Secrets of Preventing Cancer and Building Your Bones

Does the title of this post lead you to think that there's one simple thing you can do to prevent cancer and keep your bones strong as you grow old?

Sorry about that. It's actually two different "secrets"--the reason they're crammed together in one post is that I was reading the New York Times health section, and these two articles about preventing cancer and building healthy bones both caught my attention.

Note: whenever I discuss health articles from the New York Times, sensitive readers should be warned--there will likely be cursing involved.

@#%$&!!

Because while the New York Times is a great source for news, I hate their health section. They're the ones, remember, who said exercise won't keep you healthy. And their writers seem to revel in casting doubt on my long-held beliefs about the rewards of proper nutrition and plenty of exercise.

If the New York Times were my only news source, I'd be on a cupcake, cheeseburger, and champagne diet by now, and the only exercise I'd get would be scratching my head over their crossword puzzles. Sometimes the studies they cite are convincing; other times they seem to ignore tons of contrary research in order to take a controversial stand and get people riled up. Either way, I find it annoying to have to rethink things all the time. I have a tiny brain and it gets tired easily.

So wanna know what surprises they had in store about preventing cancer and building bones?

Preventing Cancer: Forget Healthy Living

Yep--they say that eating less fat and lots of fruits and vegetables and whole grain fiber, losing weight, and getting lots of exercise won't really do much to prevent cancer. In terms of healthy living, the only lifestyle choice things they had good things to say about were quitting smoking and, if you're a woman, steering clear of estrogen after menopause. (Well, I imagine if you're a guy you should steer clear of it too).

The fruits and vegetable thing took me by surprise, and elicited the most cursing. I'm certain I've read a number of studies saying that whole grain fiber and fruits and vegetables help prevent cancer. The fiber clears out your digestive system, and the produce is full of all those nifty little antioxidants that will clean up evil free radicals that contribute to cancer. Right?

Well, turns out it's not just the New York Times--everyone seems to be backing down on the diet and cancer connection. As to the ability of antioxidants in fruit and vegetables to prevent cancer--the clinical results now look "inconclusive," according to The National Cancer Institute. Likewise, the Harvard School of Public Health says you should eat your fruits and veggies, but mainly because they're good for heart disease, blood pressure, vision, and gastrointestinal problems like constipation or irritable bowel. As to cancer, "data from cohort studies have not consistently shown that a diet rich in fruits and vegetables prevents cancer in general."

Well, phooey.

What can prevent certain kinds of cancer? Medicines!

According to the article, a generic drug, finasteride, costing about $2 a day, could prevent as many as 50,000 cases of prostate cancer a year. A related drug, dutasteride, (about $3.50 a day), has the same effect.

Likewise, according to the Times, studies have found that taking tamoxifen or raloxifene could cut breast cancer by 50% among high-risk women. Most side effects of the drugs, like hot flashes, were temporary. There was a very slightly increased risk of blood clots and uterine cancer with tamoxifen, but with raloxifene there was no excess uterine cancer, and the clotting risk was 30 percent less than tamoxifen.

Even better, women did not have to take the drug for a lifetime — just five years. And they said the cost for tamoxifen runs about 30 cents a day; raloxifene is $3.30 a day.

So why would doctors and high-risk patients not be jumping all over this to try to prevent cancer? Well, the Times interviewed Dr. Therese B. Bevers, a medical director at a Cancer Prevention Center. She believes that doctors don't want to take the first step — calculating a woman’s lifetime risk of getting breast cancer. Why not? Because that might lead to the next step: "spending an hour or so discussing cancer risk and drug risks and benefits."

An hour or so? Really? When was the last time your doctor spent an hour or so explaining anything? I can't believe doctors can't figure out how to give a brief overview of options in a much shorter time than that. And if it would prevent so many more cases of breast cancer, wouldn't the time be worth it?

Apparently the drugs are a good idea if your lifetime odds exceed 20 percent. (They use the example of a 55-year-old woman who began menstruating early had her first child late, and whose mother and sister got breast cancer. There's an assessment tool here, though they warn you it's designed for medical professionals.)

Equally puzzling, though, is the reaction of high risk patients when doctors do discuss the drug option. According to Bevers, about half the time they turn them down. “The Number one reason I hear is, ‘Oh, I just don’t like to take medications."

Personally, if my risk of breast cancer were calculated to be significantly higher than nomal? I think I'd give the medication a shot.

But no matter what the New York Times says, I'm not entirely giving up on the idea that my bok choy and blueberries and cardio are gonna help me out too.

How to Prevent Bone Loss? Jump!

So the article on exercise and bone loss starts with a disconcerting statistic: a year after fracturing a hip, about one in five people over age 65 will die.

Yikes! I guess I'd really rather not fracture my hip when I'm older.

There is more depressing news, too: a lot of the exercise people used to think would help isn't doing much to build bone density. You need “large forces released in a relatively big burst.” Apparently weight lifting isn’t explosive enough for most people, nor is swimming or cycling. Running can be, although it doesn't work for everyone. Brisk walking helped bone density in older women, but "it must be truly brisk."

What works, they suggest, is jumping--if your bones are strong enough to begin with. “You probably don’t need to do a lot either.” But this recommendation came from... you guessed it. A study of mice.

Photo:armadillo444

Oh wait, not that kind of mice...

It seems that in a Japanese study, mice jumped 40 times a week for 24 weeks and built up bone density, and maintained it by jumping 20 or 30 times a week. (I did not allow myself to discover how they got the mice to jump...I hate animal research and think we should do a lot less of it.)

Anyway, six jumps a day, then down to three or four. Sure, I could add that to my exercise to-do list. And maybe I will someday, if I became convinced that I'm one of those people for whom running doesn't work, and I decide I really need to start jumping too to build my bones.

But just because it worked for mice? At this point, I'm not exactly jumping to any conclusions about humans.

So would you take prescription drugs to prevent breast or prostate cancer if you were high risk? Would you jump up and down like a Japanese mouse to build your bone density?

Exercising over The Holidays and Important Poll!

Photo: Lincolnian (Brian)

So I've got a short guest post up over at Blogher on exercising over the holidays. Nothing you health & fitness mavens don't know already, but I'm hoping if at least a couple people who are registered at Blogher leave a comment then I won't look like a totally hopeless dweeb. You can even say mean things, or totally unrelated things! And I'll most likely reply because I'll be so excited to see any Cranky Fitness people who might stop by.

(Note: this is NOT the corporate-sponsored forum I was pimping for alerting you to over the summer. It's just the regular Blogher and I'd love to get a contributing editor gig there some day).

So here's the Important Poll Question:

If you go to the Blogher Post, or my Twitter Page, you can see I've uploaded an actual photo instead of the standard Crab picture I use as an icon or avatar or whatever that teensy little picture is called on Blogger.

So the new one is not a professional photo, just a backyard photo. I'm not wearing makeup I look all crinkly and middle-aged and, well, kinda butch. But, as Popeye used to say, "I yam what I yam." Anyway, I'm trying to decide whether to start using that as my Blogger icon too, so there's a "face" behind the crab.

However, I'm pretty darn attached to the crab!

Hi Crab!

So what do you guys think? Crab, or crinkly face, or some other option?

Which avatar should Crabby use for her blog comments?
	Crab Picture
	Crinkly Face
	Dolly Parton
	Tuna Sandwich
	Wait, I Don't Even Like Tuna
	What Was This Poll About Again?
	Oh That's Right, Avatars!
	OK, Maybe 30 Possible Answers Are Too Many
	Even If They're Free
pollcode.com free polls

And stay tuned--actual health and fitness news on Monday!

Maybe It's A Tumor: Calling In Sick For a Workout

How sick is sick enough to skip a workout?

We all know how sick you have to be to miss work. For me, that's when I get up and wonder, "Can I make it twelve hours on my feet today?" If I'm asking the question, the answer is generally "Don't. Even. Try. It."

I've worked out when I'm technically not feeling well, for a couple of reasons: First, because I know that working out (if, say, I've got a head cold) will make me feel better, as long as I do it gently. Second, because I hate to act like a wuss when Attila's there, lookin' all buff and fit.

So when is "sick" or "not feeling good" a sign to lie down and not get on the elliptical?

Generally speaking (ie, according to people who know more about this than I do), if your symptoms are all above your neck and you're not running a fever, you're good to have a nice, gentle, low-to-moderate intensity workout. We're talking stuffy nose stuff here, not "I'm in the depths of the worst head cold ever" symptoms. If you're running a fever, feeling lightheaded, or you have symptoms *below* the neck (like a chesty cough or what I'll delicately term "tummy issues"), Stay Home.

Having the flu--that is, body aches, fever, headache, and exhaustion--is a very good reason not to work out.

(Having the flu, in fact, is a very good reason for calling in zombie and staying put for ten days or so.)

Do not do this.

Having a stomach bug is an excellent reason for not working out, especially if your symptoms are...er...unpredictable.

Sinus infection? For Frog's sake, stay the heck home. With a galloping sinus infection, you're likely to bonk yourself in the head with a barbell or fall off the treadmill.

Head colds are a different matter. If you're over the worst of it and no longer feel like your head is stuffed with concrete, you might could do a mile on the 'mill at a nice, pleasant walk. Better, get outside and do your walking, in the sun (if there is any where you are) and away from people who could catch your bug.

Bronchitis is a good reason to stay home. So are generalized viral infections--the sort of thing my doctor calls "viral syndrome"--as both those conditions can wear you out far more than you'd think.

And, of course, if you're pregnant or nursing, you need to be extra-double-careful.

When do you skip? When do you go to the gym or out for a trot? And what do you use to wipe down the machines when you're done, so other people don't catch your plague?

Generation BMI

Photo: hoyasmeg

There are all kinds of phrases designating the time period in which we were born. Generation X, Gen Y and specifics aside, I'm somewhere between Baby Boomer and Millennial (a proper lady never voluntarily reveals her age - and neither do I). And even though this generation coming up has been known as the "iGeneration" for growing up in the shadow of the Internet, I have begun to think that maybe we should be referring to them as "Generation BMI" given the intense focus on childhood obesity and the well-meaning attempts at reining that in.

This particular bee in my bonnet got buzzing when some area towns began flirting with the notion of the schools measuring each student's BMI and sending the results home to their parents. These are the same schools which have slashed recess and phys ed programs, but I digress. I'm not about to touch that third rail know as "school funding". I'm also in the camp of thinking that medical issues are better dealt with through pediatricians but understand that not every child might have access to one. My specific concern is the negative emotional message these adolescents might be receiving while we're trying to correct a physical issue (obesity) - which may or may not actually be a problem because they haven't finished growing yet.

Based on personal experience, I was always a slim child until adolescence came along and hit me with the lumpy stick. My two siblings, who were always very trim, just kept growing in proper proportion to their weight and height (damn them!) - but not me. It's not good to feel different at this stage of life. I don't know about you but I remember adolescence as a frantic, hormone swill of a time filled with extreme self-conscious behavior and constant anxiety over fitting in. That was pretty much the extent of my world but in that regard, I think I was a pretty typical pre-teen. It was bad enough that I was conscious of my growing weight but God forbid anyone else take notice too. (Cue nervous mother.) So it didn't help matters when my well-meaning mother got me a girdle after I turned twelve and insisted I wear it.

Talk about humiliation! I became obsessed about my weight and appearance, although thankfully never fell into any kind of serious eating disorder other than general overeating to help soothe my hurt feelings (oh, the irony!). A year later I experienced the growth spurt that my mother thought was never going to happen and "evened out" quite nicely, thank you very much, but now with the very heavy baggage of what I believed was conditional acceptance based on appearance. LaGuadia Sky Caps would need a payloader to carry these bags from the curb.

I recognize the need to tackle this obesity problem but wonder if doing it through the schools is such a great idea - especially during adolescence. While researching whether or not BMI screening in schools was as helpful a tool as it was intended to be, I came across this article which pretty much nailed what I was thinking - especially in the "Potential Harm" section and beyond.

It stated that while more research needed to be done, the only study regarding a parent's reaction to receiving a BMI report of their child being overweight was to restrict the child's caloric intake - which could prove damaging to a child who has not gone through puberty yet. This could lead to stunted growth and behavioral issues such as sneak eating, hiding food, overeating and eventual yo-yo dieting; all of which ultimately increase the risk of obesity.

Another issue that can arise is the stigma of a child being labeled "fat". A BMI reading of overweight can be devastating for a child whose main purpose in his or her early life is to "fit in". There is an awareness in children very early on that being overweight is socially unacceptable - the health risks surrounding that are the least of their concerns. "Few problems in childhood have as significant an impact on emotional well-being as being overweight". As such, overweight children are at increased risk for lower self-esteem, depression and isolation.

Lower self-esteem in this instance is a bit of a double-edged sword. While labeling a child as overweight can undermine his or her self-acceptance as well as that of others, not addressing it at all can lead to increased weight over a prolonged period, which is just a continuation of the problem. A child needs a good sense of self to set the stage for achievement in school, personal interactions and the world beyond. I've heard of schools no longer printing the honor roll in the newspapers to preserve the self-esteem of the kids who didn't make it and yet there seems not to be the same concern with BMI screenings. Is this the Jekyll and Hyde of political correctness? Do some self-esteem issues trump others?

Body dissatisfaction is one of the greatest risk factors involved in the onset of eating disorders. While the correlation between BMI and body dissatisfaction begins in childhood and is small, the size of the correlation increases with age. Peer and parent pressure along with the constant media bombardment of the "perfect body image" already serve to undermine a child's satisfaction with his or her own body. BMI, while intended to be helpful, may be having the opposite effect.

There are very few bandwagons that I don't jump on but this is one of them. While I acknowledge the problem of childhood obesity I also cringe at the idea of telling a not-yet-done-growing child that they are overweight when in fact, their height possibly just hasn't caught up to their weight and left to its own devices, will self-correct. Physical health risks may have been averted but what of the emotional damage? There must be a balance somewhere but I haven't found it yet. And it's not just the schools getting into the BMI business that worries me (even though that's where an "overweight" reading is likely to spread like wildfire) - it's even how some pediatricians approach the topic. How about a little sensitivity for starters. How about the doctor taking the parent aside and talking about it amongst adults instead of right in front of the child? Or how would you respond to the doctor's nurse asking, "Any concerns about his/her weight, Mom?" just after weighing the child in - but still within earshot of that child? My response? "Ask me when he/she is done growing".

I know a lot needs to be done in terms of making our kids healthier and preparing them well for adulthood. We need to make sure they get enough exercise and are eating healthy foods as often as possible - and in a world of fast food and video games, that can be a real challenge. But by properly addressing their physical needs, we also need to keep their psychological health intact as well. We need to bring up the best generation we can.

So what do you think is the right balance to strike here? To BMI or not to BMI before puberty - that is the question.

Does Low-Carb Make You Crankier Than Low Fat?

Photo: FL4Y

So scientists just did another study pitting low-carb diets against low-fat diets. They took a bunch of overweight Australians, put some on low carb and some on low fat diets, and followed them for a year. Both groups lost about the same amount of weight (30 lbs), but by the end, who was in a better mood?

Well, looks like the Low Fat team won this round.

Hooray for the Low Fat Team!!
Photo: terrapin

Yep: the low-fat dieters were feeling significantly more chipper after a year of dieting than the low-carb group.

But here's the most shocking result the researchers found:

After the first eight weeks, both groups improved in mood. And while the Low-Carbers went back to baseline, the Low-Fatters remained more upbeat than they were when they started, even a year later.

But wait a minute... isn't dieting supposed to be miserable? Doesn't it make us feel anxious, pissy, deprived, fatigued, and depressed?

Well, apparently not for this group. But the low carbers couldn't hang on to their improved moods, while the low-fatters did.

According to the researchers, “this outcome suggests that some aspects of the low-carbohydrate diet may have had detrimental effects on mood that, over the term of one year, negated any positive effects of weight loss.” They wondered if it was the "social difficulty" of going low-carb, or the impact the diet itself might have on serotonin levels.

(Personally, I'm not in either the low-fat or the low-carb camp: for me, I like a good balance of carbs, protein, and healthy fats. It's the kind of fats and carbs that matter to me--I try to eat the healthy kinds, not the junky kinds).

But it's funny, I hadn't realized how much I'd bought into the idea that "dieting is miserable" until this study reminded me that actually, that's not necessarily true. I've settled into healthy eating patterns and have been at a fairly stable weight for so long, I forgot that deciding to lose weight and succeeding can make you happier! Seems obvious, but so many aspects of the process are annoying that I kinda lost sight of the big picture.

In fact, I remember years ago when the Lobster and I decided to change our eating habits, track what we consumed, and try to lose weight, we refused to call it a "diet." We called it going on a "Thing."

We'd say things like:

"Wow, I didn't realize how small a serving of pasta was until we started the Thing."

"Hey look how loose these pants are, I think the Thing is working!"

Even now, when I start getting a bit sloppy about too many treats I'll say: "if I don't stop eating so much junk, I'm going to have to go back on a Thing."

But when we were on The Thing? I'd forgotten that we were actually pretty psyched about it most of the time. Sure, the tracking and measuring and planning was a huge pain in the ass, but there was a big sense of accomplishment at (mostly) sticking to our plans and (mostly) meeting our goals.

However, we only had about 20 or so pounds to lose. We weren't in a hurry, and we didn't have to do anything drastic. And lucky for us, we both have pretty "normal" metabolisms that respond obediently to increased exercise, fewer empty calories, and more muscle mass. I know many folks can do all the right stuff and not get results, which must be incredibly frustrating.

But it's interesting the way I automatically assume that "dieting" is some sort of unpleasant ordeal, when my own experience was that it was pretty darn rewarding, even though I was certainly happy to stop measuring and counting once I reached my goal. I know restricting caloric intake can be completely counter-productive for a lot of people--but this study reminded me that for other people, it can also lead to a better mood.

Now I haven't personally noticed my low-carb friends being any more depressed or cranky than other dieters, but now I'm wondering, after this study, if there are any extra mood challenges with that sort of plan. And I'm curious about the "social difficulty" of a low carb plan--I picture hordes of angry pitch-fork wielding villagers chanting "bread, you must east bread!"--but I expect it's probably a bit more subtle than that.

What have you folks found? Does "dieting" or otherwise consciously limiting your food intake make you feel more miserable, or more upbeat? Does low-carb feel any worse (or better) than other plans?