Sunday, July 15, 2007

What do the WHEL Study and the movie Sicko have in common?

Before the credits start to roll, Michael Moore's movie Sicko ends with the simple statement "Eat your fruits and vegetables and take a walk". Good advice for all of us in order to reduce our risk of many chronic diseases such as cancer, heart disease, and diabetes, and thus reduce our interactions (and cost) with the healthcare system.

Now recently reported data from the control group in the Women's Healthy Eating and Living Study (WHEL) has shown that the combination of eating 5 or more daily servings of fruits and vegetables plus walking an average of 30 minutes/day 6 days/week can reduce the risk of breast cancer recurrence nearly 50%. The good news is that these remarkable and hopeful data were true even in women who were obese.

The bad news from this study however, showed only 30% of the non-obese women and only 16% of the obese women in this group adhered to both of healthy lifestyle guidelines. There can be a multitude of reasons why such as low number of the 1,490 women in the control arm of the study achieved these baseline guidelines. Maybe they were told something non-specific like I was ("eat right and exercise") when I asked my oncologist after chemo was completed what I could do to help myself both recover and improve my odds for long-term survival. I didn't know what that well-intended but vague advice really meant for a cancer survivor, and I am a Registered Dietitian! Since 1995, I have been dedicated to finding a better answer to my question than I was given and then sharing the information with other cancer survivors.

Now these specific (and easy to achieve) suggestions may be "what the doctor orders". A very important point to understand is that these remarkable results were ONLY seen when daily exercise was combined with the daily 5+ servings of fruits/veg. The advantage simply was not there if women only practiced one or the other of the healthy behaviors.

My recommendations:
(1) If you are done with your breast cancer therapy, don't wait for this study to be repeated in order to start implementing these two healthy lifestyle recommendations.

(2) If you are currently in treatment for breast cancer, don't wait until therapy is completed to get started on these two healthy lifestyle recommendations. You may not be able to achieve 5+ servings of fruits and vegetables every single day while undergoing your therapy, or 30 minutes of walking every day, but do your best to get started now. It is very likely that additional future research will show that early changes in this manner during therapy will also be helpful.

(3) If you have (or have completed treatment for) another type of cancer, don't wait for this study to repeated for your type of cancer. Follow these same two recommendations now. They are the same recommendations for optimizing your overall health.

(4) If you are a cancer survivor and have lost significant weight during therapy and/or also have medical conditions such as diabetes, overweight/obesity, food allergies, GI disorders or symptoms as a few examples, I highly recommend seeking the expertise of a Registered Dietitian (RD) at your cancer treatment facility who can assess your overall nutritional and lifestyle requirements to design a plan that meets your individual nutritional needs to improve your overall health.

(5) Think of these %'s. A reduction in recurrence of ~50% is truly astounding with strategies that are easy to achieve (available and affordable). Do not wait for more research to try to find a "silver bullet", either a specific food or a specific vitamin, antioxidant, dietary supplement, herb, etc.

Here is the article information. You can find the abstract by clicking on PubMed on my favorite links and type in any key words (I would simply use Rock CL breast cancer):
Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity.
Pierce JP, Stefanick ML, Flatt SW, Natarajan L, Sternfeld B, Madlensky L, Al-Delaimy WK, Thomson CA, Kealey S, Hajek R, Parker BA, Newman VA, Caan B, Rock CL.
J Clin Oncol. 2007 Jun 10;25(17):2345-51.

Much more data will be coming out from the WHEL Study over the next year. I'll keep posting it.

Just to let you know that I "walk the walk", I do consume a minimum of 9 (yes a minimum of 9!) servings of fruits and vegetables daily, even on days that I travel. I also walk at least 30 minutes daily. Usually I take my dog for a 30-40 minute walk 2x/day that is a "power walk". I make her move for most of that time (only when we get to a park at the end of our walk do I let her slow down to sniff everything!).

Do I recommend seeing the movie Sicko? Yes.................if I can synthesize my thoughts about it, I'll post them later.

In the meantime, at the risk of sounding like your mother but really as your cheerleader, eat your veggies and take a brisk walk!

Diana Dyer, MS, RD :-)

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