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Cancer is increasing worldwide. Patterns of cancer are also changing. The evidence is summarised in the 2018 World Cancer Research Fund/American Institute for Cancer Research report Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. The plasticity of cancer patterns implicates environmental factors as determinants of cancer, and nutrition influences key cellular and molecular processes that characterise cancer. Epidemiology identifies associations between aspects of diet, nutrition, and physical activity with one or more cancers; there is evidence for plausible mechanisms that imply that these are causal. Some nutritional exposures (alcohol and processed meat) are likely causal factors, but no singular factor protects against cancer (except dietary fibre for colorectal cancer). Cancer protection mainly derives from a systemic metabolic environment that promotes healthy cell replication and tissue integrity. Such a nutritional state reflects avoiding excess adiposity through healthy dietary patterns rich in plant foods (legumes, wholegrains, pulses, vegetables and fruits), with modest meat, fish and dairy, low in alcohol and salt preserved foods, and an active way of life, avoiding sedentary behaviours. Less is known about the impact of nutritional interventions in people with a diagnosis of cancer, but nutrition including adiposity and physical activity predict breast cancer outcome. Promoting healthy ways of life requires public information and education, but alone these do not generate change; a socio-political and cultural environment that is conducive to adopting healthy behaviours is needed. Uncertainties in the evidence offer promising directions for future research, but sufficient is known to act as a basis for public policy and clinical practice.

Breast cancer prevention is of great importance to reduce high incidence in South Africa. This study aimed to investigate adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations and the association with breast cancer risk in black urban women from Soweto, South Africa. A total of 396 breast cancer cases and 396 population-based controls from the South African Breast Cancer study (SABC) matched on age and demographic settings were included. Validated questionnaires were used to collect dietary and epidemiological data. To assess adherence to these recommendations, an eight-point adherence score was developed, using tertiles among controls for scoring each recommendation (0, 0·5 and 1) with zero indicating the lowest adherence to the recommendations. OR and 95 % CI were estimated using multivariate logistic regression models to analyse associations between the WCRF/AICR score and breast cancer risk. Greater adherence (>4·5 v. <3·25) to the 2018 WCRF/AICR Cancer Prevention Recommendations was associated with a significant inverse association with breast cancer risk overall (OR = 0·54, 95 % CI 0·35, 0·91) and specifically in postmenopausal women (OR = 0·55, 95 % CI 0·34, 0·95), in cases with oestrogen positive and progesterone positive breast cancer subtypes (OR = 0·54, 95 % CI 0·39, 0·89 and OR = 0·68, 95 % CI 0·43, 0·89, respectively) and in obese women (OR = 0·52, 95 % CI 0·35, 0·81). No significant association with breast cancer risk was observed in premenopausal women. Greater adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations may reduce breast cancer risk in this black urban population of Soweto. Adherence thereof should be encouraged and form a part of cost-effective breast cancer prevention guidelines.

Background: Some recent molecular epidemiology studies of the effects of genetic and environmental factors on human health have required the enrollment of more than 100 000 participants and the involvement of regional study offices across the country. Although regional study office investigators play a critical role in these studies, including the acquisition of funds, this role is rarely discussed. Methods: We first differentiated the functions of the regional and central study offices. We then investigated the minimum number of items required and approximate cost of a molecular epidemiology study enrolling 7400 participants from a model region with a population of 100 000 for a 4-year baseline survey using a standard protocol developed based on the protocol of Japan Public Health Center-based Prospective Study for the Next Generation. Results: The functions of the regional study office were identified, and individual expenses were itemized. The total cost of the 4-year baseline survey was 153 million yen, excluding consumption tax. Accounting difficulties in conducting the survey were clarified. Conclusions: We investigated a standardized example of the tasks and total actual costs of a regional study office. Our approach is easy to utilize and will help improve the management of regional study offices in future molecular epidemiology studies.

This piece holds onto the foundation of the material conditions of the experience of Indigenous people out of which decolonial theory springs, first by exploring decolonial theory as it re-shapes practice globally, and second by recognising how radical power risks becoming harnessed and domesticated in Western academic spaces. Finally, it suggests that the Global Challenges Research Fund is not fertile ground for truly decolonising geographical knowledge in the UK.

Evidence on adherence to diet-related cancer prevention guidelines and associations with colorectal cancer (CRC) risk is limited and conflicting. The aim of this cohort analysis is to evaluate associations between adherence to the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) 2007 recommendations and incident CRC. The UK Women’s Cohort Study comprises over 35 372 women who filled in a FFQ at baseline in 1995. They were followed up for CRC incidence for a median of 17·4 years, an individual score linking adherence to eight of the WCRF/AICR recommendations was constructed. Cox proportional hazards regression provided hazard ratios (HR) and 95 % CI for the estimation of CRC risk, adjusting for confounders. Following exclusions, 444 CRC cases were identified. In the multivariate-adjusted model, women within the second and third (highest) categories of the WRCF/AICR score had HR of 0·79 (95 % CI 0·62, 1·00) and 0·73 (95 % CI 0·48, 1·10), respectively, for CRC compared with those in the lowest, reference category. The overall linear trend across the categories was not significant (P=0·17). No significant associations were observed between the WCRF/AICR score and proximal colon, distal colon and rectal cancers separately. Of the individual score components, a BMI within the normal weight range was borderline significantly protective only for rectal cancer in the fully adjusted model. In view of the likely different causes of CRC subtypes, further research is needed to identify the optimal dietary patterns associated with reducing colon and rectal cancer risk, respectively.

Bowel cancer risk is strongly influenced by lifestyle factors including diet and physical activity. Several studies have investigated the effects of adherence to the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) cancer prevention recommendations on outcomes such as all-cause and cancer-specific mortality, but the relationships with molecular mechanisms that underlie the effects on bowel cancer risk are unknown. This study aimed to investigate the relationships between adherence to the WCRF/AICR cancer prevention recommendations and wingless/integrated (WNT)-pathway-related markers of bowel cancer risk, including the expression of WNT pathway genes and regulatory microRNA (miRNA), secreted frizzled-related protein 1 (SFRP1) methylation and colonic crypt proliferative state in colorectal mucosal biopsies. Dietary and lifestyle data from seventy-five healthy participants recruited as part of the DISC Study were used. A scoring system was devised including seven of the cancer prevention recommendations and smoking status. The effects of total adherence score and scores for individual recommendations on the measured outcomes were assessed using Spearman’s rank correlation analysis and unpaired t tests, respectively. Total adherence score correlated negatively with expression of Myc proto-oncogene (c-MYC) (P=0·039) and WNT11 (P=0·025), and high adherers had significantly reduced expression of cyclin D1 (CCND1) (P=0·042), WNT11 (P=0·012) and c-MYC (P=0·048). Expression of axis inhibition protein 2 (AXIN2), glycogen synthase kinase (GSK3β), catenin β1 (CTNNB1) and WNT11 and of the oncogenic miRNA miR-17 and colonic crypt kinetics correlated significantly with scores for individual recommendations, including body fatness, red meat intake, plant food intake and smoking status. The findings from this study provide evidence for positive effects of adherence to the WCRF/AICR cancer prevention recommendations on WNT-pathway-related markers of bowel cancer risk.

Background Knowledge creation (KC) produces resources to synthesize policy evidence and contributes to breakthroughs in unresolved health problems by discovering the previously unknown. Nevertheless, few studies have attempted to analyze which factors contribute to KC. This study aims to investigate the factors hindering the active occurrence of KC by using women’s health research as a representative example of an under-researched healthcare field in South Korea. Methods The study adopted a qualitative approach to exploring factors influencing KC from researchers’ perspectives. We conducted semi-structured interviews with 14 experts who have experience in planning women’s health research, research policymaking or conducting research in South Korea. Data were analyzed using a qualitative thematic analysis according to Castleberry and Nolen. Results Factors affecting KC across all three government-funded research processes were identified. Most of the identified factors were found to be barriers to KC, rather than enablers. The key influencing factors included a focus on urgent, politicized societal issues rather than ongoing health concerns, insufficient motivation and support for researchers, weak communication within interdisciplinary research teams, and challenges with expanding research networks. Conclusion To bridge the know–do gap in the health policy-making process, it is essential to produce sufficient high-quality knowledge that can serve as policy evidence. The findings of this study illuminate the conditions faced by under-researched topics and identify the factors necessary to enhance KC. We believe our findings will help reshape and invigorate discourse and research policies on KC in healthcare.

Against a backdrop of historic inequities between Northern and Southern scholars, the UK’s Global Challenges Research Fund (GCRF) calls for “meaningful and equitable” research partnerships between UK-based academics and partners in the Global South. This paper draws on qualitative data from three workshops in the Ethiopia, Rwanda and the UK to interrogate GCRF funding criteria from the perspectives of African-based research partners. The GCRF criteria are considered with respect to African partners’ experiences of, and aspirations from, such international research partnerships in order to enrich and extend ongoing debates about power relations in development research. The study finds that GCRF criteria do address many of the familiar historic concerns of African partners, while also identifying ways in which this and similar funding schemes may unintentionally reproduce structural inequities within the South. In highlighting these less visible equity concerns, the paper draws lessons for funders, academics and others concerned with establishing genuinely equitable research partnerships.

The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) published evidence-based recommendations for cancer prevention focusing on body weight, physical activity, and diet. Our aim is to evaluate whether adherence to the WCRF/AICR recommendations could reduce endometrial cancer risk. We used data from a multicentric, Italian hospital-based case–control study (1992–2006) including 454 endometrial cancer cases and 908 age-matched controls. Adherence to the WCRF/AICR recommendations was measured using a score (range: 0–7) based on seven components: body mass index (BMI), physical activity and five dietary items; higher scores indicated higher adherence. Odds ratios (OR) were estimated by multiple (adjusted) conditional logistic regression models including terms for major confounders and energy intake. Adherence to the WCRF/AICR recommendations was inversely related to endometrial cancer risk (OR = 0·42, 95 % confidence interval (CI) 0·30, 0·61 for the highest compared with the lowest score quartile), with a significant trend of decreasing risk with increasing adherence. An inverse association was also observed for a score including only dietary recommendations (OR = 0·67, 95 % CI 0·46, 0·96 for the highest compared with the lowest score tertile). In stratified analyses, the association was stronger among women with a normal weight, those who were older, and consequently those in post-menopause, and those with ≥ 2 children. In conclusion, high adherence to the WCRF/AICR recommendations has a favourable role in endometrial cancer risk, which is not fully explained by body weight.

The Thailand Research Fund (TRF) paid for a total of 12 research projects on Thai fruits and fruit products. The studies looked at and measured the social return on investment (SROI). The fruits studied included functional fruits like mango, pomelo, papaya, and banana. We collected the data through structured questionnaires and in-depth interviews with the key informants of the 12 research projects. We employed the SROI analysis tool to analyze the data. The value of the net benefit of the research projects in terms of output and outcome was estimated to be 125,389,794 THB (Thai Baht), while the Thailand Research Fund (TRF)’s research funding for these projects amounted to 11,883,370 THB. Therefore, the SROI of the projects is estimated to be 10.55. This value implies that the TRF was able to achieve an SROI of 10.55 THB for each 1.0 THB investment in the research projects. The findings suggest that TRF’s investment in the research projects on Thai functional fruits and fruit products was successful and effective as well as worth value. The study findings might be beneficial for TRF, research grant associations, and educational institutions to formulate appropriate policies for further research support.