Exercise & Nutrition: Lowering your risk/recurrence 2012

By Marie Murphy Exercise Specialist IOC Sports NutritionistIrish Olympian (Marathon)

Overview Cardiovascular Exercise Physiological benefits of exercise Aerobic exercise reducing our risk/recurrence of cancer Research Studies Understanding metabolic equivalents (METs) Fitness level and prevention of disease Knowing and getting our METs Getting started with aerobic training Conclusion

Research studies have shown that cardiovascular and resistance training are an important part of living beyond cancer. Over 20 studies have looked at the how exercise programmes can affect the physical well-being of cancer survivors ICS 2011

Aerobic Benefits Strength Training BenefitsReduce Risk/Recurrence of Cancer Reduce Risk/Recurrence of CancerLess body fat Less body fatFaster metabolism Faster metabolismGreater endurance Greater muscular enduranceSlower heart rate Greater muscular strengthLower blood pressure Greater bone densityImproved cholesterol profiles Improved cholesterol profilesImproved capacity to use oxygen (METs) Improved coordination and balanceImproved cardiovascular function Improved cardiovascular functionImproved blood sugar regulation Improved blood sugar regulationDecreased inflammation Decreased inflammationEnhanced immune function Increases lean muscle massPrevention of osteoporosis Prevention of osteoporosisImproved flexibility Increased mobility / flexibilityProtection against coronary heart disease Prevention of age-related myoatrophyBetter weight control and management Better weight control and managementLess depression and anxiety Improved body imageExtension of active lifetime Extension of active lifetime

Research Studies (what we know) Being physically activity after a cancer diagnosis can help reduce the risk of a recurrence by up to 50% At least 9 MET-h/wk cardio exercises positive results (2-3 hours/week @ 15-20 minutes/mile) Each additional hour/week >9 METs of physical activity the risk of breast/colon cancer incidence decreased by 6% Sternfield, B. et al 2009

What are METS Metabolic Equivalents (METS) METS are a measurement of the body’s capacity to utilize oxygen for a given work load. 3.5 ml/kg/min = 1 MET Heat produced while exercising is directly proportional to the rate of energy expanded. Understanding your METS will help you understand how to reduce your risk/recurrence of cancer.

Fitness level Direct impact on how many METS you expand per min. Prevention of disease 4-6 METS 5-7days/week 15-20 MET hours a week (reduce risk) 30-60 minutes / 5-7 days a week Providing Ireland the best scientific information available on how to improve your health and reduce the risk of illness and injury.

Research Study 2004 - Exercise and the recurrence of breast cancer >17.2 MET/hr/week Positive Results <17.2 MET/hr/week greater risk for the recurrence of breast cancer (Kendall A. Et al. 2004)• 374 breast cancer patients• Age 40 years and younger• 13.2 years following diagnoses

Know Your METS 20 minutes / mile = 3.8 METS/hour 5 days / 30 minutes = 10 MET/hours/wk 15 minutes / mile = 4.6 METS/hour 5 days / 30 minute = 12 MET/hours/wk

How Can I Get The Needed METS? Three Options1. Increasing Duration (30 > 45 > 60mins.)2. Increasing Frequency (3 > 5 > 7days)3. Increasing Intensity (30 > 20 > 10min./mi.)

Fitness Testing Walk 1 mile on a flat surface and record how long it takes you to cover the distance. (example 19 minutes) Walk at your best effort without talking; as you are measuring your bodies capacity to utilize oxygen and talking uses oxygen  From the chart below look and see which level your time falls into. (example; 19 minutes you will be in the intermediate group) Level Minutes/mile Training Pace METs/hr 3 hrs Beginner 20-26 minutes 23-30 minutes 3.0-3.5 9-11 Intermediate 14-19 minutes 17-21 minutes 3.8-4.2 12-13 Advanced 11-13 minutes 13-15 minutes 4.6-5.0 14-15

Getting Started with Aerobic Training Know your fitness level at the start (1 mile time trial). Programme should gradually progress (15 minutes, 3-5 days a week > 20 minutes, 3-5 days a week). Hold the same routine for three weeks before increasing volume or intensity. Set a goal 15weeks programme (5 x 3 weeks routine). Keep a record of your METs. Wear comfortable shoes and clothing.

Conclusion (Exercise) Substantial evidence supports the benefits of exercise in reducing our risk/recurrence of cancer. 15-20 MET/hrs/wk guidelines for prevention of disease. 3 miles @ 15-20 min./mile 5 days/week = 15-20 METs At least 9 MET-hr/wk positive results after diagnosis/treatment Consistency is the most important thing in exercising. “A little a lot, is better than, a lot a little.” 

Nutrition Overview Prevention/Protective Nutrition Specific Food Groups Cancer Promoters/Inhibitors Positive/Negative Adaptation to Training Refuelling Energy Stores (amount, type, timing) Carbohydrates, Protein & Fat (grams/kg) Supplements Body Fluids (losses/requirements) Conclusion

A good cancer survivors diet is similar to a cancer prevention diet.The main differences are that people undergoing chemotherapy may have higher nutritional needs and poor appetites. It is very important to eat the most nutritious foods you can get.

A diet thats high in vegetables, fruits, wholegrains, beans, fish, low in fat and high in fiber is cancer-protective.A good diet boosts overall health and clearlyhelps protect against heart disease and diabetes.

 Getting enough calories to keep up your strength Eat as healthy a diet as possible to: -Boost your immune system -Deal with possible nutritional deficiencies Cancer treatment may: -Decrease your appetite -Lower your ability to digest food -Interfere with your bodys ability to absorb and use nutrients

 Good fats are very important. -olive oil and omega-3 oils including flax seed oil and fish oil. Avoid processed fats and oils, such as trans and hydrogenated fats in margarines and fats used for baking. Your body may be better able to tolerate fish and chicken and less able to digest red meat. If you do eat meat, try to buy grass-fed or free-range. Stay away from highly processed meats, especially those that include nitrites and nitrates.

 Whole grains (whole wheat pasta, brown rice, oats, barley) Spinach, kale, broccoli, Brussels sprouts (dark green vegetables) Garlic, onions, scallions, leeks, and other vegetables from the allium family. Carrots, winter squash, pumpkins, apricots. (orange foods) Beans, lentils, peas, kidney beans, navy beans

 Make sure that your diet contains plenty of low-fat protein, such as cold-water fish (salmon, sardines, mackerel), beans, and white meat chicken or turkey. Protein rebuilds muscle and tissue(Particularly important when your body has undergonechemotherapy, surgery and radiation)

 Phytochemicals and other cancer-fighting ingredients work together, synergistically. Take it easy on the supplements. Consumers are getting a lot of inaccurate information about supplements, their capabilities, and their ingredients. Get information from your physician, registered dietitian, or another reliable source before taking supplements or special products.

Promoters Inhibitors Tobacco – Alcohol Anticancer Phytochemicals Sugar/white flour Omega-6s Omega-3s Chemical pollution Detox Phytochemicals Sedentary lifestyle Physical Activity Powerlessness Social support/stress mgt Lack of sunshine Sunshine/Vitamin D David Servan-Schreiber, MD, PhD University of Pittsburgh School of Medicine Anti-Cancer: A New Way of Life

Very Important Component Recovery-Rest Nutrition New Fitness LevelAppropriate amount of Overcompensation overload Training or Racing PositiveCurrent Fitness Training Effect Fatigue

Too much stress applied in workouts Too little recovery time between workouts and/or lack of sleep Poor nutrition before, during or after workouts Overload Lower Fitness Level Training or Racing CompensationCurrent Fitness Recovery Negative Fatigue Training Effect

 Amount, type and timing of CHO intake to maximize recovery after training and prior to workouts Appeal, palatability and convenience of suitable carbohydrate sources A range of normal foods that meet these criteria can be selected to meet individual preferences.

Carbohydrates are found in: Fruits Vegetables Grains: breads, cereals, rice, pastaCHO intake ranges of 5 to 7g/kg/day for general training needs and 7 to 10g/kg/day for increased endurance workouts.Example: 70kg female walker x 5g = 350 grams350 grams x 4 = 1400 calories of carbohydrates Pre-workouts Meal 1-4hr = 1-4g/kg/BM

 Those who exercise regularly should consume slightly more protein than sedentary individuals. Protein needs are increased when your body has undergone chemotherapy, surgery and radiation. During heavy training. Protein intake (g/kg/d) Sedentary Individual 0.8-1.2 g/kg//d Regular exercisers 1.2-1.4 g/kg/d Heavy training/Undergoing treatment 1.4-1.7 g/kg/dExample: 80kg male walker x 1.7g = 136 grams136 grams x 4 = 544 calories of protein

 Fish, chicken, turkey, meat, beans, lentils. Cheese, eggs, yogurts. Fruit smoothies Breakfast cereal and skim milk/soya Sports bars

 Necessary to insulate & protect body organs Necessary for absorption & transport of fat soluble vitamins Most concentrated source of food energy1 gram = 9 calories (CHO & protein have 4 calories/gram) Too much fat can lead to weight gain

 Increase fruit and vegetable consumption Choose lean meat, fish, poultry, & low fat dairy products Decrease fried foods & high fat snacks Fat intake based on your body weight. (Example: body weight (kg) multiplied by 1.0 - <1.5 grams of fat.

 Iron is an important component of haemoglobin and myoglobin. Haemoglobin transports oxygen in the blood. Myoglobin transports oxygen in the muscles. Iron is required for red blood cell production. Iron is required for a healthy immune system. Age Males Females Adults 8 mg/day 18 mg/day High sweat losses have higher iron losses.

• Eat iron-rich plant food every day (iron fortified cereal, bread, green leafy vegetables)• Eat lean red meat (veal, beef, lamb)• Combine plant foods with food rich in vitamin C and/or meat• Avoid consumption of coffee and strong teaThree main causes of iron deficiency• a high iron turnover (physiological demands)• nutrition (energy balance/vitamins and minerals)• high carbohydrate diets (compounds that inhibit iron absorption)

 Totalbody water below normal impairs the bodys ability to regulate heat resulting in increased body temperature and an elevated heart rate. Perceived exertion is increased. Mental function is reduced. Gastric emptying is slowed. Men average 3L/day Women average 2L/day

 Genetics - some people innately sweat more than others Body Size - larger athletes tend to sweat more than smaller athletes Fitness - fitter people sweat earlier in exercise and in larger volumes Environment - sweat losses are higher in hot, humid conditions Exercise Intensity - sweat losses increase as exercise intensity increases

 Weighing before and after exercise. Each kilogram of weight lost is equivalent to one liter of fluid.Example: An individual who finishes an exercise session1 kg lighter and has consumed 1 liter of fluid during thesession has a total fluid loss of 2 liters. Monitoring urine output allows individualized assessment of hydration status. Color allows self-assessment by the individual.

 Dehydration is a major issue and fluid replacement is essential for optimum performance. Fluidand electrolyte consumption of 1.2-1.5 liters for each kg of weight lost for adequate hydration and sodium balance. Theoptimal level in a sodium re-hydration drink has been measured at 50-80mmol/L. Thirst is not perceived until a water deficit of 2% body mass is incurred.

 Eat a variety of foods (whole natural foods) Limit your overall fat consumption, favouring good fats It is better to steam, boil, bake or stir-fry food Eat more fruits and vegetables (organic) Eat garlic if you can tolerate it Eat more high fiber foods such as whole grain breads, cereals and legumes. Eliminate refined sugars, junk food and empty processed food.

 Our bodies are complex systems and require many varied nutrients to be healthy. Understanding these needs is not always easy, especially in light of changing recommendations and media reports. In decreasing the risk of cancer or the risk of recurrence emphasis should always be on a varied healthy diet that includes physical activity and weight management.Authorisation to reproduce this material must be obtained from the copyright holder Marie Murphy

Thank You coachmurphy@mbsfitness.com

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Exercise & Nutrition: Lowering your risk/recurrence 2012

by Marie Murphy on Sep 23, 2012

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Exercise & Nutrition: Lowering your risk/recurrence 2012 Presentation Transcript