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Make a Commitment to a Healthy Lifestyle

by Wendy Demark-Wahnefried, PhD, RD

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A cancer diagnosis can be scary, but it also can serve as a wake-up call that can steer survivors, as well as their family members, toward the road to better health. While earlier reports suggested that large numbers of cancer survivors start to exercise more and eat healthier diets after their diagnosis, more recent studies suggest that these numbers may not be as high as previously thought, or that survivors “fall off the wagon” as time progresses.

Making a lasting commitment toward a healthy lifestyle is especially important for cancer survivors since their risk for heart disease, diabetes, osteoporosis, and second cancers is much higher than that of the general public. This elevated risk for other diseases was a key factor that the American Cancer Society panel of experts considered when they reissued the 2006 Diet and Exercise Guidelines for Cancer Survivors. A brief summary of these guidelines follows.

Lighten Up
Data from recent studies suggest that survivors who are normal weight and able to maintain their weight after diagnosis have a better prognosis, and are at lesser risk for heart disease and diabetes. How can you tell if you are overweight? Follow these simple steps:
1. Multiply your weight (pounds) by 703.
2. Divide the resulting number by your height (inches), and repeat this step once more. The resulting number is your body mass index, or BMI.
3. Compare your BMI against the healthy standard of 18.5 to 24.9. Example: A 5'4" person weighing 150 pounds: 150 x 703 = 105,450 ÷ 64 = 1,648 ÷ 64 = 25.75 (overweight).

Nourish your body with foods that promise plenty of nutrients and few empty calories.

Author of Article photo

Dr. Wendy Demark-Wahnefried

Those who are overweight should strive for a one to two pound weight loss per week and should seek approval from their oncologist if currently undergoing treatment. Newer guidelines established by the American Institute of Cancer Research and the World Cancer Fund recommend that survivors become as lean as possible without becoming underweight (BMI less than 18.5) after completing treatment.

Get Moving
Previous research has shown that regular exercise improves quality of life, reduces fatigue, and prevents other diseases, including heart disease, osteoporosis, and some second cancers. Recent data from observational studies on breast and colon cancer survivors now suggests that exercise is associated with lower rates of recurrence and mortality. Try to exercise for at least 30 minutes on most days of the week.

If you’re not a regular exerciser, start slowly and gradually increase the number of minutes you exercise each day. Walking is a great way to begin. Strength training exercises, such as leg squats or graduated weight training, also are important to preserve muscle, which can be lost with some forms of treatment, such as adjuvant chemotherapy. Start your day with exercise, and you’ll find that you have more pep throughout the day; you also may enjoy a better night’s sleep.

Eat Healthy
Nourish your body with foods that promise plenty of nutrients and few empty calories. Serve up whole grains, fruits, and vegetables while limiting consumption of red meats, saturated fat, sugar, refined carbohydrates, and salt. Recent findings suggest that limiting fat may be important for reducing recurrence of breast cancer, especially among estrogenreceptor negative women (though weight loss also may be important).

It is also important to rely on food, rather than supplements, as sources of nutrients. While a majority of cancer survivors report taking dietary supplements, newer studies suggest that some dietary supplements, even lower dose multivitamin supplements, may not be beneficial and may actually increase cancer risk. Both the aforementioned guidelines currently recommend against the use of supplements.

Need Some Help?
Embarking on lifestyle changes can be a challenge. Several clinical trials investigating the benefits of exercise and dietary change are currently under way and accessible at various cancer centers throughout the U.S. and Canada. Call (800) 4-CANCER or visit www.clinicaltrials.gov to find out more.

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Dr. Wendy Demark-Wahnefried is a professor of Behavioral Science at the University of Texas M. D. Anderson Cancer Center and holds an adjunct appointment in the Duke School of Nursing.

This article was published in Coping® with Cancer magazine, March/April 2008.

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