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Healthnotes Newswire (June 12, 2008)—A study in the Journal of Clinical Oncology found that cancer survivors who practiced the positive lifestyle behaviors recommended by the American Cancer Society had a higher quality of life than those who made fewer changes.

Over ten million Americans have had some form of cancer; fortunately, certain lifestyle behaviors can help beat it and keep it from coming back. For example, physical activity helps prevent many types of cancer. The American Cancer Society recommends that cancer survivors get at least 150 minutes of moderate to strenuous or 60 minutes of strenuous exercise per week. They also recommend eating “5-A-Day”—five daily servings of fruits and vegetables—and not smoking.

The new study surveyed 9,105 survivors of six different kinds of cancer—breast, prostate, colorectal, uterine, skin melanoma, and bladder—to see the extent to which the survivors followed the American Cancer Society’s recommendations and how their habits affected their health-related quality of life.

A range of healthy habits is the key

Physical activity goals were met by 30 to 47% of the survivors, while only 15 to 19% met the 5-A-Day fruit and vegetable recommendation. Most survivors (up to 92%) did not smoke. “This suggests that it may be important to develop a multibehavioral lifestyle intervention rather than develop single behavior interventions,” the study’s authors commented.

Survivors of breast, prostate, and colorectal cancers who met the 5-A-Day or not smoking recommendations had a significantly higher quality of life than those who didn’t, and survivors of all types of cancer who were more physically active reported a higher quality of life. “Physical activity is a key lifestyle behavior that should be incorporated into all the interventions to improve health-related quality of life,” concluded the authors.

Dr. Lise Alschuler, author of Definitive Guide to Cancer: An Integrated Approach to Prevention, Treatment and Healing, said, “It seems to me that the main reason for the low rate of healthier lifestyle adoption is the difficulty of the changes themselves. It is hard for anyone to change their diet and equally as difficult to increase exercise. People who are successful in making positive changes to their dietary and exercise patterns feel better. As a result of eating differently and exercising regularly, people become more engaged in the process of living and as a result have more vitality and wellness.”

(J Clin Oncol 2008;26:2198–204)

Healthnotes Newswire (June 5, 2008)—Studies have consistently shown a link between physical activity and lower breast cancer risk. The British Medical Journal reports that a new review of the research confirms this relationship and further finds that women who exercised the most had a 25% less breast cancer risk than women who exercised the least.

A lifetime of physical activity (compared with only several years or months) and vigorous physical activity (compared with mild or moderate) were associated with even greater cancer protection. The majority of studies suggest that the more a person exercises, the more benefits she might gain, but further research is needed to determine the optimal frequency, type, and duration of physical activity to reduce risk.

The association between physical activity and decreased cancer risk was strongest in postmenopausal women, women with a normal body mass index, and non-white racial groups.

One recent study found that women who exercised throughout their lifetime had a 23% lower risk of premenopausal breast cancer than women with less activity. The women’s activity levels were equivalent to 3.25 hours per week of running or 13 hours per week of walking. High activity levels from 12 to 22 years old were associated with the lowest risk in that study.

What’s the bottom line on exercise?

Physical activity may reduce cancer risk by lowering the levels of hormones such as estrogen, insulin, and insulin-like growth factor. These hormones are important for health but when present in excess can promote cancer development in certain people.

An Institute of Medicine report recommends that women exercise moderately for 60 minutes each day. This may include brisk walking (faster than three miles per hour) or running. Children should engage in 90 minutes or more of physical activity each day. Tips for a successful exercise plan include:

• Choose something you like to do so that you are more likely to stick with it.

• For some, social support may increase the likelihood of engaging in exercise; work out with a buddy to keep it interesting.

• Mix it up. Choose different physical activities so that you don’t get bored (a major reason that people stop exercising).

• Always check with a doctor before starting a new exercise plan, particularly if you are over age 40 or have a medical condition.

(Br J Sports Med 2008; doi:10.1136/bjsm.2006.028132; J Natl Cancer Inst 2008;100:728–37)

Healthnotes Newswire (May 29, 2008)—The President’s Council on Physical Fitness and Sport recently released a fitness test for people over age 18. The test helps estimate aerobic fitness level, muscle strength and endurance, flexibility, and body composition.

Better overall physical fitness helps lower the risk of cardiovascular disease, diabetes, high blood pressure, stroke, and certain cancers. It can also improve mood and help avoid accidents and muscle strain due to underused and inflexible muscle groups.

The new President’s Challenge and Adult Fitness Test was created to help people understand their own fitness level and make positive gains in physical fitness. The test is available as a downloadable booklet at www.adultfitnesstest.org/resources/testbooklet.pdf; individual results can be entered and evaluated online.

Each test section is followed by a “FITT” box which stands for Frequency—how often the exercise is performed; I—the intensity at which the exercise is carried out; T—time, or how long the session lasts; and T—type of exercise being performed. These boxes help users customize their fitness goals.

Aerobic Fitness

To test aerobic, or cardiovascular, fitness, choose a 1-mile walk or a 1.5-mile run. For the walk, after a brief warm up, have a partner time you walking at a brisk pace for one mile, and take your pulse immediately after finishing. For the running option, warm up with a light jog. Then, having a partner time you, run as fast as possible for 1.5 miles. Only attempt the run if you currently run for at least 20 minutes three or more times per week.

FITT tips

Frequency: Depending on the level of intensity, exercise three to five days per week.

Intensity: Moderate-intensity exercise is a brisk walk; vigorous activity is running.

Time: For moderate activity, do at least 30 minutes per session; vigorous activity should last for 20 to 30 minutes.

Type: Examples are walking, running, dancing, cycling, and swimming.

Muscular Strength and Endurance

These tests assess basic muscle strength required to carry out household or work-related tasks. Do half sit-ups by lying face-up on a rug or mat with knees bent at a right angle and feet flat on the floor. With palms flat on the floor, sit up and slide hands forward 3.5 inches (mark distance with masking tape on the working surface before starting). Having a partner time you, do as many sit-ups as you can in one minute. Then do push-ups with legs extended (men) or with knees touching the floor (women). Do as many push-ups as you can and record the number.

FITT tips

Frequency: Do muscular strength and endurance exercises on at least three days per week.

Intensity: Vary the intensity during the workout.

Time: Gradually increase the number of half sit-ups and push-ups until you can do three sets of 25 half sit-ups and three sets of 10 to20 push-ups.

Type: Master the test movements and then add other equipment (balance balls, weights, or elastic tubing).

Flexibility

These tests assess the range of motion of muscles needed to walk, lift, and step normally. Sitting on the floor, place a yardstick between the legs with feet about a foot apart. Place a piece of tape across the yardstick at the 15-inch mark. With fingers on the yardstick, slowly reach forward as far as possible. Record to the nearest inch that your fingertips can reach.

FITT tips

Frequency: Do flexibility exercises at least three days per week.

Intensity: Stretch to the point of tension, never to pain.

Time: Hold each stretch for 20 to 30 seconds, repeating three times.

Type: Begin with static stretches, gradually adding dynamic (moving) stretches. Try learning a practice that includes flexibility exercises, such as yoga and Pilates.

Body Composition

Body mass index (BMI) and waist circumference can be measured to estimate disease risk. To calculate BMI, weigh yourself and have a partner measure your height with shoes off. Wrap a flexible tape measure around your abdomen just above the hip bones; measure and record. Determine your BMI using the booklet’s chart.

A normal BMI is between 18.5 and 24.9; overweight is between 25 and 29.9; obese is greater than 30.

If you are overweight or obese, you can improve your BMI and waist circumference by making sure that you burn more calories than you eat. In order to lose weight, emphasize whole grains, fiber, fruits and vegetables; limit processed and high-carb, high-fat foods, and work in 60 to 90 minutes of daily moderate intensity exercise.

(www.adultfitnesstest.org/adultFitnesstestLanding.aspx; accessed 26 May 2008.)

Healthnotes Newswire (February 14, 2008)—Lycopene—a powerful antioxidant found in tomatoes—has gained notice for its role in strengthening the immune system, preventing macular degeneration and cardiovascular disease, and for fighting cancer. Findings from several studies suggest that lycopene supplements and eating tomatoes and tomato-based foods may protect against prostate cancer. Now a new study suggests that lycopene supplements might slow prostate gland enlargement and reduce symptoms in men with benign prostate hyperplasia (BPH).

BPH, a noncancerous enlargement of the prostate gland that affects many men over 50 years old, causes symptoms ranging from a weak urinary stream and frequent urination (especially at night), to severe and painful urinary urges. Although there does not appear to be any relationship between BPH and prostate cancer, hormonal changes that occur with aging might contribute to both.

The new study, published in the Journal of Nutrition, included 37 men between ages 45 and 70 with BPH. They received either a supplement providing 15 mg of lycopene per day or placebo for six months. At the end of the study, the men who took lycopene had no change in the estimated size of their prostate glands. In contrast, the men who did not take lycopene experienced increasing enlargement of their prostate glands. Taking lycopene was also associated with greater improvement in BPH symptoms.

“This study provides early evidence that lycopene might help men with BPH by slowing the enlargement of the prostate gland and reducing symptoms,” commented study coauthor Hans-Konrad Biesalski of the Institute of Biological Chemistry and Nutrition at the University of Hohenheim in Stuttgart, Germany. “For the majority of men who experience mild symptoms of BPH, eating more tomatoes and tomato-based foods is a safe and inexpensive way to possibly modify the course of their condition.”

Lycopene is one of the reasons that tomatoes have a rich red color. It’s a pigment in the antioxidant carotenoid family. Small amounts of lycopene are also found in watermelon, pink grapefruit, and guava.

Three raw tomatoes or 1/2 cup of tomato sauce provide about the same amount of lycopene as the supplements used in this study. People who can’t eat tomatoes or don’t like them would need to eat 10 ounces of watermelon or 6 1/2 pink grapefruits to get a similar amount. Men with BPH might also consider adding soy foods, onions, and garlic to their regular diets, and getting plenty of exercise to stave off increasing enlargement and worsening symptoms.

(J Nutr 2008;138:49–53)

Healthnotes Newswire (February 7, 2008)—Many studies have shown that fruits, vegetables, fiber, and fish are the key components of a diet that is most likely to prevent cancer. Eating red meat (beef, pork, and lamb) and processed meat (hot dogs, sausage, cold cuts, and many lunch meats) has been shown to increase the risk of some cancers, and now a new study, published in PloS (Public Library of Science) Medicine, adds evidence in favor of cutting down meat-heavy meals.In this study, nearly 500,000 men and women between ages 50 and 71 who were enrolled in the National Institutes of Health–American Association of Retired Persons (NIH–AARP) Diet and Health Study filled out health and lifestyle questionnaires upon enrollment and were monitored for cancer diagnosis for an average of 6.8 years.

People who ate the most red meat, defined as all types of beef, pork, and lamb, had a 51% higher risk of esophageal cancer, 24% higher risk of colorectal cancer, 61% higher risk of liver cancer, and 20% higher risk of lung cancer than people who ate the least. People who ate the most processed meat, defined as bacon, lunch meats, cold cuts, ham, and sausage and hot dogs made from beef, pork, and poultry, were 20% more likely to develop colorectal cancer and 16% more likely to develop lung cancer than people who ate the least. The study did not specify what effects meats like unprocessed poultry or ham might have on cancer risk.

Eating for cancer prevention

• Get your veggies: A few foods like green tea, tomatoes, and cruciferous vegetables such as broccoli, cabbage, Brussels sprouts, and kale have received a lot of attention for their anticancer effects. Scientists think that these effects are due to their high content of special cancer-fighting antioxidants and other compounds.

• Get your fiber: Fiber-dense foods including beans, lentils, nuts, seeds, and whole grains might prevent cancer by binding and helping to eliminate toxic, cancer-causing substances in the digestive tract, and by helping to keep blood sugar levels normal.

• Be picky about protein: People—usually vegetarians—who rely on legumes, nuts, and whole grains for protein generally get more fiber and tend to eat more fruits and vegetables than people who eat meat. A number of studies have found that vegetarians have lower cancer rates than nonvegetarians.

• Meat addicts, mix it up: Choose vegetarian options more often to reduce the number of meaty meals. And try replacing red meat with more fish or white meats. Many of today’s meat substitutes, such a products made from vegetable protein, can be found in easy, prespiced packages that are much harder to distinguish than skeptical meat-eaters might think.

“Many of the people I work with are trying to move toward a more healthful eating plan by trying more vegetarian dishes,” commented Mary Saucier Choate, author of the book and class series Better Eating for Life and a registered dietician who heads the Food and Nutrition Education program at the Co-op Food Stores in Hanover and Lebanon, New Hampshire. “A powerful first step toward this is simple—eat more dried beans and legumes. These do double duty as a vegetable and a source of protein (as well as fiber, folate, and trace minerals). I encourage people to choose convenient, low-sodium canned versions and add them to salads, soups, and pasta sauces to “beef” them up without any downside for health.”

(PloS Med 2007;4:online publication)

Healthnotes Newswire (January 10, 2008)—Vitamin D is in the news again, and this time the sunshine vitamin is fighting breast cancer. In the largest study of its kind, German researchers reported in Carcinogenesis that vitamin D protects against postmenopausal breast cancer.A necessary nutrient for bone health, vitamin D is also attracting attention for its role in immune function. Several studies have suggested that vitamin D might help protect against breast, colon, and prostate cancers, possibly by inhibiting the growth of cancer cells and stopping cancer from spreading.Most previous studies have looked at the effect of vitamin D obtained from foods—such as egg yolks, butter, fish, and fortified foods—on breast cancer risk. But foods aren’t able to satisfy the body’s requirement for the vitamin by themselves. By far, the most abundant source of vitamin D is from the body itself upon exposure of the skin to sunlight. With the widespread use of sunscreens and decreased time spent outdoors, vitamin D deficiency is becoming increasingly common. People living at higher latitudes are at particularly high risk for vitamin D deficiency during the winter and spring months.

The new study compared the blood levels of vitamin D in 1,394 postmenopausal breast cancer patients with those of 1,365 healthy postmenopausal women.

Having a higher vitamin D level was associated with a lower risk of having breast cancer. The relationship was stronger in women who had never used hormone therapy and in women who had been pregnant two or more times. The researchers noted that vitamin D’s protective effect was more pronounced at lower levels; at higher levels, its protective effect leveled off.

While this study wasn’t able to answer the question of how much vitamin D is needed for breast cancer protection, many doctors recommend that women supplement with 1,000 IU per day. It’s also reasonable—and a good idea—to expose the hands, arms, and face to the sun during the middle of the day for about 15 minutes, three times per week during the summer months, and to skip the sunblock altogether during the winter months in northern areas. Cod liver oil can also be a terrific source of vitamin D, supplying up to 400 IU in 1 teaspoon of the oil.

(Carcinogenesis 2007;e-pub ahead of print)