Researchers continue to discover evidence of the health benefits for cancer survivors (especially for women) who exercise during treatment and beyond. But studies designed to measure the effectiveness of exercise programs consistently fail to find approaches that are successful long-term.
Why is it that we can’t design an exercise program that excels at helping people become more active after a cancer diagnosis?
“If we had a pill that conferred all the confirmed health benefits of exercise, would we not do everything humanly possible to see to it that everyone had access to this wonder drug?” asked Dr. R.E. Sallis.1
Obviously, each person’s situation is unique, and every exercise prescription must reflect the specific diagnosis, treatment, and health status. Still, oncology centers can do far more to clarify what kind of exercise is important, and why, and what a successful exercise program looks like.
Benefits of Moderate Activity
Researchers, and most Americans, know that compared with a sedentary lifestyle, 150 minutes weekly of moderate activity throughout the day reduces the risk for heart disease, type 2 diabetes, high blood pressure, and many forms of cancer. This often-cited Surgeon General recommendation for 30 minutes of exercise daily, most days of the week, has been public policy for more than a decade.
But recent research reveals that it is your minutes of activity and your hours of uninterrupted sitting that are critical determinants of health.
“People convince themselves they are living a healthy lifestyle, doing their 30 minutes of exercise a day. But they need to think about the other 23.5 hours,” says Dr. Emma Wilmot, University of Leicester, England.2
“People who go to the gym do not reverse the health impact of prolonged sitting,” says Dr. James Levine.3
This idea is an unwelcome surprise to committed exercisers and to those who are trying to start. How can this be? We’ve been told repeatedly that 30 minutes of exercise daily is the magic number for health. But we often overlook the part that emphasizes the need to be active throughout the day. What is it about prolonged sitting that is so disastrous?
James Levine, MD, is Director of the Mayo Clinic, Arizona State University Obesity Solutions Initiative, and author of Get Up! Why Your Chair Is Killing You and What You Can Do About It. He explains that when we eat a meal, our blood sugar shoots up, our pancreas pushes out insulin, and the insulin drives the meal’s sugar into our muscles. If muscles are idle, the surplus blood sugar fills the bloodstream. If this is repeated daily for years, we can get diabetes.
Dr. Levine suggests that even if you run for 30 minutes in the morning, if you then drive to work, sit at your computer, eat lunch at your desk, and work through your lunch hour, you’ll have elevated blood sugar.
The easy solution is moderate physical activity immediately after your meal—take a walk. Dr. Levine says that just a 15-minute walk at 1 mph after eating will cut the blood sugar peaks in half.
Exercise Doesn’t Mean Weight Loss
A second factor that may discourage people is the assumption that moderate activity will result in weight loss. Too often, programs that focus on increasing activity tout weight loss as motivation. That misunderstanding derails many people who try to commit to improved health.
“Some people say exercise doesn’t do anything. Well, exercise does a lot. It just may not show up on the scale,”4 says John Jakicic, MS, PhD, Director, Physical Activity and Weight Management Research Center, University of Pittsburgh.
Many people think, “No weight loss, no improvement in health.” That’s simply wrong. Activity confers health benefits, and weight loss confers health benefits; the benefits are similar, but the paths to achieve them are not the same.
If you are slowly gaining weight as you age, and you don’t know why, you are not alone. Even in 2016, activity and obesity researchers are perplexed about the causes of the creeping weight gain that has led to America’s “obesity epidemic.”
Does Exercise Affect Weight?
The rift among scientists about the cause for the rise in overweight Americans became public when cardiologist Dr. Aseem Malhotra wrote that no matter how vigorously you exercise, or how many activity trackers you use, “exercise won’t make you lose weight.”5 But he agrees that working out will make you healthier and less susceptible to disease.
“No matter what your size, even 20 to 30 minutes of physical activity that breaks you into a sweat five times per week will substantially improve your health and well-being,”5 he said. But if weight loss is your goal, your diet has to change, he says. “You can’t outrun a poor diet.”5
That unleashed a barrage of responses from exercise physiologists who claim that Dr. Malhotra ignored more than a decade of evidence showing the opposite.
Everyone agrees that the causes of weight loss, weight gain, and obesity are too complicated to untangle. It is extremely difficult to design studies that yield a clear answer to the question, “What is the best way to lose weight?”
But many exercise researchers cite studies that indicate physical activity plays a crucial role in preventing weight gain as we age. The question remains—How do we engage in sufficient physical activity to manage our weight?
Work and Exercise
Too many Americans today sit all day at work. And because we spend so much time at work, we need ways to become more active physically at work. So how do we do that?
Researchers have looked at workplace fitness programs, and found that a fitness center at the workplace doesn’t help much. Some of the problems associated with workplace fitness are:
- Exercise ruins hairstyles needed for businesslike appearance
- Employees dislike being seen in sports clothing
- Employees feel pressure to work through lunch or run errands to support their families
- Employees worry colleagues will view time spent exercising as dodging work responsibilities.
Here are some tactics to reach 150 minutes weekly of moderate activity throughout the day by getting out of that chair that is killing you:
- Set your desk alarm to sound every hour, reminding you that it is time to move. If you move for 4 minutes every hour in an 8-hour day, that’s 32 minutes; you’ve achieved success.
- Take a walk to talk to your colleagues instead of e-mailing or phoning them. A face-to-face discussion brings an extra measure of engagement; you are more active and more productive.
- Stop working through your lunch hour. Enough said.
Bottom line: It may be easier than you think to accumulate enough of the right kinds of activity to lower your risk for relapse, prevent chronic illness, and keep your weight under control.
- Sallis RE. Exercise is medicine and physicians need to prescribe it! British Journal of Sports Medicine. 2009;43:3-4.
- Sitting for long periods ‘is bad for your health.’ BBC News. October 15, 2012. www.bbc.com/news/health-19910888.
- Levine JA. Get Up! Why Your Chair Is Killing You and What You Can Do About It. New York, NY: Palgrave Macmillan; 2014.
- Oaklander M. The new science of exercise. Time. September 12, 2016. http://time.com/4475628/the-new-science-of-exercise.
- Malhotra A. Take off that Fitbit. Exercise alone won’t make you lose weight. Washington Post. May 2015. www.washingtonpost.com/posteverything/wp/2015/05/15/take-off-that-fitbit-exercise-alone-wont-make-you-lose-weight/?utm_term=.a00fdc9f2221.