Table 2.

Operationalization of adherence to WCRF/AICR recommendations.

WCRF/AICR Recommendations for Cancer Survivors	Sub-Recommendations	Operationalization	Scoring
1.Body fatness: Be as lean as possible without becoming underweight	(1a)Ensure that body weight throughout childhood and adolescent growth projects toward the lower end of the normal BMI range at age 21 years (1b)Maintain body weight within the normal range from age 21 years (1c)Avoid weight gain and increases in waist circumference throughout adulthood	BMI (kg/m2)
		18.5–22.9	2
		23-25	1
		<18.5 or >25	0
2.Physical activity: Be physically active as part of your everyday life	(2a)Be moderately physically active, equivalent to brisk walking, for ≥30 min every day (2b)As fitness improves, aim for ≥60 min of moderate, or for ≥30 min of vigorous physical activity every day (2c)Limit sedentary habits such as watching television	Physical activity (MET-hour/week)
		Tertile 3 (>40.3)	2
		Tertile 2 (19.6–43.3)	1
		Tertile 1 (<19.6)	0
3.Foods and drinks that promote weight gain: Limit consumption of energy-dense foods; avoid sugary drinks	(3a)Consume energy-dense foods (225–275 kcal/100 g) sparingly (3b)Avoid sugary drinks (servings/week) (3c)Consume fast foods sparingly, if at all	Energy dense diet 1 (kcal/100 g)		Tertiles High 2 Middle 1 Low 0
		Tertile 1 (<154.2)	2
		Tertile 2 (132–154.2)	1
		Tertile 3 (>132)	0
		Sugary drinks (g/day)
		None	2
		≤50	1
		>50	0
4.Plant foods: Eat mostly foods of plant origin	(4a)Eat ≥5 portions/servings (>400 g) of a variety of non-starchy vegetables and of fruits every day (4b)Eat relatively unprocessed cereals (grains) and/or pulses (legumes) with every meal (4c)Limit refined starchy foods (4d)People who consume starchy roots or tubers as staples should also ensure sufficient intake of non-starchy vegetables, fruit, and pulses (legumes)	Non-starchy vegetable and fruit intake (g/day)		Tertiles High 2 Middle 1 Low 0
		Tertile 3 (>586.2)	2
		Tertile 2 (371.5–586.2)	1
		Tertile 1 (<371.5)	0
		Refined grains (g/day)
		Tertile 1 (<15)	2
		Tertile 2 (15–45)	1
		Tertile 3 (>45)	0
5.Animal foods: Limit intake of red meat (beef, pork, lamb, and goat) and avoid processed meat	(5a)People who eat red meat should consume <500 g/week, very little if any to be processed meats	Red meat and processed meat intake (g/day)
		Tertile 1 (<5)	2
		Tertile 2 (5–60.5)	1
		Tertile 3 (>60.5)	0
6.Preservation, processing, preparation: Limit consumption of salt. Avoid moldy cereals (grains) or pulses (legumes)	(6a)Avoid salt-preserved, salted, or salty foods; preserve foods without using salt (6b)Limit consumption of processed foods with added salt to ensure an intake of<6 g (2.4 g sodium)/day (6c)Do not eat moldy cereals (grains) or pulses (legumes)	Sodium intake (mg/day)
		Tertile 1 (<3521.7)	2
		Tertile 2 (3521.7–4602.2)	1
		Tertile 3 (>4602.2)	0

Abbreviations: WCRF/AICR, World Cancer Research Fund/American Institute for Cancer Research; BMI, Body Mass Index; MET, metabolic equivalent task; ¹ Energy dense diet denotes energy intake per amount of total food intake (kcal per 100 g).