Couples More Likely to Get Healthy Together

What You Need to Know: People are more successful in taking up healthy habits if their partner makes positive changes too.

The Evidence: Scientists at UCL funded by Cancer Research UK, the British Heart Foundation, and the National Institute on Aging looked at how likely people were to quit smoking, start being active, or lose weight in relation to what their partner did. The research looked at 3,722 couples, either married or living together and over the age of 50, who were taking part in the English Longitudinal Study of Ageing (ELSA).

• People were more successful in swapping bad habits for good ones if their partner made a change as well. For example, among women who smoked, 50 percent managed to quit if their partner gave up smoking at the same time, compared with 17 per cent of women whose partners were already non-smokers, and eight per cent of those whose partners were regular smokers.
• Men were equally affected by their partners and were more likely to quit smoking, get active, or lose weight if their partner made the same behaviour change.

My Take: Now is the time to exercise (even a 30 minute brisk walk, 5 times perweek can meaningfully improve your health), maintain a healthy diet and weight, be prudent about alcohol consumption, and quit tobacco. These lifestyle changes can make a big difference to our health and cancer risk. And this study shows that when couples make those changes together they are more likely to succeed. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad:  Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minuteable now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

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References:

• Sarah E. Jackson, Andrew Steptoe, Jane Wardle. The Influence of Partner’s Behavior on Health Behavior Change. JAMA Internal Medicine, 2015; DOI: 10.1001/jamainternmed.2014.7554

• Cancer Research UK. “Couples more likely to get healthy together.” ScienceDaily. ScienceDaily, 19 January 2015. <www.sciencedaily.com/releases/2015/01/150119124551.htm>.

How Can You Reduce Your Risk of Getting Cancer?

Recent reports suggest that about 2 out of 3 cancers may be due to “bad luck.” Today, we focus on the other third: What can you do to reduce your risk of cancer?

What You Need to Know:

• Maintaining a healthy body weight and being physically active had the greatest impact on overall risk of a cancer-related death. 
• Restricting alcohol consumption to one drink per day for women and two drinks per day for men was associated with 29% reduced risk for obesity-related cancers. Additionally, the risk was up to 71% lower for the most common site-specific cancers in the United States (breast, prostate, and colorectal).

Background

• As people make their resolutions for 2015, two new studies — which show that curbing alcohol consumption, adding more plant foods to the diet, and losing excess weight can help reduce the risk of developing cancer — serve as a reminder that a healthy lifestyle is important.
• In 1997, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued cancer prevention guidelines for weight management, diet, and physical activity. These were updated in 2007 and are considered to be the most comprehensive scientific analysis of cancer prevention and causation ever undertaken. Specifically, the guidelines reported that excess body fat is associated with an increased cancer risk and that there is convincing evidence that the consumption of alcohol, red meat, and processed meat elevates cancer risk. Since that time, numerous studies have reported links between colorectal cancer risk and alcohol, between breast cancer mortality and obesity, between breast cancer relapse and obesity, and between breast cancer risk and red meat.

The Evidence: The first study, published online January 6 in Cancer Causes & Control, showed that eating a plant-based diet and limiting alcohol intake, both already included in various cancer prevention guidelines, could help cut the risk for obesity-related cancers (about a third of all of cancers). In a cohort of nearly 3000 adults, the researchers found that restricting alcohol consumption to one drink per day for women and two drinks per day for men was associated with 29% reduced risk for obesity-related cancers. Additionally, the risk was up to 71% lower for the most common site-specific cancers in the United States (breast, prostate, and colorectal). For individuals who consume starchy vegetables, such as corn, potatoes, and yams, sufficient consumption of nonstarchy legumes, fruits, and vegetables was associated with a reduction in the risk for colorectal cancer.

Pronounced Effect on Cancer Risk

In their study, Makarem and colleagues investigated whether the healthful behaviors outlined in the WCRF/AICR guidelines were associated with the risk for obesity-related cancers, in particular, breast, prostate, and colorectal cancer. Of the 2983 adults enrolled in the Framingham Offspring cohort from 1991 to 2008, the researchers identified 480 incident obesity-related cancers.

Data from food frequency questionnaires, anthropometric measures, and self-reported physical activity were used to develop a 7-component score based on recommendations for body fatness; physical activity; foods that promote weight gain; plant foods; animal foods; alcohol; and food preservation, processing, and preparation. The cohort was, on average, middle aged to older and overweight, but had a relatively high level of physical activity. The mean duration of follow-up was 11.5 years.

The overall score was not associated with obesity-related cancer risk after adjustment for confounders such as age, sex, smoking, energy, and pre-existing conditions (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.86 – 1.02). However, when the score components were considered separately, the researchers found that for every unit increment in the alcohol score (representing an improvement and more closely meeting the guideline recommendations), there was 29% lower risk for obesity-related cancers (HR, 0.71; 95 % CI, 0.51 – 0.99) and a 49% to 71% reduced risk for breast, prostate, and colorectal cancers.

Similarly, each unit increment in the subcomponent score for nonstarchy plant foods (fruits, vegetables, and legumes) for those who eat starchy vegetables was associated with a 66% lower risk for colorectal cancer (HR, 0.44; 95% CI, 0.22 – 0.88).

Healthy Body Weight and Exercise Reduce Mortality

The second study, published online January 7 in the American Journal of Clinical Nutrition, reported similar results. Researchers found that greater adherence to the cancer prevention guidelines of the American Cancer Society (ACS) was associated with a reduction not only in cancer incidence, but also in cancer mortality and total mortality.

The ACS guidelines recommend that individuals avoid smoking, achieve and maintain a healthy weight, be physically active, and eat a healthy diet that emphasizes plant foods. In their study, Geoffrey Kabat, PhD, senior epidemiologist in the Department of Epidemiology & Population Health at the Albert Einstein College of Medicine in Bronx, New York, and colleagues report that maintaining a healthy body weight and being physically active had the greatest impact on overall mortality for both men and women.

The researchers used data from the NIH-AARP Diet and Health Study, a prospective cohort study of 566,401 adults who were 50 to 71 years of age in 1995 and 1996, when they enrolled in the study. They were followed for a median of 10.5 years for cancer incidence, 12.6 years for cancer mortality, and 13.6 years for total mortality.

During the study period, there were 73,784 cases of cancer, 16,193 cancer deaths, and 81,433 deaths from any cause. The patients were stratified by how closely they adhered to ACS guidelines, and adherence to the guidelines was associated with a reduced risk for all cancers combined. When the highest level of adherence was compared with the lowest level, the hazard ratio was 0.90 for men and 0.81 for women.

In addition, increased adherence was associated with a reduction in risk for 14 of 25 specific cancers. Reduction in the risk for gallbladder cancer was 65% in men and women combined, for endometrial cancer was 60%, for liver cancer was 48% in men, for colon cancer was 48% in men and 35% in women, and for rectal cancer was 40% in men and 36% in women.

My Take: These results add to the existing evidence on the potential role of limiting alcohol intake and increasing the intake of plant foods in influencing cancer risk. Dietary advice on cancer should focus on encouraging the consumption of a plant-based diet providing abundant non-starchy fruits, vegetables, and legumes, and restricting alcohol, if consumed at all, to the recommended levels. Try to stick to the ACS Guidelines, as the closer you follow them, the greater the benefit in cancer risk-reduction. Finally, exercise and don’t use tobacco. I’m Dr. Michael Hunter.

References: Cancer Causes Control. Published online January 6, 2015. Abstract; Am J Clin Nutr. Published online January 7, 2015. Abstract; http://www.medscape.com/viewarticle/837976#vp_2

Sitting Too Long? You May Increase Your Risk of Cancer

What You Need to Know: If you’re spending a lot of time sitting every day, either in front of the TV or at work, you may be at higher risk for developing certain types of cancer, according to new research published this week in the Journal of the National Cancer Institute.

The Evidence: The study found an additional two hours a day of sedentary behavior was linked to an 8% increase in colon cancer risk, a 10% increase in endometrial cancer risk and a 6% increase in risk for lung cancer. It did not find the same connection for breast, rectum, ovary and prostate cancers or for non-Hodgkin lymphoma.

• Researchers came to these conclusions by analyzing 43 existing studies – that included more than 4 million study participants and 68,936 cancer cases – to measure the relationship between hours spent sitting and certain types of cancers.
• It’s important to note that while the study identifies a link between sedentary behavior and an increased risk for certain cancers, the research doesn’t prove cause and effect.

“Does sitting in front of the TV cause colon cancer? No,” said Dr. Martin Heslin, chief of surgical oncology at the University of Alabama at Birmingham. “But the recommendations (of the study) are awesome.” Heslin, who was not involved in the research, says that in addition to sedentary behavior, several factors can increase your risk of cancer, including drinking or smoking too much, being obese and having a genetic predisposition.

 

It’s nearly impossible to say that any one of these factors causes someone to get a specific cancer, he says, but these are the behaviors we can control to help reduce our risk.

“You can affect TV time by turning it off,” said Heslin, though he acknowledges it’s not so easy to turn off work if you’re stuck in an office all day.

In that case, Heslin suggests looking for opportunities to leave your desk, such as standing up while working or taking a walk, to reduce the number of hours you spend sitting down.

“If I ever have the opportunity to design (a meeting room), I’m putting a waist-high table in the room, and no chairs,” Heslin said.

According to an editorial accompanying the study, organizations such as the American Cancer Society and the UK Department of Public Health address the need to reduce hours spent sitting, but do not offer any quantitative recommendations or strategies to help people improve. Daniela Schmid, one of the study’s co-authors and a faculty member in the University of Regensburg’s department of epidemiology and preventive medicine, hopes to change that.

“The findings of our study may encourage public health efforts to expand physical activity recommendations to reduce time spent in sedentary behavior,” Schmid said.

Previous studies support the findings in Schmid’s study. A 2012 study conducted by the National Institutes of Health concluded that sitting for several hours a day is bad for you, even if you are physically active. Researchers found even exercising at least 150 minutes each week – the generally accepted public health guideline for physical activity – can’t reverse the negative effects of sitting down for hours. In that study, sitting increased an individual’s risk for major chronic diseases such as Type 2 diabetes, cardiovascular disease, and breast and colon cancers.

My Take: If you sit regularly, get up periodically (even if that means every 20-30 minutes for a few minutes). In addition, aim for a minimum of 150 minutes per week of the equivalent of a brisk walk (for example, 30 minutes daily for five times per week). I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: CNN Health, 16 June 2014