Development and validation of a short screener to evaluate adherence to the World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-03-03 DOI:10.1016/j.clnu.2025.02.033

Alice Chaplin , Mar Nafría , Lara Prohens , Margarita Morey , Elena Rayo , Marissa M. Shams-White , Nigel Brockton , Jill Reedy , Panagiota Mitrou , Adela Castelló , Estefanía Toledo , Montserrat Fitó , Olga Castañer , María Dolors Zomeño , Sonia Eguaras , Albert Sesé , Dora Romaguera

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引用次数: 0

Abstract

Background and aims

Adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations is associated with reduced risk for cancer and all-cause mortality. The aim of this study was to develop and validate a short screener to assess adherence to these guidelines.

Methods

The study was divided into two phases: Screener development (Phase I) and a validation study (Phase II). A subsample of participants from the PREDIMED-Plus study, an ongoing randomised lifestyle intervention trial which focuses on cardiovascular disease prevention, were invited from two recruiting centres in Spain for the pilot testing (n = 110) and validation (n = 148) of the tool. Participants completed the WCRF/AICR Screener, and dietary and lifestyle data were collected using validated methods (anthropometric measurements by trained staff, and validated diet and physical activity (PA) questionnaires). A score reflecting adherence to the recommendations was derived for each method (Screener and validated instruments), adapted from the 2018 WCRF/AICR Score. Relative agreement between the total scores was evaluated by Spearman correlation (r) and intraclass correlation coefficients (ICC). Cross-classification and Kappa coefficient (κ) were used for individual recommendations.

Results

The WCRF/AICR Screener has 13 questions covering seven recommendations (regarding body weight; PA; plant-based foods; fast and processed foods; red and processed meat; sugar-sweetened drinks; and alcoholic drinks) with a score range of 0–7 (higher scores indicated greater adherence). There was a significant correlation (r = 0.70) and a moderate agreement (ICC = 0.68) between the WCRF/AICR Screener (mean ± SD, 3.20 ± 0.92) and validated methods (3.05 ± 1.01) scores. The scores for individual recommendations showed very good agreement for body weight (κ = 0.84), substantial agreement for alcoholic drinks (κ = 0.71), moderate agreement for PA (κ = 0.58), red and processed meat (κ = 0.58) and sugar-sweetened drinks (κ = 0.56). Fair agreement was observed for plant-based foods (κ = 0.30) and fast and processed foods (κ = 0.27).

Conclusions

The WCRF/AICR Screener is a valid tool for assessing adherence to the WCRF/AICR Cancer Prevention Recommendations at an individual level, and could be useful for rapid assessment of diet and lifestyle in clinical settings for cancer prevention strategies.

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开发和验证一个简短的筛选，以评估遵守世界癌症研究基金会/美国癌症研究所癌症预防建议

背景和目的遵守世界癌症研究基金会/美国癌症研究所（WCRF/AICR）癌症预防建议与降低癌症风险和全因死亡率相关。本研究的目的是开发和验证一个简短的筛选来评估这些指南的遵守情况。该研究分为两个阶段：筛选器开发（I期）和验证研究（II期）。PREDIMED-Plus研究是一项正在进行的专注于心血管疾病预防的随机生活方式干预试验，从西班牙的两个招募中心邀请了参与者的子样本进行该工具的试点测试（n = 110）和验证（n = 148）。参与者完成了WCRF/AICR筛选，并使用经过验证的方法收集饮食和生活方式数据（由训练有素的工作人员进行人体测量，以及经过验证的饮食和身体活动（PA）问卷）。根据2018年WCRF/AICR评分，得出了反映每种方法（筛选器和经过验证的工具）对建议遵守情况的评分。采用Spearman相关系数(r)和类内相关系数（ICC）评价总分之间的相对一致性。交叉分类和Kappa系数（κ）用于个体推荐。结果WCRF/AICR筛查有13个问题，涵盖7项建议(关于体重；PA;植物性食物;快餐和加工食品；红肉和加工肉类；含糖饮料;以及酒精饮料)，得分范围在0-7之间（得分越高表明依从性越强）。WCRF/AICR筛选评分（mean±SD, 3.20±0.92）与验证方法评分（3.05±1.01）之间存在显著相关（r = 0.70）和中度一致（ICC = 0.68）。个体推荐评分显示，体重（κ = 0.84）非常一致，酒精饮料（κ = 0.71）非常一致，PA （κ = 0.58）、红肉和加工肉（κ = 0.58）和含糖饮料（κ = 0.56）的一致性中等。植物性食品（κ = 0.30）与快餐和加工食品（κ = 0.27）之间的一致性相当。结论WCRF/AICR筛查是一种有效的工具，可用于评估个人对WCRF/AICR癌症预防建议的依从性，并可用于快速评估临床环境中癌症预防策略的饮食和生活方式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.