Rates of childhood obesity have increased from 4% to 20% over the past 50 years. From a cancer prevention perspective, this is worrying news: childhood obesity often continues into adulthood, and our work shows that excess body weight in adults is linked to at least 13 different types of cancer. What’s more, our research has shown that higher body weight in childhood, adolescence and young adulthood is linked to an increased risk of colorectal cancer in later life.
To maintain a healthy weight, children need more support to eat a nutritious diet. Policy can help foster systems and structures that make healthy diets easier and, for kids, schools are a great place to start.
The morning bell
My apartment in London overlooks a primary school attended by about 130 students. Waiting for my morning bus to WCRF’s offices, I see parents accompanying their children along the bustling road to the school gates. From a nutrition perspective, this particular route must feel a bit like running the gauntlet: a rotating billboard in view of the bus stop advertises burgers and fries, while every other business sells fast food. UNICEF’s Feeding Profit report, published last year, highlights this as a global problem.
To tackle the food environment around schools, several local authorities in the UK have chosen to restrict the opening of new fast food restaurants around schools. Cities such as Leeds and Manchester have opted to either reduce the number of new outlets near schools or prohibit them entirely.
Elsewhere in the world, governments have chosen to implement school-focused marketing restrictions. Latin American countries are leaders in this space, with countries like Chile and Mexico banning unhealthy foods from being advertised in schools. In 2021, the local congress in Lima, Peru went further, passing a law to prohibit the marketing of unhealthy foods within 200 metres of schools.
Lunchtime
From my own childhood in Canada, memories from the school cafeteria include slices of pizza, chocolate chip cookies and a freezer selling ice cream and popsicles. Although we occasionally managed to bargain for a few dollars for pizza, my parents worried that this menu wasn’t healthy enough. We mostly packed our own, a task added to already busy mornings.
Comparing notes with my partner who grew up in Sweden – where school lunches have been free for all children regardless of income for over 70 years – he remembers a self-service soup and salad bar to go with the daily mains. That didn’t stop students from complaining – tarragon fish day was particularly disliked. In high school, they would occasionally head over to the local pizzeria for lunch when their pocket money stretched to it.
Our memories reflect not only the cross-cutting appeal of pizza but the variation in school meals, even in high-income contexts. Until last year, Canada was still the only G7 country without a school food plan. However, we are not the only ones that have struggled to provide schoolchildren with nutritious lunches. Only 37% of school meal programs have an objective to prevent overweight and obesity, and wealthier countries are more likely to provide unhealthy foods.
Meanwhile, school food superstars like Brazil show us what can be done, successfully establishing legislation for coverage, quality, and procurement practices, emphasising local foods. In Japan, procurement policies also favour local producers, and pair school meals with food and nutrition education.
Recess
Beyond lunchtime, countries are developing innovative approaches to improving the quality of snacks sold on school premises. In Chile, a suite of policy measures aiming to reduce the consumption of foods high in calories, sugar, sodium or saturated fat has included banning their sale in schools. This has led to an impressive reduction in the sale of these unhealthy foods in school kiosks.
In January of this year, the World Health Organization published its new guideline providing evidence-based recommendations to support countries in creating healthy school food environments. This cites evidence from countries like Chile, as well as measures to directly provide children with healthy alternatives, like the European Union’s school scheme to support the distribution of milk, fruit and vegetables. Meanwhile, the School Meals Coalition, a global multi-partner initiative, facilitates country commitments to initiate or strengthen school food programmes, and fosters collaborations to support their efforts.
From the morning bell to lunchtime to recess, every part of the school day offers an opportunity to shape healthier futures. World Obesity Day calls on us to advocate for stronger food policy and equitable access to nutritious foods. If we get this right in schools, we don’t just change what children eat today – we help reduce their cancer risk tomorrow.
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This could help many people stay healthy, as there are 3 million vegetarians in the UK and interest is growing in many parts of the world.
The research, led by scientists at Oxford Population Health’s Cancer Epidemiology Unit, pooled data from more than 1.8 million people across three continents through the Cancer Risk in Vegetarians Consortium – the largest ever study of non-meat diets and cancer risk.
They compared the risk of 17 different cancers across five diet groups: meat eaters, poultry eaters (do not eat red or processed meat), pescatarians (fish eaters), vegetarians (eat dairy and/or eggs), and vegans.
Compared with meat eaters, vegetarians had:
- 21% lower risk of pancreatic cancer
- 9% lower risk of breast cancer
- 12% lower risk of prostate cancer
- 28% lower risk of kidney cancer
- 31% lower risk of multiple myeloma.
However, vegetarians had:
- Nearly double the risk of squamous cell carcinoma of the oesophagus.
Tim Key
Dietary patterns that prioritise fruit, vegetables, and fibre-containing foods, and avoid processed meat, are recommended to reduce cancer risk. Our study helps to shed light on the benefits and risks associated with vegetarian diets.
Aurora Perez Cornago,
The higher risk of oesophageal squamous cell carcinoma in vegetarians and bowel cancer in vegans may relate to lower intakes of certain nutrients more abundant in animal foods. Additional research is needed to understand what is driving the differences in cancer risk found in our study
Dr Helen Croker
The results suggest non-meat diets are linked to lower risks for some cancers, though not all, highlighting important differences between cancer types and the role of different dietary patterns. To increase your overall protection from cancer, our advice is to build meals around wholegrains, pulses, fruit and vegetables, and avoid processed meat and limit red meat.
Yashvee Dunneram
Among the 72,000 vegetarians and vegans included in our study, the numbers of cases for some cancers were small, which limits the certainty of some findings. Moreover, nutrient intakes and overall diet quality vary substantially within and between vegetarian populations. Our next challenge is to collect more data on vegan diets and more data from other parts of the world.
There were no statistically-significant differences in risk for colorectal, stomach, liver, lung (in never smokers), endometrial, ovarian, mouth and pharynx, or bladder cancers, or non-Hodgkin lymphoma, leukaemia, and oesophageal adenocarcinoma in vegetarians.
Vegans had a statistically significant higher risk of colorectal (bowel) cancer when compared with meat eaters. For the other cancers studied, there was no evidence that risk in vegans differed from meat eaters, and for some less common cancers there were too few vegan cases to analyse. Further studies are needed to confirm these results in the vegan population.
Pescatarians had lower risks of breast and kidney cancers, as well as a lower risk of bowel cancer. Poultry eaters were found to have a lower risk of prostate cancer.
The full findings were published on 27 February 2026 in the British Journal of Cancer.
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It has long been established that junk food advertising drives consumption of unhealthy food and drink, shaping preferences from a young age and contributing to overweight and obesity.
The strength of the evidence base is perhaps best corroborated by the enormous advertising budgets of unhealthy food and drink companies. If advertising didn’t pay off, why would Coca-Cola allocate a whopping $5 billion to their worldwide advertising budget in 2024?
Restricting junk food advertising is therefore a powerful and proven public health measure. Yet, most recently, you may have seen measured responses from public health advocates in the UK, including World Cancer Research Fund, upon the introduction of long-awaited junk food advertising restrictions in January 2026.
Marketing regulations can underdeliver
The bottom line is that whilst the UK’s restrictions mark a step forward in protecting children’s health at a time when obesity rates continue to rise, they have been weakened and delayed by industry influence – most notably through the introduction of a sweeping brand exemption. This significantly undermines the policy in two key ways. First, it allows brands that are synonymous with foods high in fat, salt and sugar (HFSS) to continue being advertised – think the famous Golden Arches. Second, the lack of brand restrictions enables companies to promote entire HFSS product ranges, just not individual products. Ultimately this preserves brand visibility and influence while circumventing the spirit of the regulations.
The brand exemption is not the only weakness of the advertising restrictions. Work on this policy began as far back as 2018, and in the years since, the marketing landscape has evolved dramatically. Simply put, the regulations are not a match for the rapidly changing marketing landscape. For example, direct marketing channels, such as email and text messaging, remain unchecked, allowing unhealthy food and drink companies to continue targeting consumers.
The unseen cost of delays and dilution
The unfortunate tale of industry influence is not unique to the UK. Globally, efforts to curb the scourge of junk food on society are denied, diluted, derailed and delayed by industry.
Marketing restrictions are difficult to get over the line. In the UK, the policy was subject to five separate consultations and four delays to its rollout. That is an immense amount of government time, effort and resources. Moreover, the burden it places on the public health sector, which often operate under capacity constraints, must be acknowledged.
We also need to recognise that obesity, a key risk factor for cancer, is linked to deprivation. In many countries, those living in the most deprived areas are more likely to be living with obesity compared to those in the most affluent communities. Delays or failures to implement effective policies therefore disproportionately impact those who are already most vulnerable.
Industry opposition at full throttle
The resistance we see to advertising restrictions can partly be explained by the fact that marketing is not a peripheral commercial function. Instead, it sits at the very core of food and drink businesses, playing a pivotal role in building brand value, customer loyalty and long-term profitability.
Marketing restrictions are also unusually visible. Unlike reformulation targets or nutrient thresholds, which operate largely behind the scenes, advertising bans are immediately noticeable. They can also be drawn into wider debates around personal responsibility, censorship and creativity – making the more contested and politically charged. They tend to hit a nerve.
Recognition of these issues is not a justification for inaction. The reality is that companies by their very nature are required to innovate, and they can do so in a way that supports public health rather than undermining it.
Action must go beyond the status quo
Let’s be clear, no one is suggesting that junk food marketing restrictions alone will solve the obesity crisis. However, the version we’ve seen introduced in the UK will most certainly underdeliver, especially given the restrictions don’t sit within a broader framework of measures designed to improve the nation’s diet yet. Countries in Latin America, including Chile and Mexico, have taken more holistic approaches which embed marketing restrictions within a wider set of measures including mandatory warning labels and robust school food standards
But when governments introduce policies that appear ambitious on paper but lack the strength to deliver in practice, they risk entrenching the status quo while giving the impression of action. This pattern is not unique to food. Similar delays and dilutions are seen across alcohol, gambling and other health-harming industries, where commercial interests routinely take priority over public health.
Ultimately, the question is not what needs to be done, but what governments are willing to do to protect public health.
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Today the UK Government published a long-awaited update to the Nutrient Profile Model (NPM) – a quiet but powerful public health tool that is central to cancer prevention and tackling diet-related diseases.
NPMs are used to assess how healthy foods are, classifying products as healthier or less healthy (often referred to as HFSS – high in fat, salt and sugar). While no system is perfect, the NPM is critical because it underpins food policy, determining which products are captured by regulation and which are allowed to escape it.
The UK’s existing junk food advertising and promotion restrictions are still based on the 2004 NPM. This means the effectiveness of these policies depends entirely on a model developed more than 20 years ago.
A robust, evidence-based NPM is essential to prevent unhealthy products continuing to fall through regulatory gaps. Since the original model was developed, the science on diet and health has moved on.
Obesity firmly established as major driver of cancer
In particular, evidence linking unhealthy diets, overweight and obesity, and cancer risk has grown substantially. Obesity is now firmly established as a major driver of cancer and one of the leading preventable causes of the disease in the UK and globally. If food policy is to meaningfully improve diets and reduce obesity-related cancer risk, it must be built on a credible, up-to-date NPM.
Importantly, the updated NPM will better reflect recommendations from the independent Scientific Advisory Committee on Nutrition (SACN) on free sugars and fibre, ensuring policy aligns with current scientific guidance.
We therefore warmly welcome today’s publication of the revised NPM, first consulted on in 2018. This is an important step forward. However, the updated NPM is not yet applied in policy.
The Government has committed to holding a public consultation in 2026 on applying the 2018 NPM to advertising and promotion restrictions. We stand ready to work with the UK Government at this next stage to ensure the NPM delivers real progress for cancer prevention and overall public health.
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World Cancer Research Fund – part of the World Cancer Research Fund network – welcomes many of the recommendations in the new US Dietary Guidelines for Americans that support healthier diets and reduce the burden of diet-related disease.
When it comes to cancer prevention, we have some concerns with the guidelines relating to alcohol and red and processed meat.
The strong emphasis on healthy dietary patterns, including increased consumption of fruits, vegetables and wholegrains, is very helpful – as are the recommendations to limit highly processed foods and products high in added sugars. The clear inclusion of plant-source protein foods – such as beans, lentils, nuts, seeds and soy – is also positive.
The guidance to drink mainly water and to avoid sugar-sweetened beverages and consume less alcohol is helpful, as we know there is no safe level of drinking alcohol when it comes to cancer prevention. Finally, we strongly welcome support for breastfeeding.
These Guidelines help to translate evidence into clear public advice and shape future policies. However, from a cancer prevention perspective, the Guidelines’ increased emphasis on animal-source proteins, and particularly the emphasis on red meat, is at odds with the scientific evidence linking higher intakes of red and processed meat to increased cancer risk.
Similarly, the promotion of whole-fat dairy raises concerns, given the potential contribution to excess weight gain. In light of such issues, we remain committed to informing the public with authoritative advice, which we develop based on the latest scientific evidence from leading researchers worldwide.
Below is a more detailed summary of the what the Guidelines mean for cancer prevention.
Important takeaways from the guidance
- Clear guidance is provided to prioritise whole foods and limit highly processed products, including advice to avoid salty and sweet packaged snacks and to favour nutrient-dense, home-prepared meals. This approach is closely aligned with our emphasis on limiting fast foods and processed foods high in fat, starches and sugars, and on reducing overall dietary energy density as a pathway to achieving a healthier body weight and lowering cancer risk.
- The Guidelines strengthen the stance on added sugars and sugar-sweetened beverages, including explicit recommendations to limit consumption of sugar-sweetened drinks and to limit added sugars at meals. This aligns well with our evidence of sugar intake as a contributor to excess weight gain and poorer overall diet quality.
- Plant foods remain important to the guidance, with daily targets for fruit and vegetable intake and a clear recommendation to prioritise fibre-rich whole grains. This maps directly onto our emphasis on dietary and lifestyle patterns and core cancer prevention recommendations.
- Breastfeeding is explicitly encouraged, with guidance to breastfeed exclusively for the first six months and to continue breastfeeding for two years or beyond. This is consistent with our recommendation that mothers breastfeed where possible and complements the focus on breast cancer prevention.
Important clarifications based on our global scientific research
- The Guidelines place a strong emphasis on increasing protein intake, explicitly including red meat and setting a higher quantitative protein target.
From a cancer prevention perspective, this emphasis would benefit from clearer direction to prioritise plant-based protein sources such as tofu, beans, lentils and other legumes, as well as nuts, seeds, fish and poultry, while reiterating World Cancer Research Fund guidance to limit red meat consumption and avoid processed meat altogether. - Furthermore, the Guidelines promote protein-rich foods, in relation to meat; specifically, meat with no or limited added sugars, refined starches or chemical additives is recommended. Avoidance of processed meat aligns with our recommendation to eat little, if any, processed meat based on strong evidence of an increased risk of colorectal cancer.
- While the Guidelines prioritise fibre-rich wholegrains, they do not have significant prominence in the new ‘Real Food’ pyramid, which undermines their importance.
- The Guidelines adopt a general recommendation to consume less alcohol. For cancer prevention, it is best not to drink alcohol at all, as there is no safe threshold of consumption for cancer risk for at least seven cancer types.
- The explicit endorsement of full-fat dairy, with guidance to consume three servings per day, warrants careful interpretation given its contribution to excess weight and some variation in evidence by cancer site. Framing dairy as one possible option, rather than a central or universal recommendation, may therefore be more appropriate.
- The Guidelines’ discussion of “healthy fats” includes foods such as butter and beef tallow, while still recommending that saturated fat remain below 10% of total energy intake.
This recommendation needs careful explanation because butter and beef tallow are high in saturated fat and can affect overall energy balance. Maintenance of a healthy weight is important, as overweight and obesity increase the risk of at least 13 cancers.
Three important policy implications for the future
- Affordability and access: Achieving the dietary pattern outlined in the guidelines will require targeted policy measures to improve the availability and affordability of fresh and whole foods. At present, such diets remain out of reach for many Americans, particularly those on lower incomes. Without significant structural interventions there is a risk that the guidelines may exacerbate existing health inequalities.
- Clarity and implementation: Greater clarity is needed on how “highly processed foods” are defined within the guidelines and how this definition will be operationalised. Clear definitions are essential to inform coherent policy action, regulation, monitoring and public communication.
- Policy alignment and delivery: It remains unclear whether new or strengthened policy measures will be introduced to support the recommended dietary changes, or how these guidelines will be embedded across food, agriculture, procurement and public health policies to enable meaningful implementation. In addition, the guidelines should also consider broader factors such as sustainability and planetary health.
Explore our research
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After years of delays, a law to ban ads for unhealthy food and drink before 9pm on TV and across online platforms, will start.
Commenting on the ban, Dr Giota Mitrou, Executive Director of Research and Science at World Cancer Research Fund (WCRF) International, said:
“Marketing is a well-established driver of consumption of unhealthy foods, and children – who are the primary targets of junk food advertising by large corporations – are particularly vulnerable. These long-awaited restrictions therefore mark an important step forward in protecting children’s health.
“However, we must recognise the fact that these measures have not only been severely delayed, but also significantly weakened by broad exemptions for brand advertising.
“The scale of childhood obesity crisis demands greater and more far-reaching action. The latest data shows that 10.5% of children in Reception and 22.2% of children in Year 6 are living with obesity, with prevalence more than double in the most deprived areas compared with the least deprived.
“The UK government must expand the range of products in scope of the ban, removing brand exemptions, and extend protections to the outdoor environment. We must not let large corporations’ water down and undermine efforts to give all children the healthiest start.
World Cancer Research Fund remains committed to working with the government to address obesity, which is a cause of at least at least 13 types of cancer.”
Delay to the junk food marketing restrictions
In 2020 – as part of its Obesity Strategy – the government under Boris Johnson promised to implement a ban on products that were high in fat, salt and sugar (HFSS) online and before 9pm on TV, saying it would come into force by 2023.
However, under pressure from industry, the enforcement was delayed while a further review was undertaken.
These delays mean that today’s implementation will be three years later than originally promised, and severely weakened.
Research has demonstrated that children eat significantly more calories in a day, after watching just 5 minutes of junk food advertising.
Building Momentum report
In 2020, World Cancer Research fund produced its Building Momentum report showing the lessons of implementing robust restrictions of food and non-alcoholic beverage marketing to children
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Ahead of the Budget, the Chancellor said it would deliver on the priorities of the British people to cut waiting lists, national debt and the cost of living.
In response to the Autumn Budget 2025, Kate Oldrige Turner, Head of Policy and Public Affairs at World Cancer Research Fund said:
“Almost half of cancer cases are preventable by addressing key risk factors such as obesity and alcohol, so we are pleased to see the UK Government take concrete steps on prevention in this Autumn Budget.
“The expansion of the UK’s world-leading levy on sugar-sweetened beverages to include milk-based drinks and plant-milk alternatives, alongside lowering the sugar threshold to 4.5g per 100ml, are particularly welcome measures. This will build on the immense success of the levy, which has reduced the average sugar content of drinks sold in the UK by almost half since it was introduced. Crucially, it will drive further reformulation and ensure that more drinks sold to consumers are healthier.
“We are also relieved that the Chancellor will raise alcohol duty in line with inflation. The World Health Organization has identified alcohol duty as one of the most effective ways to tackle alcohol-related harm, including alcohol-related cancers, so we are glad to see the UK Government take this forward.
As a research funder, we would have liked to see the important contribution of the life sciences sector acknowledged in the Chancellor’s speech. Continued support and investment in research are essential to advance our understanding of cancer prevention and survivorship.
To improve public health and reduce burden on the NHS, today’s measures must be the beginning – not the end – of a bold approach to prevention. With the National Cancer Plan for England expected early next year, the UK has a crucial opportunity to put prevention at the heart of its cancer strategy.
We look forward to working with the UK government to make prevention a reality – helping millions of people live free from the devastating effects of cancer.
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At World Cancer Research Fund, we’re proud to launch Cook through cancer: Meals that matter, a new cookbook designed to support people living with and beyond cancer. The recipes were developed by Gopi Chandratheva, a Registered Nutritionist who specialises in creating nourishing and delicious recipes for a range of health-focused organisations.
In this blog, Gopi shares her inspiration for the cookbook and how she approached developing recipes for people affected by cancer.
Creating recipes with purpose
We asked Gopi to share what went into developing the recipes for the new Cook through cancer cookbook.
“When developing recipes, I usually start with a brief. For example, with World Cancer Research Fund, I had to make sure they are in line with their Recommendations and previous recipes, that they are budget-friendly, nutritious and easily accessible to people. It’s also important to make sure everyone can follow along, so I time every step out.
“I’ll start by brainstorming a few ideas for what I can create, and then discuss which ones they’re interested in. One key consideration today is ensuring that the ingredients are affordable, given how expensive groceries have become. I also want to keep the method simple, avoiding any complicated techniques. From start to finish, each recipe usually takes me a few days to develop.
“Working with World Cancer Research Fund was wonderful. I tried to be mindful of the challenges people going through cancer treatment can experience, especially with regards to changes in their sense of taste or possible feelings of nausea.
“With all the myths out there about cancer, I’m so glad to be able to use my skills to help people using real, evidence-based information that can help make tasty, nutritious meals.”
Cooking classes that make a difference
Gopi also delivers some of our Cook Through Cancer classes, free online cookery sessions for people living with and beyond cancer. These classes combine practical cooking demonstrations with expert nutrition support.
Gopi says, “The classes are really enjoyable. I was a bit nervous because it’s been a while since I’ve done live cooking sessions, but it was really fun and lively.”
Each class includes an Oncology Specialist Dietitian who answers participants’ questions with evidence-based advice. Gopi is pleased that the classes have been a success:
“The participants have really enjoyed it, and they always go away smiling – that’s the most important thing for me.”
Gopi’s favourite recipe
Gopi has a favourite recipe from the cookbook and the classes she delivers:
“My favourite recipe I’ve made for the classes is the Buddha bowl. It’s a go-to for me because it’s a balanced meal on its own but it’s so customisable.
“You can add whatever leftovers you have, as long as they fill the different categories of vegetables, protein, complex carbs and healthy fats, you have a complete meal with all the necessary food groups. Plus, it’s quick!”
Top tips for cooking during cancer treatment
Gopi shared her top tips for cooking during cancer treatment:
- Try to think about meal prepping. Stocking your pantry with tinned pulses means you have a great source of iron and protein right on hand to add to stews and soups.
- Stock up your freezer – it’s a great resource for keeping frozen fruit and veg and other ingredients that can help you make a meal in minutes.
- Batch cook and freeze your leftovers for an easy meal when you don’t feel up to cooking from scratch.
- Even something as simple as a slice of wholemeal toast with scrambled egg and spinach can make all the difference.
Get your copy
Whether you’re living with cancer, supporting someone who is or simply looking for nourishing recipes that are easy to prepare, Cook through cancer: Meals that matter is here to help.
Download your free copy or order a printed version today and start cooking meals that truly make a difference.
More about Gopi
When she isn’t devising tasty recipes, Gopi shares advice and information on healthy eating on Instagram. She also specialises in obesity and weight management providing one to ones, talks on nutrition, mentoring nutritionists and working for the NHS.
Gopi has been working in the nutrition field for many years with extensive experience and knowledge. She started working as a dietetic assistant in hospitals such as the Royal Marsden, where she developed her passion for helping those living with and beyond cancer.
Brought up in a family where food was central, Gopi has always been interested in food and health, and works hard to develop recipes that are as simple and delicious as they are good for you.
Find out more about Gopi: Her website | Follow her on Instagram
Recipes suitable for people living with cancer
The UK Women’s Cohort Study (UKWCS), which we provided initial funding for, recently celebrated its 30th anniversary! This is an incredible achievement because many research projects only last a couple of years. Such a long-term project can provide scientists with richer, more detailed information to help prevent cancer.
The UKWCS, led by Prof Janet Cade from the School of Food Science and Nutrition at the University of Leeds, is one of the largest cohort studies investigating diet and cancer in the UK, comprising over 35,000 middle-aged women and representing a wide range of different eating patterns, which can help scientists research what protects against cancer and coronary heart disease. Participants are regularly followed up to examine what effect food and nutrient intakes have on their long-term health.
Preventing cancer through what we eat
The first survey was funded by World Cancer Research Fund and the data produced from this survey and later ones has been used to investigate:
- meat and fibre intake and breast cancer
- vitamin C supplementation and breast cancer
- fibre intake in type 2 diabetes and cardiovascular disease
Over 3 decades, these investigations have provided interesting findings. For example, women who eat more fibre have a lower risk of stroke, and women who eat more red and processed meat have a greater risk of developing breast cancer.
Of course, we do not eat specific nutrients alone, so dietary patterns have also been identified and explored. Compared with meat eaters, vegetarians and fish-eaters (non meat-eaters who do eat fish) may have some protection against post-menopausal breast cancer.
This wide-ranging set of data can be used to identify common trends and to help target health information. For instance, women who eat more fruit and vegetables tend to be vegetarian or vegan, to take vitamin or mineral supplements, to be married, to be non-smokers, and to be educated to at least A-level or degree level.
To celebrate the milestone, World Cancer Research Fund hosted a party for colleagues who have worked with UKWCS over the last 30 years, in person and online from all over the country. Prof Cade talked about the UKWCS, and gave us some reminders of how different the world was 30 years ago. Diet is complex, so we need to understand how various factors interact to influence our health. It was fantastic to hear about all the findings so far from the project, and see so many people in the room who could share memories of working together.
Dr Darren Greenwood shared some reflections about the history of the UKWCS and its origins, from when we awarded the University of Leeds funding to investigate links between diet and cancers. The UKWCS grew and grew as more researchers worked with the data, and were awarded further funding. Sadly some members of the original cohort have died since the study launched. Yet Dr Greenwood reminded us that this data tells a story that helps us decode how to prevent cancer, and help people live longer, healthier lives.
This legacy is one of the enduring strengths of the UKWCS. The study has been cited in at least 9 government policy documents, providing direct life-changing information to help improve health and lives on a population scale.
Dr Diane Threapleton is one of the researchers who has used UKWCS data, including looking at how increasing fruit and vegetable intake slows weight gain. She focussed on the women of the study, highlighting how the data, time and samples they provided open a vital window into how what we eat interacts with real life. This was a timely reminder of the contributions of the women of the study, without whom none of this would have been possible.
Insights into ageing and beyond
After this, we heard from Yuanyuan Dong, who is working with the UKWCS to examine how diet affects the risk of rheumatoid arthritis. Yuanyuan joined us online from China, highlighting the global reach of the experts working with the cohort.
Finally, Dr Sarah Jing Guo told us about her plans for the UKWCS data – looking to the next 30 years! She gave us details of what her PhD student, Xinyue Liu, is examining with her project looking into how replacing processed meat with unprocessed meat or dairy products affects the risk of developing type 2 diabetes. She also gave us insights into how the cohort data could aid research into an ageing population, looking at Parkinson’s disease, Alzheimer’s or musculoskeletal disorders.
This amazing piece of long-term research is an important reminder of how small seeds of funding can have an impact over many decades and even lifetimes. We’re truly grateful to the donors of 30 years ago who helped make this research happen.
> More details about the UK Women’s Cohort Study, including information about publications
Documents from the UK Women’s Cohort Study
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We spoke to Dr Renate Winkels (pictured) and Dr Laura Winkens, at Wageningen University & Research, to discover more about their studies in bowel (also known as colorectal) cancer.
Your team looked at what influences people’s health behaviours after they’ve been treated for bowel cancer. What do you mean by health behaviours and what did you find out?
Health behaviours are the everyday choices people make that affect their health. In this study, we focused on 2 things:
- healthy eating (more fruit, vegetables, whole grains and beans; and less fast food, red meat, processed meat, sugary drinks and alcohol)
- physical activity
For people who’ve had bowel cancer, healthy behaviour may be associated with living longer, feeling better and having fewer problems like fatigue.
However, in previous studies, we found that many bowel cancer survivors don’t make big changes after treatment. Survivors are dealing with side-effects from the cancer or its treatment (such as gastrointestinal problems, fatigue or body image distress), which can make it hard to eat well and stay active.
Our study looked at what helps or gets in the way of healthy behaviour for people who have finished treatment for bowel cancer. We found:
Personal factors matter
How much time people have, their motivation, what they believe about healthy habits, what they know, and the skills they have can all influence whether they eat well and stay active.
Support helps
Encouragement and support from family and friends, or feeling like healthy habits are normal in their social circle, can make a big difference.
Environment plays a role
Access to gyms, parks, or even just good weather can affect how easy it is to be active.
Cancer symptoms can get in the way
Ongoing physical issues after cancer treatment, like fatigue or bowel problems, often make it harder for people to stick to healthy habits. But if someone is feeling physically well, they’re more likely to eat better and stay active.
Mental health may be important
Depression or being unhappy with one’s body seem to be linked with less healthy behaviour.
In short, to help people with bowel cancer lead healthier lives after treatment, we need to focus on motivation, knowledge, support, and overcoming the challenges they face physically and emotionally.
Towards a more complete picture
Your team conducted a “systematic review”. What is that and why is it important?
We wanted to find out what other scientists had studied, so we could build our study on the latest evidence. Moreover, we wanted to provide an overview of the topic. We looked at 21 papers, but we started with around 800 publications, and had to sift through them to identify the relevant ones.
You divided the studies into quantitative or qualitative. Why did you choose to look at both?
Quantitative studies collected a lot of numbers and measurements. The studies used standardised questionnaires to collect data on dietary intake and other aspects of lifestyle. Those studies answer questions like “how many” or “how much”.
Qualitative studies focus more on experiences. Such studies are mostly interviews to better understand why people do what they do, or how people behave.
Together, they provide a richer, more complete picture of the challenges and motivations colorectal cancer survivors face.
Were you surprised that people find it hard to change their behaviour?
Not really. Most people will recognise how challenging it can be to always make healthy choices. After cancer, when you’re rebuilding your life, that can be even harder.
How important is mental health for people living with and beyond bowel cancer?
Mental health is a very broad topic. People who have had bowel cancer may have a stoma, or be suffering from fatigue, or from bowel functioning problems. These can have a real impact on your life, and it’s important to address them. Some care teams really have an eye on this, but it’s not always the case. One patient told me that she did not dare to discuss her feelings of severe fatigue with her oncologist, as the oncologist told her that “fatigue was not a thing” for people with bowel cancer. We need more awareness and integrated care that addresses both mental and physical health to truly support survivors’ wellbeing.
You’ve also looked at whether following our Cancer Prevention Recommendations can reduce fatigue for people with bowel cancer.
We set up a study to assess whether following the Recommendations would help people to feel less fatigue. Cancer-related fatigue is a symptom that many bowel cancer patients experience during treatment and after completion. What is disturbing is that this type of persistent, overwhelming sense of physical, emotional or mental fatigue is not proportional to activity nor relieved by resting or sleeping.
We recruited participants for the trial who were experiencing cancer-related fatigue. In a randomised study, half of the group received lifestyle coaching to improve their adherence to the Recommendations, while the control group did not.
The coaching really helped the participants to adopt a healthier lifestyle: over time, this group reported eating more fruit and vegetables, and less processed meat and sugar-sweetened beverages. Also, physical activity levels went up more in the group that received coaching than in the control group.
Nevertheless, those changes didn’t result in less fatigue. This suggests that while these changes have many benefits, managing fatigue may require additional, targeted interventions.
This grant was funded by Wereld Kanker Onderzoek Fonds based in the Netherlands, as part of the World Cancer Research Fund International network.
The UK government published its 10-year Health Plan on 3 July, setting out its ambitions to reform the health system and shift the focus from sickness to prevention.
As a cancer prevention charity with a vision of a world where no one dies from a preventable cancer, we welcome the Plan’s direction but there are many key areas of health policy where it simply falls short of what the public needs.
Positive inclusions
Many of the commitments in the Plan had already been announced and were warmly received, such as the expansions of free school meals and the Soft Drinks Industry Levy.
Encouragingly, the Plan also includes new mandatory measures that mark a meaningful step towards creating healthier environments for all.
These include:
- Mandatory healthy food sales reporting for all large companies in the food sector.
- Mandatory healthy food standard to improve the healthiness of sales.
- Updates to the nutrient profile model, used to set marketing restrictions on junk food.
- 10% uplift to restore the value of the Healthy Start scheme from 2026–27.
- Mandatory labelling on alcoholic drinks to include consistent nutritional information and health warning messages.
- Place-based approach to physical activity, including £250m for 100 places via Sport England, at least £400m for local community sports facilities, and new school sport partnerships.
- National walking and running campaign led by Sir Brendan Foster.
- Development of a new physical activity strategy.
These measures are welcome steps forward in improving our food and drink environment and enabling people to be more physically active.
We hope the forthcoming National Food Strategy will drive deeper systemic changes to ensure affordable, accessible healthy food for everyone in England.
Critical missed opportunities
On alcohol, the Plan falls short of prioritising the range of evidence-based policies proven to reduce alcohol consumption, which causes around 17,000 UK cancer diagnoses each year.
Notably, it fails to include minimum unit pricing (MUP) for alcohol in England, despite the success of MUP in reducing alcohol-related deaths in Scotland and Wales. Worryingly, England continues to lag the devolved nations on this crucial policy.
The Plan also makes no mention of strengthening marketing restrictions on alcohol, and so enables industry to continue to normalise drinking as an aspirational lifestyle choice.
Given the rising number of alcohol-related deaths each year, we are urging the UK government to deliver a National Alcohol Strategy for England. As outlined in our recent letter to the Prime Minister, Keir Starmer, during Cancer Prevention Action Week, we continue to call for bold action on alcohol-related cancer.
Equally disappointing is the absence of action to strengthen protections and support for breastfeeding and infant feeding. There are no new mandatory, independently enforced regulations on the composition, marketing and labelling of baby and toddler foods. This is a missed opportunity, particularly in light of the UK government’s stated goal to raise the healthiest generation of children ever.
We will continue to urge the government to adopt the recommendations of the Competition and Markets Authority’s market study on infant and follow-on formula.
Turning ambitions into action
This Plan arrives as Labour marks its first year in government under Starmer. This government now has the opportunity – and responsibility – to turn its prevention agenda into lasting structural change that improves the nation’s health.
The upcoming National Cancer Plan for England presents a further chance to address modifiable risk factors and fill the gaps left by the 10-year Health Plan.
We welcome the Prime Minister’s willingness to challenge accusations of “nanny statism” and urge the government to ensure all health strategies are protected from undue industry influence.
We want prevention to be the foundation of all health strategies. We stand ready to bring our scientific and policy expertise to the table – and we’re calling on the UK government to work with us to turn bold ambition into real change, helping millions live longer, cancer-free lives.
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Research funded by World Cancer Research Fund has shown that people living with cancer who closely follow a sustainable and nutritious diet – the EAT-Lancet reference diet – have a lower risk of dying from cancer and from all causes.
This is the first study to look at the impact of the EAT-Lancet diet on people living with or beyond cancer – as opposed to the general population. Prof Sabine Rohrmann and her team at the University of Zurich, in collaboration with colleagues from another Swiss university, the UK and Austria, used UK Biobank data to see if closely following this diet – with its emphasis on eating a rich variety of plant foods – affected the risk of death for people with a cancer diagnosis at the time they were recruited for the study.
Studying more than 25,000 people with an average age of 60 years at recruitment, the researchers used dietary information collected in the UK Biobank to develop a score that reflected how closely participants followed the EAT-Lancet diet.
More support needed for people facing cancer
Of the 25,348 cancer survivors in the group studied, 4,781 people died during the study follow-up. Prof Rohrmann’s results showed modest links between closely following the diet and a lower risk of dying from cancer, and of dying from all causes. The researchers didn’t observe a link between the diet and dying from heart disease.
Almost 64% of the participants were female, and participants who followed the EAT-Lancet diet more closely were more likely to be female. However, this study confirmed previous evidence showing that people living with and beyond cancer do not tend to follow healthy diets after their diagnosis. This emphasises the need to help people form healthier habits and overcome the barriers to eating well, such as treatment side-effects affecting appetite and taste.
These findings highlight the importance of greater nutrition support and guidance for people facing cancer. Guidelines aimed at the general population are unlikely to consider the needs of people living with and beyond cancer. With a lack of evidence-based recommendations for this population, the gap can sometimes be filled by practices not supported by the science – such as excessive use of dietary supplements.
This evidence showing the benefits of the EAT-Lancet diet follows recent research by our Global Cancer Update Programme, which provided guidance for people with a breast or a bowel cancer diagnosis.
Prof Sabine Rohrmann
We specifically put the focus of our study on cancer survivors because we believe that it is important to encourage them to follow a healthy lifestyle. For this, we need more evidence and so far, research on lifestyle changes in cancer survivors is still scarce.
Dr Julia Panina, Head of Research Funding
This study provides important new evidence that following the EAT-Lancet reference diet may reduce the risk of mortality in people living with and beyond cancer. The focus on the consumption of plant-based foods reflects our Cancer Prevention Recommendations to eat more wholegrains, vegetables, fruit and beans, and to limit red and processed meat. Importantly, these findings also show that diets supporting cancer survivorship can promote more sustainable eating and help protect the environment.
The EAT-Lancet reference diet was created by a team of scientists (The EAT-Lancet Commission on Food, Planet, Health) in 2019. It is a mainly plant-based diet that, according to the Commission, addresses the environmental impact of food production and consumption better than most national dietary guidelines.
> Read the paper: Higher adherence to the EAT-Lancet reference diet is inversely associated with mortality in a UK population of cancer survivors
> On the blog: Plant-based diets: eating for our health and the planet