Q: What is the most important thing a transplant survivor can do to ensure a healthier life?
A: Recent research has shown that regular exercise affects much more than physical strength, weight loss and cardiovascular health. A number of studies have shown clear benefits in memory and brain function, post-treatment fatigue, recurrent malignancy and the risk of new cancers. See:
Q: Can exercise really improve memory and brain function?
A: While many claims have been made for supplements, diets and other factors improving brain function, research studies have given conflicting results. However, moderate aerobic exercise, like walking for 45 minutes three times a week, has consistently improved memory and brain function - in some studies by as much as 20 percent.
Aerobic exercise increases the creation of new brain cells in the areas of the brain that control memory, complex thought and decision-making. Aerobic exercise also increases both the production of molecules that carry brain signals and the connections between cells where these molecules work. Other forms of exercise such as stretching and light strength training do not show the same specific benefit in memory and brain function, even though they certainly contribute other important health benefits. See:
Q: How does exercise improve fatigue?
A: A number of studies during the past 15 years have indicated that physical activity is the most important method for overcoming fatigue and decreased physical function after transplantation. Studies have evaluated exercise programs for cancer or transplant patients before, during, and after treatment.
Study designs have varied, but the consistent finding is that exercise such as walking 30 minutes a day, strength training with resistance bands, and stretching can have a substantial benefit.
Shorter or less severe chemotherapy side effects, enhanced immune function and elevated mood have all been observed to be linked to exercise. Improvement in these areas significantly decreases the fatigue that results from prolonged, intensive treatments like chemotherapy and bone marrow or blood stem cell transplantation. See:
Q: What effect does exercise have on cancer risk?
A: The physiological changes that result from exercise have several effects on the risk of cancer. More than two dozen studies have shown that women who exercise have a 30-40% lower risk of breast cancer. This result appears to be related to the effect of exercise on estrogen levels.
Similarly, dozens of studies have shown that regular exercise decreases risk of colon cancer by 20%, especially in men. Studies have even shown that exercise reduces the risk of cancer in heavy smokers.
Exercise can also decrease the risk of recurrent disease in cancer survivors. Exercise reduces the amount of fat in the abdomen even in those who don’t have dramatic weight loss. The decreased amount of fat in the abdomen reduces insulin levels that might otherwise promote the growth of cancer cells. See:
Q: What can I do to improve my chances of success when starting an exercise program?
A: Work with your healthcare provider to understand any limitations that you might have and to determine the level of exercise that is appropriate for your specific situation. Having realistic goals about what you can do and how quickly you can increase your activity will help you be successful.
It’s also very important to find a type of exercise you like and that is easily accessible to you. Getting started each day is the hardest step, so make that part as easy as you can by choosing something you can do for a few minutes at a time, if necessary. If you can do an activity for 30 days in a row, it is likely to become a habit, and you’ll find it much easier to continue.
You will have better success if you exercise with someone else or if are accountable to someone else in maintaining your program. Start a walking partnership with a friend or family member. Walking a dog is another great way to be accountable. You can be sure that your dog will eagerly await your daily walks. See:
They noted that it had long been “well established that higher quantities of physical activity have beneficial effects on numerous age-related conditions such as osteoarthritis, falls and hip fracture, cardiovascular disease, respiratory diseases, cancer, diabetes mellitus, osteoporosis, low fitness and obesity, and decreased functional capacity.”
One of the new studies adds mental deterioration, with exercise producing “a significantly reduced risk of cognitive impairment after two years for participants with moderate or high physical activity” who were older than 55 when the study began.
Most early studies demonstrating the benefits of exercise were done with men. Now a raft of recent studies has shown that active women reap comparable rewards.
Sedentary skeptics are fond of saying that of course exercise is associated with good health as one ages; the people who exercise are healthy to begin with. But studies in which some participants are randomly assigned to a physical activity program and others to a placebo (like simply being advised to exercise) call their bluff. Even less exacting observational studies, like the Nurses’ Health Study, take into account the well-being of participants at enrollment.
Thus, in one of the new studies, Dr. Qi Sun of Harvard School of Public Health and co-authors reported that among the 13,535 nurses who were healthy when they joined the study in 1986, those who reported higher levels of activity in midlife were far more likely to still be healthy a decade or more later at age 70. The study found that physical activity increased the nurses’ chances of remaining healthy regardless of body weight, although those who were both lean and active had “the highest odds of successful survival.”
Taking the benefits of exercise one system at a time, here is what recent studies have shown, including several published in The Archives of Internal Medicine in December.
Cancer. In a review last year of 52 studies of exercise and colon cancer, researchers at Washington University School of Medicine in St. Louis concluded that people who were most active were 21 percent less likely to develop the disease than those who were least active, possibly because activity helps to move waste more quickly through the bowel.
The risk of breast cancer, too, is about 16 percent lower among physically active women, perhaps because exercise reduces tissue exposure to insulin-like growth factor, a known cancer promoter.
Indirectly, exercise may protect postmenopausal women against cancers of the endometrium, pancreas, colon and esophagus, as well as breast cancer, by helping them keep their weight down.
Osteoporosis and fragility. Weak bones and muscles increase the risk of falls and fractures and an inability to perform the tasks of daily life. Weight-bearing aerobic activities like brisk walking and weight training to increase muscle strength can reduce or even reverse bone loss. In one of the new studies, German researchers who randomly assigned women 65 and older to either an 18-month exercise regimen or a wellness program demonstrated that exercise significantly increased bone density and reduced the risk of falls. And at any age, even in people over 100, weight training improves the size and quality of muscles, thus increasing the ability to function independently.
Cardiovascular disease. Aerobic exercise has long been established as an invaluable protector of the heart and blood vessels. It increases the heart’s ability to work hard, lowers blood pressure and raises blood levels of HDL-cholesterol, which acts as a cleansing agent in arteries. As a result, active individuals of all ages have lower rates of heart attacks and strokes.
Though early studies were conducted only among men, in a 2002 study published in The New England Journal of Medicine, Dr. JoAnn E. Manson and colleagues found that among 73,743 initially healthy women ages 50 to 79, walking briskly for 30 minutes a day five days a week, as well as more vigorous exercise, substantially reduced the risk of heart attacks and other cardiovascular events.
In another study, women who walked at least one hour a day were 40 percent less likely to suffer a stroke than women who walked less than an hour a week.
Diabetes. Moderate activity has been shown to lower the risk of developing diabetes even in women of normal weight. A 16-year study of 68,907 initially healthy female nurses found that those who were sedentary had twice the risk of developing diabetes, and those who were both sedentary and obese had 16 times the risk when compared with normal-weight women who were active.
Another study that randomly assigned 3,234 prediabetic men and women to modest physical activity (at least 150 minutes a week) found exercise to be more effective than the drug metformin at preventing full-blown diabetes.
Dementia. As the population continues to age, perhaps the greatest health benefit of regular physical activity will turn out to be its ability to prevent or delay the loss of cognitive functions. The new study of 3,485 healthy men and women older than 55 found that those who were physically active three or more times a week were least likely to become cognitively impaired.
One study conducted in Australia and published in September 2008 in The Journal of the American Medical Association randomly assigned 170 volunteers who reported memory problems to a six-month program of physical activity or health education. A year and a half later, the exercise group showed “a modest improvement in cognition.” Various other studies have confirmed the value of exercise in helping older people maintain useful short-term memory, enabling them to plan, schedule and multitask, as well as store information and use it effectively.Continue reading the main story