Nutr Res Pract.  2018 Feb;12(1):52-60. 10.4162/nrp.2018.12.1.52.

Development of quantitative index evaluating anticancer or carcinogenic potential of diet: the anti-cancer food scoring system 1.0

Affiliations
  • 1Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, 123, Jeokgeum ro, Danwon-gu, Gyeonggi 15355, Korea. crusion3@naver.com

Abstract

BACKGROUND
/OBJECTIVE: Cancer is closely related to diet. One of the most reliable reports of the subject is the expert report from the World Cancer Research Fund & American Institute of Cancer Research (WCRF&AICR). However, majority of the studies including above were written with academic terms and in English. The aim of this study is to create a model, named Anti-Cancer Food Scoring System (ACFS), to provide a simple index of the anticancer potential of food.
SUBJECTS/METHODS
We created ACFS codes of various food groups. The evidence of the ACFS codes was provided by the literature at a level comparable to that suggested in the WCRF&AICR report or from the WCRF&AICR report. The ACFS grade was calculated considering food group, cooking, and normalization. Application was performed for Koreans' 20 common meals, which encompass multinational recipes. RESULT: We calculated the ACFS grades of Koreans' 20 common meals. The results were not significantly different from the WCRF&AICR guidelines or information from the National Cancer Information Center of Korea. The grades were briefly interpreted as follows: grade S. ideal for cancer prevention; grade A. good for cancer prevention; grade B, might have anticancer potential; grade C, difficult to be regarded as preventive or carcinogenic; grade D, might against cancer prevention; grade E, probably against cancer prevention.
CONCLUSIONS
The ACFS provides a simple index of anticancer potential of diets. This indicator can be useful for the people without expertise, and is effective in evaluating the diets including Asian foods. The ACFS can help design of future clinical or nutritional studies of cancer prevention.

Keyword

Cancer; diet; prevention

MeSH Terms

Asian Continental Ancestry Group
Cooking
Diet*
Financial Management
Humans
Information Centers
Korea
Meals

Cited by  1 articles

Development of the anti-cancer food scoring system 2.0: Validation and nutritional analyses of quantitative anti-cancer food scoring model
Yeo-Jin Hong, Jeongseon Kim, Hye Yoon Lee, Chai Hong Rim
Nutr Res Pract. 2020;14(1):32-44.    doi: 10.4162/nrp.2020.14.1.32.


Reference

1. GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016; 388:1459–1544.
2. Stewart B, Wild CP. World Cancer Report 2014. Lyon: International Agency for Research on Cancer;2014.
3. National Center for Health Statistics (US). Health, United States, 2016: with Chartbook on Long-term Trends in Health. Hyattsville (MD): National Center for Health Statistics;2017.
4. Statistics Korea. Cause of death statistics [Internet]. Daejeon: Statistics Korea;2016. cited 2017 September 14. Available from: http://kostat.go.kr/portal/eng/surveyOutline/5/1/index.static.
5. Nagao M, Tsugane S. Cancer in Japan: prevalence, prevention and the role of heterocyclic amines in human carcinogenesis. Genes Environ. 2016; 38:16.
Article
6. Anand P, Kunnumakkara AB, Sundaram C, Harikumar KB, Tharakan ST, Lai OS, Sung B, Aggarwal BB. Cancer is a preventable disease that requires major lifestyle changes. Pharm Res. 2008; 25:2097–2116.
Article
7. World Cancer Research Fund. American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, D.C.: AICR;2007.
8. Hastert TA, Beresford SA, Sheppard L, White E. Adherence to the WCRF/AICR cancer prevention recommendations and cancer-specific mortality: results from the Vitamins and Lifestyle (VITAL) Study. Cancer Causes Control. 2014; 25:541–552.
Article
9. World Cancer Research Fund International (GB). Continuous update project (CUP) [Internet]. London: World Cancer Research Fund International;2017. cited 2017 September 14. Available from: http://www.wcrf.org/int/research-we-fund/continuous-update-project-cup.
10. Guenther PM, Casavale KO, Reedy J, Kirkpatrick SI, Hiza HA, Kuczynski KJ, Kahle LL, Krebs-Smith SM. Update of the healthy eating index: HEI-2010. J Acad Nutr Diet. 2013; 113:569–580.
Article
11. Cavicchia PP, Steck SE, Hurley TG, Hussey JR, Ma Y, Ockene IS, Hébert JR. A new dietary inflammatory index predicts interval changes in serum high-sensitivity C-reactive protein. J Nutr. 2009; 139:2365–2372.
Article
12. World Cancer Research Fund. American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, D.C.: AICR;2007. p. 60.
13. M A M, Pera G, Agudo A, Bueno-de-Mesquita HB, Palli D, Boeing H, Carneiro F, Berrino F, Sacerdote C, Tumino R, Panico S, Berglund G, Manjer J, Johansson I, Stenling R, Martinez C, Dorronsoro M, Barricarte A, Tormo MJ, Quiros JR, Allen N, Key TJ, Bingham S, Linseisen J, Kaaks R, Overvad K, Jensen M, Olsen A, Tjønneland A, Peeters PH, Numans ME, Ocké MC, Clavel-Chapelon F, Boutron-Ruault MC, Trichopoulou A, Lund E, Slimani N, Jenab M, Ferrari P, Riboli E, González CA. Cereal fiber intake may reduce risk of gastric adenocarcinomas: the EPIC-EURGAST study. Int J Cancer. 2007; 121:1618–1623.
Article
14. Mayne ST, Risch HA, Dubrow R, Chow WH, Gammon MD, Vaughan TL, Farrow DC, Schoenberg JB, Stanford JL, Ahsan H, West AB, Rotterdam H, Blot WJ, Fraumeni JF Jr. Nutrient intake and risk of subtypes of esophageal and gastric cancer. Cancer Epidemiol Biomarkers Prev. 2001; 10:1055–1062.
15. González CA, Riboli E, Badosa J, Batiste E, Cardona T, Pita S, Sanz JM, Torrent M, Agudo A. Nutritional factors and gastric cancer in Spain. Am J Epidemiol. 1994; 139:466–473.
Article
16. Chen H, Tucker KL, Graubard BI, Heineman EF, Markin RS, Potischman NA, Russell RM, Weisenburger DD, Ward MH. Nutrient intakes and adenocarcinoma of the esophagus and distal stomach. Nutr Cancer. 2002; 42:33–40.
Article
17. De Stefani E, Boffetta P, Deneo-Pellegrini H, Mendilaharsu M, Carzoglio JC, Ronco A. Carbohydrates and risk of stomach cancer in Uruguay. Int J Cancer. 1999; 82:618–621.
Article
18. Ji BT, Chow WH, Yang G, McLaughlin JK, Zheng W, Shu XO, Jin F, Gao RN, Gao YT, Fraumeni JF Jr. Dietary habits and stomach cancer in Shanghai, China. Int J Cancer. 1998; 76:659–664.
Article
19. Kaaks R, Tuyns AJ, Haelterman M, Riboli E. Nutrient intake patterns and gastric cancer risk: a case-control study in Belgium. Int J Cancer. 1998; 78:415–420.
Article
20. López-Carrillo L, López-Cervantes M, Ward MH, Bravo-Alvarado J, Ramírez-Espitia A. Nutrient intake and gastric cancer in Mexico. Int J Cancer. 1999; 83:601–605.
Article
21. Harrison LE, Zhang ZF, Karpeh MS, Sun M, Kurtz RC. The role of dietary factors in the intestinal and diffuse histologic subtypes of gastric adenocarcinoma: a case-control study in the U.S. Cancer. 1997; 80:1021–1028.
Article
22. Møller ME, Dahl R, Bøckman OC. A possible role of the dietary fibre product, wheat bran, as a nitrite scavenger. Food Chem Toxicol. 1988; 26:841–845.
Article
23. Jakszyn P, Bingham S, Pera G, Agudo A, Luben R, Welch A, Boeing H, Del Giudice G, Palli D, Saieva C, Krogh V, Sacerdote C, Tumino R, Panico S, Berglund G, Simán H, Hallmans G, Sanchez MJ, Larrañaga N, Barricarte A, Chirlaque MD, Quirós JR, Key TJ, Allen N, Lund E, Carneiro F, Linseisen J, Nagel G, Overvad K, Tjonneland A, Olsen A, Bueno-de-Mesquita HB, Ocké MO, Peeters PH, Numans ME, Clavel-Chapelon F, Trichopoulou A, Fenger C, Stenling R, Ferrari P, Jenab M, Norat T, Riboli E, Gonzalez CA. Endogenous versus exogenous exposure to N-nitroso compounds and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study. Carcinogenesis. 2006; 27:1497–1501.
Article
24. Freedman ND, Cross AJ, McGlynn KA, Abnet CC, Park Y, Hollenbeck AR, Schatzkin A, Everhart JE, Sinha R. Association of meat and fat intake with liver disease and hepatocellular carcinoma in the NIH-AARP cohort. J Natl Cancer Inst. 2010; 102:1354–1365.
Article
25. Fedirko V, Trichopolou A, Bamia C, Duarte-Salles T, Trepo E, Aleksandrova K, Nöthlings U, Lukanova A, Lagiou P, Boffetta P, Trichopoulos D, Katzke VA, Overvad K, Tjønneland A, Hansen L, Boutron-Ruault MC, Fagherazzi G, Bastide N, Panico S, Grioni S, Vineis P, Palli D, Tumino R, Bueno-de-Mesquita HB, Peeters PH, Skeie G, Engeset D, Parr CL, Jakszyn P, Sánchez MJ, Barricarte A, Amiano P, Chirlaque M, Quirós JR, Sund M, Werner M, Sonestedt E, Ericson U, Key TJ, Khaw KT, Ferrari P, Romieu I, Riboli E, Jenab M. Consumption of fish and meats and risk of hepatocellular carcinoma: the European Prospective Investigation into Cancer and Nutrition (EPIC). Ann Oncol. 2013; 24:2166–2173.
Article
26. Kurozawa Y, Ogimoto I, Shibata A, Nose T, Yoshimura T, Suzuki H, Sakata R, Fujita Y, Ichikawa S, Iwai N, Fukuda K, Tamakoshi A. Dietary habits and risk of death due to hepatocellular carcinoma in a large scale cohort study in Japan. Univariate analysis of JACC study data. Kurume Med J. 2004; 51:141–149.
Article
27. Huang YS, Chern HD, Wu JC, Chao Y, Huang YH, Chang FY, Lee SD. Polymorphism of the N-acetyltransferase 2 gene, red meat intake, and the susceptibility of hepatocellular carcinoma. Am J Gastroenterol. 2003; 98:1417–1422.
Article
28. Kanazir M, Boricic I, Delic D, Tepavcevic DK, Knezevic A, Jovanovic T, Pekmezovic T. Risk factors for hepatocellular carcinoma: a case-control study in Belgrade (Serbia). Tumori. 2010; 96:911–917.
Article
29. Yu SZ, Huang XE, Koide T, Cheng G, Chen GC, Harada K, Ueno Y, Sueoka E, Oda H, Tashiro F, Mizokami M, Ohno T, Xiang J, Tokudome S. Hepatitis B and C viruses infection, lifestyle and genetic polymorphisms as risk factors for hepatocellular carcinoma in Haimen, China. Jpn J Cancer Res. 2002; 93:1287–1292.
Article
30. Tavani A, La Vecchia C, Gallus S, Lagiou P, Trichopoulos D, Levi F, Negri E. Red meat intake and cancer risk: a study in Italy. Int J Cancer. 2000; 86:425–428.
Article
31. Srivatanakul P, Parkin DM, Khlat M, Chenvidhya D, Chotiwan P, Insiripong S, L'Abbé KA, Wild CP. Liver cancer in Thailand. II. A case-control study of hepatocellular carcinoma. Int J Cancer. 1991; 48:329–332.
Article
32. Talamini R, Polesel J, Montella M, Dal Maso L, Crispo A, Tommasi LG, Izzo F, Crovatto M, La Vecchia C, Franceschi S. Food groups and risk of hepatocellular carcinoma: a multicenter case-control study in Italy. Int J Cancer. 2006; 119:2916–2921.
Article
33. Sawada N, Inoue M, Iwasaki M, Sasazuki S, Shimazu T, Yamaji T, Takachi R, Tanaka Y, Mizokami M, Tsugane S. Japan Public Health Center-Based Prospective Study Group. Consumption of n-3 fatty acids and fish reduces risk of hepatocellular carcinoma. Gastroenterology. 2012; 142:1468–1475.
Article
34. Daniel CR, Cross AJ, Graubard BI, Hollenbeck AR, Park Y, Sinha R. Prospective investigation of poultry and fish intake in relation to cancer risk. Cancer Prev Res (Phila). 2011; 4:1903–1911.
Article
35. Fernandez E, Chatenoud L, La Vecchia C, Negri E, Franceschi S. Fish consumption and cancer risk. Am J Clin Nutr. 1999; 70:85–90.
Article
36. Wang MP, Thomas GN, Ho SY, Lai HK, Mak KH, Lam TH. Fish consumption and mortality in Hong Kong Chinese--the LIMOR study. Ann Epidemiol. 2011; 21:164–169.
Article
37. Luo J, Yang Y, Liu J, Lu K, Tang Z, Liu P, Liu L, Zhu Y. Systematic review with meta-analysis: meat consumption and the risk of hepatocellular carcinoma. Aliment Pharmacol Ther. 2014; 39:913–922.
Article
38. Endres S, Ghorbani R, Kelley VE, Georgilis K, Lonnemann G, van der Meer JW, Cannon JG, Rogers TS, Klempner MS, Weber PC, Schaefer EJ, Wolff SM, Dinarello CA. The effect of dietary supplementation with n-3 polyunsaturated fatty acids on the synthesis of interleukin-1 and tumor necrosis factor by mononuclear cells. N Engl J Med. 1989; 320:265–271.
Article
39. Ferguson LR. Meat and cancer. Meat Sci. 2010; 84:308–313.
Article
40. Yang G, Shu XO, Li H, Chow WH, Cai H, Zhang X, Gao YT, Zheng W. Prospective cohort study of soy food intake and colorectal cancer risk in women. Am J Clin Nutr. 2009; 89:577–583.
Article
41. Wang L, Lee IM, Zhang SM, Blumberg JB, Buring JE, Sesso HD. Dietary intake of selected flavonols, flavones, and flavonoid-rich foods and risk of cancer in middle-aged and older women. Am J Clin Nutr. 2009; 89:905–912.
Article
42. Akhter M, Inoue M, Kurahashi N, Iwasaki M, Sasazuki S, Tsugane S. Japan Public Health Center-Based Prospective Study Group. Dietary soy and isoflavone intake and risk of colorectal cancer in the Japan public health center-based prospective study. Cancer Epidemiol Biomarkers Prev. 2008; 17:2128–2135.
Article
43. Oba S, Nagata C, Shimizu N, Shimizu H, Kametani M, Takeyama N, Ohnuma T, Matsushita S. Soy product consumption and the risk of colon cancer: a prospective study in Takayama, Japan. Nutr Cancer. 2007; 57:151–157.
Article
44. Budhathoki S, Joshi AM, Ohnaka K, Yin G, Toyomura K, Kono S, Mibu R, Tanaka M, Kakeji Y, Maehara Y, Okamura T, Ikejiri K, Futami K, Maekawa T, Yasunami Y, Takenaka K, Ichimiya H, Terasaka R. Soy food and isoflavone intake and colorectal cancer risk: the Fukuoka Colorectal Cancer Study. Scand J Gastroenterol. 2011; 46:165–172.
Article
45. Ramadas A, Kandiah M. Food intake and colorectal adenomas: a case-control study in Malaysia. Asian Pac J Cancer Prev. 2009; 10:925–932.
46. Huang XE, Hirose K, Wakai K, Matsuo K, Ito H, Xiang J, Takezaki T, Tajima K. Comparison of lifestyle risk factors by family history for gastric, breast, lung and colorectal cancer. Asian Pac J Cancer Prev. 2004; 5:419–427.
47. Nishi M, Yoshida K, Hirata K, Miyake H. Eating habits and colorectal cancer. Oncol Rep. 1997; 4:995–998.
Article
48. Le Marchand L, Hankin JH, Wilkens LR, Kolonel LN, Englyst HN, Lyu LC. Dietary fiber and colorectal cancer risk. Epidemiology. 1997; 8:658–665.
Article
49. Inoue M, Tajima K, Hirose K, Hamajima N, Takezaki T, Hirai T, Kato T, Ohno Y. Subsite-specific risk factors for colorectal cancer: a hospital-based case-control study in Japan. Cancer Causes Control. 1995; 6:14–22.
Article
50. Hoshiyama Y, Sasaba T. A case-control study of stomach cancer and its relation to diet, cigarettes, and alcohol consumption in Saitama Prefecture, Japan. Cancer Causes Control. 1992; 3:441–448.
Article
51. Kono S, Imanishi K, Shinchi K, Yanai F. Relationship of diet to small and large adenomas of the sigmoid colon. Jpn J Cancer Res. 1993; 84:13–19.
Article
52. Yu Y, Jing X, Li H, Zhao X, Wang D. Soy isoflavone consumption and colorectal cancer risk: a systematic review and meta-analysis. Sci Rep. 2016; 6:25939.
Article
53. Chen Y, Tong Y, Yang C, Gan Y, Sun H, Bi H, Cao S, Yin X, Lu Z. Consumption of hot beverages and foods and the risk of esophageal cancer: a meta-analysis of observational studies. BMC Cancer. 2015; 15:449.
Article
54. Wada K, Tsuji M, Tamura T, Konishi K, Kawachi T, Hori A, Tanabashi S, Matsushita S, Tokimitsu N, Nagata C. Soy isoflavone intake and stomach cancer risk in Japan: from the Takayama study. Int J Cancer. 2015; 137:885–892.
Article
55. Ko KP, Park SK, Yang JJ, Ma SH, Gwack J, Shin A, Kim Y, Kang D, Chang SH, Shin HR, Yoo KY. Intake of soy products and other foods and gastric cancer risk: a prospective study. J Epidemiol. 2013; 23:337–343.
Article
56. Kweon SS, Shu XO, Xiang Y, Cai H, Yang G, Ji BT, Li H, Gao YT, Zheng W, Epplein M. Intake of specific nonfermented soy foods may be inversely associated with risk of distal gastric cancer in a Chinese population. J Nutr. 2013; 143:1736–1742.
Article
57. Lee JK, Park BJ, Yoo KY, Ahn YO. Dietary factors and stomach cancer: a case-control study in Korea. Int J Epidemiol. 1995; 24:33–41.
Article
58. You WC, Blot WJ, Chang YS, Ershow AG, Yang ZT, An Q, Henderson B, Xu GW, Fraumeni JF Jr, Wang TG. Diet and high risk of stomach cancer in Shandong, China. Cancer Res. 1988; 48:3518–3523.
Article
59. Inoue M, Tajima K, Hirose K, Kuroishi T, Gao CM, Kitoh T. Life-style and subsite of gastric cancer--joint effect of smoking and drinking habits. Int J Cancer. 1994; 56:494–499.
Article
60. Gao CM, Takezaki T, Ding JH, Li MS, Tajima K. Protective effect of allium vegetables against both esophageal and stomach cancer: a simultaneous case-referent study of a high-epidemic area in Jiangsu Province, China. Jpn J Cancer Res. 1999; 90:614–621.
Article
61. Ko KP, Park SK, Park B, Yang JJ, Cho LY, Kang C, Kim CS, Gwack J, Shin A, Kim Y, Kim J, Yang HK, Kang D, Chang SH, Shin HR, Yoo KY. Isoflavones from phytoestrogens and gastric cancer risk: a nested case-control study within the Korean Multicenter Cancer Cohort. Cancer Epidemiol Biomarkers Prev. 2010; 19:1292–1300.
Article
62. Sakai T, Kogiso M. Soy isoflavones and immunity. J Med Invest. 2008; 55:167–173.
Article
63. Verdrengh M, Collins LV, Bergin P, Tarkowski A. Phytoestrogen genistein as an anti-staphylococcal agent. Microbes Infect. 2004; 6:86–92.
Article
64. Yang ZP, Zhao Y, Huang F, Chen J, Yao YH, Li J, Wu XN. Equol inhibits proliferation of human gastric carcinoma cells via modulating Akt pathway. World J Gastroenterol. 2015; 21:10385–10399.
Article
65. Wu AH, Yu MC, Tseng CC, Pike MC. Epidemiology of soy exposures and breast cancer risk. Br J Cancer. 2008; 98:9–14.
Article
66. Chen M, Rao Y, Zheng Y, Wei S, Li Y, Guo T, Yin P. Association between soy isoflavone intake and breast cancer risk for pre- and post-menopausal women: a meta-analysis of epidemiological studies. PLoS One. 2014; 9:e89288.
Article
67. Lee SA, Shu XO, Li H, Yang G, Cai H, Wen W, Ji BT, Gao J, Gao YT, Zheng W. Adolescent and adult soy food intake and breast cancer risk: results from the Shanghai Women's Health Study. Am J Clin Nutr. 2009; 89:1920–1926.
Article
68. Yamamoto S, Sobue T, Kobayashi M, Sasaki S, Tsugane S. Japan Public Health Center-Based Prospective Study on Cancer Cardiovascular Diseases Group. Soy, isoflavones, and breast cancer risk in Japan. J Natl Cancer Inst. 2003; 95:906–913.
Article
69. Wu AH, Koh WP, Wang R, Lee HP, Yu MC. Soy intake and breast cancer risk in Singapore Chinese Health Study. Br J Cancer. 2008; 99:196–200.
Article
70. Teas J. The consumption of seaweed as a protective factor in the etiology of breast cancer. Med Hypotheses. 1981; 7:601–613.
Article
71. Yamamoto I, Maruyama H, Moriguchi M. The effect of dietary seaweeds on 7,12-dimethyl-benz[a]anthracene-induced mammary tumorigenesis in rats. Cancer Lett. 1987; 35:109–118.
Article
72. Ohigashi H, Sakai Y, Yamaguchi K, Umezaki I, Koshimizu K. Possible anti-tumor promoting properties of marine algae and in vivo activity of Wakame seaweed extract. Biosci Biotechnol Biochem. 1992; 56:994–995.
Article
73. Moore MA, Park CB, Tsuda H. Soluble and insoluble fiber influences on cancer development. Crit Rev Oncol Hematol. 1998; 27:229–242.
Article
74. Tokudome S, Kuriki K, Moore MA. Seaweed and cancer prevention. Jpn J Cancer Res. 2001; 92:1008–1009.
Article
75. Korean Diabetes Association. Korean food exchange lists. 3rd edition [Internet]. Seoul: Korean Diabetes Association;2010. cited 2017 December 29. Available from: http://www.diabetes.or.kr/english/resource/index.php?category=3.
76. The Korean Nutrition Society Database [Internet]. Seoul: The Korean Nutrition Society;2017. cited 2017 September 19. Available from: http://www.kns.or.kr/.
77. Food Standards Agency (GB). Signpost labeling: board paper FSA 06/06/03 (Annex 6) [Internet]. London: Food Standards Agency;2006. cited 2017 February 1. Available from: http://www.food.gov.uk/multimedia/pdfs/fsa060303.pdf.
78. Rayner M, Scarborough P, Stockley L. Nutrient Profiles: Options for Definitions for Use in Relation to Food Promotion and Children's Diets. London: British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford;2004.
79. Doll R, Peto R. The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst. 1981; 66:1191–1308.
Article
80. Hastert TA, Beresford SA, Patterson RE, Kristal AR, White E. Adherence to WCRF/AICR cancer prevention recommendations and risk of postmenopausal breast cancer. Cancer Epidemiol Biomarkers Prev. 2013; 22:1498–1508.
Article
81. National Cancer Information Center of Korea [Internet]. Goyang: National Cancer Information Center;cited 2017 September 19. Available from: http://www.cancer.go.kr/mbs/cancer/index.jsp.
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