Agreement between dietary and lifestyle guidelines for cancer prevention in population samples of Europeans and Mesoamericans.

Objective: To assess concordance with selected individual guideline components of the 1997 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) diet and lifestyle recommendations to decrease cancer risk across four population samples.

Methods: The study was a prospectively designed survey examining concordance with individual-level guidelines of the WCRF/AICR recommendations using target criteria across sites. The status of concordance with eight dietary and eight lifestyle components subject to evaluation was described and compared across samples and with the target criteria. Population samples were from the Netherlands, Scotland, Mexico, and Guatemala. In total 3564 male and female adults 18 to 70 y old were recruited in equal proportions by site.

Results: Overall concordance with the WCRF/AICR was low in all samples, with 28%, 63%, 77%, and 81% of subjects concordant with at least half of the selected recommendation components in the Netherlands, Scotland, Mexico, and Guatemala, respectively. Concordance was especially low for the recommendations to prefer fish or poultry, limit refined sugar consumption, and avoid eating charred food and especially high for the recommendations that dietary supplements are probably unnecessary, to avoid being underweight, and to consume predominately plant-based diets.

Conclusion: A prospectively designed research instrument with exhaustive prior examination of operative criteria allows for the assessment of individual-level concordance or compliance with cancer-prevention guidelines. We postulate that efforts to maintain currently positive practices are the strategic priority in Central America, whereas efforts at behavioral reorientation are needed in Europe to bring the populations into concordance.