A “Teachable Moment” for Prevention

The role of diet and exercise in cancer risk reduction is gaining more research attention. The top preventable causes of death in the US are tobacco use, overweight, and sedentary behavior (1). Of these modifiable factors, experts estimate that a full one-third of cancers are attributable to overweight and sedentary behavior (2). In post-menopausal women with a BMI over 25 kg/m2, data show increased risk of developing breast cancer, having a shorter survival time after a breast cancer diagnosis and a higher likelihood of mortality (3). In contrast, women with a BMI < 25 kg/m2 have longer breast cancer survival and a lower risk of a breast cancer recurrence; they also have lower risk of developing heart disease and diabetes (4). To determine your own body mass index go to:

While the majority of women in the US have a BMI over 25, the good news is that physical activity is associated with lower rates of breast cancer. Regular exercise benefits all systems of the body and thus, is one of the best choices for improving your health. Positive effects of routine activity include building stronger muscles and bones, having more energy, less depression, more aerobic capacity, better cognition, and burning more calories towards losing weight, for starters. Women who regularly, do even moderate exercise, such as walking, were shown to be less likely to develop breast cancer, than those less active. Further, in a study by Holmes et al. (5), women starting to exercise after a breast cancer diagnosis, showed lower rates of cancer recurrence than those who were more sedentary. The protective effects that are associated with breast cancer may be linked to the positive effects of exercise on the immune system. The American Cancer Society recommends 30 minutes of moderate to vigorous exercise at least 5 days/week for adults.

So is it generally difficult to motivate breast cancer patients and survivors to improve their health habits? Often, it is quite the opposite. Breast cancer patients and survivors often express interest in learning more about the role of diet and exercise in cancer risk reduction and in sources of information and experts to help them make such changes This period of particular interest has been labeled “a teachable moment” (6) related to the level of readiness that patients and survivors often display. However, in general, more information on the benefits of healthy habits is available across communication channels which may account for the increased interest in healthy eating and exercise, as well.

Becoming more nutrition savvy and physically active can have systemic benefits across areas of your life, beyond its physical benefits. In addition, in making a commitment to improve your own health habits, you may serve as a positive role model for those around you such as your spouse, your friends, and your sons and daughters. In taking time to improve your health, you may be providing a “teachable moment” to those around you!

By: Diane Baer Wilson, EdD, RD – Wellness after Cancer dbwilson@vcu.edu

References:

1. Mokdad AH, Marks JS, Stroup BF, Gerberling JL. JAMA 2004; 291:1238-1245.
2. American Cancer Society, 2011. (www.cancer.org)
3. Eliassen AH, Colditz GA, Rosner B. et al. Adult weight change and risk of breast cancer. JAMA 2006; 296; 193-201.
4. Nichols HB, Trentham-Dietz A, Egan KM et al. Body mass index before a diagnosis: associations with all-cause breast cancer and cardiovascular disease. Epidemiol Biomarkers Prevention 2009; 18: 1403-1409.
5. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity after a cancer diagnosis. JAMA 2005;295:2479-2486.
6. Wahnefried DM, Azia NM, Rowland JH, Pinto BM. Riding the crest of the teachable moment for promoting health after a breast cancer diagnosis. J Clin Oncol 2005; 23:5814-5830.