LIFESTYLE CHOICES PLAY A LARGE ROLE in cancer incidence and risk: Up to 50% of cancers could be prevented through behavior change, said Linda Nebeling, a behavioral researcher in the Division of Cancer Control and Population Sciences of the National Cancer Institute. Nebeling spoke at a session on “Lifestyle Choices, the Food Environment and Health Equity Impact Cancer Prevention and Control” held April 9 at the American Association for Cancer Research (AACR) Annual Meeting 2024 in San Diego. (The AACR publishes Cancer Today.)

Obesity and overweight status, poor diet and lack of physical activity are well-known risk factors for cancer. Thirteen cancer types have been linked to obesity, and obesity increases the risk of death for patients across all cancer types, Nebeling said. Yet, despite widespread knowledge of the risks, many cancer survivors tend to have unhealthy lifestyle practices, said Wendy Demark-Wahnefried, a researcher specializing in nutrition and cancer at the University of Alabama at Birmingham. A 2019 analysis of 51 studies that included more than 2.6 million adult cancer survivors revealed that 61% were overweight or obese, 69% ate a low-fiber diet, 66% ate fewer than five daily servings of fruits and vegetables, 58% ate a high-fat diet and 57% were underactive.

Demark-Wahnefried described several dietary or activity interventions intended to change unhealthy behaviors among cancer patients, including the ongoing AMPLIFY trial, a web-based diet and exercise trial for cancer survivors. After six months, study participants on average had achieved reductions in weight and waist circumference compared with a control group that did not see reductions, Demark-Wahnefried said. Participants also significantly improved their diet quality.

Xavier Morales, executive director of the Praxis Project, a community-action nonprofit based in San Francisco, described a different kind of intervention: a 2014 drive to enact a sugary-drink tax in Berkeley, California. Consumption of soda and other sugary drinks has been linked to obesity and being overweight, which in turn has been tied to several chronic diseases, including cancer.

According to Morales, the mission of the Praxis Project “is to build healthy communities by transforming the power relationships and structures that affect our lives and communities” through public advocacy and local organizing.

In Berkeley, the Praxis Project and members of the community banded together to put on the ballot a proposal to make soft-drink producers and distributors, not consumers, pay a tax of 1 cent tax per ounce of soda sold. In the face of a well-funded campaign by the beverage industry to defeat the tax proposal, 74% of voters approved the measure, Morales said. From 2018 to 2023, $11.9 million in revenue raised by the tax was distributed to 11 community-based organizations and the Berkeley Unified School District Cooking & Gardening Program. Since passage of the Berkeley measure, similar beverage taxes have been passed in other communities, including San Francisco; Boulder, Colorado; Oakland, California; and Philadelphia.

“We built community power to be able to offset the political and economic power the beverage industry usually brings to bear in these cases,” Morales said of the broad-based, grassroots campaign to pass the tax.

Kevin McLaughlin is the executive editor of Cancer Today.