This is a repository copy of Nutrition and Cancer: Evidence Gaps and Opportunities for 
      Improving Knowledge.
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      Version: Accepted Version
      Article:
      Thorne, J orcid.org/0000-0002-3037-8528, Moore, JB orcid.org/0000-0003-4750-1550 and
      Corfe, BM (2020) Nutrition and Cancer: Evidence Gaps and Opportunities for Improving 
      Knowledge. Proceedings of the Nutrition Society. ISSN 0029-6651 
      https://doi.org/10.1017/S0029665120000099
      © The Authors 2020. This article has been published in a revised form in Proceedings of 
      the Nutrition Society at http://doi.org/10.1017/S0029665120000099. This version is free to 
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         1    Title Page 
         2    The Nutrition Society Member-led Meeting was held at the University of Sheffield, UK on 11 July 
         3    2019. 
         4    Meeting report: “1st Annual Nutrition and Cancer Networking” 
         5    Title 
         6    Nutrition and Cancer: Evidence Gaps and Opportunities for Improving Knowledge 
         7    Short Title 
         8    Nutrition and Cancer Meeting 
         9    Authors’ names 
                                 1,2,3                         1                     3,4
       10     James L Thorne         *, J Bernadette Moore , Bernard M Corfe  
       11     Affiliations 
       12     1School of Food Science and Nutrition, Faculty of Environment, University of Leeds, UK 
       13     2The Leeds Breast Cancer Research Group, Faculty of Medicine, University of Leeds, UK 
       14     3NIHR Cancer and Nutrition Collaboration  
       15     4Molecular Gastroenterology Research Group, Department of Oncology & Metabolism, University 
       16     of Sheffield, Sheffield, UK 
       17     Correspondence 
       18     James L Thorne 
       19     School of Food Science and Nutrition  
       20     Faculty of Environment  
       21     University of Leeds  
       22     UK 
       23     LS2 9JT 
       24     j.l.thorne@leeds.ac.uk 
       25     +44 113 343 0684 
       26     Short title 
       27     Nutrition and Cancer 
       28     Keywords 
       29     Cancer; Nutrients; Diet; Prehabilitation; Chemotherapy 
       30                                         
                                                                                                                                 1 
       31    Abstract 
       32    The Nutrition Society’s 1st Annual Nutrition and Cancer Networking Conference brought together 
       33    scientists from the fields of Nutrition, Epidemiology, Public Health, Medical Oncology and Surgery 
       34    with representatives of the public, cancer survivors and cancer charities. Speakers representing these 
       35    different groups presented the challenges to collaboration, how the needs of patients and the public 
       36    can be met, and the most promising routes for future research. The conference programme promoted 
       37    debate on these issues to highlight current gaps in understanding and barriers to generating and 
       38    implementing evidence-based nutrition advice. The main conclusions were that the fundamental 
       39    biology of how nutrition influences the complex cancer risk profiles of diverse populations needs to 
       40    be better understood. Individual and population level genetics interact with the environment over a 
       41    lifespan to dictate cancer risk. Large charities and government have a role to play in diminishing our 
       42    current  potently  obesogenic  environment  and  exploiting  nutrition  to  reduce  cancer  deaths. 
       43    Understanding how best to communicate, advise, and support individuals wishing to make dietary 
       44    and lifestyle changes, can reduce cancer risk, enhance recovery, and improve the lives of those living 
       45    with and beyond cancer. 
       46                                    
                                                                                                                     2 
       47                                                 Introduction 
       48    The link between nutrition and cancer is now unequivocal. Around 10-15% of all cancers are 
       49    considered preventable by nutritional parameters, and correct nutrition can improve both recovery 
                                          (1, 2)
       50    from treatment and survival      . The World Cancer Research Fund and American Institute for Cancer 
                                        (2)                                (3)                                      (4)
       51    Research (WCRF/AICR) , the American Cancer Society , and the World Health Organisation  
       52    have provided evidence-based nutrition and physical activity public health guidelines to reduce 
       53    cancer  risk.  Overwhelming  consensus  exists  for  advising  people  to:  maintain  a  healthy  weight 
       54    (typically considered a BMI of 18.5-24.9 with WCRF suggesting to be at the lower end of this range); 
       55    engage in regular physical activity; consume a diet rich in vegetables, fruits, whole grains and plant-
       56    based  protein  sources  such  as  legumes,  nuts  and  seeds  legumes;  limit  consumption  of  highly 
       57    processed or ‘fast foods’ that are high in saturated fat, sugar, salt and refined carbohydrates; limit 
       58    consumption of red and processed meats, sugar-sweetened beverages and alcohol. Adherence to these 
       59    guidelines has repeatedly been shown to reduce risk of cancer incidence in multiple populations at 
                                                (5-8)               (9)          (10)           (11-13)
       60    multiple sites including colorectal    , head and neck , pancreas      , and breast     .  
       61     
       62    Sex and ethnicity modify cancer risk, as do multiple genetic variants that mediate risk for body fatness 
       63    and/or cancer. The molecular explanations for site-, sex-, and ethnicity-specific risk profiles remain 
       64    as gaps in current understanding and represent a significant barrier to enacting stratified (if not yet 
       65    personalised)  prevention  strategies.  Other  critical  unanswered  questions  include:  how  best  to 
       66    communicate existing advice that is based on robust and convincing evidence to the public; should 
       67    advice differ following diagnosis or following treatment and what are the most pressing nutrition 
       68    research areas to reduce cancer rates and improve survival and quality of life? The aim of the 1st 
       69    Annual Nutrition and Cancer Networking Conference, held in Sheffield in July 2019, was to bring 
       70    together  nutritional  scientists,  clinicians,  funding  agencies,  patients  and  their  representatives  to 
       71    discuss these outstanding issues.  
       72     
       73                              Nutrition across the course of cancer treatment 
       74    Malnutrition is a frequent complication of cancer therapy and impairs patient survival and recovery. 
       75    Speaker Dr Alessandro Laviano (University of Sapienza) contributed to The European Society for 
       76    Clinical  Nutrition  and  Metabolism  (ESPEN) guidelines for cancer patients, which are aimed at 
       77    identifying early warning signs of malnutrition and provide methods for multi-disciplinary teams to 
                                                                                (14)
       78    prevent the deterioration of metabolic health of cancer patients      . Patients at risk of cachexia and 
       79    sarcopenia, or who may have their therapy dose capped due to excessive BMI may benefit most from 
       80    prehabilitation. Studies of dose capping in obese individuals suggest better outcomes when doses are 
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