Exercise and Health: How Much Is Enough?

The American Cancer Society recommends that cancer patients aim for 150 minutes, or 2.5 hours, of physical activity a week. Broken down over seven days, this amount of time averages out to about twenty-two minutes a day. If you think about it this way, this is an incredibly doable goal. What’s even better is that those twenty-two minutes don’t have to be done at once.

In fact, research suggests that shorter bouts of exercise may have greater health benefits than longer endurance workouts. A 2016 study by Martin Gibala and his colleagues at McMaster University found that in previously sedentary individuals brief, but strenuous (10 minutes total, with only three 20 second episodes of flat-out exertion) exercise bouts three times a week for 12 weeks resulted in similar improvements in physiological and biological measures of fitness compared to those who exercised 45 minutes a week for twelve weeks.

It seems that benefits are also derived from bouts of intense exercise even as short as 4 seconds every hour! A study published last week by Edward Coyle and his team from the Human Performance Laboratory at University of Texas at Austin found that hourly 4 second bursts of maximal intensity cycle sprints interrupting prolonged sitting lowered the next day’s biological response to a high fat meal, decreasing markers of cardiovascular risk (triglyceride spike).

Previous research found the same effect for three 10-minute walks compared to a 30-minute walk in adults with borderline hypertension. The shorter walks had the same effect on blood pressure, but unlike the thirty-minute walk, they also reduced spikes in blood pressure, and so they had greater implications for overall health. We also know that simply sitting less and moving more is the ideal approach, as research suggests that:

walking more and sitting less is even healthier for you than exercising an hour a day if you are then sedentary for fourteen hours
replacing thirty minutes of sedentary time with light activity will reduce mortality risk
short bouts of activity will result in reduced inflammation and other hallmark biological factors driving cancer development

COVID-19 and Exercise

Exercise During a Pandemic

The extend time we are all spending at home due to SARS-CoV-2 virus and the ensuing COVID-19 illness is resulting in excess sitting and lack of exercise. However, this is a time to stand up and get moving as being in motion will improve all aspects of your health, boost your immune system, and create an environment that can better keep you virus free.

The human body, which is an evolutionary masterpiece of biological engineering, is designed to be in motion. Yet in large part, most of the hours of our lives are spent sitting. Recently, scientists have discovered that sitting is becoming a major health liability, and it is as detrimental to our health as smoking or eating poorly or any other number of less-than-healthy lifestyle choices that make us vulnerable to disease.

It is a well-accepted fact that exercise lowers your risk of cancer and other diseases such as heart disease, stroke, diabetes, and Alzheimer’s disease, as well as leading to increased quality and quantity of life. As we are all more or less isolated in our homes, how do we make it work for ourselves.

Making it Work for You

We believe that the best coach is our own body, so listen to your body and respond to its requests and needs. If you feel strong, balanced, flexible, and confident, you’re likely on the right track. Getting aerobic exercise (elevating your heart rate) on a regular basis is important, as is keeping your muscle strength up.

Break Up Your Day with Exercise Bursts

Use short workouts to break up your day. Three brisk 10-minute walks help to break up a long day of sitting.
If you like to run, a series of short sprints burns more calories than a long jog.

Break Up Your Sitting Time

Based on multiple studies, we encourage you to break up your sitting time by at least standing up:

Don’t do this once in a while, but hourly.
Standing will feel strange at first, but stick with it. As with most habits, after your body gets used to standing up, you will start to prefer this to sitting down to do work.
The ironing board is a great (and cheap) substitute for a standup desk at home and allows you to spread out your work.
Try standing when you watch television or shows on your computer.
Consider buying a lightweight laptop desk (which start at around $40) easily used at home, work, and even during travel.
Think about your children. School-age children need standup desks. They sit most of the day and then come home and sit for most of the evening— doing homework, playing video games, eating dinner, or watching TV.

Walk Instead of Sitting

Don’t do this occasionally, do this every day, at least once every one to two hours, even if you are merely walking around your house, around the block, or around the office.
Take the stairs at work, at the movie theater, at the airport, at doctors’ appointments— anytime you are going up or down, use the stairs.
Conduct walking meetings. Carry a clipboard to take notes. If someone at work wants to discuss an idea, suggest that you walk outside as you talk.
Park away from your destination and walk a few extra steps.
Walk to work, if possible, or bike.
Walk after dinner with those you care about— it allows you time to catch up and connect. Walking after a meal (especially a big meal) helps your body process food and could keep older people from developing diabetes.
Listen to a book on tape while you walk.

Develop a Fitness Routine

When you are ready for aerobic training and fitness, we suggest finding a friend to join you. For Alison, having a workout partner is an essential part of improving her fitness that helps keep her motivated and makes her responsible to someone other than herself.

Build your strength and your stamina. Resistance work is great for building muscle mass and protecting bone health. And your own body is your best source of resistance. A near perfect exercise is the simple plank. This activates your large muscle groups and builds arm strength. You can include free weights or resistance bands to create more tension on the muscles.

Start with something easily accessible that works with your schedule and temperament. Alison admires the runners who jog by our house every morning and evening, but she has no desire to be one of them. Be honest with yourself about what you want to do and what you can sustain. You don’t have to run a marathon. You just have to find a way to move more that works for you.

Taking Pills versus Changing Habits

SLEEP AS A SUPERNUTRIENT

Sleeping well is profoundly healing; a vital “activity” in which we must engage to foster well-being. Virtually nothing else can change your outlook on life and your ability to heal as much as sleep does, and there’s a lot to be said about what goes on biologically during these hours, too. Anticancer living means prioritizing this highly productive healing time, and addressing any obstacles or difficulties. Your body will thank you!

Taking Pills versus Changing Behaviors

We are strong proponents of cancer survivors and others avoiding sleeping pills. There are of course times when taking sleeping pills may be appropriate, under the guidance of a physician, to help break a bad cycle or for a limited period to help with jet lag. But it is vital to understand that sleeping pills do not tackle the root problem leading to sleep disturbances. Also, pill-assisted sleep is not truly restorative sleep. While sleeping pills do put you to sleep, benzodiazepines and other drugs do not move you through all stages of sleep. In fact, no drug on the market increases the deepest stages of sleep, the restorative part of sleep, critical for maintaining health. So, you may feel like you have gotten a good night’s sleep, but the true restoration needed to improve your health will still be missing.

Methods for Improving Sleep

There are several anticancer living approaches to addressing the stressors that inhibit healthy sleep, and these include the following:

COGNITIVE BEHAVIORAL THERAPY-INSOMNIA (CBT-I)

This short, focused talk therapy is extremely effective in treating insomnia. In just a few weeks, patients learn to change their sleep habits and research shows that it is much more effective than prescription drugs in providing long- term results. CBTI can be delivered in person, in group formats, by telephone, or via internet-based treatment and has been shown to have long-term benefits for improving sleep.

TAI CHI

In his work at the Semel Institute for Neuroscience, UCLA, Michael Irwin, MD, has done remarkable research that looks at the efficacy of tai chi for helping breast cancer survivors who suffer from insomnia. The results show that tai chi promotes “robust” improvements in sleep duration and quality, which are comparable to CBTI, or talk therapy, and provides additional benefits of reduction of depression and daytime fatigue. This is a remarkable finding in that CBTI has been the gold standard nonpharmaceutical treatment for insomnia— but it can be expensive. Tai chi, on the other hand, is often offered at community or senior centers, public libraries, or in outdoor parks, for little or no cost. Plus, there is the added benefit of doing it as part of a group, which bestows additional health benefits associated with being connected to a social group or network. Irwin notes that the subtle, rhythmic movements of tai chi relax the body, slow breathing, and reduce inflammation, which is associated with cancer recurrence.

Irwin’s study recruited ninety breast cancer survivors ranging in age from fortytwo to eighty-three. Half the women were in a group that engaged in weekly CBTI and the other group did weekly tai chi for three months. Both groups were closely monitored monthly, and fifteen months later both groups reported continued improved sleep and less fatigue. Not only was tai chi as effective as CBTI at improving sleep outcomes, Irwin found that tai chi led to greater reduction in inflammatory markers than CBTI. They also demonstrated that this practice reduced inflammatory gene expression profiles— a key factor in preventing disease onset or progression, including cancer.

This study, Irwin believes, points to the importance of sleep in terms of overall health and homeostasis (internal balance). “We know that quality sleep is important to the regulation of our endocrine system, the sympathetic nervous system, and the immune system— three systems that need to be well balanced in order to stave off serious diseases, including cancers. Making lifestyle changes such as engaging in tai chi, for example, can rebalance one’s circadian rhythm and restore and reinforce healthy sleep architecture, which are thought to be important in promoting health and even possibly in preventing cancer recurrence.”

MEDITATION

Meditation has also been shown to promote restful sleep. Irwin and his team taught meditation to a small group of people over fifty-five years of age who complained of moderate sleep disruption. These meditators were compared to another control group of the same age that was given basic sleep education. The meditators not only slept better but also reported less depression and daytime fatigue. Also important, in study after study we see that participating in meditation also leads to higher melatonin levels, the hormone that is necessary to help us initiate and maintain our sleep.

YOGA

In a study conducted at the University of Rochester, four hundred cancer survivors who were experiencing sleep disturbances reported that both their subjective and objective sleep quality improved after attending two yoga sessions a week for just four weeks. In addition, research we conducted at MD Anderson in women with breast cancer undergoing radiotherapy found that those who practiced yoga up to three times a week during radiotherapy had better cortisol regulation than a light stretching control group at the end of treatment and one month later. In fact, cortisol levels for the women in the yoga group dropped more on a daily basis than that of the control group, allowing the body to relax and prepare itself for sleep. We have also found that women undergoing chemotherapy who practice yoga at least two times a week or more also report improved sleep outcomes. Though more research is needed to show if tai chi, meditation, yoga, or other mind- body practices have a long-term impact on sleep quality and health outcomes, the data that’s been gathered is promising.