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US Adults Fall Short of the Dietary Guidelines for Cancer Prevention Regardless of BMI Category

Published:March 30, 2021DOI:https://doi.org/10.1016/j.jand.2021.02.013

      Abstract

      Background

      Cancer risk is determined by specific factors, including body weight and dietary patterns. Accordingly, the World Cancer Research Fund/American Institute for Cancer Research published updated cancer prevention recommendations in 2018 based on comprehensive reviews of modifiable behaviors associated with cancer risk.

      Objective

      The objective of this study was to determine the extent to which US adults meet these evidence-based recommendations and how adherence differs by weight status.

      Design

      This was a cross-sectional study using nationally representative data from the 2005-2016 National Health and Nutrition Examination Survey (NHANES).

      Participants/setting

      Dietary intake data for 30,888 adults 18 years and older with normal body mass index (BMI), overweight, or obesity were analyzed.

      Main outcome measures

      Differences in dietary intakes and the proportion of adults meeting guidelines were compared across BMI categories.

      Statistical analyses performed

      Logistic regression and 1-way analysis of covariance were used to analyze differences in adherence to recommendations, controlling for age, sex, race/ethnicity, and family income as a percent of the federal poverty rate.

      Results

      Regarding fruit and nonstarchy vegetables, 62.8% of adults with normal BMI, 64.5% with overweight, and 70.1% with obesity fell short of recommendations. Regarding whole grains, 67.9% of adults with normal BMI, 70.2% with overweight, and 73.1% with obesity did not meet the recommendation. Regarding red meat, 36.7% of adults with normal BMI, 41.6% with overweight, and 43.5% with obesity consumed >18 oz/week, with a significant difference in mean intakes between adults with normal BMI and obesity (P < .001). Adults with obesity consumed significantly less dietary fiber and more processed meat than adults with normal BMI and overweight (P < 0.001).

      Conclusions

      Few U.S. adults meet cancer prevention recommendations; adults with obesity are significantly less likely to do so. Future research should evaluate compounded risk resulting from obesity and poor dietary patterns inconsistent with current evidence-based guidelines, and inform targeted interventions to address these issues.

      Keywords

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      Biography

      M. Good is an undergraduate student, Division of Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, and a clinical dietitian, Nationwide Children’s Hospital, Columbus, OH.

      Biography

      A. C. Braun is a clinical research specialist, Division of Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus.

      Biography

      C. A. Taylor is a professor, Division of Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus.

      Biography

      C. K. Spees is an associate professor, Division of Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus.