Lifestyle vs. Breast Cancer Risk

Lifestyle vs. Breast Cancer Risk

By: Allison D. Salibian, B.S., CPT

No one can accurately predict an individual’s risk for breast cancer, but there have been recent studies which have helped illuminate ways to protect against it.  Each year, researchers for the American Cancer Society and the Women’s Health Initiative, among other groups, learn more about how a woman's lifestyle and health habits -- how much she weighs, the amount she exercises, what she eats -- can affect her risk of developing breast cancer.

Most Americans are overweight.  Approximately 2/3 of the U.S. population has a BMI above 25 (1).  Unfortunately, this fact goes hand-in-hand with the current breast cancer statistics: about 1 in 8 U.S. women (just over 12%) will develop invasive breast cancer over the course of her lifetime (1).  At what point does being overweight start to increase a woman's risk for breast cancer?  A recent American Cancer Society Study found that women who gained 21-30 pounds since age 18 were 40% more likely to develop breast cancer than women who had not gained more than 5 pounds, and women who gained 70 pounds doubled their risk (2).  Further, excess weight greatly increases the risk for metastatic tumors, which are more difficult to treat than tumors that have not spread. Women who gained more than 60 pounds since age 18 were 3 times more likely to have metastatic breast cancer than women who gained less than 20 pounds as an adult (3).

Most Americans do not exercise enough.  The U.S. Department of Health and Human Services (HHS) defines a minimum standard of exercise for adults as 150 minutes of moderate exercise or 75 minutes of vigorous intensity (4).  These guidelines are echoed by the American Heart Association, the American Cancer Society, and the American Medical Association, to name a few.  Activities considered moderate are those that make you breathe as hard as you would during a brisk walk. This includes things like walking, biking, and even housework and gardening. Vigorous activities generally engage large muscle groups and cause a noticeable increase in heart rate, breathing depth and frequency, and sweating. 

Physical activity affects breast cancer in 2 distinct ways: directly, by influencing circulating hormones, and indirectly, by helping to control a person’s fat content.  The more fat in a woman’s body, the more stored estrogen.  The more estrogen, the more potential stimulation of cell overgrowth and breast cancer.  Additionally, the ratio of “good” estrogens to “bad” estrogens (those which can damage DNA and increase breast cancer risk) can be improved by roughly 25% with appropriate exercise (5).  The Women’s Health Initiative found that women who followed the exercise guidelines set forth by the HHS had 18% less risk of breast cancer than women who were considered “inactive” (6).

Most Americans do not eat right.  Harvard researchers recently found that women who had the highest carotenoid levels in their blood had a 19% lower risk of breast cancer than those with the lowest levels (7).  Carotenoids are found in vegetables such as leafy greens, carrots and red peppers.  Women who consumed more carotenoids had an even lower risk of developing estrogen-receptor-negative breast cancer, which is often more aggressive.  Other nutrients, such as lycopene (the chemical that gives tomatoes their red color) have been suggested to protect against breast cancer.  Further, regular consumption of more than one alcoholic drink per day is associated with an increased risk of breast cancer, according to the American Cancer Society’s latest research, particularly in women who do not consume enough of the vitamin folate.  Therefore, for women who do drink, reducing alcohol may be an important way to reduce breast cancer risk.  The American Cancer Society recommends that all women, but especially those who drink regularly, eat five or more servings of fruits and vegetables a day, with emphasis on leafy greens and folate-rich vegetables, carotenoid-containing fruits and vegetables and other cruciferous veggies.

References:

1.       American Cancer Society, Infographics, 2013:1

2.       Breastcancer.org/symptoms/understand_bc/statistics

3.       American Cancer Society, Cancer.org, Lifestyle v. Cancer, 2013

4.       U.S. Department of Health and Human Services, Health.gov, 2008 PAG Handout

5.       Cancer Epidemiology, Biomarkers and Prevention, 2013

6.       Stopping Breast Cancer, Prevention, October 2013

7.       Elaissen, et al., Circulating Carotenoids and Risk of Breast Cancer: Pooled Analysis of Eight Prospective Studies, JNCI J Natl Cancer Inst (2012). First published online: December 6, 2012

Pumpkin Oatmeal Recipe

I love pumpkin everything during this season, but it's hard to find recipes that don't contain lots of sugar, cream or butter (ingredients I try to stay away from unless I'm celebrating).  Here's a quick, delicious recipe for pumpkin oatmeal.  It's hearty, tasty and wholesome.  Enjoy!



Ingredients

1 (14-ounce) can pumpkin puree (the unseasoned kind)

2 cups water

2 cups unsweetened almond milk, or water

2 tablespoons raisins (golden or regular)

1/4 teaspoon kosher salt

3/4 teaspoon pumpkin pie spice OR 1/2 teaspoon cinnamon plus 1/4 teaspoon ground cardamom plus 1/4 teaspoon ground cloves

2 cups quick cooking oatmeal (not the instant kind)

1/4 cup pepitas ( pumpkin seeds)

Honey or maple sugar, for serving

Heavy cream, for serving

Directions

In large saucepan over high heat, combine the pumpkin puree, water, milk, raisins, salt, and pumpkin pie spice (alternative spices). Bring to a boil.

Add the oatmeal. Turn the heat down and cook according to your oatmeal instructions; mine usually takes about 15 minutes. Stir often.

Meanwhile, in a small cast iron skillet over medium heat, toast the pepitas until they're fragrant and a gentle golden brown, about 10 minutes.

Once the oatmeal is cooked (each grain should be tender), serve with honey or maple sugar on the side, pepitas to sprinkle on top, and cream if people like it more like porridge.

Recipe courtesy Aarti Sequeira, Food Network

Go Take a Hike: The Benefits of Walking Meetings

Go Take a Hike: The Benefits of Walking Meetings
By: Allison D. Salibian, B.S., CPT

We've heard the phrase, "Go take a hike," and it usually signifies someone telling an adversary to take their ideology and get far away.  However, research published just this year shows that sharing and discussing work-related concepts can increase ingenuity and inventiveness.

Daniel Schwartz, a professor at the Stanford Graduate School of Education, co-authored a study, Give Your Ideas Some Legs, showing that creative output increases by an average of 60 percent when someone is walking.  "The kind of creativity we found for walking is more generative, more brainstorming [than sitting indoors]," he says.

Many business owners have embraced walking meetings.  Steve Jobs, the late founder of Apple, Facebook's Mark Zuckerberg and Jack Dorsey of Twitter have all been known to favor walking meetings.  Recently, Nilofer Merchant, a former technology executive, extolled the benefits of walk-and-talk meetings at a TED conference, noting the health advantages and the closer connections people form when away from the more traditional setting of a conference room.

Julia Kline, a Ph.D candidate at the University of Michigan, co-authored another study, Your Brain on Speed, also published this year, which found that walking speed does not diminish "spatial working ability" -- essentially the ability to walk and talk and remember items that were discussed.  "These two findings really should encourage people to get out into the world and walk during their meetings," she says.  "Walking meetings have become one of the ways that you can motivate the whole company to get up and get moving."

As a personal trainer, I encourage staying physically active throughout the week, warning against sedentary practices, such as eating at your desk or going home and sitting in front of the the t.v. after work.  However, my eyes have been opened to another way to encourage movement.  Now that I know walking speed has been shown not to negatively effect assimilation of data during walking meetings, may I suggest a HIIT training meeting?  For example, 30 seconds at a quick pace where no one can really speak because of heavy breathing, followed by 2.5 minutes of slow, steady-paced walking where the content of the meeting is resumed.

Anyone out there in cyberspace up for the challenge?  Let me know, and I will come lead your group's pace.

How Much is One Ounce of Meat?

How Much is One Ounce of Meat?

Copied from: http://nutrition.cedwvu.org/howmuchmeat.php

For my clients, who I require to input your eating habits into "My Fitness Pal" or other software, and for myself, who religiously enters every bite I take throughout the day to track calories and macronutrients:

1 ounce of meat

• the size of a small matchbook cover (yes, that small!)
  
• 1/4 cup tuna or ground beef
  
• 1/2 small chicken leg or thigh
  
• 1 slice of sandwich size meat
  
• 1 oz. of cooked, diced meat: fill measuring cup just below the 2 ounce mark.

Substitutes for 1 ounce of meat

• 1/2 cup cooked lentils, peas or soup beans
  
• 1 egg
  
• 1/4 cup egg substitute
  
• 1/3 cup nuts
  
• 4 ounces tofu
  
• 1 ounce hard cheese (about 1 3/4 tablespoons)

2 ounces of meat

• 1/2 cup tuna or ground beef
  
• 1 small chicken leg or thigh
  
• 2 slices of sandwich size meat
  
• 2 oz. of cooked, diced meat: fill measuring cup just below the 3 ounce mark.

3 ounces of meat

• 3 oz. of cooked, diced meat: fill measuring cup just below the 5 ounce mark.

4 ounces of meat

• 4 oz. of cooked, diced meat: fill measuring cup just below the 6.5 ounce mark.

Leanest Cuts

Fish (unbreaded)
Chicken Breast
Turkey Breast
Ground Chicken Breast
Ground Turkey Breast
Pork Tenderloin
Pork Loin Roast or Sirloin Chops
Fat Free Hot Dogs
Beef Eye of Round Roast
Beef Top Round Steak
Bottom Round Roast
Top Sirloin Steak
Deer Meat

Medium Fat

Chicken, Dark Meat from Thighs or Wings
Turkey, Dark Meat from Thighs or Wings
Beef, Ground Sirloin
Ground Beef, 95% lean
Beef Chuck Shoulder Roast
Beef Top Round
Beef Tenderloin
Flank Steak (Beef)
Round Steak

High Fat, High Cholesterol

Ground Beef (less than 95% lean)
Ribs (Beef or Pork)
Chicken - Any cut that includes skin and fat
Ground Chicken
Ground Turkey
Short Loin (Beef or Pork)
Beef Brisket
Sausage
Bacon
Bologna, Pepperoni, Salami
Spam®, Vienna Sauages
Regular Hot Dogs

- See more at: http://nutrition.cedwvu.org/howmuchmeat.php#sthash.R7gNNblG.dpuf

Being Fit Keeps You Mentally Ready For Work

We keep hearing about how obesity can be a dangerous risk to your physical health, but according to a study from Israel in the Journal of Applied Psychology, avoiding exercise can also take a toll on your mental health, leading to depression and greater burnout rates at work.

Researchers found that employees who engaged in physical activity were less likely to experience a deterioration of their mental health, including symptoms of burnout and depression. The best benefits were achieved among those exercising for four hours per week – they were approximately half as likely to experience deterioration in their mental state as those who did no physical activity.

Depression is a clinical mood disorder, and burnout is defined by physical, cognitive, and emotional exhaustion. Both contribute to a possible “spiral of loss” where the loss of one resource, such as a job, could have a domino effect and lead to the loss of other resources such as one’s home, marriage, or sense of self-worth.

The study was originally designed to examine the relationship between depression and burnout by assessing the personal, occupational, and psychological states of 1,632 healthy workers in both the private and public sectors. Participants completed questionnaires when they came to medical clinics for routine check-ups and had three follow-up appointments over a period of nine years.

The results indicate that an increase in depression predicts an increase in job burnout over time, and vice versa. But for the first time, the researchers also considered the participants’ levels of physical activity, defined as any activity that increases heart rate and makes you sweat. The participants were divided into four groups: one that did not engage in physical activity; a second that did 75 to 150 minutes of physical activity a week; a third that did 150 to 240 minutes a week; and a fourth that did more than 240 minutes a week.

Depression and burnout rates were clearly the highest among the group that did not participate in physical activity. The more physical activity that participants engaged in, the less likely they were to experience elevated depression and burnout levels during the next three years. The optimal amount of physical activity was a minimum of 150 minutes per week, where its benefits really started to take effect.  In those who engaged in 240 minutes of physical activity or more, the impact of burnout and depression was almost nonexistent. But even 150 minutes a week will have a positive impact.

Exercise and being fit helps people to deal with their workday, improving self-efficacy and self-esteem, and preventing the spiral of loss.  Most stress management programs focus on reducing stressful situations such as workload and the environment. However, as successful as these might be, life still throws us some stressful situations to deal with.  Being fit and exercising regularly is the best way to be prepared as the Scouts would say.

You can’t, and don’t want to, remove all stress from your life (only dead people have no stress), but being fit is your best defense against the negative effects of stress.

The Myth About the Fat-Burning Zone

The body does burn a higher percentage of calories from fat in the "fat burning zone" (60-65% of your maximum heart rate). However, at higher intensities (70-90% of your maximum heart rate), you burn a greater number of overall calories, which is what ultimately matters when it comes to losing weight. The chart below details the fat calories expended by a 130-pound woman during "cardio" exercise. 

As you can see, lower intensity workouts will burn half of the total calories from fat stores in your body, rather than from muscle or sugar.  However, high intensity workouts yield more calories burned per minute.  Additionally, the excessive post-exercise oxygen consumption (epoc) is higher after high-intensity workouts, leading to increased metabolism and prolonged breakdown of fat stores. 

So, even though it is harder to work out at higher intensitites, wouldn't you rather make every minute count AND increase your chance of prolonged fat breakdown?  Try it ... create the crave for harder workouts!

	Low Intensity - 60-65% MHR	High Intensity - 80-85% MHR
Total Calories expended per min.	4.86	6.86
Fat Calories expended per min.	2.43	2.7
Total Calories expended in 30 min.	146	206
Total Fat calories expended in 30 min.	73	82
Percentage of fat calories burned	50%	39.85%

Source: From The 24/5 Complete Personal Training Manual, 24 Hour Fitness, 2000

For those who say they don't believe:

Many of my clients, jokingly or not, say they don't believe that I was very overweight.  For those of you who have either said it to my face, behind my back or in your heads, here's proof.  I'm proud of the hard work and determination I have exhibited throughout my physical transformation.  I'm also blessed that I still feel like that happy, young mommy that I did 3 years ago.  I'm actually more complete of a person now, I think. I hope to portray that confidence, character, hopefulness and happiness to my clients, friends and family every day, no matter how I look on the outside.

 

Left: 168 lbs.          Right: 118 lbs

Body Fat %: 32       Body Fat %: 12