CHAPEL HILL, N.C. (AP) — The University of North Carolina-Chapel Hill has revised a textbook for a required fitness course that called cancer “a disease of choice” and included a theory asserting Holocaust victims failed to tap into their inner strength.

The university released a statement saying revisions to “21st Century Fitness” began in spring, in cooperation with the publisher, The News & Observer reported Tuesday. The university had made no mention of a revision when the Raleigh newspaper asked about the online textbook’s contents last month .

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The textbook is part of online courseware sold by Perceivant to multiple universities, and was authored by two Brigham Young University faculty members. Perceivant’s director of collegiate partnerships, Joel Davis, told the newspaper that its contracts allow universities to customize content based on its individual needs.

It’s read by students in the one-credit course Lifetime Fitness, which assigns students reading material on lifestyles while incorporating physical activity. It’s required of all undergraduates, with nearly 5,000 taking the class each year.

Student critics said the textbook didn’t give enough attention to the genetic and societal factors that affect people’s health, implying cancer, diabetes and cardiovascular problems were functions of people’s choices.

“There’s an extreme emphasis on personal responsibility that pretty much explicitly blames people in poor health, which I thought was very problematic,” UNC alumnus Skye Golann said. He said it’s the one textbook that every UNC student has “supposedly” read, and is not up to the university’s standards.

Co-author Ron Hager defended the book as promoting healthy lifestyles. In an email to The News & Observer , he wrote that some of the criticisms take the text out of context.

“I seriously doubt anyone would say they choose cancer or heart disease or type 2 diabetes, etc.,” Hager wrote. “But without question, choices can and do have consequences and there is ample evidence of various kinds ... that show certain behaviors within our control can contribute to increased risk of disease, and not at a minuscule level.”

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Last week, the Simon Wiesenthal Center demanded UNC drop the textbook, which, in a news release, it said “insults the memory of Holocaust victims.”

The release targeted the textbook’s interpretation of a theory by Holocaust survivor and psychotherapist, Viktor Frankl. His widely read book, “Man’s Search for Meaning,” describes his experiences as a concentration camp inmate and his assertion that humans can find meaning and a reason to live even amid the worst of conditions.

The textbook authors offered this interpretation of Frankl’s writings: “The people in the camps who did not tap into the strength that comes from recognizing their intrinsic worth succumbed to the brutality to which they were subjected. They gave up or felt they were not deserving of being treated better.”

“Succumbed to brutality?” the Jewish human rights organization’s Rabbi Abraham Cooper said. “These innocent people were systematically starved, beaten, and worked to death by the Nazis.”

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Information from: The News & Observer, http://www.newsobserver.com