate multilevel and transdisciplinary components into cancer epidemiology research, with the goal of informing new strategies that improve cancer health, especially among understudied and underserved populations.