European Code Against Cancer, 5th edition – diet, excess body weight, physical activity, sedentary behavior, breastfeeding, and cancer
IARC / European Commission (ECAC5) · 2026 · Europe
Source and licence
- Authors
- Michael F Leitzmann, Ioanna Bakogianni, Annie S Anderson et al.
- Title
- European Code Against Cancer, 5th edition – diet, excess body weight, physical activity, sedentary behavior, breastfeeding, and cancer
- Journal
- Molecular Oncology, 2026
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC12809479
Licence statement of the original publication
This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.
Open the original publication →Full text on Europe PMC
Recommendations
We found no explicitly labelled recommendations in this publication; its recommendations are in the running text of the original.
Abstract
Diet, body weight, physical activity, sedentary behavior, and breastfeeding are modifiable factors influencing the cancer burden in the European Union, shaped by underlying social, commercial, environmental, and behavioral conditions. Excess body weight has reached epidemic levels, significantly influenced by widespread intake of sugar‐sweetened beverages and ultra‐processed foods rich in sugar, fat, and salt. Consumption of red and processed meat also commonly exceeds dietary recommendations. Physical inactivity and prolonged sedentary behavior are widespread. Breastfeeding rates vary widely across Europe but are generally low, particularly in high‐income countries. To reduce cancer risk, the European Code Against Cancer, 5th edition (ECAC5) recommends a diet rich in whole grains, vegetables, legumes, and fruits, while limiting red meat and avoiding processed meat. Intake of vegetables, legumes, and fruits prevents aerodigestive tract cancers, while diets high in whole grains and low in red and processed meat reduce colorectal cancer risk. Avoiding excess body weight through diet and physical activity, and limiting prolonged sitting, decreases risk of numerous cancers. Promoting and supporting sustained breastfeeding contributes to lowering breast cancer risk. Key policy interventions, such as fiscal incentives, urban planning, marketing restrictions, and public awareness campaigns, are central to creating supportive environments for cancer prevention.
Contents of the original publication
The section headings of the original.
- Introduction
- Prevalence of risk and protective factors (diet, excess body weight, physical activity, sedentary behavior, and breastfeeding) within the European Union (EU)
- Diet
- Excess body weight
- Physical activity
- Sedentary behavior
- Breastfeeding
- Cancer burden in the EU/Europe attributable to unhealthy diet, excess body weight, physical inactivity and sedentary behavior, and breastfeeding
- Recommendations for individuals
- Scientific justification for update of the diet recommendation in ECAC5
- Evidence on the association between diet and cancer, and benefits of following the recommendation
- Presentation of the diet recommendation
- Equity
- Suitability, actionability, and acceptability of the recommendations for the individual
- Factors excluded from current diet recommendation
- Scientific justification for update of the excess body weight recommendation in ECAC5
- Evidence on the association between excess weight and cancer, and benefits of following the recommendation
- Presentation of the excess weight recommendation
- Equity
- Suitability, actionability, and acceptability of the recommendations for the individual
- Scientific justification for update of the recommendation on physical activity and sedentary behavior in ECAC5
- Evidence on the relations of physical activity and sedentary behavior to cancer, and benefits of following the recommendation
- Presentation of the physical activity and sedentary behavior recommendation
- Equity
- Suitability, actionability, and acceptability of the recommendation for the individual
- Scientific justification for update of the recommendation on breastfeeding in ECAC5
- Evidence on the association between breastfeeding and cancer, and benefits of following the recommendation
- Presentation of the breastfeeding recommendation
- Equity
- Suitability, actionability, and acceptability of the recommendation for the individual
- Co‐benefits for prevention of noncommunicable diseases (NCDs) other than cancer with similar risk factors and opportunities for health promotion
- Recommendations for policymakers
- Diet
- Key policies
- Creating enabling environments
- Feasibility and resources
- Excess body weight
- Key policies
- Creating enabling environments
- Feasibility and resources
- Physical activity and sedentary behavior
- Key policies
- Creating enabling environments
- Feasibility and resources
- Breastfeeding
- Key policies
- Creating enabling environments
- Feasibility and resources
- Conclusions
- Supporting information
- Data accessibility
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