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Original Article
General Awareness and Practice of Dietary Recommendations for Cancer Prevention among Participants of the 2023 Korean National Cancer Prevention for Dietary Awareness and Practice Survey
Yoonjoo Choi1orcid, Hyein Jung1orcid, Byungmi Kim1,2orcid
Cancer Research and Treatment : Official Journal of Korean Cancer Association 2026;58(2):393-406.
DOI: https://doi.org/10.4143/crt.2024.642
Published online: June 18, 2025

1Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Korea

2Department of Public Health & AI, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea

Correspondence: Byungmi Kim, Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center and Department of Public Health & AI, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea
Tel: 82-31-920-2962 E-mail: kbm5369@ncc.re.kr
*Yoonjoo Choi and Hyein Jung contributed equally to this work.
• Received: July 12, 2024   • Accepted: June 17, 2025

Copyright © 2026 by the Korean Cancer Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    Most cancers are preventable by improving dietary habits; therefore, individuals with poor dietary behaviors should be encouraged to adopt more active steps to prevent cancer. We surveyed Korean adults to identify the awareness and practice of the recommended guidelines for dietary factors.
  • Materials and Methods
    The 2023 Korean National Cancer Prevention for Dietary Awareness and Practice Survey was a cross-sectional online survey of 4,000 adults aged 20–69. The survey included questions on sociodemographics, lifestyle, and awareness and practice of five dietary recommendations (consuming fruits and vegetables, consuming a balanced diet, avoiding salt, charred foods, and alcohol intake).
  • Results
    Despite more than 90.0% being aware that each dietary recommendation can be a risk determinant for cancer, the practice rate for recommendations showed lower rates than recognition. Especially, in both males and females, the younger (odds ratio [OR], 1.971 in males and 4.863 in females), with no nutritional education (OR, 2.715 in males and 2.093 in females), and the obese (OR, 1.451 in males and 1.579 in females) had higher odds of significant non-adherents (failed to comply with 3-5 recommendations) than participants who were older, had nutritional education, and normal body mass index, respectively.
  • Conclusion
    Although there is high awareness of dietary recommendations for cancer prevention, participants who were younger, had no nutritional education, or were obese showed poor adherence to cancer-preventive dietary practices. Our findings highlight the need for targeted interventions to improve the dietary habits of this at-risk population.
  • Key words: Practice, Awareness, Cancer prevention, Dietary recommendation
Globally, 10 million deaths are attributed to cancer, and 19.3 million new cases are diagnosed annually [1]. The burden of cancer was expected to increase by 47% by 2020, reaching 28.4 million cases by 2040, and may be exacerbated by an increase in risk factors [1]. According to the World Health Organization (WHO), 30%-50% of cancers are preventable, especially by improving dietary habits, which account for a large proportion of cancer causes [2]. Therefore, the WHO, World Cancer Research Fund (WCRF), and American Institute for Cancer Research (AICR) have developed cancer prevention guidelines that recommend adopting a healthy diet to prevent cancer [3,4].
South Korea has also established a recommendation for cancer prevention comprising 10 items agreed upon with the participation of many experts from the National Cancer Center and Ministry of Health and Welfare in 2006 (S1 Fig.); the recommendation was revised in 2016 and has been maintained so far. Of these 10 items, the following 5 correspond to diet [5]: consuming a sufficient amount of fruits and vegetables, consuming a balanced diet, reducing salt intake, avoiding burnt or charred foods, and limiting alcohol consumption. These are major recommendations from the WHO, European Union, WCRF, and AICR [3,6,7] and have been related to cancer prevention or the risk of cancer in many studies.
In recent years, the rapid changes in the food environment, such as the proliferation of processed foods and the increased use of fast-food restaurants and convenience stores, have made it more challenging to adopt healthy eating habits [8,9]. To prevent cancer, individuals with poor dietary habits should be encouraged to improve their behaviors, while those already making efforts should be motivated to take more proactive measures for cancer prevention [10]. Cancer prevention guidelines can play a pivotal role in this process.
For these recommendations to translate into tangible healthy lifestyle practices, it is essential that the public is well aware of them. Health Behavior Theory suggests that individual perception acts as the starting point for behavioral change, and awareness is considered a crucial antecedent of practice [11]. Specifically, understanding how certain behaviors impact one’s health can foster positive attitudes, which in turn enhance the likelihood of behavioral implementation [12]. For instance, without sufficient awareness of the importance of consuming vegetables and fruits for cancer prevention, individuals are less likely to adopt such behaviors. A lack of awareness often stems from inadequate information dissemination or the absence of effective educational programs, leading to lower adherence rates [13]. This highlights the importance of awareness not only in initiating actions but also in sustaining them.
In this context, examining the public’s awareness and adherence to dietary guidelines, which constitute a significant part of cancer prevention, is a critical aspect of developing effective cancer prevention policies. Therefore, this study aimed to explore the awareness and practice of dietary recommendations for cancer prevention among the general population in South Korea and identify those with particularly low practice rates.
1. Study participants and data collection
In this cross-sectional study, the general population of Korean adults aged 20-69 years were recruited to obtain nationwide information on the awareness and practice of dietary recommendations for cancer prevention. The participants were recruited from probability-based web panels registered with a professional research organization, and participants were selected using proportional quota sampling to age, sex, and population distribution of the provinces. The survey was facilitated through online or e-mail links of structured questionnaire forms available from September 4-25, 2023, and the survey was concluded once the target sample size was achieved. Among 5,642 participants, 907 who were not eligible and 735 who did not complete the survey were excluded. Therefore, 4,000 participants (2,036 male and 1,964 female) were included in the final analysis.
2. Questionnaires
Factors such as sex, age, region, educational level, marital status, monthly household income, physical activity, nutritional education, obesity, history of chronic disease, and awareness of dietary factors for cancer prevention were assessed using self-administered structured questionnaires. Participants were divided into three age groups: 20-39, 40-59, and 60-69 years. Regions were categorized as metropolitan cities, small and medium-sized cities, and rural areas. Educational level was categorized as middle school or less, high school, and college or more. Marital status was categorized as married, single, or other (widow/divorced/separated). Monthly household income level was classified as < 3 (approximately 2,300 dollars), 3-5.99, and ≥ 6 million won. Physical activity was defined as 150 min/week of moderate to vigorous-intensity activity and was categorized as active or inactive. We recorded responses on whether participants had received nutritional education as yes and no. Obesity was defined by body mass index (BMI) calculated as weight divided by height in meters squared (kg/m2) and categorized as follows: underweight (< 18.5), normal (18.5 ≤ BMI < 23.0), overweight (23.0 ≤ BMI < 25.0), and obese (≥ 25.0) [14]. The history of chronic disease (yes or no) was self-identified and self-reported. Awareness of dietary factors for cancer prevention was determined as the percentage of participants who responded “Yes” to the question “Have you ever heard that you can prevent cancer through dietary practices?”
3. Awareness and practice ascertainment
The survey included information regarding the degree of subjective awareness and practice of the five dietary recommendations for cancer prevention. During the survey, participants were asked to answer the following questions to obtain a degree of awareness and practice: “How much do you know about the following five dietary recommendations for cancer prevention?,” “How much do you practice the following five dietary recommendations for cancer prevention?” Five dietary recommendations included “consuming a sufficient amount of fruits and vegetables,” “consuming a balanced diet,” “reducing salt intake,” “avoiding burnt or charred foods,” and “limiting alcohol consumption.” As for the subjective degree of awareness and practice, six responses were available: no, low, moderate, high, very high awareness, and do not know in awareness; and no, less, moderate, often, always practice, and do not know in practice. We grouped “no awareness,” and “low awareness” into the “low awareness group,” “moderate awareness,” “high awareness,” and “very high awareness” into the “high awareness group,” and “no practice” and “less practice” into the “no-to-less practice group,” “moderate practice,” “often practice,” and “always practice” into the “moderate-always practice group.” In addition, the participants were categorized into “complete adherents (fully comply with all dietary recommendations) “partial adherents (failed to comply with 1-2 dietary recommendations),” and “significant non-adherents (failed to comply with 3-5 dietary recommendations)” according to the number of five dietary recommendations complied with. This classification excluded 88 participants who answered “I don’t know I am practicing” at least one of the five recommendations.
4. Statistical analysis
Descriptive statistics are presented as numbers and percentages for categorical variables and mean or standard deviation for continuous variables. The chi-square test and general linear regression were used to explore the association between dietary recommendation practices and sociodemographic, lifestyle, and other potentially related factors. Multivariable logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of sex, age, region, educational level, marital status, monthly household income level, physical activity, nutritional education, history of chronic disease, and obesity were associated with the practice of each dietary recommendation. The reference for logistic regression analysis is the “moderate-always practice group” or “complete adherent group”, and ORs were adjusted for each factor. A two-sided p-value < 0.05 indicated statistical significance. Data were analyzed using SAS ver. 9.4 (SAS Institute Inc.).
1. Participant characteristics
Sociodemographic characteristics are presented in Table 1. The mean age of the 2,036 males was 45.3±13.4 years, and 1,964 females were 45.5±13.2 years. Of the participants, 44.7% of males and 45.0% of females were aged 40-59 years, 50.3% of males and 48.6% of females lived in small and medium-sized cities, 82.2% of males and 74.3% of females had attended college or higher, and 56.3% of males and 57.2% of females were married. Most had a monthly household income level of 3-5.99 million Korean Won (47.1% in males and 44.3% in females), were physically inactive (85.0% in males and 88.0% in females), had no nutritional education (82.1% in males and 79.1% in females), and had a normal weight (35.7% in males and 57.0% in females); 36.6% of males and 31.2% of females had a history of chronic disease. Male participants were inclined to have higher education levels and household income, be single, be physically active, have lower rates of having nutritional education, be obese, and have a history of chronic disease (all p < 0.05). Most participants (80.5% in males and 84.7% in females) were aware of the importance of diet in cancer prevention, and the awareness rate in females was higher than that of males (p < 0.001).
2. Awareness and practice rate of each dietary recommendation for cancer prevention
The subjective awareness and practice rate of each dietary recommendation is shown in Table 2. More than 90% of males and females were highly aware of each dietary recommendation. The recommendation with the highest practice rate is “avoiding burnt or charred foods.” More than 80% of the participants moderate-always practiced the dietary recommendation “avoiding burnt or charred foods” in both males and females (80.3% in males and 83.8% in females). The lowest moderate-always practice rate for both males and females was “consuming a balanced diet” (70.8% for males and 67.1% for females). The rate of moderate-always practice for the other three dietary recommendations was 72.5% in males and 74.0% in females for “consuming a sufficient amount of fruits and vegetables,” 72.3% in males, and 75.9% in females for “reducing salt intake,” and 72.4% in males and 74.0% in females for “limiting alcohol consumption.” There was a sex difference in the awareness and practice rate of dietary recommendations. In females, the rate of high awareness group in the “consuming a sufficient amount of fruits and vegetables” and “limiting alcohol consumption,” and the moderate-always practice rate of “reducing salt intake,” and “avoiding burnt or charred foods” were significantly higher than males (all p < 0.05). However, for recommendation “consuming a balanced diet,” the proportion of males in the moderate-always practice group was higher than of females (p=0.021).
3. Practice of “consuming a sufficient amount of fruits and vegetables”
The rate of the no-to-less practice group was higher among males who aged 40-59 or those living in rural areas; females who were younger or living in single-person households; and both males and females who had low awareness and had low income level were inactive, did not receive nutritional education, or were obese (all p < 0.05) (S2 Table). Compared with the moderate-always practice group, males those who had low awareness of recommendation, were 40-59 years old, were physically inactive, had no nutritional education, were overweight, and obese had a higher no-to-less practice odds for “consuming a sufficient amount of fruits and vegetables” (OR, 2.797; 95% CI, 1.994 to 3.923; OR, 1.421; 95% CI, 1.065 to 1.896; OR, 1.467; 95% CI, 1.079 to 1.995; OR, 1.952; 95% CI, 1.438 to 2.650; OR, 1.339; 95% CI, 1.036 to 1.729; and OR, 1.288; 95% CI, 1.011 to 1.641, respectively) after adjusting for confounding variables (Table 3). Females with low awareness of the recommendation had high ORs of no-to-less practice (OR, 1.795, 95% CI, 1.179 to 2.734). Young female participants had a higher probability of no-to-less practice (OR, 2.676; 95% CI, 1.834 to 3.905 in 20-39 years and OR, 1.831; 95% CI, 1.320-2.540 in 40-59 years). Females with physically inactive (OR, 1.913; 95% CI, 1.292 to 2.834), lack of nutritional education (OR, 1.694; 95% CI, 1.275 to 2.251), and obese (OR, 1.415; 95% CI, 1.062 to 1.886) had a higher probability of no-to-less practice (Table 4). There was no significant difference in the odds of being in the no-to-less practice group between males and females (OR, 0.990; 95% CI, 0.849 to 1.154) (S3 Table). Regarding the dietary recommendation to “consuming a sufficient amount of fruits and vegetables”, 67.4% of males and 69.9% of females were found to be both a high awareness and practice group. However, 22.4% of males and 23.3% of females were in a high awareness group, but they were in a no-to-less practice group, showing differences in perception and behavior (S4 Table).
4. Practice of “consuming a balanced diet”
Participants who had low awareness, were younger, in single households, with a lower income level, physically inactive, and had no nutritional education showed a higher ratio of no-to-less practice on this recommendation than their counterparts (all p < 0.05) (S5 Table). Moreover, obese females were associated with higher no-to-less practices (p < 0.001). Among males, compared to the moderate-always practice group, the odds of the no-to-less practice group were 111.5% higher in the low awareness group (OR, 2.115; 95% CI, 1.438 to 3.113), 64.8% higher in the 40-59 years (OR, 1.648; 95% CI, 1.225 to 2.216), 48.8% higher in single households (OR, 1.488; 95% CI, 1.141 to 1.939), 81.5% higher in physically inactive (OR, 1.815; 95% CI, 1.324 to 2.487), and 93.5% in lack of nutritional education groups (OR, 1.935; 95% CI, 1.436 to 2.608) (Table 3). Similarly, females in the group of 20-39 years (OR, 2.232; 95% CI, 1.579 to 3.155), 40-59 years (OR, 1.597; 95% CI, 1.191 to 2.141), widow/divorced/separated (OR, 1.709; 95% CI, 1.199 to 2.437), inactive (OR, 1.902; 95% CI, 1.336 to 2.708), lack of nutritional education (OR, 1.981; 95% CI, 1.519 to 2.585), and obese (OR, 1.616; 95% CI, 1.233 to 2.117) demonstrated a higher link to the no-to-less practice group compared to those in the moderate-always practice group (Table 4). In addition, compared to males, females had 24.5% lower odds of being in the no-to-less practice group than the moderate-always practice group (OR, 0.755; 95% CI, 0.651 to 0.876) (S3 Table). For the recommendations to “consuming a balanced diet”, 67.1% of males and 63.8% of females demonstrated both high awareness and high practice. However, 25.2% of males and 30.0% of females reported high awareness but no-to-less practice (S4 Table).
5. Practice of “reducing salt intake”
Both males and females who were younger, single, and physically inactive had lower practice of this recommendation than their counterparts (all p < 0.05). The no-to-less practice rate was significantly higher among males who had lack of nutritional education and were obese; and among females who had lower awareness, higher education level, and lower income level (all p < 0.05) (S6 Table). Male participants who had low awareness (OR, 2.797; 95% CI, 1.994 to 3.923), were 20-39 years (OR, 2.206; 95% CI, 1.535 to 3.172), 40-59 years (OR, 1.442; 95% CI, 1.062 to 1.956), physically inactive (OR, 1.693; 95% CI, 1.238 to 2.315), had no nutritional education (OR, 1.583; 95% CI, 1.190 to 2.106), had a history of chronic disease (OR, 1.283; 95% CI, 1.029-1.599), and obese (OR, 1.474; 95% CI, 1.162 to 1.870) showed respectively higher odds of the no-to-less practice compared to the moderate-always practice group (Table 3). Females who had low awareness (OR, 1.795; 95% CI, 1.179 to 2.734), were 20-39 years (OR, 2.814; 95% CI, 1.921 to 4.122), 40-59 years (OR, 1.442; 95% CI, 1.029 to 2.019), and physically inactive (OR, 2.749; 95% CI, 1.735 to 4.353) exhibited significantly higher odds of the no-to-less practice compared to the reference group (Table 4). No significant difference was observed in the odds of no-to-less practice between males and females (OR, 1.112; 95% CI, 0.952 to 1.299) (S3 Table). Regarding the recommendation of “reducing salt intake”, 68.0% of males and 71.7% of females were both high awareness and practice group. The discordant group with high awareness but no-to-less practice included 23.3% of males and 21.1% of females (S4 Table).
6. Practice of “avoiding burnt or charred foods”
Males who had a higher no-to-less practice rate of this recommendation were participants who had low awareness, were younger or single households, and had a lower education level, a lower income level, and a lack of nutritional education (all p < 0.05). Females with a lower awareness and education level also had a lower practice level (p < 0.01) (S7 Table). Among males, had low awareness, younger and non-nutritional education was associated with a higher no-to-less practice of this recommendation (OR, 3.449; 95% CI, 2.414 to 4.928 for low awareness; OR, 1.686; 95% CI, 1.113 to 2.555 for 20-39 years; OR, 1.639; 95% CI, 1.156 to 2.323 for 40-59 years, and OR, 1.684; 95% CI, 1.204 to 2.355 for lack of nutritional education group) (Table 3). In females, the dietary recommendation of “avoiding burnt or charred foods” showed no significant difference in practice according to sociodemographic covariates except subjective awareness and age. Younger females and those with low awareness were associated with a considerably higher probability of the no-to-less practice group compared to the moderate-always practice group (OR, 1.734; 95% CI, 1.120 to 2.685 in 20-39 years; OR, 3.937; 95% CI, 2.630 to 5.894 in low awareness) (Table 4). In addition, females had 24.0% higher odds of being in the no-to-less practice group compared to the males (OR, 1.240; 95% CI, 1.038 to 1.481) (S3 Table). For “avoiding burnt or charred foods”, concordance of awareness and practice was the highest among all recommendations, with 75.0% of males and 79.2% of females showing both high awareness and practice. The discordant group (high awareness but no-to-less practice) was relatively smaller, at 15.4% for males and 13.1% for females (S4 Table).
7. Practice of “limiting alcohol consumption”
In this recommendation, male participants who had low awareness, were 40-59 years, widowed/divorced/separated, physically inactive, obese, non-nutritional education, and no chronic disease showed a higher rate of no-to-less practice than their counterparts (all p < 0.05). Females who had a higher no-to-less practice rate group were participants who were younger, in single households, and physically inactive, had a lower income level, and had a lack of nutritional education (p < 0.05) (S8 Table). Male participants who were low awareness, 40-59 years old, physically inactive, overweight, obese, and had no nutritional education were highly associated with the OR of the no-to-less practice group (OR, 1.449; 95% CI, 1.015 to 2.069; OR, 1.429; 95% CI, 1.070 to 1.906; OR, 1.496; 95% CI, 1.098 to 2.038; OR, 1.326; 95% CI, 1.025 to 1.715; OR, 1.280; 95% CI, 1.005 to 1.163; and OR, 1.996; 95% CI, 1.467 to 2.715, respectively) (Table 3). In females, no-to-less practice was associated with younger age groups (OR, 2.668; 95% CI, 1.830 to 3.890 for 20-39 years; OR, 1.824; 95% CI, 1.316 to 2.530 for 40-59 years), physically inactive (OR, 1.902; 95% CI, 1.284 to 2.817), obese (OR, 1.413; 95% CI, 1.060 to 1.882), and lack of nutritional education (OR, 1.676; 95% CI, 1.261 to 2.227) (Table 4). There was no statistically significant difference in the odds of being in the no-to-less practice group between males and females (OR, 0.993; 95% CI, 0.851 to 1.157) (S3 Table). Regarding the recommendation of “limiting alcohol consumption,” 66.4% of males and 68.8% of females demonstrated both high awareness and practice. Meanwhile, 23.3% of males and 23.7% of females showed high awareness but no-to-less practice (S4 Table).
8. Dietary recommendation adherence according to covariates
The dietary recommendation adherence rate stratified with covariates is shown in S9 Table. Participants who were older, physically active, had nutritional education, and had a normal BMI tended to be complete adherents in both males and females (p < 0.01). In addition, female participants who were married and had a higher income level were more likely to be complete adherents (p < 0.05). Figs. 1 and 2 show the association between the dietary recommendation adherence according to covariates by sex. Among males, compared to the complete adherent group, the partial adherents and significant non-adherents had a higher prevalence in 20-39 years (partial adherents: OR, 1.509; 95% CI, 1.057 to 2.153; significant non-adherents: OR, 1.971; 95% CI, 1.292 to 3.007) and 40-59 years (partial adherents: OR, 1.718; 95% CI, 1.290 to 2.287; significant non-adherents: OR, 2.017; 95% CI, 1.426 to 2.852) group. The physically inactive (partial adherents: OR, 1.391; 95% CI, 1.050 to 1.842; significant non-adherents: OR, 1.910; 95% CI, 1.320 to 2.764), and the obese males group (partial adherents: OR, 1.331; 95% CI, 1.040 to 1.704; significant non-adherents: OR, 1.451; 95% CI, 1.096 to 1.921) were associated with a higher probability of partial adherents and significant non-adherents compared to complete adherents. Moreover, in males, the lack of nutritional education group was significantly associated with a higher likelihood of a significant non-adherents (OR, 2.715; 95% CI, 1.875-3.941). Females who were 20-39 years (partial adherents: OR, 1.765; 95% CI, 1.249 to 2.495; significant non-adherents: OR, 4.863; 95% CI, 2.974 to 7.950), had lack of nutritional education (partial adherents: OR, 1.687; 95% CI, 1.308 to 2.176; significant non-adherents: OR, 2.093; 95% CI, 1.474 to 2.972), had a history of chronic disease (partial adherents: OR, 1.966; 95% CI, 1.421 to 2.719; significant non-adherents: OR, 2.492; 95% CI, 1.514 to 4.101), and were obese (partial adherents: OR, 1.358; 95% CI, 1.010 to 1.827; significant non-adherents: OR, 1.579; 95% CI, 1.098 to 2.270) were associated with a higher probability of partial adherent and significant non-adherents. In addition, the physically inactive female group was positively associated with partial adherents compared with complete adherents (OR, 1.252; 95% CI, 1.001 to 1.565).
In this cross-sectional study of South Korean adults, we explored the practice rates of dietary recommendations for cancer prevention and identified participants with particularly low practice rates. Participants were highly aware (80.5% in males and 84.7% in females) of the importance of dietary factors for cancer prevention. Moreover, in each dietary recommendation, more than 90% of the participants were aware of the dietary recommendations for cancer prevention. However, only 70.8%-80.3% of males and 67.1%-83.8% of females reported practicing each dietary recommendation at moderate-to-always level. Notably, sex-specific differences in awareness and practice were observed. Males showed lower awareness of “fruit and vegetable intake” and “limiting alcohol consumption,” and also reported lower adherence to “reducing salt intake” and “avoiding burnt or charred foods.” Conversely, females were less likely than males to practice the guideline on “eating a variety of foods,” indicating sex-based variation in behavioral adherence depending on the type of recommendation. Participants who were young, lacked nutritional education, and were obese were associated with a lower practice of the five dietary recommendations. Moreover, in both males and females, those who were younger, lacked nutritional education, or were obese had significantly higher ORs of being partial or non-adherents to the five dietary recommendations. Additionally, males with lower physical activity levels had a higher OR of partial adherents and significant non-adherents compared to physically active males.
The relatively low practice rate to cancer prevention dietary guidelines among younger age groups carries significant implications. Globally, the issue of early-onset cancer in younger individuals is becoming increasingly problematic, which has been attributed to the adoption of westernized dietary habits [15]. Poor dietary habits established at a young age are likely to persist over time, increasing the risk of developing chronic diseases such as obesity, diabetes, and hypertension [16]. These conditions are closely associated with cancer, underscoring the critical importance of forming healthy dietary habits during youth. Furthermore, individuals who have not received adequate nutrition education may face difficulties in selecting healthy food options. Such individuals are more likely to choose inexpensive and easily accessible options, such as ultra-processed foods and fast-food, ultimately leading to health problems [17]. Education on healthy dietary habits is essential for effective cancer prevention.
Obesity, in particular, shares dietary risk factors with cancer and is itself a major risk factor for cancer development. It is associated with an increased risk of chronic diseases as well as cancers such as breast, colorectal, and endometrial cancer [18]. While obese individuals may require greater efforts to maintain a healthy diet, this study revealed that they are less likely to adhere to cancer prevention dietary guidelines, which raises significant concerns. The findings also highlight the necessity of appropriate interventions for individuals with obesity in the context of cancer prevention. Also, this study found that individuals who are physically inactive are also less likely to adhere to cancer prevention dietary guidelines. Previous research suggests that regular physical activity can reduce cancer risk by up to 20%. However, a lack of physical activity not only negates this preventive effect but also increases the likelihood of cancer [19]. This highlights the need for targeted interventions for such populations.
In particular, the sex-based differences observed in this study indicate the need for tailored intervention strategies. Males showed lower awareness and adherence in multiple dietary guidelines, whereas females demonstrated lower adherence to the recommendation on consuming a balanced diet. This suggests that standardized interventions may be insufficient to improve cancer-preventive dietary behaviors. Therefore, nutrition education programs should be designed to reflect sex-specific characteristics, with a focus on enhancing awareness among men and addressing behavioral and structural barriers among women. Indeed, numerous previous studies have consistently reported that health-related awareness and behavioral patterns differ by sex [20,21], which supports the effectiveness of gender-specific education and interventions. Therefore, future cancer prevention policies should incorporate sex-tailored strategies as an essential component.
Our study has some limitations. First, because this study has a cross-sectional design and a small sample size, it may prevent us from establishing causality. Second, an online survey could reduce participants’ concentration and cause them to mindlessly respond, which could lead to inaccurate responses. Third, because only interested individuals in the survey and those who could use the Internet participated in the online survey, this survey could not include individuals who were not interested in the survey, or who were not proficient in Internet use. Lastly, in this study, the degree of practice of the five dietary recommendations for cancer prevention was obtained through a survey. However, in our survey, there are no specific survey items on the frequency or amount of intake. Therefore, our study relies on the subjective perception of participants, so further studies are needed to determine the degree of practice through specific intake to reduce subjective bias.
Despite these limitations, our study has several strengths. First, the study population was selected by considering sex, age, and region, and the survey period was short at 3 weeks. Therefore, the results of this study reflected the overall current practice rate of dietary recommendations for cancer prevention in the Korean population. However, to generalize the results nationwide, we need to study a larger population with nationwide sampling and face-to-face surveys. Second, to our knowledge, this study is the first to investigate the practice of dietary recommendation behaviors for cancer prevention. Moreover, we categorized the practice groups as no-to-less, moderate, and always according to the practice rate of each dietary recommendation, owing to which we could determine which recommendation had the lowest practice. Third, we considered the impact of potential confounders; thus, we adjusted for age, sex, region, educational level, marital status, monthly household income level, physical activity, nutritional education, history of chronic disease and cancer, and obesity to analyze the independent effects of each covariate and dietary recommendation for cancer prevention.
In conclusion, this study showed the level of practice of dietary recommendations for cancer prevention among Korean adults. Most were aware of the dietary recommendations for cancer prevention and the importance of dietary factors. However, in both males and females, dietary recommendations for cancer prevention were not sufficiently practiced among those younger, lack of nutritional education, and were obese. Additionally, physically inactive males showed lower practice. To increase the practice of dietary recommendations, it is important to identify individuals with low practice rates and conduct appropriate educational interventions. Our findings provide insights into policy efforts that should be made to actively improve poor dietary behaviors, which account for a large proportion of cancer cases.
Supplementary materials are available at Cancer Research and Treatment website (https://www.e-crt.org).
crt-2024-642_S1_Fig.pdf
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crt-2024-642_S7_Table.pdf
crt-2024-642_S8_Table.pdf
crt-2024-642_S9_Table.pdf

Ethical Statement

The survey protocol and secondary data were approved by the Institutional Review Board of the National Cancer Center, Republic of Korea (NCC2023-0251). All participants provided written informed consent.

Author Contributions

Conceived and designed the analysis: Choi Y, Jung Hyein, Kim B.

Collected the data: Choi Y, Jung H.

Contributed data or analysis tools: Choi Y, Jung H, Kim B.

Performed the analysis: Jung H.

Wrote the paper: Choi Y, Jung H.

Writing-Review and editing: Choi Y, Kim B.

Conflict of Interest

Conflict of interest relevant to this article was not reported.

Acknowledgments

This research was supported by the National Cancer Center Research Grant [NCC-2311440-3].

Fig. 1.
Association between the dietary recommendation adherences according to covariates in male. Odds ratios (ORs) represent the prevalence of the “partial adherents” or “significant non-adherents” groups. The reference group is “complete adherents” who fully comply with 5 dietary recommendations. The “partial adherents” group represented participants who failed to comply with 1-2 dietary recommendations. The “significant non-adherents” group represented participants who failed to comply with 3-5 dietary recommendations. Participants who responded “I do not know I am practicing” at least 1 dietary recommendation (n=46) were excluded from this analysis. ORs were adjusted for age (20-39, 40-59, and 60-69 years), region (metropolitan cities, small and medium-sized cities, and counties), educational level (middle school or less, high school, and college or more), marital status (married, single, and widow/divorced/separated), monthly household income level (< 3, 3-6, and ≥ 6 million Korean Won), physical activity (active and inactive), nutritional education (yes and no), history of chronic disease (yes and no), and obesity (underweight, normal, overweight, and obese). Obesity: Underweight: body mass index (BMI) < 18.5 kg/m2; Normal, BMI ≥ 18.5 and < 23.0 kg/m2; Overweight, BMI ≥ 23.0 and < 25.0 kg/m2; Obese, BMI ≥ 25.0 kg/m2. CI, confidence interval. *p < 0.05, **p < 0.01, ***p < 0.001.
crt-2024-642f1.jpg
Fig. 2.
Association between the dietary recommendation adherences according to covariates in female. Odds ratios (ORs) represent the prevalence of the “partial adherents” or “significant non-adherents” groups. The reference group is “complete adherents” who fully comply with 5 dietary recommendations. The “partial adherents” group represented participants who failed to comply with 1-2 dietary recommendations. The “significant non-adherents” group represented participants who failed to comply with 3-5 dietary recommendations. Participants who responded “I do not know I am practicing” at least 1 dietary recommendation (n=42) were excluded from this analysis. Odds ratios were adjusted for age (20-39, 40-59, and 60-69 years), region (metropolitan cities, small and medium-sized cities, and counties), educational level (middle school or less, high school, and college or more), marital status (married, single, and widow/divorced/separated), monthly household income level (< 3, 3-6, ≥ 6 million Korean Won), physical activity (active and inactive), nutritional education (yes and no), history of chronic disease (yes and no), and obesity (underweight, normal, overweight, and obese). Obesity: Underweight: body mass index (BMI) < 18.5 kg/m2; Normal, BMI ≥ 18.5 and < 23.0 kg/m2; Overweight, BMI ≥ 23.0 and < 25.0 kg/m2; Obese, BMI ≥ 25.0 kg/m2. CI, confidence interval. *p < 0.05, **p < 0.01, ****p < 0.0001.
crt-2024-642f2.jpg
Table 1.
Sociodemographic characteristics of the study population
Variable Male (n=2,036) Female (n=1,964) p-value
Age (yr) 45.3±13.4 45.5±13.2 0.555
 20-39 725 (35.6) 667 (34.0) 0.433
 40-59 909 (44.7) 883 (45.0)
 60-69 402 (19.7) 414 (21.1)
Region
 Metropolitan cities 869 (42.7) 880 (44.8) 0.392
 Small and medium-sized cities 1,025 (50.3) 955 (48.6)
 Rural areas 142 (7.0) 129 (6.6)
Educational level
 Middle school or less 13 (0.6) 31 (1.6) < 0.001
 High school 350 (17.2) 473 (24.1)
 College or more 1,673 (82.2) 1,460 (74.3)
Marital status
 Married 1,147 (56.3) 1,123 (57.2) < 0.001
 Single 775 (38.1) 656 (33.4)
 Widow/Divorced/Separated 114 (5.6) 185 (9.4)
Monthly household income (million Korean Won)
 < 3 460 (22.6) 516 (26.3) 0.023
 3-5.99 958 (47.1) 869 (44.3)
 ≥ 6 618 (30.4) 579 (29.5)
Physical activitya)
 Active 306 (15.0) 235 (12.0) 0.005
 Inactive 1,730 (85.0) 1,729 (88.0)
Nutritional education
 Yes 364 (17.9) 410 (20.9) 0.016
 No 1,672 (82.1) 1,554 (79.1)
Obesityb)
 Underweight 53 (2.6) 228 (11.6) < 0.001
 Normal 726 (35.7) 1,119 (57.0)
 Overweight 564 (27.7) 305 (15.5)
 Obese 693 (34.0) 312 (15.9)
History of chronic disease
 No 1,291 (63.4) 1,351 (68.8) < 0.001
 Yes 745 (36.6) 613 (31.2)
Awareness of dietary importance for cancer prevention
 No 397 (19.5) 301 (15.3) 0.001
 Yes 1,639 (80.5) 1,663 (84.7)

Values are presented as mean±standard deviation or number (%). p-values were calculated using χ2 tests for categorical variables and general linear regression for continuous variables.

a) Physical activity was defined as moderate-to-vigorous intensity activity for 150 min/wk,

b) Obesity: Underweight: body mass index (BMI) < 18.5 kg/m²; Normal, BMI ≥ 18.5 and < 23.0 kg/m2; Overweight, BMI ≥ 23.0 and < 25.0 kg/m2; Obese, BMI ≥ 25.0 kg/m2.

Table 2.
Subjective awareness and practice rate of 5 dietary recommendations for cancer prevention
Variable Male (n=2,036) Female (n=1,964) p-value
Subjective awareness
 Consuming a sufficient amount of fruits and vegetables
  High 1,835 (90.1) 1,832 (93.3) 0.001
  Low 160 (7.9) 111 (5.7)
  Do not know 41 (2.0) 21 (1.1)
 Consuming a balanced diet
  High 1,888 (92.7) 1,852 (94.3) 0.112
  Low 120 (5.9) 94 (4.8)
  Do not know 28 (1.4) 18 (0.9)
 Reducing salt intake
  High 1,866 (91.7) 1,829 (93.1) 0.120
  Low 134 (6.6) 113 (5.8)
  Do not know 36 (1.8) 22 (1.1)
 Avoiding burnt or charred foods
  High 1,850 (90.9) 1,822 (92.8) 0.080
  Low 148 (7.3) 116 (5.9)
  Do not know 38 (1.9) 26 (1.3)
 Limiting alcohol consumption
  High 1,835 (90.1) 1,825 (92.9) 0.006
  Low 156 (7.7) 110 (5.6)
  Do not know 45 (2.2) 29 (1.5)
Subjective practice
 Consuming a sufficient amount of fruits and vegetables
  Moderate-always 1,475 (72.5) 1,453 (74.0) 0.221
  No-to-less 544 (26.7) 502 (25.6)
  Do not know 17 (0.8) 9 (0.5)
 Consuming a balanced diet
  Moderate-always 1,442 (70.8) 1,318 (67.1) 0.021
  No-to-less 574 (28.2) 631 (32.1)
  Do not know 20 (1.0) 15 (0.8)
 Reducing salt intake
  Moderate-always 1,471 (72.3) 1,490 (75.9) 0.033
  No-to-less 550 (27.0) 462 (23.5)
  Do not know 15 (0.7) 12 (0.6)
 Avoiding burnt or charred foods
  Moderate-always 1,635 (80.3) 1,645 (83.8) 0.017
  No-to-less 383 (18.8) 303 (15.4)
  Do not know 18 (0.9) 16 (0.8)
 Limiting alcohol consumption
  Moderate-always 1,473 (72.4) 1,453 (74.0) 0.087
  No-to-less 541 (26.6) 501 (25.5)
  Do not know 22 (1.1) 10 (0.5)

Values are presented as number (%). p-values were calculated using χ2 tests.

Table 3.
Odds ratio (95% CI) of “no-to-less practice” for each dietary recommendation for cancer prevention according to covariates in male
Consuming a sufficient amount of fruits and vegetables Consuming a balanced diet Reducing salt intake Avoiding burnt or charred foods Limiting alcohol consumption
Subjective awareness
 High 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Low 2.797 (1.994-3.923)* 2.115 (1.438-3.113)** 2.797 (1.994-3.923)** 3.449 (2.414-4.928)*** 1.449 (1.015-2.069)*
 Do not know 1.892 (0.885-4.046) 1.869 (0.719-4.856) 1.892 (0.885-4.046) 1.527 (0.663-3.519) 1.852 (0.913-3.755)
Age (yr)
 20-39 1.131 (0.791-1.618) 1.222 (0.850-1.757) 2.206 (1.535-3.172)**** 1.686 (1.113-2.555)** 1.128 (0.788-1.616)
 40-59 1.421 (1.065-1.896)** 1.648 (1.225-2.216)*** 1.442 (1.062-1.956)* 1.639 (1.156-2.323)* 1.429 (1.070-1.906)**
 60-69 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
Region
 Metropolitan cities 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Small and medium-sized cities 0.984 (0.798-1.214) 1.087 (0.883-1.337) 1.138 (0.922-1.403) 0.993 (0.783-1.258) 1.015 (0.822-1.252)
 Rural areas 1.083 (0.719-1.630) 1.046 (0.693-1.578) 1.167 (0.770-1.769) 1.301 (0.837-2.023) 1.091 (0.724-1.642)
Educational level
 Middle school or less 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 High school 1.007 (0.295-3.440) 2.847 (0.604-13.413) 2.528 (0.539-11.850) 0.607 (0.173-2.125) 1.029 (0.301-3.518)
 College or more 0.856 (0.254-2.889) 3.075 (0.660-14.333) 2.310 (0.499-10.699) 0.482 (0.140-1.662) 0.868 (0.257-2.931)
Marital status
 Married 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Single 1.106 (0.845-1.449) 1.488 (1.141-1.939)* 1.179 (0.903-1.539) 1.264 (0.938-1.702) 1.120 (0.854-1.469)
 Widow/Divorced/Separated 1.374 (0.891-2.120) 1.410 (0.906-2.194) 1.139 (0.714-1.815) 1.406 (0.857-2.308) 1.442 (0.933-2.228)
Monthly household income (million Korean Won)
 < 3 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 3-5.99 0.891 (0.684-1.161) 0.894 (0.688-1.161) 1.036 (0.793-1.355) 1.097 (0.814-1.478) 0.885 (0.679-1.154)
 ≥ 6 0.828 (0.612-1.121) 0.819 (0.607-1.105) 1.128 (0.833-1.527) 0.993 (0.704-1.402) 0.829 (0.612-1.123)
Physical activity
 Active 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Inactive 1.467 (1.079-1.995)* 1.815 (1.324-2.487)*** 1.693 (1.238-2.315)** 1.216 (0.868-1.703) 1.496 (1.098-2.038)*
Nutritional education
 Yes 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 No 1.952 (1.438-2.650)**** 1.935 (1.436-2.608)**** 1.583 (1.190-2.106)** 1.684 (1.204-2.355)** 1.996 (1.467-2.715)****
History of chronic disease
 No 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Yes 1.013 (0.813-1.263) 1.022 (0.822-1.272) 1.283 (1.029-1.599)* 1.056 (0.824-1.355) 1.017 (0.816-1.268)
Obesity
 Underweight 0.471 (0.207-1.073) 0.937 (0.490-1.791) 0.796 (0.406-1.562) 0.512 (0.213-1.234) 0.467 (0.205-1.065)
 Normal 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Overweight 1.339 (1.036-1.729)*** 1.071 (0.829-1.384) 0.975 (0.748-1.270) 0.965 (0.720-1.294) 1.326 (1.025-1.715)**
 Obese 1.288 (1.011-1.641)* 1.249 (0.986-1.584) 1.474 (1.162-1.870)** 1.138 (0.871-1.487)* 1.280 (1.005-1.631)*

Odds ratios represent the prevalence in the “no-to-less practice” group. The reference group was the “moderate-always practice” group. Odds ratios were adjusted for age (20-39, 40-59, and 60-69 years), region (metropolitan cities, small and medium-sized cities, and counties), educational level (middle school or less, high school, and college or more), marital status (married, single, and widow/divorced/separated), monthly household income level (< 3, 3-6, ≥ 6 million Korean Won), physical activity (active and inactive), nutritional education (yes and no), history of chronic disease (yes and no), and obesity (underweight, normal, overweight, and obese). Obesity: Underweight: body mass index (BMI) < 18.5 kg/m2; Normal, BMI ≥ 18.5 and < 23.0 kg/m2; Overweight, BMI ≥ 23.0 and < 25.0 kg/m2; Obese, BMI ≥ 25.0 kg/m2. CI, confidence interval.

* p < 0.05,

** p < 0.01,

*** p < 0.001,

**** p < 0.0001.

Table 4.
Odds ratio (95% CI) of “no-to-less practice” for each dietary recommendation for cancer prevention according to covariates in female
Consuming a sufficient amount of fruits and vegetables Consuming a balanced diet Reducing salt intake Avoiding burnt or charred foods Limiting alcohol consumption
Awareness of dietary recommendation
 High 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Low 1.795 (1.179-2.734)* 1.448 (0.933-2.247) 1.795 (1.179-2.734)* 3.937 (2.630-5.894)*** 1.055 (0.665-1.673)
 Do not know 1.441 (0.467-4.448) 1.048 (0.300-3.657) 1.441 (0.467-4.448) 0.264 (0.035-1.988) 1.299 (0.548-3.078)
Age (yr)
 20-39 2.676 (1.834-3.905)**** 2.232 (1.579-3.155)**** 2.814 (1.921-4.122)**** 1.734 (1.120-2.685)* 2.668 (1.830-3.890)****
 40-59 1.831 (1.320-2.540)* 1.597 (1.191-2.141)* 1.442 (1.029-2.019)* 1.420 (0.978-2.062) 1.824 (1.316-2.530)*
 60-69 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
Region
 Metropolitan cities 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Small and medium-sized cities 0.928 (0.747-1.153) 1.185 (0.965-1.454) 1.028 (0.820-1.288) 1.073 (0.827-1.390) 0.927 (0.746-1.152)
 Rural areas 0.830 (0.532-1.296) 1.241 (0.826-1.863) 1.323 (0.861-2.034) 1.290 (0.790-2.108) 0.815 (0.522-1.272)
Educational level
 Middle school or less 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 High school 1.032 (0.419-2.547) 1.242 (0.518-2.975) 0.753 (0.304-1.864) 0.866 (0.315-2.377) 1.027 (0.416-2.532)
 College or more 0.830 (0.337-2.044) 1.166 (0.488-2.789) 0.697 (0.282-1.719) 0.748 (0.273-2.051) 0.826 (0.335-2.033)
Marital status
 Married 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Single 1.166 (0.888-1.531) 1.261 (0.973-1.635) 1.018 (0.771-1.346) 0.991 (0.715-1.374) 1.160 (0.884-1.523)
 Widow/Divorced/Separated 1.321 (0.897-1.945) 1.709 (1.199-2.437)* 0.885 (0.575-1.364) 0.939 (0.587-1.504) 1.302 (0.884-1.917)
Monthly household income (million Korean Won)
 < 3 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 3-5.99 0.792 (0.608-1.031) 0.883 (0.686-1.135) 1.224 (0.928-1.613)* 0.835 (0.611-1.141) 0.795 (0.611-1.035)
 ≥ 6 0.763 (0.563-1.035) 0.903 (0.677-1.203) 0.868 (0.628-1.200) 0.760 (0.529-1.093) 0.762 (0.562-1.034)
Physical activity
 Active 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Inactive 1.913 (1.292-2.834)*** 1.902 (1.336-2.708)*** 2.749 (1.735-4.353)**** 1.364 (0.882-2.108) 1.902 (1.284-2.817)**
Nutritional education
 Yes 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 No 1.694 (1.275-2.251)*** 1.981 (1.519-2.585)**** 1.280 (0.969-1.691) 1.360 (0.977-1.893) 1.676 (1.261-2.227)***
History of chronic disease
 No 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Yes 0.968 (0.765-1.225) 1.193 (0.959-1.483) 1.02 (0.800-1.301) 0.918 (0.693-1.217) 0.976 (0.771-1.235)
Obesity
 Underweight 0.973 (0.695-1.361) 0.903 (0.656-1.245) 0.865 (0.608-1.231) 0.865 (0.575-1.302) 0.986 (0.704-1.380)
 Normal 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
 Overweight 1.079 (0.795-1.465) 0.971 (0.728-1.296) 0.945 (0.686-1.302) 1.009 (0.707-1.440) 1.081 (0.797-1.467)
 Obese 1.415 (1.062-1.886)* 1.616 (1.233-2.117)*** 1.327 (0.990-1.780)* 1.005 (0.707-1.429) 1.413 (1.060-1.882)*

Odds ratios represent the prevalence in the “no-to-less practice” group. The reference group was the “moderate-always practice” group. Odds ratios were adjusted for age (20-39, 40-59, and 60-69 years), region (metropolitan cities, small and medium-sized cities, and counties), educational level (middle school or less, high school, and college or more), marital status (married, single, and widow/divorced/separated), monthly household income level (< 3, 3-6, ≥ 6 million Korean Won), physical activity (active and inactive), nutritional education (yes and no), history of chronic disease (yes and no), and obesity (underweight, normal, overweight, and obese). Obesity: Underweight: body mass index (BMI) < 18.5 kg/m2; Normal, BMI ≥ 18.5 and < 23.0 kg/m2; Overweight, BMI ≥ 23.0 and < 25.0 kg/m2; Obese, BMI ≥ 25.0 kg/m2. CI, confidence interval.

* p < 0.05,

** p < 0.01,

*** p < 0.001,

**** p < 0.0001.

  • 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49. ArticlePubMedPDF
  • 2. Kerschbaum E, Nussler V. Cancer prevention with nutrition and lifestyle. Visc Med. 2019;35:204–9. ArticlePubMedPMCPDF
  • 3. World Cancer Research Fund/American Institute for Cancer Research. Diet, nutrition, physical activity and cancer: a global perspective: a summary of the third expert report. World Cancer Research Fund International; 2018.
  • 4. World Health Organization. Cancer prevention [Internet]. World Health Organization; [cited 2025 Dec 12]. Available from: https://www.who.int/health-topics/cancer#tab=tab_2
  • 5. National Cancer Center. 10 Recommendations for cancer prevention [Internet]. National Cancer Center; 2024. [cited 2025 Dec 12]. Available from: https://www.ncc.re.kr/main.ncc?uri=english/sub01_Activities04
  • 6. World Health Organization. Guideline: sodium intake for adults and children [Internet]. World Health Organization; 2024. [cited 2025 Dec 12]. Available from: https://www.who.int/publications/i/item/9789241504836
  • 7. International Agency for Research on Cancer. European code against cancer, 4th edition. World Health Organization, International Agency for Research on Cancer; 2014.
  • 8. Pinho MG, Lakerveld J, Harbers MC, Sluijs I, Vermeulen R, Huss A, et al. Ultra-processed food consumption patterns among older adults in the Netherlands and the role of the food environment. Eur J Nutr. 2021;60:2567–80. ArticlePubMedPDF
  • 9. Kesse-Guyot E, Alles B, Brunin J, Fouillet H, Dussiot A, Berthy F, et al. Environmental impacts along the value chain from the consumption of ultra-processed foods. Nat Sustain. 2023;6:192–202. ArticlePDF
  • 10. Klein WM, Dwyer LA, Goddard KA. The long behavioral tail of the COVID-19 pandemic: a cancer control perspective. JAMA Oncol. 2024;10:159–60. ArticlePubMedPMC
  • 11. Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice. 4th ed. Jossey-Bass; 2008.
  • 12. Fishbein M, Ajzen I. Belief, attitude, intention, and behavior: an introduction to theory and research. Addison-Wesley Publishing Company; 1975.
  • 13. Bartholomew Eldredge LK, Markham CM, Ruiter RA, Fernandez ME, Kok G, Parcel GS. Planning health promotion programs: an intervention mapping approach. 4th ed. Jossey-Bass; 2016.
  • 14. Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, et al. 2018 Korean Society for the Study of Obesity guideline for the management of obesity in Korea. J Obes Metab Syndr. 2019;28:40–5. PubMedPMC
  • 15. Ugai T, Sasamoto N, Lee HY, Ando M, Song M, Tamimi RM, et al. Is early-onset cancer an emerging global epidemic? Current evidence and future implications. Nat Rev Clin Oncol. 2022;19:656–73. ArticlePubMedPMCPDF
  • 16. Lee KX, Quek KF, Ramadas A. Dietary and lifestyle risk factors of obesity among young adults: a scoping review of observational studies. Curr Nutr Rep. 2023;12:733–43. ArticlePubMedPDF
  • 17. Hosseinpour-Niazi S, Niknam M, Amiri P, Mirmiran P, Ainy E, Izadi N, et al. The association between ultra-processed food consumption and health-related quality of life differs across lifestyle and socioeconomic strata. BMC Public Health. 2024;24:1955.ArticlePubMedPMCPDF
  • 18. Colditz GA, Peterson LL. Obesity and cancer: evidence, impact, and future directions. Clin Chem. 2018;64:154–62. ArticlePubMedPDF
  • 19. Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, et al. Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Intern Med. 2016;176:816–25. ArticlePubMedPMC
  • 20. Galdas PM, Cheater F, Marshall P. Men and health help-seeking behaviour: literature review. J Adv Nurs. 2005;49:616–23. ArticlePubMed
  • 21. Wardle J, Haase AM, Steptoe A, Nillapun M, Jonwutiwes K, Bellisle F. Gender differences in food choice: the contribution of health beliefs and dieting. Ann Behav Med. 2004;27:107–16. ArticlePubMed

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        Awareness and Practice of Dietary Recommendations for Cancer Prevention among Participants of the 2023 Korean National Cancer Prevention for Dietary Awareness and Practice Survey
        Cancer Res Treat. 2026;58(2):393-406.   Published online June 18, 2025
        DOI: https://doi.org/10.4143/crt.2024.642
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      Awareness and Practice of Dietary Recommendations for Cancer Prevention among Participants of the 2023 Korean National Cancer Prevention for Dietary Awareness and Practice Survey
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      Fig. 1. Association between the dietary recommendation adherences according to covariates in male. Odds ratios (ORs) represent the prevalence of the “partial adherents” or “significant non-adherents” groups. The reference group is “complete adherents” who fully comply with 5 dietary recommendations. The “partial adherents” group represented participants who failed to comply with 1-2 dietary recommendations. The “significant non-adherents” group represented participants who failed to comply with 3-5 dietary recommendations. Participants who responded “I do not know I am practicing” at least 1 dietary recommendation (n=46) were excluded from this analysis. ORs were adjusted for age (20-39, 40-59, and 60-69 years), region (metropolitan cities, small and medium-sized cities, and counties), educational level (middle school or less, high school, and college or more), marital status (married, single, and widow/divorced/separated), monthly household income level (< 3, 3-6, and ≥ 6 million Korean Won), physical activity (active and inactive), nutritional education (yes and no), history of chronic disease (yes and no), and obesity (underweight, normal, overweight, and obese). Obesity: Underweight: body mass index (BMI) < 18.5 kg/m2; Normal, BMI ≥ 18.5 and < 23.0 kg/m2; Overweight, BMI ≥ 23.0 and < 25.0 kg/m2; Obese, BMI ≥ 25.0 kg/m2. CI, confidence interval. *p < 0.05, **p < 0.01, ***p < 0.001.
      Fig. 2. Association between the dietary recommendation adherences according to covariates in female. Odds ratios (ORs) represent the prevalence of the “partial adherents” or “significant non-adherents” groups. The reference group is “complete adherents” who fully comply with 5 dietary recommendations. The “partial adherents” group represented participants who failed to comply with 1-2 dietary recommendations. The “significant non-adherents” group represented participants who failed to comply with 3-5 dietary recommendations. Participants who responded “I do not know I am practicing” at least 1 dietary recommendation (n=42) were excluded from this analysis. Odds ratios were adjusted for age (20-39, 40-59, and 60-69 years), region (metropolitan cities, small and medium-sized cities, and counties), educational level (middle school or less, high school, and college or more), marital status (married, single, and widow/divorced/separated), monthly household income level (< 3, 3-6, ≥ 6 million Korean Won), physical activity (active and inactive), nutritional education (yes and no), history of chronic disease (yes and no), and obesity (underweight, normal, overweight, and obese). Obesity: Underweight: body mass index (BMI) < 18.5 kg/m2; Normal, BMI ≥ 18.5 and < 23.0 kg/m2; Overweight, BMI ≥ 23.0 and < 25.0 kg/m2; Obese, BMI ≥ 25.0 kg/m2. CI, confidence interval. *p < 0.05, **p < 0.01, ****p < 0.0001.

      Fig. 1.

      Fig. 2.

      Awareness and Practice of Dietary Recommendations for Cancer Prevention among Participants of the 2023 Korean National Cancer Prevention for Dietary Awareness and Practice Survey
      Variable Male (n=2,036) Female (n=1,964) p-value
      Age (yr) 45.3±13.4 45.5±13.2 0.555
       20-39 725 (35.6) 667 (34.0) 0.433
       40-59 909 (44.7) 883 (45.0)
       60-69 402 (19.7) 414 (21.1)
      Region
       Metropolitan cities 869 (42.7) 880 (44.8) 0.392
       Small and medium-sized cities 1,025 (50.3) 955 (48.6)
       Rural areas 142 (7.0) 129 (6.6)
      Educational level
       Middle school or less 13 (0.6) 31 (1.6) < 0.001
       High school 350 (17.2) 473 (24.1)
       College or more 1,673 (82.2) 1,460 (74.3)
      Marital status
       Married 1,147 (56.3) 1,123 (57.2) < 0.001
       Single 775 (38.1) 656 (33.4)
       Widow/Divorced/Separated 114 (5.6) 185 (9.4)
      Monthly household income (million Korean Won)
       < 3 460 (22.6) 516 (26.3) 0.023
       3-5.99 958 (47.1) 869 (44.3)
       ≥ 6 618 (30.4) 579 (29.5)
      Physical activitya)
       Active 306 (15.0) 235 (12.0) 0.005
       Inactive 1,730 (85.0) 1,729 (88.0)
      Nutritional education
       Yes 364 (17.9) 410 (20.9) 0.016
       No 1,672 (82.1) 1,554 (79.1)
      Obesityb)
       Underweight 53 (2.6) 228 (11.6) < 0.001
       Normal 726 (35.7) 1,119 (57.0)
       Overweight 564 (27.7) 305 (15.5)
       Obese 693 (34.0) 312 (15.9)
      History of chronic disease
       No 1,291 (63.4) 1,351 (68.8) < 0.001
       Yes 745 (36.6) 613 (31.2)
      Awareness of dietary importance for cancer prevention
       No 397 (19.5) 301 (15.3) 0.001
       Yes 1,639 (80.5) 1,663 (84.7)
      Variable Male (n=2,036) Female (n=1,964) p-value
      Subjective awareness
       Consuming a sufficient amount of fruits and vegetables
        High 1,835 (90.1) 1,832 (93.3) 0.001
        Low 160 (7.9) 111 (5.7)
        Do not know 41 (2.0) 21 (1.1)
       Consuming a balanced diet
        High 1,888 (92.7) 1,852 (94.3) 0.112
        Low 120 (5.9) 94 (4.8)
        Do not know 28 (1.4) 18 (0.9)
       Reducing salt intake
        High 1,866 (91.7) 1,829 (93.1) 0.120
        Low 134 (6.6) 113 (5.8)
        Do not know 36 (1.8) 22 (1.1)
       Avoiding burnt or charred foods
        High 1,850 (90.9) 1,822 (92.8) 0.080
        Low 148 (7.3) 116 (5.9)
        Do not know 38 (1.9) 26 (1.3)
       Limiting alcohol consumption
        High 1,835 (90.1) 1,825 (92.9) 0.006
        Low 156 (7.7) 110 (5.6)
        Do not know 45 (2.2) 29 (1.5)
      Subjective practice
       Consuming a sufficient amount of fruits and vegetables
        Moderate-always 1,475 (72.5) 1,453 (74.0) 0.221
        No-to-less 544 (26.7) 502 (25.6)
        Do not know 17 (0.8) 9 (0.5)
       Consuming a balanced diet
        Moderate-always 1,442 (70.8) 1,318 (67.1) 0.021
        No-to-less 574 (28.2) 631 (32.1)
        Do not know 20 (1.0) 15 (0.8)
       Reducing salt intake
        Moderate-always 1,471 (72.3) 1,490 (75.9) 0.033
        No-to-less 550 (27.0) 462 (23.5)
        Do not know 15 (0.7) 12 (0.6)
       Avoiding burnt or charred foods
        Moderate-always 1,635 (80.3) 1,645 (83.8) 0.017
        No-to-less 383 (18.8) 303 (15.4)
        Do not know 18 (0.9) 16 (0.8)
       Limiting alcohol consumption
        Moderate-always 1,473 (72.4) 1,453 (74.0) 0.087
        No-to-less 541 (26.6) 501 (25.5)
        Do not know 22 (1.1) 10 (0.5)
      Consuming a sufficient amount of fruits and vegetables Consuming a balanced diet Reducing salt intake Avoiding burnt or charred foods Limiting alcohol consumption
      Subjective awareness
       High 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Low 2.797 (1.994-3.923)* 2.115 (1.438-3.113)** 2.797 (1.994-3.923)** 3.449 (2.414-4.928)*** 1.449 (1.015-2.069)*
       Do not know 1.892 (0.885-4.046) 1.869 (0.719-4.856) 1.892 (0.885-4.046) 1.527 (0.663-3.519) 1.852 (0.913-3.755)
      Age (yr)
       20-39 1.131 (0.791-1.618) 1.222 (0.850-1.757) 2.206 (1.535-3.172)**** 1.686 (1.113-2.555)** 1.128 (0.788-1.616)
       40-59 1.421 (1.065-1.896)** 1.648 (1.225-2.216)*** 1.442 (1.062-1.956)* 1.639 (1.156-2.323)* 1.429 (1.070-1.906)**
       60-69 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
      Region
       Metropolitan cities 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Small and medium-sized cities 0.984 (0.798-1.214) 1.087 (0.883-1.337) 1.138 (0.922-1.403) 0.993 (0.783-1.258) 1.015 (0.822-1.252)
       Rural areas 1.083 (0.719-1.630) 1.046 (0.693-1.578) 1.167 (0.770-1.769) 1.301 (0.837-2.023) 1.091 (0.724-1.642)
      Educational level
       Middle school or less 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       High school 1.007 (0.295-3.440) 2.847 (0.604-13.413) 2.528 (0.539-11.850) 0.607 (0.173-2.125) 1.029 (0.301-3.518)
       College or more 0.856 (0.254-2.889) 3.075 (0.660-14.333) 2.310 (0.499-10.699) 0.482 (0.140-1.662) 0.868 (0.257-2.931)
      Marital status
       Married 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Single 1.106 (0.845-1.449) 1.488 (1.141-1.939)* 1.179 (0.903-1.539) 1.264 (0.938-1.702) 1.120 (0.854-1.469)
       Widow/Divorced/Separated 1.374 (0.891-2.120) 1.410 (0.906-2.194) 1.139 (0.714-1.815) 1.406 (0.857-2.308) 1.442 (0.933-2.228)
      Monthly household income (million Korean Won)
       < 3 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       3-5.99 0.891 (0.684-1.161) 0.894 (0.688-1.161) 1.036 (0.793-1.355) 1.097 (0.814-1.478) 0.885 (0.679-1.154)
       ≥ 6 0.828 (0.612-1.121) 0.819 (0.607-1.105) 1.128 (0.833-1.527) 0.993 (0.704-1.402) 0.829 (0.612-1.123)
      Physical activity
       Active 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Inactive 1.467 (1.079-1.995)* 1.815 (1.324-2.487)*** 1.693 (1.238-2.315)** 1.216 (0.868-1.703) 1.496 (1.098-2.038)*
      Nutritional education
       Yes 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       No 1.952 (1.438-2.650)**** 1.935 (1.436-2.608)**** 1.583 (1.190-2.106)** 1.684 (1.204-2.355)** 1.996 (1.467-2.715)****
      History of chronic disease
       No 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Yes 1.013 (0.813-1.263) 1.022 (0.822-1.272) 1.283 (1.029-1.599)* 1.056 (0.824-1.355) 1.017 (0.816-1.268)
      Obesity
       Underweight 0.471 (0.207-1.073) 0.937 (0.490-1.791) 0.796 (0.406-1.562) 0.512 (0.213-1.234) 0.467 (0.205-1.065)
       Normal 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Overweight 1.339 (1.036-1.729)*** 1.071 (0.829-1.384) 0.975 (0.748-1.270) 0.965 (0.720-1.294) 1.326 (1.025-1.715)**
       Obese 1.288 (1.011-1.641)* 1.249 (0.986-1.584) 1.474 (1.162-1.870)** 1.138 (0.871-1.487)* 1.280 (1.005-1.631)*
      Consuming a sufficient amount of fruits and vegetables Consuming a balanced diet Reducing salt intake Avoiding burnt or charred foods Limiting alcohol consumption
      Awareness of dietary recommendation
       High 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Low 1.795 (1.179-2.734)* 1.448 (0.933-2.247) 1.795 (1.179-2.734)* 3.937 (2.630-5.894)*** 1.055 (0.665-1.673)
       Do not know 1.441 (0.467-4.448) 1.048 (0.300-3.657) 1.441 (0.467-4.448) 0.264 (0.035-1.988) 1.299 (0.548-3.078)
      Age (yr)
       20-39 2.676 (1.834-3.905)**** 2.232 (1.579-3.155)**** 2.814 (1.921-4.122)**** 1.734 (1.120-2.685)* 2.668 (1.830-3.890)****
       40-59 1.831 (1.320-2.540)* 1.597 (1.191-2.141)* 1.442 (1.029-2.019)* 1.420 (0.978-2.062) 1.824 (1.316-2.530)*
       60-69 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
      Region
       Metropolitan cities 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Small and medium-sized cities 0.928 (0.747-1.153) 1.185 (0.965-1.454) 1.028 (0.820-1.288) 1.073 (0.827-1.390) 0.927 (0.746-1.152)
       Rural areas 0.830 (0.532-1.296) 1.241 (0.826-1.863) 1.323 (0.861-2.034) 1.290 (0.790-2.108) 0.815 (0.522-1.272)
      Educational level
       Middle school or less 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       High school 1.032 (0.419-2.547) 1.242 (0.518-2.975) 0.753 (0.304-1.864) 0.866 (0.315-2.377) 1.027 (0.416-2.532)
       College or more 0.830 (0.337-2.044) 1.166 (0.488-2.789) 0.697 (0.282-1.719) 0.748 (0.273-2.051) 0.826 (0.335-2.033)
      Marital status
       Married 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Single 1.166 (0.888-1.531) 1.261 (0.973-1.635) 1.018 (0.771-1.346) 0.991 (0.715-1.374) 1.160 (0.884-1.523)
       Widow/Divorced/Separated 1.321 (0.897-1.945) 1.709 (1.199-2.437)* 0.885 (0.575-1.364) 0.939 (0.587-1.504) 1.302 (0.884-1.917)
      Monthly household income (million Korean Won)
       < 3 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       3-5.99 0.792 (0.608-1.031) 0.883 (0.686-1.135) 1.224 (0.928-1.613)* 0.835 (0.611-1.141) 0.795 (0.611-1.035)
       ≥ 6 0.763 (0.563-1.035) 0.903 (0.677-1.203) 0.868 (0.628-1.200) 0.760 (0.529-1.093) 0.762 (0.562-1.034)
      Physical activity
       Active 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Inactive 1.913 (1.292-2.834)*** 1.902 (1.336-2.708)*** 2.749 (1.735-4.353)**** 1.364 (0.882-2.108) 1.902 (1.284-2.817)**
      Nutritional education
       Yes 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       No 1.694 (1.275-2.251)*** 1.981 (1.519-2.585)**** 1.280 (0.969-1.691) 1.360 (0.977-1.893) 1.676 (1.261-2.227)***
      History of chronic disease
       No 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Yes 0.968 (0.765-1.225) 1.193 (0.959-1.483) 1.02 (0.800-1.301) 0.918 (0.693-1.217) 0.976 (0.771-1.235)
      Obesity
       Underweight 0.973 (0.695-1.361) 0.903 (0.656-1.245) 0.865 (0.608-1.231) 0.865 (0.575-1.302) 0.986 (0.704-1.380)
       Normal 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference) 1.000 (reference)
       Overweight 1.079 (0.795-1.465) 0.971 (0.728-1.296) 0.945 (0.686-1.302) 1.009 (0.707-1.440) 1.081 (0.797-1.467)
       Obese 1.415 (1.062-1.886)* 1.616 (1.233-2.117)*** 1.327 (0.990-1.780)* 1.005 (0.707-1.429) 1.413 (1.060-1.882)*
      Table 1. Sociodemographic characteristics of the study population

      Values are presented as mean±standard deviation or number (%). p-values were calculated using χ2 tests for categorical variables and general linear regression for continuous variables.

      Physical activity was defined as moderate-to-vigorous intensity activity for 150 min/wk,

      Obesity: Underweight: body mass index (BMI) < 18.5 kg/m²; Normal, BMI ≥ 18.5 and < 23.0 kg/m2; Overweight, BMI ≥ 23.0 and < 25.0 kg/m2; Obese, BMI ≥ 25.0 kg/m2.

      Table 2. Subjective awareness and practice rate of 5 dietary recommendations for cancer prevention

      Values are presented as number (%). p-values were calculated using χ2 tests.

      Table 3. Odds ratio (95% CI) of “no-to-less practice” for each dietary recommendation for cancer prevention according to covariates in male

      Odds ratios represent the prevalence in the “no-to-less practice” group. The reference group was the “moderate-always practice” group. Odds ratios were adjusted for age (20-39, 40-59, and 60-69 years), region (metropolitan cities, small and medium-sized cities, and counties), educational level (middle school or less, high school, and college or more), marital status (married, single, and widow/divorced/separated), monthly household income level (< 3, 3-6, ≥ 6 million Korean Won), physical activity (active and inactive), nutritional education (yes and no), history of chronic disease (yes and no), and obesity (underweight, normal, overweight, and obese). Obesity: Underweight: body mass index (BMI) < 18.5 kg/m2; Normal, BMI ≥ 18.5 and < 23.0 kg/m2; Overweight, BMI ≥ 23.0 and < 25.0 kg/m2; Obese, BMI ≥ 25.0 kg/m2. CI, confidence interval.

      p < 0.05,

      p < 0.01,

      p < 0.001,

      p < 0.0001.

      Table 4. Odds ratio (95% CI) of “no-to-less practice” for each dietary recommendation for cancer prevention according to covariates in female

      Odds ratios represent the prevalence in the “no-to-less practice” group. The reference group was the “moderate-always practice” group. Odds ratios were adjusted for age (20-39, 40-59, and 60-69 years), region (metropolitan cities, small and medium-sized cities, and counties), educational level (middle school or less, high school, and college or more), marital status (married, single, and widow/divorced/separated), monthly household income level (< 3, 3-6, ≥ 6 million Korean Won), physical activity (active and inactive), nutritional education (yes and no), history of chronic disease (yes and no), and obesity (underweight, normal, overweight, and obese). Obesity: Underweight: body mass index (BMI) < 18.5 kg/m2; Normal, BMI ≥ 18.5 and < 23.0 kg/m2; Overweight, BMI ≥ 23.0 and < 25.0 kg/m2; Obese, BMI ≥ 25.0 kg/m2. CI, confidence interval.

      p < 0.05,

      p < 0.01,

      p < 0.001,

      p < 0.0001.

      Table 1.

      Table 2.

      Table 3.

      Table 4.

      Cancer Res Treat : Cancer Research and Treatment
      © Korean Cancer Association.
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