Public Health Nutrition and Individual Food Choice

Question 1

2 factors that have convincing evidence for decreasing risk of colorectal cancers?

Answer 1

Physical activity

Foods containing dietary fibre

Question 2

4 factors that have convincing evidence for increasing risk of colorectal cancers?

Answer 2

Red meat

Processed meat

Alcohol drinks (men)

Body/abdominal fatness

Question 3

Factors that decrease and increase risk of certain types of cancers?

Answer 3

Question 4

How does obesity increase endometrial and breast cancer risk?

Answer 4

Hyperoestrogenaemia from aromatase

Question 5

How does obesity increase pancreatic, kidney and colorectal cancer risk?

Answer 5

Inflammation and other growth factors

Question 6

How does obesity increase oesophageal cancer risk?

Answer 6

Tissue damage from acid reflux

Question 7

How does obesity increase gallbladder cancer risk?

Answer 7

Tissue damage from gallstones

Question 8

How does exercise after diagnosis of colorectal cancer affect survival?

Answer 8

May improve survival and decrease recurrence

Question 9

How does western dietary pattern affect cancer recurrence and survival?

Answer 9

Poorer rates of disease-free survival, recurrence free survival and overall survival

Question 10

Other problems with obesity?

Answer 10

Surgical complications

DVT

Chest infection

Wound infection

Pressure ulcers

In the longer term:

Dealing with a stoma

Chemotherapy

Recurrent cancer and there may be a second primary cancer

CVD risk increase

Question 11

Sociological influences of cancer risk?

Answer 11

Gender

Age

Ethnicity

Socioeconomic status (car ownership, poor housing, less education, unemployment, lower social class of father)

Income

Education

Marital status

Question 12

Why is education not enough?

Answer 12

Can increase awareness but has not demonstrated a change in diet

Right pricing, marketing, availability strategies need to accompany investments in educational programmes

Question 13

Four influences on individual dietary change?

Answer 13

Awareness

Access and availability - elderly, for example

Acceptability (cultural norms) - habit, resistance to change, marketing

Affordability

Question 14

3 nutritional concerns in the GI system?

Answer 14

Poor compliance with gluten free diet

Over-nutrition

Excess sugar intake

Question 15

Reasons for poor compliance with gluten free diet?

Answer 15

Limited knowledge

• Confidence in treatment
• Availability of GF foods
• Sensory acceptance of GF foods
• Social inconvenience
• Insufficient social support
• Dining out, asymptomatic disease

Question 16

Percentage of total dietary energy that free sugars should be?

Answer 16

Should not exceed 5%

Question 17

5As of behaviour change counselling?

Answer 17

Ask - permission to discuss diet

Assess - habits and motivation

Advise - health benefits and personalised instruction

Agree - set goals

Assist - self-monitoring tools and feedback; prevent relapse and provide referral (if applicable) and social support