The comprehensive approach to diet: A critical review

Recent disappointing results have challenged the earlier results of ecologi cal studies that launched the hypothesis of a strong relationship between d iet and cancer. The present state of knowledge regarding the relationship b etween cancer and diet is considered and discussed here. Steps for improvin g the understanding of the relationship and the content of recommendations for cancer prevention and survival are proposed, such as determining the po ssible food effect at each step of the carcinogenesis process, considering the dietary pattern instead of a single nutrient or food, introducing the d iet quality index for evaluating cancer risk and developing more comprehens ive statistical methods in nutritional epidemiology. In support of these pr opositions, previous, recent and on-going studies are reviewed and discusse d. A holistic model of diet is described as a conclusion.