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Fitness Fights Cancer
The Fitter You Are the Less Likely You Are to Develop or Die from Cancer
Chalk up one more for exercise as medicine. A link has been found between fitness in middle age and future cancer risk. The fittest men were up to 68 percent less likely to develop cancer 20 to 25 years later. Every additional three minutes on the treadmill test reduced cancer death risk by 14 percent.
Data from preventive health exams at the Cooper Clinic in Dallas made the study possible. “There’s really no other population where we have the assessment back in time,” lead author Dr. Susan Lakoski told PBS News Hour.
Lakoski and her team studied more than 17,000 men, who had been pushed to their limit on the treadmill when they were about 50 years of age; grade and then speed was increased until they were no longer able to keep up. Twenty to 25 years later, Medicare claims data was analyzed to see who had developed the top three cancers in men: prostate, colorectal, and lung.
Lakoski, an assistant professor of internal medicine at the University of Vermont, presented the results at the annual meeting of the American Society of Clinical Oncology on June 2, 2013.
During the 20 to 25 year follow-up, 2,332 men developed prostate cancer, 276 developed colorectal cancer, and 277 developed lung cancer; 347 men died from cancer.
The top 20% on the treadmill test, when compared to the bottom 20%, had a 68 percent lower risk of lung cancer and 38 percent lower risk on colorectal cancer. Prostate cancer risk didn’t decline with increasing fitness, but the risk of death from prostate cancer did.
The risk of death in those who developed any of the three cancers was significantly lower for the fittest men. As noted, every additional three minutes on the treadmill lowered their risk of dying from cancer by 14 percent.
Many other studies have found a connection between cardiovascular fitness and cancer, but this is one of the first to be based on actual fitness testing; most earlier studies were based on self reporting. This is the first study to show that fitness can predict cancer risk years into the future.
Being an observational study, causation was not established. The study showed that fitness and cancer are linked, but not why. Asked by PBS News Hour to make an educated guess, Dr. Lakoski gave a detailed and convincing explanation:
Your fitness is your ability to be efficient at getting oxygen to all of your organs. And we know that being efficient and getting oxygen to all of your organs is very important in modulating different pathways involved in inflammation, hormone levels, immune surveillance, and oxidative damage. All of these things play into reduced cancer risk. We did not assess these pathways in this particular study, but what we did show was that fitness does reduce the risk of cancer.
“Be fit,” says Dr. Lakoski, is the message. She now puts every cancer patient that comes to see her on the treadmill to assess their fitness.
“If I can put you on a treadmill and say, ‘You went this many minutes…that is associated with X reduction in cancer risk…, that’s very meaningful,” she told Maggie Fox of NBC News. “Two things you can’t change are your genes and your age,” she added. “But you can get more fit.”
Bravo, Dr. Lakoski!
* * *
I believe I am one of the 17,000 men included the Lakoski study. My fitness was first evaluated at the Cooper Clinic in 1988, when I was 50. You can read all about it: http://www.cbass.com/COOPER.HTM
You’ll see that Dr. Jensen was already using treadmill times to encourage patients to become fitter and healthier. David Prokop wrote about it in Muscle & Fitness magazine:
At the Cooper Clinic, Jensen watched Bass closely throughout his treadmill test, encouraging him or just offering interesting health statistics.
At 17 minutes on the treadmill, with Bass' heart rate at 150 as he walked steadily, Jensen told him, "You can eliminate fatigue as a health risk factor at your current level."
As the clock was approaching 19 minutes, Jensen told Bass, "Once you get past the 19-minute point, you'll be at the excellent percentile for your age group."
Bass went all the way to 28 minutes, finally stopping at a maximum heart rate of 183. Twenty-eight minutes is actually considered a superior fitness level for men under 30. Clarence was 50 then. It's also 1.5 minutes beyond the 99th percentile for men in his age group.
"You certainly have proven today the fallacy of the belief that you can't bodybuild and be aerobically fit at the same time." Jensen said. "That's a myth that has to be dispelled."
Later, Jensen told the Basses: "I believe you've got to have balance in your training regimen, but it's pretty hard to get people to believe that. I'd like to get more bodybuilders out here and test them. This is what we need to do to get the word out - that weight or resistance training, done properly, along with aerobic exercise, can give you tremendous aerobic fitness as well as muscular strength and tone."
Clearly, resistance training helped me get to 28 minutes on the Cooper Clinic treadmill test.
A 2009 study, which used both strength and aerobic fitness data from the Cooper Clinic, found that both forms of training help ward off cancer:
Muscular strength in the upper and lower body was tested using one-rep maximum in the bench press and leg press.
The study found that muscular strength and cardiorespiratory fitness were only “moderately correlated.” This suggests that the associations between the two forms of fitness and cancer risk involve “different mechanisms.” Both strength and aerobic fitness appear to have profound and independent effects on cancer risk. A combination of the two forms of fitness, working together, would appear to be most protective—and that’s what the study found.
Age-adjusted death rate in men with high levels of both muscular strength and cardiovascular fitness was 60% lower than the death rate in unfit men with the lowest level of muscular strength. Unquestionably, it pays to be both strong and fit.
The report listed a number of “plausible mechanisms” that may explain the independent protective benefits of higher levels of muscular strength. They include: “regulation in the metabolism of insulin, and insulin-like growth factors…, reduced exposure to systemic inflammation, sex hormones, improved antioxidant defense and immune function, and reduced overall and central adiposity.”
Sounds a lot like Dr. Lakoski’s explanation, doesn’t it? Both explanations, taken together, help us understand why exercise is such powerful medicine.
The parallels or overlaps between the two forms of fitness are also consistent with “The Aerobic-Strength Alliance” described in my book Take Charge. The idea is that the two forms of training produce responses along a single continuum. You can’t have one without some of the other.
Importantly, resistance training challenges muscle fibers and pathways seldom used in traditional cardiovascular training; for example, neither running or biking do much of anything for the muscles of the upper body. To be totally fit you must train the entire body.
The take-home message is loud and clear: Resistance training and aerobic exercise work together to fight cancer.
For more details on the 2009 study go to
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