After October: From breast cancer awareness to action

Breast Cancer Awareness month is coming to a close. Thanks to the efforts of local and national organizations and a number of events in our area, we should all be aware of the importance of education, screening, treatment, and research toward a cure for breast cancer. These are all worthy goals that deserve our full attention and support. Now it is time to take the awareness that we gained over the past month and turn it in to action. 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, in particular certain gene mutations, including BRCA1 and BRCA2. Between 20­–30% of cases occur in women who have a family history of breast cancer, which can double the risk of being diagnosed.

However, most women who are diagnosed with breast cancer have no family history, so there are other factors that play a role. Many of these are lifestyle factors that can reduce the risk for and improve the treatment and survival of breast cancer patients. The good news is that these changes benefit all of us because they also reduce the risk of other cancers, cardiovascular disease, and most other chronic diseases.

Avoid tobacco use. While the results of studies of smoking and breast cancer are mixed, a conservative interpretation is that smoking may increase the risk. Smoking increases the risk of other cancers, especially lung cancer, as well as heart attack, stroke, and other lung diseases. Not smoking, or quitting now, is among the best health decisions a woman can make.

Consume alcohol in moderation. Alcohol can alter the level of hormones, including estrogen, that increase breast cancer risk. Women who consume more than two drinks per day increase their risk of breast cancer by 20% over women who don’t drink.

Maintain a healthy body weight. Being overweight can increase the risk of breast cancer in post-menopausal women by 30–60%. Excess body fat can alter the levels of estrogen and other hormones. The good news is that losing as little as 10 pounds can reduce this risk. Additionally, being overweight is associated with a higher risk of diabetes and heart disease, among other conditions.

Be physically active every day. Regular activity and exercise can lower breast cancer risk by as much as 20%by reducing the level of certain hormones that are associated with breast cancer. Women who exercise also tend to handle breast cancer treatment better than women who aren’t active and exercise can reduce the risk of cancer reoccurrence by 25%. These benefits can be achieved through 45–60 minutes of brisk walking five days per week.

Eat a healthy diet. The evidence from studies on the effect of diet on breast cancer risk is mixed, with more research needed. In general, increasing fruit, vegetable, and whole grain intake is associated with at least some decrease in breast cancer risk. These foods are rich in vitamins, minerals, and fiber, so eating more of them is beneficial for reasons beyond cancer prevention.

The bottom line is that turning awareness into action to improve health behaviors can prevent breast cancer and reduce the risk of other cancers as well as many other serious health problems.


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“Is it okay to be fat if you are fit?” is the wrong question. Instead, ask “Is it ever okay to be unfit?”

I get a lot of questions about nutrition, exercise, and health. Given the considerable uncertainty and misinformation about these topics, it comes as no surprise that people have questions. Sometimes there are no clear answers to these questions. And sometimes the question itself shifts the focus away from a more important aspect of health. This is true of one of the most common questions I get: Is it okay to be obese if I exercise?

The idea that it is okay to be fat if you are fit is not new. In fact, decades of research shows that being obese but physically fit is associated with a lower risk of dying from cardiovascular disease than being thin but unfit. When assessing health risks associated with obesity, fitness matters. That said, excess body fat can lead to other health problems, even if you are fit.

A better question would be, Is it ever okay be unfit? The answer is no! This is the topic of my Health & Fitness column in the Aiken Standard this week.

Overweight men walking


There is no question that being physically fit can improve your health, reduce your risk of developing certain chronic diseases like heart disease and some cancers, and help you live a longer, healthier life. This is true even when you take body fatness into account. People who are overweight or obese should have more health problems and die sooner, but many don’t.

The difference is physical fitness. Men and women who are obese but physically fit have a lower risk of serious health problems than those who are obese but unfit and, surprisingly, even lower than people who are at a “healthy” body weight but unfit. This suggests that a “healthy” body weight has less to do with weight and more to do with fitness.

This relationship holds true even when you start adding in other health problems, like high blood pressure or diabetes. Even though obesity is associated with and thought to cause these conditions, physical fitness seems to reduce the risk significantly. Again, this suggests some of the health problems linked to obesity may be due, at least in part, to low physical fitness.

Physical fitness in these studies typically refers to cardiorespiratory or aerobic fitness measured during in exercise test on a treadmill or stationary bike. A broader definition of fitness also includes muscular strength, muscular endurance, and flexibility. You can improve your fitness by participating in regular exercise to develop your endurance, strength, and flexibility. The benefits are linked to the intensity and duration of the exercise, so the more you do, the better your fitness, but substantial benefits can be achieved from walking for 30 minutes per day.

In the much of the research, subjects were divided into five fitness categories. The most significant differences in health and longevity were seen when comparing the highest and lowest fitness groups. But the biggest reduction in health risk was between the lowest fitness and the next highest group. This means that becoming even a little more fit is beneficial.

If you are overweight, becoming more fit may matter as much as losing weight for improving your health. If you don’t need to lose weight, remember that there is no such thing as a healthy weight unless you are fit. Regardless of your weight, everyone can benefit from regular exercise to achieve and maintain the strength, endurance, and flexibility necessary for good health and wellbeing.


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Speaking of the benefits of outdoor activity, the USC Aiken Outdoor Expo 2017 is this weekend!

Speaking of the benefits of outdoor activity, USC Aiken is hosting the CSRA Great Escape Outdoor Expo on Saturday, Oct. 14. Learn about ways you and your family can explore the outdoors and be active doing it!

2017 Outdoor Expo


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Invest in your health by following the Buffett plan.

Making smart investments that pay off over time is a key to creating wealth and sustaining financial wellbeing as we age. Warren Buffett is widely regarded as a successful investor and financial leader. His careful investment strategies have allowed him to amass an impressive personal fortune and lead to him be considered one of the foremost experts on investing.

For these reasons, Buffett’s business and financial advice is respected and followed by many people to achieve wealth and financial security. This same strategy can be applied to health with the same good results. Here is how following Buffett’s investing strategy can help you achieve good health now and maintain it long into the future. Just like saving for retirement, you will be glad you have plenty of good health in the bank when you get older.

This is the topic of my Health & Fitness column in the Aiken Standard this week. Since I am not an expert in the world of finance and investing, I did run this by a colleague from the School of Business to make sure I was on the right track.

couple jogging on beach


Make smart, not popular, choices.  Many of Buffett’s investments have been in industries or companies that others have overlooked in favor of more trendy options. However popular, these investments may not be smart choices in the long run. Similarly, new exercise trends and popular dietary supplements may seem appealing for weight loss, but the results are often disappointing. Sometimes the best approach for health is something much less exciting: making smart diet choices and daily exercise will almost always pay off for years to come.

Plan for the long-term success, not quick results.  Investments promising that you will get rich overnight are appealing. While you may make money initially, in the long run you may not have anything to show for it or you may end up losing money. Many fad diets and exercise trends are the health equivalent of get rich quick schemes. For example, they may promote weight loss right away, but fall short when it comes to keeping the weight off. Some popular high-intensity training programs can lead to rapid increases in fitness and strength. But for some people they can lead to injury or, at the very least, a negative experience that may turn them off from exercise in the future. Just as Warren Buffett makes investment decisions that will promote long-term income, you should make diet and exercise choices that will pay off for years to come. Even though the health “income” may accumulate more slowly, it is more likely to be lasting.

Diversify your investments.  Buffett’s strategy has been to invest in multiple industries. This allows him to maximize income and insulates his portfolio from losses in any one area. Similarly, you should diversify your health investments. Instead of focusing only on your diet or just on exercise, include both diet and exercise in your health portfolio. That way you will get the benefits of both treatments and maximize your return on investment. This works because the health benefits of good nutrition and physical activity are additive. In fact, in some cases the activity is essential for the diet to be effective, and vice versa.

Your goal should be to make smart investments in your health by choosing diet and activity strategies that you can live with and that will pay off long into the future. Applying Warren Buffett’s investment strategies can help guide you toward making these prudent decisions.

But a healthy, happy life involves more than good nutrition and exercise. You need to take time for yourself and do things you enjoy. Fortunately, there is another Buffett we can take inspiration from: Jimmy Buffett. Sometimes, escaping to Margaritaville is just what the doctor ordered!


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Explore the great outdoors

You probably know that exercise is good for you and that going for a daily walk is associated with improved health. A lower risk of weight gain, diabetes, heart disease, and some cancers are among a long list of positive health effects of physical activity. Lesser known benefits include improved mental health, cognitive function, and greater feelings of wellbeing

What you may not know is that where you exercise matters and that exercise outdoors, especially in nature, can be particularly beneficial. This is not surprising given that being active in a natural environment has been shown to have an impact on mental health. This is the topic of my Health & Fitness column in the Aiken Standard this week.

father and son walking in woods


Indeed, activity outdoors leads to enhanced feelings of energy and diminished fatigue, anxiety, anger, and sadness compared to similar activity conducted indoors. Additionally, some research suggests that outdoor activity may improve attention in adults and children.

Research has uncovered additional benefits of simply going for a walk outdoors in nature as well possible explanations as to why. These studies show that participants who went for a walk in a quiet, tree-lined area experienced greater improvement in mood—they felt happier—than those who walked along a busy street in an urban area. The researchers also completed brain scans to determine that the difference in mood was related to changes in blood flow in the brain. The finding that being active in a natural environment caused physiological changes that led to psychological benefits is exciting!

Another advantage of exercising outdoors is that you might get a better workout. This is mostly due to the fact that you will likely walk or run faster outdoors, but other factors like wind resistance add to your effort. Research shows that even though people tend to exercise at a higher intensity outside, they don’t necessarily feel it. In fact, ratings of effort are lower outdoors for the same exercise.

This is partly because the pleasant visual stimuli outdoors distracts you from unpleasant sensations of effort during exercise. This is the same reason that listening to music makes exercise more enjoyable and why fitness centers have televisions on the walls or built into exercise equipment. Think of the outdoors as a really big TV screen!

Almost any indoor exercise exercise can be moved outdoors. While walking, running, and cycling are most obvious, resistance training exercises using body weight and many high-intensity interval training workouts can be modified for outdoors. Yoga, tai-chi, and aerobics classes in the park are also great ways to promote both the physical and psychological benefits of exercise.

Much of the psychological benefit of outdoor exercise occurs in the first five minutes, so even short bouts of activity are meaningful. It also means that going for a short walk outside when you have a break at work or walking instead of driving short distances can have positive effects. At home, taking the dog for a walk, playing outside with the kids, or doing yard work are good ways to be active and reap the benefits of being outdoors.

There are a great many places to walk, run, bike, or paddle outdoors in the Aiken area. With cooler weather on the way, this time of year is perfect for outdoor activity and there are many local events to motivate you to explore the great outdoors. Every little bit of activity you do outdoors will have both physical and psychological benefits to help you become and feel healthier. So, get outside and get active!


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Everyone has a plan until they get hungry.

If you are trying to lose weight or otherwise change your diet, planning meals and snacks is an important tool to help manage what you eat. Given that schedule changes and other unexpected situations can easily occur throughout the day, even the best laid plans can fail.

Figuring out how to handle changes in your plans is an essential part of successful dietary modification and a key to lasting weight control. Missing a meal or snack, eating at a different time, or simply adjusting to a new diet can trigger feelings of hunger which can lead to overeating. Hunger is a powerful physiological and psychological signal, so the drive to eat sometimes feels like it is out of our control. Worse, when you are hungry, the food you can get the most easily isn’t always consistent with what you should be eating.

If this happens to you, know that you are not alone! What to do when you suddenly feel hungry is something you will certainly have to deal with, and how you handle it can determine your long-term success. Here are a few strategies that have worked for people in my individual and group weight loss programs and may work for you, too.

Vending machine candy


What’s in your backpack

Andrea was a full-time student and held a full-time job, so she found herself eating on the go between work and school. This usually meant fast food or convenience food that she could eat quickly or while she was driving. She recognized that this eating pattern was a barrier to weight loss, but finding a way to eat healthier food was a challenge. She ended up packing a second backpack of healthy snacks that she could eat between classes or while she drove. For Andrea, having the healthy food right there with her eliminated the need to stop at a drive-thru when hunger struck.

Are you hungry or just thirsty

Barbara identified her as a “snacker,” and eating between meals was a challenge for her. In an effort to drink more water, she decided to have a big glass of water before she ate a snack. She found that after drinking water she wasn’t hungry anymore and skipped the snack. This helped her meet two goals: eating less to lose weight and drinking more water. In Barbara’s words, “When you think you are hungry, you might just be thirsty!”

Don’t eat, use your feet

Mark realized that he tended to feel hungry when he was really feeling restless or bored at work or home. Getting something to eat served as a break to distract him from those feelings. One day he went for a short five-minute walk around his office instead of getting snack. When he returned to his desk, he felt focused and energized and, importantly, didn’t really miss those extra calories. He tried the same thing home, doing something around the house or taking a short walk outdoors instead of wandering into the kitchen.

Just as Andrea, Barbara, and Mark found ways to avoid overeating when their best laid plans went awry, you can find tricks to help you make smarter choices when hunger strikes. The important point is that even the most careful meal planning can be disrupted for a variety of reasons, including being hungry, bored, or influenced by others. To paraphrase Mike Tyson, everyone has a plan until they get hungry! What matters most is what you do next.


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Juiced! Why fruit juice isn’t quite the same as eating fruit.

Nutrition information is often confusing and conflicting, making healthy food choices a challenge. Fortunately, there are some recommendations that are consistent. Among these is eating more fruit. But what if the way you were consuming fruit meant that you were missing some of the nutrients that make it so healthy?  This is the topic of my Health & Fitness column in the Aiken Standard this week.

Orange-orange juice


Fruits are excellent sources of essential vitamins, minerals, and fiber. Fruit also provides energy in the form of naturally occurring sugar. Whole fruit and fruit juice are considered equivalent in current nutrition recommendations. However, fruit juice has been implicated as a contributor to weight gain and poor health, especially in children.

This is because fruit juice often comes in the form of fruit-flavored drinks that contain little or no actual juice but plenty of added sugar, so they are essentially soda without bubbles. Even though real fruit juice contains about the same amount of sugar and calories as soda or other sweetened drinks, they are not comparable when it comes to nutrition.

One consequence of consuming food and beverages that are flavored like fruit but are actually much sweeter is that it may make real fruit less palatable. People, especially children, may develop an expectation that “fruit” should taste as sweet soda or candy and prefer the sugar-sweetened version over the real fruit.

It seems reasonable that since juice is made from fruit, drinking juice must be the same as eating fruit. This isn’t always the case. Depending on how the juice was made will determine whether it is comparable to eating fruit.

Juice that is pressed is missing some of the nutrients of the fruit, most importantly fiber. A good example is apple juice. Apples contain sugar, vitamins, minerals, and fiber. The fiber is in the cell membranes of the apple and the juice, containing the sugar and other nutrients, is in the cells.

When you eat an apple, you are getting all the components of the apple, including the fiber. Apples that are pressed into juice contain the sugar, but not the fiber. In this case, eating the whole fruit is better than drinking the juice.

If the juice is made from whole fruit that is blended it may contain the fiber. Many smoothies are made with whole fruit, so these drinks are comparable to eating fruit. Better yet, some smoothies also include vegetables making them a good source of both fruits and vegetables.

Fruit smoothies are often used as meals or snacks to promote weight loss, but this requires some careful consumption to be effective. Many smoothies contain additional ingredients, some of which contribute nutrients as well as others that simply add sugar and calories. These extra calories can interfere with weight loss.

Additionally, drinking your fruit may lead to overconsumption that you don’t notice. It is far easier to drink juice or a smoothie than it is to eat a piece of fruit, so you are more likely to consume excess sugar and calories with juice. A single 8 oz. serving of apple juice can contain the juice of 3 or more apples. While drinking a glass of apple juice may not seem like a big deal, eating three apples would certainly get your attention!

While eating whole fruit is recommended over drinking juice, the most important thing is to include fruit in your diet. But make sure you are getting 100% real fruit, not sweetened, flavored drinks and snacks that are essentially candy and soda!


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