Table 1.

Operationalization of WCRF/AICR Recommendations.

WCRF/AICR Recommendations	Personal Recommendations	Operationalization/Comments	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 body mass index (BMI) at age 21 years	At age 12, compared to kids of same sex and age, you were: thinner	1
		At age 12, compared to kids of same sex and age, you were: same	0.5
		At age 12, compared to kids of same sex and age, you were: heavier	0
	1b) Maintain body weight within the normal range from age 21 years	2 of the following: BMI 18.5–25 at ages 30 and 50a	1
		1 of the following: BMI 18.5–25 at ages 30 and 50 a	0.5
		0 of the following: BMI 18.5–25 at ages 30 and 50 a	0
	1c) Avoid weight gain and increases in waist circumference throughout adulthood	Insufficient data
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.	Very Heavy/Heavy job or >5 hours/week of leisure time physical activity (age 30–39)	1
		Medium job or 2–4 hours/week of leisure time physical activity (age 30–39)	0.5
		Standing/Sedentary job or<2 hours/week of leisure time physical activity (age 30–39)	0
	2b) As fitness improves, aim for ≥60 min of moderate or for ≥30 min of vigorous physical activity every day.	Insufficient data
	2c) Limit sedentary habits such as watching television.	Insufficient data
3) Foods and drinks that promote weight gain. Limit consumption of energy-dense foods; avoid sugary drinks.	3a) Consume energy-dense foods sparingly.	Energy density: ≤125 kcal/100 g/day	1
		Energy density: >125 to <175 kcal/100 g/day	0.5
		Energy density: >175 kcal/100 g/day	0
	3b) Avoid sugary drinks.	Sugary drink intake (sweetened fruit juice and soft drinks): 0 g/day	1
		Sugary drink intake: 0<250≤ g/day	0.5
		Sugary drink intake: >250 g/day	0
	3c) Consume fast foods sparingly, if at all.	Insufficient data
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 fruit every day.	Fruit and vegetable intake: ≥5 servings/day	1
		Fruit and vegetable intake: 3–4 servings/day	0.5
		Fruit and vegetable intake: ≤2 servings/day	0
	4b) Eat relatively unprocessed cereals (grains) and/or pulses (legumes) with every meal.	Dietary fiber intake: ≥25 g/day	1
		Dietary fiber intake: 12.5 to <25 g/day	0.5
		Dietary fiber intake: <12.5 g/day	0
	4c) Limit refined starchy foods.	Starch: <200 gr/day	1
		Starch: 200<to 300 gr/day	0.5
		Starch: ≥300 gr/day	0
	4d) People who consume starchy roots or tubers as staples should also ensure sufficient intake of non-starchy vegetables, fruit, and pulses (legumes).	Insufficient data
5) Animal foods. Limit intake of red meat and avoid processed meat	5a) People who eat red meat should consume <500 g/week and very few, if any, processed meats.	Red and processed meat: <500 g/week and processed meat intake <3 g/day	1
		Red and processed meat: <500 g/week and processed meat intake 3 to <50 g/day	0.5
		Red and processed meat: ≥500 g/week or processed meat intake ≥50 g/day	0
6) Alcoholic drinks. Limit alcoholic drinks.	6a) If alcoholic drinks are consumed, limit consumption to ≤2 drinks/day for men and 1 drink/day for women.	Drinks/day: ≤2 (men)	1
		Drinks/day: ≤1 (women)	1
		Drinks/day: >2 to 3 (men)	0.5
		Drinks/day: >1 to 2 (women)	0.5
		Drinks/day: >3 (men)	0
		Drinks/day: >2 (women)	0
7) Preservation, processing, preparation. Limit consumption of salt. Avoid moldy cereals (grains) or pulses (legumes).	7a) Avoid salt-preserved, salted, or salty foods; preserve foods without using salt.	Insufficient data
	7b) Limit consumption of processed foods with added salt to ensure an intake of <6 g (2.4 g sodium)/day.	Sodium from foods: <2.4 g/day	1
		Sodium from foods: 2.4 to 4 g/day	0.5
		Sodium from foods: >4 g/day	0
	7c) Do not eat moldy cereals (grains) or pulses (legumes).	Insufficient data
8) Dietary supplements. Aim to meet nutritional needs through diet alone.	8a) Dietary supplements are not recommended for cancer prevention.	Insufficient data

AICR: American Institute of Cancer Research; WCRF: World Cancer Research Fund.

^aWhen BMI at age 50 was unavailable we used BMI at age 30.