Take steps to reduce breast cancer risk. Literally.

Many local and national organizations are busy promoting breast cancer awareness, sharing information about the disease, raising money to support research, and celebrating survivors as a part of Breast Cancer Awareness month. This represents the most visible part of a year-round effort to educate about, screen for, and hopefully cure this devastating disease. Of course, these are all worthy goals that deserve our attention and support. What is often missing are the steps women—especially young women—can take to reduce their risk for, or even prevent, breast cancer. This is the topic of my Health & Fitness column in the Aiken Standard this week.

cancer exercise group

Approximately 1 in 8 women will develop breast cancer. The American Cancer Society estimates that around 300,000 new cases of breast cancer are diagnosed and nearly 40,000 women die from this disease each year. Breast cancer can occur in men, but these cases are rare, so the focus is rightfully on women.

Much attention is given to genetic factors that increase the risk of breast cancer. These include certain gene mutations, including BRCA1 and BRCA2, as well as family history. A woman who has a first-degree relative (mother, sister, or daughter) who has had breast cancer has nearly twice the risk of being diagnosed herself.

Considering that most women diagnosed with breast cancer have no family history, it is also important to try to reduce other modifiable risk factors. This involves making health behavior changes that are probably familiar to most people. Among these is regular exercise.

Regular activity and exercise can lower breast cancer risk by as much as 30%, according to a study of over 3,000 women. The intensity of the activity didn’t seem to matter, so participation in light activity such as housework and gardening was as effective as walking. What did matter was the amount of time spent being active. Women who reported even low amounts of activity showed a 6% reduction in breast cancer risk, but the greatest benefits were seen in women who were active for over 10 hours per week.

Women who exercise regularly also have a lower chance of recurrence of breast cancer. As many as 1 in 5 of breast cancer survivors experience a recurrence within 10 years. Even relatively low levels of exercise may reduce this risk, and women who do exercise have greater rates of survival. The amount of exercise needed to realize these benefits is equivalent to 45–60 minutes of brisk walking five days per week.

Exercise is effective for reducing breast cancer risk because it lowers levels of the hormone estrogen. This is important because estrogen is linked with the majority of breast cancers and is especially relevant for women with estrogen receptor-positive cancers.

Exercise can also reduce the risk of breast cancer by helping with weight control. Excess body fat increases levels of estrogen, resulting in a higher risk of breast cancer diagnosis and recurrence. Regular physical activity is essential for losing weight and keeping it off. Exercise can also help reduce the increased risk of breast cancer that comes with weight gain, something that is common as women get older.

Women who have been active their whole lives have the lowest risk of breast cancer, but it is never too late to start. Women who exercise also tend to handle breast cancer treatment better than women who aren’t active. In fact, post-cancer exercise programs are becoming more common as a way to help women recover from cancer treatment and prevent recurrence.

Other lifestyle changes that can reduce the risk of breast cancer include maintaining a healthy body weight, consuming alcohol in moderation, not smoking, and eating a diet rich in fruits and vegetables. The good news is that these changes will also help you reduce your risk of other cancers, cardiovascular disease, and most other chronic diseases, too.

Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
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 drbrianparr@gmail.com | http://twitter.com/drbrianparr

How to avoid doing too much too soon when you start an exercise program

Regular exercise is one of the most important things you can do for your health. For many people, this means walking on the treadmill for an hour, doing a circuit on the weight machines, or going through the same aerobics class again all in the name of losing weight and getting fit. But it doesn’t have to be this way.

The current trend of high-intensity exercise workouts (CrossFit is one example) that emphasize shorter bouts of vigorous aerobic and strength exercise can hardly be described as boring and can produce even greater results than traditional exercise regimens. Some of these programs claim that you can “transform your body” or lose 10–20 pounds by participating in a three-week fitness challenge. Or maybe you are interested in trying high-intensity interval training (HIIT) to get the benefits of exercise in as little as 10 minutes per session.

It’s not as easy as it sounds, though. In order to get the fitness and weight loss benefits, the exercise must be done at a very high intensity, which may not be right for everyone. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Boot camp workout

To be sure, these types of fitness programs can be safe and effective for burning calories and improving fitness. But because they are intense means that you need to be fit to even get started, so they may not be a good choice for people who are not already in shape or who are new to exercise. There is a greater risk of injury and even heart attacks in people who are unfit and start exercising at a very high intensity. At the very least, muscle soreness is likely and may impact your ability—and motivation—to repeat that exercise the next day.

Ideally, an exercise program would begin with a health and fitness assessment by a certified exercise professional to determine potential health risks. These results would be used to create an exercise prescription. For participants who have risk factors like high blood pressure or diabetes, those variables would be monitored to make sure the exercise sessions were safe and effective.

In the real world, many people who have these conditions simply show up at a gym to begin an exercise program, often with little or no review of health history or assessment of fitness. In most cases this is safe, but without some form of monitoring participants who have high blood pressure or diabetes may have problems. This is especially concerning since many people don’t know they have these conditions, which is why seeing a physician is often recommended before undergoing fitness testing or starting an exercise program, especially if you are over 40 years of age or have other health problems.

A good personal trainer or exercise leader should ask about your health history and perform some type of assessment to gauge your current fitness and use this information to start you at an appropriate level. Even the most intense exercise programs, classes, or videos are scalable to all fitness levels, but you need to know where you are starting from. Additionally, a qualified personal trainer or group exercise leader can help you learn proper techniques to reduce the risk of injury and improve your progress.

Once you begin, resist the temptation to do too much, too soon by going at your own pace. This is especially important in group exercise programs where you may feel pressure to keep up with other, fitter participants. Listen to your body, too. Feeling some level of fatigue and soreness is normal, but severe shortness of breath, chest discomfort, or muscle and joint pain, especially if it comes on suddenly, is a good reason to slow down or stop. Make sure you communicate how you are doing to trainer or exercise leader, too.

Maybe you will find that the intensity and variety of these exercise programs keeps you motivated to meet your goals.  But don’t forget that even if you aren’t pushing yourself, any exercise you do will have significant health and fitness benefits.

Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
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 drbrianparr@gmail.com | http://twitter.com/drbrianparr

How low should you go?

When it comes to your health, making even small changes can lead to big improvements. Whether you are trying to eat a healthier diet, get in shape, or lose weight, a little effort can go a long way. But doing more can produce even more meaningful changes.

The same is true for risk factors including blood pressure, cholesterol, and glucose. For example, if you have high blood pressure, you can reduce your risk of having a heart attack or stroke by lowering it, even if it doesn’t get into the “normal” range. This is often a goal for patients with high cholesterol or diabetes, too.

According to recent news reports, a major study suggests that treating risk factors—specifically, hypertension—to bring them well below previous targets has even greater benefits. This study, and how it applies to other health indicators, is the topic of my Health & Fitness column in the Aiken Standard this week.

blood pressure

The study, which examined the effect of lowering blood pressure on heart attack and stroke risk, produced such remarkable findings that the results will be published two years ahead of schedule. The researchers found that lowering systolic blood pressure (the top number) to less than 120 mmHg resulted in a risk of heart attack or stroke that was significantly lower than that of treating blood pressure to a typical goal of below 140 mmHg.

This suggests that getting your blood pressure out of the “high” category isn’t enough and that lowering it more is beneficial. Not only is this is good news for people with hypertension, but it also likely applies to other conditions as well. For example, the goal for people with type 2 diabetes is to get blood glucose level, frequently determined by the “A1c” number, as low as possible to prevent complications like blindness, kidney failure, and amputations. And it seems that the risk of heart problems are reduced proportionally to how low LDL cholesterol gets.

This concept can also be applied to health behaviors. For people who are mostly sedentary, something as simple as a 30 minute walk each day can lead to big improvements in fitness. And simply swapping high-calorie drinks like soda or sweet tea for water or other calorie-free beverages can result in noticeable weight loss for many people. And overweight individuals can reduce their risk of diabetes by losing as little as 10% of their excess weight.

But greater changes to activity level or diet almost always have even bigger benefits. Cutting back on calories from drinks is a good start, but losing significant weight almost always requires making other changes in what you eat and how active you are. Walking is an excellent exercise, but greater improvements can be achieved by doing more, either longer duration or a higher intensity. And building muscle will require doing some form of resistance training—walking typically isn’t enough.

It’s true that every pound of weight loss matters, and many people notice changes in how they feel or how their clothes fit after losing as few as 10 pounds. But real transformations in appearance or health require more significant weight loss, especially for people with greater obesity.

Although the SPRINT study focused on only one factor, blood pressure, we shouldn’t limit ourselves to making only one change when it comes to our health. Indeed, the benefits of increasing activity, losing weight, and eating healthier together far exceed doing only one. And, while even small changes make a difference, doing more will almost always result in bigger benefits.

Forget about low-carb, go smart carb.

Nutrition advice tends to be complicated and contradictory, making simple answers to the question, “What should I eat?” anything but simple (but you still need to do it!). This is particularly true when it comes to carbohydrates. On one hand, current recommendations call for carbohydrates to be the major part of your diet. On the other hand, low-carbohydrate diets are at odds with these recommendations but are still very popular.

For example, the Atkins diet restricts all carbohydrates, including refined grains and sugars. The Paleolithic diet emphasizes minimally processed foods that may have been consumed by our ancient ancestors including lean meat, eggs, fruit, and vegetables while restricting the consumption of grains and added sugars. Both have been shown to promote weight loss better than traditional low-fat diets.

Proponents of low-carbohydrate diets claim that restricting carbohydrates promotes fat loss and eating carbohydrates leads to fat storage and weight gain. It is also likely that people who follow low-carbohydrate diets find them easier to stick to than other diets, so they may actually end up eating fewer calories.

But the problem may not be carbohydrates in general, it might be eating too few of the right carbohydrates. Given that September is Whole Grains Month, this seems like a good time to explore the benefits of going smart-carb instead of low-carb. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Food grains

Sources of carbohydrates include whole grains (such as whole wheat bread), refined grains (white bread), and sugars. Both refined grains and sugars tend to raise blood glucose rapidly, called the glycemic index, which leads to an increase in certain hormones, including insulin. Insulin stimulates the uptake of nutrients into cells, including the storage of fat in adipose tissue. This is one reason why carbohydrates are linked to fat gain and why restricting carbohydrates leads to fat loss.

But carbohydrates from whole grains don’t raise either blood glucose or insulin as much. This “low and slow” response has several benefits, including improved blood glucose regulation, lower triglycerides, and, potentially, reduced fat storage. For these reasons, complex carbohydrates from whole grains are called “good carbs,” in contrast to refined grains and sugars, known as “bad carbs.”

Considering that the typical American diet contains too much carbohydrate from sugars and refined grains and not enough whole grains, restricting carbohydrates may have some benefits. But there is another approach: be smart about your carbohydrate choices. Instead of cutting out all carbohydrates, focus on reducing refined grains and sugars and emphasizing whole grains.

You can meet this goal by limiting your intake of sugars, especially added sugars, and refined grains while increasing your consumption of whole grains, fruits, and vegetables that are high in fiber. When comparing food labels, look for foods that contain whole grains (the first ingredient should be something like “whole wheat flour”) and higher levels of fiber. But be aware that some foods, like many breakfast cereals, contain whole grains but are also high in added sugar. The best advice is to get the majority of your carbohydrates from real food, including vegetables, fruits, whole grains, and legumes, rather than from processed foods.

Something to keep in mind is that although low-carbohydrate diets are associated with weight loss and good health, they are not the only way to achieve these benefits. Indeed, people who are considered to be fit and healthy have a wide range of eating patterns, from vegetarian and low-fat diets to extreme low-carbohydrate diets and everything in between. The one factor they have in common is that they are active. It may be that regular exercise is just as important as what you eat when it comes to promoting health.

Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

What is your second chance New Year’s Resolution?

Last week I was a guest on the RadioMD show, Train Your Body, to talk about the idea of using this transition from summer into fall as a second chance to revisit stalled or failed New Year’s Resolutions. In the discussion, Melanie Cole (the host) asked listeners to share their Second Chance New Year’s Resolutions.

I figured I would play along, too. Here’s mine…

Version 2

I registered to complete a fitness challenge at our campus Wellness Center called PacerFit. It is a 12-week program with weekly workouts that are scored based on performance (time to complete, weight lifted, reps completed, etc.). Most of the participants are students–many of them mine–so the pressure is on!

This is part of a broader goal of mine to shift my focus from exercise for health to exercise for fitness. For the past several years, my activity and exercise habits have been more geared to meeting health goals. But this seems like a good time to start doing more real training for the purpose of improving fitness. And the PacerFit challenge seems like a good way to start.

Good luck with your second chance New Year’s resolution!

Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

A second chance for your New Year’s resolutions

How are you doing on your New Year’s resolutions? Hopefully, you are still on track to meet your goals. If not, you are in good company. Research suggests that by this time well over half of people who made New Year’s resolutions have either lost momentum or given up altogether and that only 8% will achieve their goal.

There are a host of reasons for this. Some of the most common resolutions—quitting smoking, losing weight, and getting in shape—are also some of the most difficult behaviors to change because they require making significant lifestyle modifications. To make things worse, many people set unrealistic goals or try to take on too much at once.

Many people who fail to keep their New Year’s resolutions this year will recycle them next year and try again. In fact, most people who manage to successfully quit smoking or lose weight have tried many times in the past. Sometimes experience, even a bad experience, is the best way to learn what does and doesn’t work.

But there is no need to wait until January 1 to try again. It turns out that now is a perfect time to restart your stalled New Year’s resolution or finally get around to doing what you planned months ago. Labor Day marks the end of summer and the beginning of a new school year, so it is a natural time to set goals and make changes. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Resolution list

Since setting a date to begin a behavior change is critical step in the process, why not give yourself a second chance on your New Year’s resolutions today?

Here is some advice to help restart (or start!) your New Year’s resolutions successfully.

Be realistic. Many people fail to keep their resolutions simply because they don’t set realistic goals or aren’t honest with themselves about what it will take to meet those goals. For example, running a marathon is an ambitious goal for almost everyone, especially someone who doesn’t exercise at all. A resolution to work up to jogging five days per week, with a goal of completing a 5k run is more realistic and achievable.

Focus on learning. Making most health behavior changes involves learning as much as doing. Something as simple as eating healthier meals requires learning about the nutrients that make some foods better than others, learning to read food labels to select healthy foods, and learning how to cook and prepare healthy meals. If your resolution is to learn about healthy meals, you will be able to achieve that goal and be well on your way to eating a healthier diet.

Manage your time. Most health improvement projects require taking time to learn about, implement, and maintain those healthy behaviors. If you resolve to manage your time to include exercise or meal preparation in your daily schedule you will be much more likely to meet your goals. Trying to add these new activities as “extras” to your already busy day will inevitably lead to them getting squeezed out.

Plan ahead. Most people already know that changing health behaviors can be challenging, even under the best circumstances. It’s no wonder that holidays, travel, and other life events can complicate or even derail an otherwise successful diet or exercise program. Make it your resolution to think about what you can do before, during, and after these (and other) disruptions occur to keep yourself on track.

Hopefully these steps will help you keep your resolutions, achieve your goals, and make this a happy, healthy year. As a bonus, you can take January 1 off!

Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

It’s not your fault, but it is your responsibility.

Eating well and being physically active are two of the most important things you can do to promote good health. But knowing you should do these things does not always mean it is easy to actually do them.

Despite the simplicity of the message “eat healthy and exercise,” many people struggle with knowing exactly what to do and how to do it. This is largely due to the complicated and ever-changing nature of nutrition and exercise information and the fact that most people receive no education in these areas.

You may even feel like the information you read and hear is designed to confuse you. That may be true, considering that much of the nutrition information we get comes from food companies that are trying to convince us to buy their products. Even scientific research can yield conflicting results, challenging even the most knowledgeable professionals, myself included, to make sense of it. And even if you do decide to make eating or activity changes, the “best” diet or exercise program claims may make you wonder if you made the right choice.

Given this, it’s not your fault if you struggle to understand basic health information and recommendations. But it is your responsibility to learn as much as you can to make the best choices for you and your family.

This is the topic of my Health & Fitness column in the Aiken Standard this week

Man shopping in supermarket

This won’t be easy, of course. The popular media, as well as social media, promote confusion and false promises about nutrition by making claims that some foods are “toxic” while others are “superfoods.” The old good carb, bad carb or good fat, bad fat arguments have been given a new life as eat this, not that lists. The problem is that many of these claims are not supported by science. The research that is done often yields complicated or conflicting results that aren’t explained in a way that actually helps people make good decisions.

The same is true for exercise. No one doubts that exercise and physical activity are essential for good health, but there are conflicting claims about specific benefits of exercise and what the best form of exercise really is. This can lead to the idea that if you aren’t doing the right exercise, it doesn’t count. Nothing could be further from the truth! While there are reasons why some athletes might want specific types of training, the majority of people can benefit from simply spending less time sitting and going for a walk each day.

So, what can you do? Given the confusing and changing nutrition recommendations it’s best to focus on what hasn’t changed. That is, to focus on eating real food rather than processed, prepackaged foods. Planning meals and snacks to include fruits, vegetables, whole grains, nuts, legumes, lean meat, eggs, and dairy should give you plenty of healthy fats, carbohydrates, and proteins.

Instead of worrying about the “perfect” exercise, make it your goal to do something active for at least 30 minutes every day.  Beyond that, dedicating time for aerobic, strength, and flexibility exercise will bring greater benefits. Remember, the best exercise for you is the one you will do! Seek advice from people you trust and credible professionals, but remember that if it sounds too good to be true, it probably is.

Your responsibility isn’t to understand all of the nutrition, exercise, and health information you hear. It’s to make an effort to make a few simple, healthy choices despite that confusing information: Sit less, move more, and eat real food.

Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr