Saxon Graham Lecturer Explains Diet’s Role in Cancer Risk

After completing medical school in her native Spain, Bandera achieved a PhD in epidemiology and community health from the University at Buffalo in 1995. She began working with renowned epidemiologist and former chair of SPHHP’s Department of Epidemiology and Environmental Health, Saxon Graham, on cutting edge research into chronic diseases. That work set her on a path helping build multiple versions of healthy living recommendations not just for Americans, but also for the global population.

Her work earned her a place with the World Cancer Research Fund and the American Institute for Cancer Research, which tasked her and other experts with creating recommendations for reducing the risk of developing different cancers.

Successful at that task, she joined the American Cancer Society in its attempt to pare down existing recommendations available since 1984. At the time, they noted avoiding obesity, lowering fat intake, increasing fibrous foods and cruciferous vegetables, and decreasing alcohol consumption. Eventually, a lengthy list was pared to four recommendations: achieve and maintain a healthy body weight, increase physical activity, follow a healthy dietary pattern and reduce the consumption of alcohol.

“We know that people ... that follow the guidelines do better,” Bandera said. “For breast cancer survival, there's a lot of literature.”

No magic diet exists, she said, nor a magic pill— despite some seemingly marketable products that provide results only when they’re taken—to reduce the risk of cancer. It takes hard work and following a mostly plant-based diet where alcohol isn’t even considered, especially in the case of breast cancer, on which the American Cancer Society’s recommendations focus.

Meanwhile, obesity is another noteworthy risk factor. For both women and men, obesity is the second-leading risk factor behind smoking, she said, citing a 2018 study in A Cancer Journal for Clinicians. The issue is measuring obesity. Researchers and clinicians argue over what methods to follow and which are effective. Bandera is a proponent of taking body-mass index measurements and pairing them with waist circumference, even if BMI’s uses are criticized in some circles.

"In our own research, we found waist circumference was a great marker of increased risk in survivors,” Bandera said. “This study was of black women with breast cancer. It was much more than BMI. It's a measure ... about central [body] obesity, so people who have greater waist circumference ... are more likely to have metabolic syndrome. And that's going to increase risk of cardiovascular disease and many other [chronic diseases]."

The annual Saxon Graham Lecture is presented by SPHHP’s Department of Epidemiology and Environmental Health and the family of Dr. Saxon Graham.