Procarcinogenic factors in the diet include sedentary lifestyle, excess energy intake and specific dietary substances. Energy intake is positively correlated with cancer risk and mortality . Interestingly, elevated BMI, an indicator of obesity and therefore a surrogate for excess energy intake, does not seem to influence cancer risk, whereas actual energy expenditure and energy intake significantly influence risk . Epidemiologic studies indicate that cancers of the gastrointestinal tract are amongst the most susceptible to modification by dietary factors . The mechanisms of dietary carcinogenesis fall into several categories: direct DNA damage (e.g., nitrites), cytochrome activation or inhibition (e.g., alcohol), carcinogen activation (e.g., pickled/salted foods), direct cytotoxicity (e.g., mycotoxins), oxidative damage (e.g., saturated fats), alterations in physiology (e.g., rice, dietary fiber) and hormonal effects (e.g., phytoestrogens).
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