You may be aware that March is Colon Cancer Awareness Month. Among cancers that affect both men and women, colorectal cancer is the third most common diagnosed cancer and the second leading cause of cancer-related deaths in the United States. According to the American Cancer Society, almost 150,000 new cases of colorectal cancer were diagnosed and approximately 50,000 people died from the disease last year. Despite these statistics, unlike some cancers, colorectal cancer is highly preventable and can be detected early through proper screening. And what do you think one of the most important prevention tools is? That’s right—physical activity.

In 2009, a review published in the British Journal of Cancer combined the data from 52 published studies on physical activity and colon cancer1. It was determined that the most physically active participants were 24% less likely than the least active to develop colon cancer. And the good news is this pattern held true for both lifestyle and structured physical activity.

This may not be surprising to some as regular physical activity has been shown to reduce the risk of many chronic diseases. But what many may not realize is that for those diagnosed with colon cancer, regular physical activity may decrease the risk of cancer recurrence and death2,3. In the long running Nurse’s Health Study, women who engaged in moderate physical activity (i.e. brisk walking) six days per week for about an hour per day reduced their risk of colon cancer-related death by 61% and 57% for all causes of mortality, when compared with women who rarely exercised2. And maybe even more remarkable was that even if the women began exercising after their diagnosis, they reduced their risk of colon cancer-related death by 52%. So the expression “it’s never too late to start” definitely applies here. Another study, this time with both men and women who had been diagnosed with stage III colon cancer, showed similar results3. With about six hours per week of walking, just like the previous study, there was a 49% decrease in the risk of getting colon cancer again.

So once again, the evidence shows the amazing power of physical activity. The American Cancer Society recommends that adults get at least 30 minutes of moderate or vigorous physical activity on 5 or more days of the week. Moderate or vigorous activity for at least 45 minutes on 5 or more days of the week may lower your risk for colorectal cancer even more. And as a reminder, screening is the most powerful tool for preventing colon cancer.

To learn more about colon cancer visit the American Cancer Society.

1KY Wolin et al. Physical activity and colon cancer prevention: a meta-analysis. British Journal of Cancer. 2009; 100(4): 611-616.

2Meyerhardt JA, Giovannucci EL, Holmes MD, et al. Physical activity and survival after colorectal cancer diagnosis. Journal of Clinical Oncology. 2006; 24(22):3527–3534.

3Meyerhardt JA, Heseltine D, Niedzwiecki D, et al. Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. Journal of Clinical Oncology. 2006 Aug 1; 24(22): 3517-8.

The 2010 Winter Olympics, in Vancouver, British Columbia, Canada ended yesterday. There were fifteen sports and 85 medal events. These events were split up into three categories of ice sports, alpine skiing/snowboarding and Nordic events.

Here at The Cooper Institute in Dallas, Texas I felt a little bit more connected to the games this year...  Most due to the actual winter blasts we’ve had. During the games we had colder than normal temperatures and it even snowed.  We set a new 24 hour snowfall record at over 12.5”.

With a winter wonderland in Dallas and the winter Olympics it was impossible not to want to participate in my own winter games. I couldn’t build my own Luge track but some of the cars I saw sliding around on the highway made it look like I did. I did go sledding, shoveled snow and built a snowman.

During this fun I was a bit curious if I was getting any caloric expenditure.   Also, I wondered how much energy is burned in an event that sometimes lasts only a few seconds and looks to be just using gravity to go downhill.

You might be a bit surprised to see the expenditures:¹

• Vigorous Downhill Skiing at race pace – 8.0 METS
• Bobsledding and Luge – 7.0 METS
• Cross Country Skiing at more than 8mph (racing) – 14.0 METS
• Cross Country Skiing uphill at race pace – 16.5 METS
• Speed Skating – 15.0 METS
• Curling – 4.0 METS
• Ice Hockey – 8.0 METS
• Shoveling snow by hand – 6.0 METS

Remember a MET is a way of describing the amount of energy (calories) the body is burning relative to energy burned at complete rest. One MET is equal to 1 kcal/kg/hour or the same as rest or sitting quietly, two METs means the body is burning calories at twice the rate of rest, three METs is three times, and so on. So if you are shoveling snow by hand, you are burning six times as much energy as you would be just sitting at rest.

To meet the current recommendations for adults one should do at least 150 minutes per week of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week (or some combo of the two). As was discussed in the past blog “Moderate Means What,” 3.0-5.9 METS equals moderate intensity.

So I was doing pretty well when shoving my sidewalks!

¹Ainsworth BE. (2002, January) The Compendium of Physical Activities Tracking Guide. Prevention Research Center, Norman J. Arnold School of Public Health, University of South Carolina. Retrieved [02/25/10] from the World Wide Web. http://prevention.sph.sc.edu/tools/docs/documents_compendium.pdf

Whether you are making an effort to become a regular exerciser or you’ve noticed a decrease in your motivation to maintain a routine, take the following self assessment and see if your current exercise choices are really the "Best Fit" according to your schedule, likes and dislikes, social goals, and fitness goals.

Directions: Read the following statements and circle or select yes (Y) or no (N) regarding your agreement with the statement.

1. Y N I have well defined fitness goals.

2. Y N I know how to reach my fitness goals.

3. Y N My fitness program includes all 3 elements of fitness: cardiovascular, strength training and flexibility.

4. Y N I have access to the equipment, gym, or the classes I need.

5. Y N Time is always an issue regarding making time for exercise.

6. Y N I travel regularly and I find it difficult to work out.

7. Y N My job requires that I have lots of interaction with people daily.

8. Y N I am bored with my work out.

9. Y N I feel like exercising is "work" and not much fun.

10.Y N I have been exercising regularly for less than 3 months.

Now read the following paragraphs to get insights, and suggestions to attain a "Best Fit" exercise routine that fits your current lifestyle, attitudes, responsibilities, time demands, likes and dislikes, and social needs.

Sign up for group exercise classes if your assessment revealed any of the following: boredom, time crunch, lack of a balanced work out, and/or a job that lacks much people interaction Here is why: Group Exercise Classes provide a stimulating atmosphere with music and high energy leadership that puts some fun into the work out. Also, many classes offer a total body work out, so your time is effectively used and every component of fitness is addressed. Furthermore, you can benefit from new moves or experience new exercises. You may use fitness machines or apparatus that you otherwise wouldn’t have tried. You will be challenged afresh mentally, physically, and emotionally. Lastly, you will have a social network that supports your efforts and motivates you to keep exercising.

If your assessment revealed a big demand from others due to the nature of your work, consider choosing exercises that allow for "me time". For example for the cardiovascular segment of your workout, select a machine with a built in TV and get lost in a favorite show, sports programming, or relaxing comedy. Or you can opt to listen to your i-tunes while doing cardio, strength training and flexibility. Run, walk, or cycle outside and enjoy the quiet of nature and get refreshed, revitalized.

Lastly, if your assessment revealed a lack of well defined fitness goals, how to reach those fitness goals, travel concerns, and/or you have been exercising regularly but for less than 3 months, consider hiring a qualified personal trainer for 6-12 sessions. The trainer can assess your current level of fitness, accelerate your progress towards goals, address weaknesses you might otherwise ignore, and make sure you are on track. With their help you have a connection with a professional that you may consult from time to time to keep you motivated, safe, and moving forward.

Prochaska, J, Norcross, J, and DiClemente, C. Changing For Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively, Avon Books, Inc. NY. 1994.

As most individuals recognize, physical inactivity has been shown to increase the number of deaths from all-causes, as well as from heart disease and cancer. But what about individuals who meet the physical activity recommendations but spend most of the day sitting?  Does all that sitting have a negative impact on health?

A study performed by Dr. Katzmarzyk¹ and his associates (2009) examined the effects of prolonged sitting on all-cause and cardiovascular death rates in individuals who exercised and those who did not.  The researchers collected information about daily activities including time spent sitting in over 17,000 individuals.  They followed the subjects for an average of 12 years measuring the number of deaths and the cause.

Not surprising, researchers reported the highest death rates in persons who spent most of the day sitting.  However, all-cause and heart disease death rates were also higher in persons who spent more time sitting even if they met the recommended physical activity requirements.  In fact, death rates were similar in exercisers and nonexercisers who spent most of their day sitting.  

Researchers are studying the effects of excessive sitting on the body.  Some of the negative effects include Type 2 diabetes, metabolic syndrome, obesity and cardiovascular disease.  Scientists believe that an active lifestyle may provide different health benefits than occur with exercise alone, providing further protection against heart disease.    

This research highlights the need to reduce sedentary behaviors by spending more time standing, walking, and climbing the stairs.  Low intensity activities like cleaning, ironing, walking the dog and yard work are excellent ways to add activity to your day while completing chores on your ”to-do" list.  For additional health benefits, focus on increasing lifestyle activities over and above structured moderate to vigorous intensity exercise bouts. 

1.  Katzmarzyk, P.T., Church, T.S., Craig, C.L., & Bouchard, C. (2009). Sitting time and Mortality from All Causes, Cardiovascular Disease, and Cancer. MSSE, 41(5),998-1005.

The Super Bowl is over. The Saints are Super Bowl champs! Did you get your fill of football food and commercials? The conclusion of football season for many of us means that spring is just around the corner. If you believe Punxsutawney Phil who saw his shadow, however, we are in for 6 more weeks of winter. In past blogs we have discussed the decline in physical activity levels of our nation’s youth and some of the potential reasons. A recent study published in the International Journal of Behavioral Nutrition and Physical Activity has found that inappropriate clothing is another factor that may limit or even prevent young children’s outdoor play¹. Researchers looked at 49 child-care providers from 34 child-care centers in Cincinnati to determine why children’s physical activity levels vary across the centers despite experiencing the same weather conditions. They were shocked to find that having just a few children inappropriately dressed prevented an entire day-care class from going outside to play. Clothing that affected outdoor play included:

•    Inadequate weather protection (i.e. no coat/hat/gloves in the winter)
•    Unstable footwear (i.e. flip flops)
•    “Nice” outfits (i.e. clothing that had to be treated with care)
•    Jewelry (i.e. items that have the potential to get caught in equipment)
•    Ill-fitting clothes (i.e. too lose or too tight)

The teachers that were interviewed speculated reasons as to why parents may dress their children inappropriately which included:
•    Forgetfulness
•    A “car culture”
•    A hectic morning routine
•    Limited income
•    A child’s preference for a favorite piece of clothing
•    Parents concern with child’s appearance
•    Parents failing to understand the importance of outdoor play

These findings are a major cause for concern as 75% of children ages 3 to 6 spend time in childcare.

There are many organizations who are trying to raise awareness of the decline in the level of physical activity of our children and encourage a reversal of this trend. One example is the U.S. Forest Service and the Ad Council who we highlighted last June in our blog titled The Other You. Since we were talking football earlier, another organization trying to boost kid’s activity levels is the NFL. The NFL has launched the NFL PLAY 60 campaign designed to tackle childhood obesity by getting kids active through in-school, after-school, and team-based programs. They even have an online child-targeted outreach on NFLRUSH.com. As part of this campaign, we here at The Cooper Institute have teamed up with NFL PLAY 60 to launch FITNESSGRAM® into schools and after-school community organizations. NFL PLAY 60 is the premier fitness assessment tool designed to educate families and students on their health related-fitness levels and to encourage healthy behaviors for a lifetime.
To learn more about NFL PLAY 60 and FITNESSGRAM® click on the links above. And remember to think about your child’s clothes before sending them to school or daycare. You may just be affecting a whole classroom’s chance to play!

¹ Copeland, K., Sherman, S., Kendeigh, C., Saelens, B., and Kalkwarf, H. Flip flops, dress clothes, and no coat: clothing barriers to children’s physical activity in child-care centers identified from a qualitative study. Int. J. Behav. Nutr. Phys. Act. 6: 74, 2009.

Chances are you have heard news that about 2/3 of the adult U.S. population is overweight or obese.  Ever wonder where this comes from? 

The answer is The National Health and Nutrition Examination Survey (NHANES).  This is a government run study directed by the Centers for Disease Control and Prevention.   The purpose is to monitor the health status of the nation so the data can be used to develop health policies, programs, and services that target the least fit members of the U.S. population. 

In 1996, the Surgeon General’s report on physical activity and health stated that higher cardiorespiratory fitness, which is the body’s ability to use oxygen, decreases overall death rates and morbidity due to chronic diseases. The body’s ability to use oxygen is a strong predictor of many serious health conditions such as heart disease. But where does this statement come from?

While there has been supporting evidence to this statement, such as research from The Cooper Center Longitudinal Study, there has not been any NHANES data until recently. In 1999, a cardiorespiratory fitness component was added to the NHANES study to measure cardiorespiratory fitness using a treadmill test.

On January 15, cardiorespiratory fitness results for 3250 American adults ages 20-49 were published in the American Journal of Epidemiology.¹  The results were broken down by age, gender, ethnic group, and body weight category.

Differences in Cardiorespiratory Fitness

Based on Ethnic Group:	No significant difference between White, Black and Mexican American Men
Based on Gender:	As expected, women had lower cardiorespiratory fitness compared with men.	On average, Black women had significantly lower cardiorespiratory fitness than White and Mexican American women.
Based on Body Weight Category*:	Overall, normal weight men had higher cardiorespiratory fitness than overweight or obese men.	Within each category of normal, overweight and obese, there were no differences between ethnic groups for men.	Normal weight women had no significant differences between ethnic groups. For overweight and obese women there were significant differences as described below.

* Body weight categories were based on BMI as: Normal weight (BMI 18.5-24.99 kg/m²), Overweight (BMI 25-29.99 kg/m²) and obese (BMI >30 kg/m²).

Overweight and obese Black women had significantly lower cardiorespiratory fitness than their overweight and obese White and Mexican-American counterparts.  As was the case in men, obese women of all ethnic groups had lower cardiorespiratory fitness than their normal weight counterparts.

Cardiorespiratory fitness is a strong predictor of many future health problems such as heart disease and type 2 diabetes. This study is important because it provides the only source of cardiorespiratory fitness data that is based on a national random sample of the U.S. population. Because differences in cardiorespiratory fitness were seen in certain subgroups, the data can be used to develop health policies, programs, and services that target the least fit members of the U.S. population.    

So which category do you fit in and how can you change your data? You have the opportunity to change this data and beat public policy by finding a way to engage in one of the recommended activities from the Stand Up & Eat Active Living Library in hopes of changing this data for the better.

¹ CY Wang, WL Haskell, SW Farrell, MJ LaMonte, SN Blair, LR Curtin, JP Hughes, VL Burt. Cardiorespiratory fitness levels among US adults 20-49 years of age: Findings from the 1999-2004 National Health and Nutrition Examination Survey. American Journal of Epidemiology, January 2010. 

 

The diet vs exercise debate for weight loss continues as TV and web sites market their weight loss programs.  A recent study¹ performed at Louisiana State University examined the benefits of losing weight by diet only and combined diet plus exercise compared to a control group.  The purpose of the study was to determine if dieting plus exercise provides more health benefits than dieting alone. 

Thirty-six healthy male and female, healthy, overweight participants (average age of 39 years) were assigned to either a control, diet, or diet and exercise group.  The diet only group reduced their caloric intake by 25%.  The combined diet and exercise group decreased caloric intake by 12.5% and burned another 12.5% of calories during supervised exercise sessions.  They were allowed to select their own exercise intensity.  Then exercise time was adjusted until they had burned the required number of calories.  The control group was placed on a diet which allowed them to maintain their current body weight.  Researchers measured fitness level, belly fat, blood pressure, cholesterol levels, insulin sensitivity and weight loss before and after 6 months of participation in the study.    

Both the diet and diet plus exercise groups lost the same amount of weight, pounds of fat, and belly fat.  The diet plus exercise group increased fitness level by 22% with no change in the diet or control groups.  Total and bad cholesterol (LDL-cholesterol) decreased significantly in the diet plus exercise group only.   Good cholesterol levels increased significantly in all three groups including the control group.  However, blood pressure and insulin sensitivity improved in the diet plus exercise group only.     
The results of this study show that losing weight through a combination of diet and exercise provides additional benefits over diet alone. 

These findings are consistent with the fact that both fitness and fatness affect cardiovascular disease risk.  Based on data from this study and a previous study², 10-year risk of cardiovascular disease was reduced by 29% in the diet group and by 38% in the diet plus exercise group.  This research suggests that losing weight through a combination of diet and exercise provides more health benefits than diet alone. 

Another important reason to include exercise as part of a weight loss program was addressed in the Stand Up and Eat blog in August, 2008.  It reported that women who lost 10% or more of their initial body weight were more likely to keep it off after two years if they exercised.  Those who exercised an average of 275 minutes per week (40-55 minutes of exercise 5 days/week) were the most successful in keeping their weight off.  Studies support the need to include both caloric restriction and exercise for optimal weight loss and weight maintenance. 

  1.  Larson-Meyer, D.E., Redman, L., Heilbronn, L.K., Martin, C.K. & Ravussin, E. (2010). Caloric Restriction with or without Exercise: The Fitness versus Fatness Debate. MSSE, 42, 152-159.
2.  Lefevre, M., Redman, L.M., Heibronn, L.K. et al. (2009). Caloric restriction alone and with exercise improves CVD risk in healthy non-obese individuals. Atherosclerosis. 203(1), 206-213.

Have you ever taken the “Sit and Reach” test?  It is a basic physical fitness test given to participants of all ages to determine trunk flexibility? A good score on this test generally indicates good overall flexibility.  Good flexibility in turn is associated with improved range of motion in movement, and thought to reduce the risk of exercise related injury.  But there is new evidence that being flexible has a strong health related benefit of reducing arterial stiffness. Arterial stiffness in turn is associated with increases in blood pressure which is an increased risk for coronary (heart) artery disease and kidney failure.

To test the theory that poor trunk flexibility is associated with arterial stiffening, lead researcher, Kenta Yamamoto, with the University of North Texas Health Science Center in Ft. Worth, tested 526 adults and grouped them by age: 20-39 young; 40-59 middle age; 60-83 older.¹  Arterial stiffness was assessed by the brachial-ankle pulse wave velocity.  Subjects were classified as either “poor flexibility” or “high flexibility” after the sit and reach test.

Researchers tested for all three components of fitness: cardiovascular, muscular strength, and flexibility. The findings demonstrated that flexibility was an independent factor in determining risk for arterial stiffening.  Also, the results showed that age related arterial stiffness was greater in the poor flexibility subjects than the high flexibility subjects of middle age and older age.  In the young age groups there was no observed relationship of flexibility and arterial stiffness.

Further findings from this study showed a positive relationship between cardiovascular fitness and flexibility.  In general because exercise includes flexibility exercise as seen in stretching for warm up and cool down, active adults are most likely to demonstrate good flexibility than inactive adults.

Since trunk flexibility can be easily assessed on adults of all ages in practical field setting, this measurement may become a “preventive medicine score” for the prevention of arterial stiffening due to aging.  Furthermore, consideration should also be given to the promotion of regular stretching, yoga, and pilates because of their contribution to increased flexibility. Check out the Cooper Institute bookstore for helpful stretching tools.

¹Yamamoto, K., Kawano, H., Gando, Y., Iemitsu, M., et al. Poor Trunk Flexibility is associated with arterial stiffening. Am J Physiol Heart Cir Physiol. 297, H1314-H 1318, 2009.

Is one of your wishes this year to look and feel younger? Who doesn’t want those things! What if we told you we had the answer to the long sought out ‘fountain of youth’? No, it isn’t a magic pill or solution. No, you don’t have to travel far to find it. No, it isn’t something that costs a lot of money nor is it very hard to do. Would it surprise you to know that it is EXERCISE?!

Studies, including many done here at The Cooper Institute, have long shown that exercise can defend against all causes of mortality including heart disease and cancer. Recent research sheds light on one of the possible explanations as to why. Across our life, our DNA divides or replicates in order to create new cells. During this process part of the end of the DNA gets cut off. In order to protect the DNA from deterioration, there is a region of repetitive DNA at the end called a telomere that does not contain codes for proteins like the rest of DNA. So when DNA is replicating, it is part of the telomere that is getting cut off that way the actual coded DNA is protected. When the telomere gets too short however, the cell stops dividing. This cell can continue to function, possibly in an altered fashion, for some time but ultimately cell death will occur. This is thought to be one of the contributing factors to aging.

Recent research has indicated that those who exercise have longer telomeres, therefore having a greater protection against deterioration, in essence, keeping their cells younger. Specifically, German researchers have looked at the DNA of white blood cells of athletes and compared them to the white blood cells of healthy, non-smoking, sedentary adults¹. White blood cells are a key part of our immune system not only fighting off infections but also continuously seeking out abnormal cell growths and destroying them. These researchers feel that this is direct evidence of the anti-aging effect of physical exercise. If exercise maintains the youthfulness of white blood cells by preventing the shortening of the telomere, it may keep them more efficient at dealing with abnormal growths like plaques and cancer cells to name a few. And you don’t to be an athlete to have this protection. Scientists at King’s College in London found that subjects who spent just 100 minutes a week on physical activity had longer telomeres than those five or six years younger who exercised less than sixteen minutes a week². For those who exercised more than three hours each week, even longer telomeres. Their telomeres were longer than subjects ten years younger who only exercised less than sixteen minutes a week! The subjects in this study were twins one of whom exercised significantly more than the other. This strongly suggests that the difference in telomere length was due to lifestyle factors, in this case more physical activity, and not genetics.

This evidence highlights even further the amazing power of exercise! To gain this powerful benefit as well as others, be sure to follow the current guidelines for physical activity that are outlined in one of our past blogs, Be Active Your Way. And to be reminded of the many other “proven” benefits of physical activity, re-read Physical Activity—Where’s the Science? And lastly, re-visit last week’s blog, A New Look at Creating Resolutions. It provides a number of great information and links to really help you make 2010 the year that you become consistent with your physical activity.

Wishing you a happy, healthy, and youthful 2010!

 

1 Werner, C., Furster, T., Widmann, T., Poss, J., et. al. Physical exercise prevents cellular senescence in circulating leukocytes and in the vessel wall. Circ. 120: 2438-2447, 2009.

2 Cherkas, L.F., Hunkin, J.L., Bernet, S.K., Richards, B., et.al. The association between physical activity in leisure time and leukocyte telomere length. Arch. Intern. Med. 168 (2): 154-158, 2008.