Validity, consistency and network structure of the World Cancer Research Fund/American Institute for Cancer Research Screener in young adults

IntroductionThe WCRF/AICR Screener is a validated tool for assessing adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention guidelines. This study aimed to evaluate its validity among young adults and examine connections between dietary variables using network analysis.MethodsYoung adults (n = 112) were recruited (mean age 24.9 years; 70.5% women) and completed the screener alongside validated assessments: bioelectrical impedance analysis, anthropometry, accelerometry, a 4-week Ecological Momentary Dietary Assessment via smartphone app, and a food frequency questionnaire. For validation, agreement [cross-classification (%), the Kappa coefficient (κ), Spearman correlation (r), and linear regression] was determined. Dietary network structure was evaluated using the EBICglasso analysis.ResultsThe WCRF/AICR Screener showed moderate-to-strong validity (r = 0.57) and good test-retest consistency (r = 0.73). Exploratory network analysis revealed proximity between healthier foods and separately less healthy ones. It also suggested that sugar-sweetened drinks was strongly connected to multiple dietary variables, with potential influence on the overall network. In contrast, alcohol intake was relatively isolated from the rest of the variables.DiscussionThese observations support the use of the Screener for assessing cancer prevention recommendations in healthy young adults and generate exploratory hypotheses on dietary interrelationships that require confirmation in larger and more heterogeneous samples.