Monday, March 29, 2010
As a child, I would read under my duvet for hours with a flash light. In the dark, ideas seemed to flow more freely, allowing me to travel strange and wondrous worlds inaccessible during daytime hours.
In my teens, staying up late seemed sophisticated and grown-up. One time, my father (a fellow night-owl) found me at 1 a.m. penning a school essay on the topic of “Existentialism”. He sat down next to me on the edge of my bed and we talked about The Meaning of Life until 3 a.m. How cool was that!?
Throughout my youth, I would cheerfully ignore my mother’s tedious admonitions: “sleep is the best medicine” (boring!), “every hour of sleep before midnight is worth two after” (phooey!), or “early to bed, early to rise makes you healthy, wealthy and wise” (yeah, whatever). She would retire at 10 p.m. every night to get her 8 hours’ shut-eye while Dad and I watched old Westerns on television.
Over the years, my nocturnal life took on new and increasingly exhausting forms: student parties and late-night exam revision, burning the midnight oil to catch up on chores after long workdays in the office, or arguing with my husband. (In our early years of marriage, whenever we reached a certain level of fatigue almost anything could trigger a fight. We dubbed these our “eleven-o’clock-fights” as they always seemed to take place after that time. Eventually we banned potentially inflammatory topics between the hours of 11 p.m. and 7 a.m.)
And finally, the ultimate sleep-killer: motherhood and on-demand breastfeeding. Baby Number One – a fitful sleeper who rarely snoozed more than two consecutive hours for the first year – transformed me into a moody mess.
Babies Two and Three – delivered in a convenient double-pack – turned me into a sleep-deprived wreck. Yet, by the time they weaned themselves at 10 months, I had become so used to the chronic fatigue that I couldn’t remember what it felt like to be rested, alert and fresh, and so no longer missed it. I soldiered on in a daze, hoping fervently that coffee and anti-wrinkle-cream could compensate for my 5-hour-a-night sleep habit.
Eight years later, I still love the night. When the daytime hurly-burly of school runs, work deadlines, grocery shopping, meal preparation and dish-drying lies behind me and the last child has gone to bed, I feel the night beckoning me to explore the many temptations she has to offer: perhaps a few emails to friends, some pages in a good book, a spot of internet surfing, maybe a late-night recipe-test-run? The possibilities are endless, as is the wide-open mental space. No telephones, no doorbells and no squabbling children can disturb me now – I am at one with the night.
When he’s home, my husband – a sensible early-bird like my mother – marches me off to bed at 10.15 p.m. to make sure I get enough sleep. (I fondly call him the “Sleep Police”.) But when he’s away travelling for work, about three to four days most weeks, I go back to my nocturnal perambulations.
However, all good things come to an end, and my varied and stimulating nocturnal life is one of these – for sleeping as little as five to six hours a night is taking its toll. My mother, at 72, has fewer wrinkles than me; I am forgetful and often too tired to exercise; and thoughts of stimulating foods – such as chocolate, bread and dried fruit – are never far from my mind (or my waistline).
It wasn’t until I wrote my anti-cancer nutrition guide (mostly between the hours of 9 p.m. and 2 a.m....) that the importance of regular sleep really hit home. Not just because I needed to be rested in order to be creative, but also because I discovered that lack of sleep has a direct bearing on cancer.
The exact link between cancer and sleep is not clearly understood, but epidemiological research suggests that night-time shift workers have a higher risk of cancer than those who get their regular seven to eight hours of shut-eye. (More on this in my next post.) While I'm no shift worker, I do spend a lot of nocturnal waking time in front of a computer screen and hardly ever get 7 hours of uninterrupted sleep.
Giving up two to three hours of productive alone-time each day may be the hardest part of my Anti-Cancer Challenge. Yet, if I am to remain productive and healthy over the long term, I need get regular doses of high-quality sleep. This week I will describe how I plan to do this. Meanwhile, do tell me how you manage to fit healthy sleep habits into your busy lives!
Aerobic (or “cardio”) activities generally raise our heartbeat and respiration rate. Depending on the level of intensity we’re aiming at we can get so out of breath that we can’t talk, but more moderate-intensity is less taxing. Moderate activity includes recreational swimming, walking briskly (3.5 mph), cycling on fairly level terrain or – around the home – lawn-mowing, vacuuming, scrubbing floors or washing windows. Vigorous activity includes jogging or running (5 mph), swimming laps, jogging, cycling more than 10 mph or steep uphill terrain or circuit training with weight machines.
Aerobic exercise is a good way of strengthening the heart and increasing lung capacity, and has been found to reduce risk of heart attack, high cholesterol, high blood pressure and diabetes. It is also thought to help people to sleep better and reduce their stress levels. What I like about aerobic exercise is that – weather permitting – it allows me to be outside in the fresh air.
Strength training (also known as weight or resistance training) is as important as aerobic exercise. Strength training involves exercises that isolate the muscles to contract under the tension of weights, body weight or resistance bands. It promotes overall muscle tone and development and builds lean muscle mass, which increases the metabolism as muscles burn more calories at rest than fat tissue.
In my ignorant earlier years, I used to think that aerobic exercise was for women (cue: purple lycra leotards with matching sweatbands and ankle-warmers) and strength training was for men (scarily muscular beings sweating and grunting in smelly gymnasiums). Jane Fonda meets Arnold Schwarzenegger.
Only recently have I realized that strength training is a perfectly feminine endeavor and indeed very important, not just for a tone, firm silhouette but also for strong bones and muscles after menopause. What I like about strength training is that it doesn’t require a gym membership or complicated contraptions involving weights and pulleys. A few dumbbells and an exercise ball are all I need to work my muscles in the well-ventilated comfort of my home!
Incidentally, strength training can have a substantial aerobic component to it, as I have noticed on the last few strenuous repetitions of a strength-training routine; lunging or heaving weights can easily push my heart beat to 130-140 beats per minute, my heart-rate target range.
This is also where sprinting comes in, a discipline many recommend as a good way to build muscle *and* reinforce cardiovascular strength (but only if you’re already pretty fit). Sprinting involves short bursts of maximum-intensity exercise interspersed by slightly longer intervals. The good thing about sprinting is that you can do a pretty comprehensive workout in a short space of time (sprints and rest intervals spaced out over roughly 10 minutes, plus 5 minutes each for warm-up and cool-down), which is great news for time-starved people like me.
My Weekly Workout Plan
For those of you who want to join me in the Anti-Cancer Challenge, here’s my detailed weekly exercise plan. This is the “ideal-case scenario”; work, kids and Life will no doubt interfere with this occasionally, but I do aim to exercise at least five times a week.
- Monday (aerobic): gentle yoga
- Tuesday (strength): Beginners Full Body Workout
- Wednesday (aerobic): 30 minutes’ indoor rowing
- Thursday (strength): Beginners’ Full body workout (again)
- Friday (aerobic): 30 minutes’ indoor rowing
- Saturday (strength): Beginners’ Full body workout (again)
- Sunday: aerobic (30 minutes’ jogging)
Thursday, March 25, 2010
“What can be achieved with screening has been achieved. We can't do much more,” Carlo La Vecchia, head of epidemiology at the University of Milan, told The Associated Press. “It's time to move onto other things.” (Here’s the AP article.)
Let’s take a closer look at the link between exercise and cancer.
We live highly sedentary lives. Only a third of Americans undertake enough regular leisure-time physical activity to derive health benefits — that is, moderate exercise for 30 minutes five times a week or vigorous activity for 20 minutes three times a week. In the UK, only 40% of men and 28% of women reach the recommended level of physical activity.
To a large extent, this is due to the increasing mechanization of our daily lives. Household tasks are largely automated, most journeys are made by car or public transport, many formerly manual jobs in industry or agriculture are increasingly carried out by machines, and active outdoor recreation has largely been replaced by sedentary activities such as television-watching or computer games. Even a five-minute walk to the letter box has been replaced by instant messaging via email and Facebook.
Many of us confuse being “busy” with being “active”, as my own experiment in pedometry over the last week has highlighted. On typical work days, when I spend most of my time at the computer, in meetings or driving my car, I’m lucky if I clock up 8,000 steps. Days like these are busy and tiring, but involve very little physical activity.
The International Agency for Research on Cancer estimates that 25% of cancer cases worldwide are due to overweight, obesity and a sedentary lifestyle. According to the U.S. government’s Physical Activity Guidelines for Americans, individuals engaging in regular aerobic physical activity 3-4 hours a week at moderate or greater levels of intensity have on average a 30% reduction of colon cancer risk and a 20-40% reduction of breast cancer risk compared to those who are sedentary; better still, the more people exercise, the lower their cancer risk, the report states.
Meanwhile, the World Cancer Research Fund notes that exercise protects against colon cancer, probably helps reduce the risk of postmenopausal breast cancer and endometrial cancer and may also lower the risk of lung cancer, pancreatic cancer and pre-menopausal breast cancer.
Various mechanisms link sedentary lifestyles to increased cancer risk. Obesity is the most obvious connection: by moving less (and in some cases, by eating more, or making poor food choices) we risk gaining weight. Extra fat – especially around the waist – can act like a hormone “pump” and raise levels of estrogen and other substances in the blood which increase cancer risk. Being overweight can also cause inflammation, another risk factor for cancer.
Regular exercise meanwhile may boost the immune system, thus increasing our bodies’ ability to ward off enemy invaders. One as yet unproven hypothesis is that physical activity may boost the number or function of natural killer cells which may play a role in tumor suppression.
Lastly, by improving colon motility, exercise helps food move through the digestive tract more quickly. This reduces the exposure of the cells lining the digestive tract to potentially cancer-causing substances, thus potentially lowering colon cancer risk.
So the next time we put off physical activity, let’s remind ourselves that even relatively small physical efforts can translate into significant health gains.
(The bike helmet's for you, Silvia!)
Tuesday, March 23, 2010
Since they’ve all given me the green light, it is now time I stopped talking about getting fit and actually start doing it! So here it is, folks: the Anti-Cancer Challenge Fitness Plan, which I aim to follow faithfully for the next year.
For those of you who aren't aware, regular exercise is a key aspect of cancer prevention. (A separate post on this soon.) Since this blog is all about lifestyle cancer-prevention, I am basing my exercise regimen on the World Cancer Research Fund’s recommendations regarding physical activity (more details can be found here).
I have intentionally couched my exercise guidelines in affirmative terms (“I exercise” or “I jog”) rather than aspirational terms (“I plan to stretch” or “I hope to run”) to make them sound more real and convince every last cell in my body that this plan is not up for debate! Here goes:
- I exercise vigorously (at my age, 44, that’s equivalent to 130-140 beats per minute) for 30 minutes 5-6 days a week;
- On my 1-2 non-exercise days, I do yoga and/or stretching exercises and am moderately physically active for at 30-60 minutes (e.g. walking, cycling);
- I mix a variety of activities – e.g. aerobic and strength training – in my fitness routine;
- I stretch 5-10 minutes daily, following workouts;
- I limit sedentary habits such as TV (which I hardly ever watch anyway) or sitting in front of the computer (I stand up and stretch for 2-3 minutes after every hour at the computer; I do not use the computer after 10 p.m. and switch it off completely on Sundays);
- Wherever possible I climb stairs instead of taking lifts and walk or cycle instead of driving.
- Aerobic activity: Three aerobic exercise sessions of 30 minutes each (Monday, Wednesday, Friday), including five-minute warm-up (fast walking or trampolining), five-minute cool-down (stretching) and 20 minutes of vigorous aerobic activity. The types of aerobic exercise I undertake include jogging, trampoline-workouts, energetic cycling and indoor rowing. I use a cardio-monitor to track my heart beat and stay in a range of 130-140 beats per minute, which is equivalent to 75-80% of my maximum heart rate.
- Strength and endurance training: Two to three strength & endurance training sessions of 30 minutes each (Tuesday, Thursday, occasionally Saturday or Sunday). My strength training exercises will be based on routines shown here. I begin strength training today with this beginner’s total body workout.
- Yoga/Pilates/stretching: Yoga or Pilates exercises to a CD 1-2 times a week for 20-30 minutes.
- Pedometer: I wear a pedometer to assess my level of activity; I aim for 10,000 steps or more daily. (Read more about pedometry here.)
I keep a fitness diary (using this template) to chart my progress in the various forms of exercise I do. Each evening, before I go to bed, I decide on what type of exercise I will do the next day, defining clearly when I plan to do this, where and for how long, and lay out the appropriate clothes to wear. My husband has agreed to support me as my fitness partner; each week I show him my fitness diary and we discuss my progress.
If any of you wish to join me in my endeavours, I'd be delighted - it would be very motivating to have a (virtual) exercise-buddy! Since I will spell out exactly what exercise I do when and how, others can join in wherever they live. I look forward to hearing from you!
Friday, March 19, 2010
I just went to the local sports store and bought myself some nice gear. In the interest of performance measurement, I invested in a simple cardio monitor that I strap around my chest while I exercise so I can see how my heart rate is reacting to my exertions. As I will describe in my exercise plan next week, I will try to reach a specific target heart-rate for aerobic exercises, so this will come in very handy.
I also bought a basic pedometer that will count the steps I take each day. This will probably reveal the shocking truth about my extreme slothfulness; for while I have never measured this scientifically, my tense shoulders and tight hamstrings remind me of how little I move when I work, sitting in front of a computer or nutrition clients for most of my working hours.
For sheer vanity, I also purchased two simple-but-stylish pairs of jogging pants that I won't be embarrassed to take my children to school in. Since I hadn't exercised systematically for years, I never bothered to own nice sports clothes; what little exercise I did was performed in an old pair of stained sweat pants (or, on occasion, pyjamas...). But looking schleppy makes me feel schleppy, and I decided a sharper image might also help me feel fitter and more energetic.
Thus equipped, I look forward to tackling the brave new era of daily exercise. I realise it's a little early for rewards ("prewards," I like to call them), but if a bit of sporting equipment will help me get motivated, it's worth it.
Next week I will publish my exercise plan, including detailed descriptions of my planned aerobic and strength workouts. Have a good weekend!
Thursday, March 18, 2010
Over the years, various attempts at getting fit – gym memberships, swimming pool season tickets or African dance classes – ran aground after a few months due to lack of time, energy and interest. Why sweat and suffer when I could be relaxing at the movies, curled up on my couch with a good book or chatting with a friend over a cappuccino?
Imagine my shock when I met my husband 16 years ago, a man bristling with health and sporting enthusiasm and requiring daily doses of exertion for his physical and emotional well-being. After accompanying him on yoga retreats, bike outings and ski trips, and being coached patiently by him on various home training devices, I have over the years become modestly fit. However, I still struggle to take on board the idea of exercise as something I might willingly undertake – and enjoy! – daily.
And yet, it is something I now need and want to do. At 44, I need to strengthen muscles and bones to prevent muscle loss and osteoporosis after menopause. I want to keep my heart and respiratory system in shape. I also want to boost my immune system and prevent cancer (more on this in a forthcoming post). Lastly, I want to improve my sleep, mood and blood-sugar balance – all of which regular sports has been shown to do.
And then there’s good old-fashioned vanity: I dream of shedding 5-6 pounds of winter fat and the abdominal flab I have been sporting since the birth of my twins nearly eight years ago. And since I don’t believe in miracle pills or “slim-while-you-sleep” muscle stimulation electrodes, there’s only one thing for it: exercise.
So I have begun designing a program based on the World Cancer Research Fund’s “Moving More for Cancer Prevention” that should meet my sporting needs. It involves aerobic exercise – which strengthens heart and lungs, lowers blood pressure, improves cholesterol, brain function and mood – and strength exercise which increases muscle mass, helps burn more calories, maintains bone density and strengthens core muscles. On days when I’m doing neither, I plan to do yoga or simple stretches to counteract the stiffness that comes from being hunched over a computer or a steering wheel and to relax me after a hectic day. (I will post my specific exercise plan soon.)
The key to compliance of course is motivation, which I have always struggled with. Not seeing much point in exercising, I never made it a priority. The less I exercised, the more unfit I became, making it even harder to muster up the enthusiasm for exercise – a painful slog when you’re out of shape.
To break out of this vicious cycle, I have decided to take a very structured approach. First, I will make a contract with myself (using this template) setting out my goals. This involves appointing a fitness partner who supports me in getting fit; my husband has kindly agreed to do this.
Next, I will start designing weekly schedules setting out my exercise plans for each coming week. (This online fitness diary can be used both to plan ahead and to record the exercise completed.)
Intentionally setting aside time for exercise – rather than hoping that a free half-hour will magically appear out of nowhere – will be crucial to my success. Planning workouts ahead of time – defining what I will do when and where, and putting out the clothes I will be wearing the night before – will increase the likelihood of them getting done. I will reward myself for any meaningful progress I might achieve (a massage/facial/new pair of trainers?) but won’t beat myself up if results don’t happen overnight.
I’d love to hear what some of you are doing to keep fit, and especially, how you manage to keep at it. Motivational tips very welcome!
Wednesday, March 17, 2010
If all goes according to plan, each of these three cornerstones will reinforce the other two, as depicted in my modest graphic (left and below). My fervent hope is that if I can stick with it for a year, I will continue doing so for the rest of my life.
There really is no alternative. For two years now, I have been burning the candle at both ends, over-extending myself in my job while at the same time trying to be a dedicated mother-of-three, wife and homemaker. “This is just a temporary bottle-neck,” I kept telling myself. “Things will slow down soon and then I’ll get my life back.” But as month after exhausting month passed, this looked increasingly unlikely.
The first healthy habit to go overboard was sleep as I burned the midnight oil to keep up with e-mails, research and paperwork. The next casualty was exercise – for how could I exert myself physically when I was struggling just to keep my eyes open? Then even my diet started slipping: my morning coffee was getting a little stronger every month, and I was snacking on dried fruit and other sweet snacks throughout the day to boost my flagging energy levels. What little sleep I allowed myself was fitful, disrupted by my high-energy snack-habits and too much time spent in front of the computer.
During previous periods of stress, I often came down with sinus infections or digestive problems and my hormone cycle would go loopy. Ten years ago, when I was particularly overstretched for a prolonged period of time, I had to be treated for cervical carcinoma in situ. Each time I fell ill, I would swear that I’d change my ways; but once I had regained my strength I would go back to pillaging my reserves.
This time, though, I have decided not to wait until disaster strikes. At 44 I am fit enough to put healthy habits in place with relative ease, yet mature enough to stick with them (one hopes!). If I don’t take the time to look after myself now, I’ll have to spend that time in years to come in doctors’ and physiotherapists’ waiting rooms – a prospect I don’t relish.
Under the soon-to-be-published guidelines of the Anti-Cancer Challenge, more sleep will provide the energy to exercise, while exercising more will help me to sleep better. Better sleep will also allow me to reduce my sugar and caffeine consumption, again reinforcing sounder sleep! I have also noticed that when I exercise, I automatically seek out healthy foods – vegetables, fruits, lean protein – and don’t feel the slightest bit drawn to sugar or chocolate and the illusion of energy they offer. And when I eat an optimal diet I have the energy I need to exercise and cope with the demands of my busy life. A virtuous cycle!
It’s hardly rocket science, but I have summarized this virtuous cycle in a diagram (below; click on graphic for a more legible enlargement) which I have printed out and stuck on my refrigerator to remind me to look after myself.
Monday, March 15, 2010
“I applaud your new endeavor and wish you very well with it,” wrote my friend Lucy, before adding: “I have a slight reservation about the workload of the blog adding to the pressures that keep you from exercise and sleep rather than reducing the load.” Perhaps another irony to add to my son’s list, she noted wryly.
A few minutes later, Mareike, a friend since first grade, wrote: "One piece of advice: please don't get even more stressed-out because of the Challenge! I can already hear you saying 'Oh no! I've got to squeeze in a quick dose of exercise before rushing off to bed at 10.30'. Please avoid stumbling into the perfectionism-trap!" she wrote, before suggesting: "perhaps you might want to incorporate a few completely ‘pointless' activities: a half-hour on your sofa with a gossip magazine, a spot of window-shopping, a stolen hour with a good book, or an evening at the movies?"
Debby backed her up, reminding me of the importance of “just reading for pleasure, meditating, piddling around the house, or doing nothing!” Recharging time is just as necessary as a healthy diet and exercise, she reminded me. How true.
First of all, I’d like to thank my friends for their wise words of advice. Indeed, I kept putting off the launch of the Challenge while reflecting on whether and how I would be able to create the space for it so that it didn’t overwhelm me. In the end, I decided I could fit it in, as long as I set myself strict boundaries:
- Writing no more than 600-700 words per post
- Writing no more than 5 posts a week
- Not posting on weekends
- Not putting myself under pressure to write The Ultimate Post each time
- Not posting during family vacations
Meanwhile, I am deriving great strength and nourishment from my friends’ support. Not only does it feel good at a human level to be held by others as one embarks on a journey into the unknown. Having a network of close, caring friends may actually boost immunity and reduce cancer risks.
Indeed, a large-scale U.S. study published in the Journal of Oncology showed that women with breast cancer who had 10 or more close friends were four times more likely to survive their illness than those who did not. Having the support of relatives was shown to help too: women who reported having close relatives had a 2½-fold better chance of surviving breast cancer than those who did not.
Surprisingly, being married or belonging to a religious community was not associated with reduced mortality risk. “The results are consistent with the notion that among women, the most important source of support is often not the women’s spouses, but other significant network members,” the study’s authors commented.
Regardless of whether we are cancer patients, survivors or have remained untouched by cancer, we all thrive on the love and support of our close friends. So why not send an e-mail or make a phone call to a friend today; it won’t just make her or him feel good, it may also boost your own emotional and physical well-being!
Wednesday, March 10, 2010
I plumped for the first best example that popped into my head: “Imagine your mother is writing a cancer-prevention cookbook. She tests and eats anti-cancer dishes every day. And just as she finishes the book, she is diagnosed with cancer.”
My example was probably a little close to home; I have, in fact, spent the past two years writing a cancer-prevention cookbook, and I did overcome early-stage cervical cancer 10 years ago. To avoid alarming my son, I quickly reassured him that this was not a real-life scenario and that I am in excellent health. But our conversation gave rise to a niggling question in my mind: am I really doing everything I can to be healthy?
One thing is sure: I eat a healthy diet. Especially since researching and writing the book, I consume more green leafy vegetables, multicolored fruits, omega-3-rich fish, raw cocoa and green tea than most people can imagine. But while focusing so intently on the health-giving powers of food, I have, during the past two years, neglected two other important lifestyle factors that are vital in boosting my body's defences: exercise and rest.
I have three children, aged 7, 7 and 12, and a husband who is out of town many weekdays. As school is a ½-hour drive away, I spend a lot of time in an unpaid taxi-driver role. I am also a nutritionist, cooking instructor and health writer. I deal with sick pets, car and home repairs and anything else that might crop up. And because I want to feed my family healthily, I prepare our meals from scratch daily. No wonder I struggle to make time for exercise.
Or for sleep, for that matter! To service my overcharged agenda, I soldier on like the Duracell Bunny, some nights as late as 1 or 2 a.m. With the alarm set for 6.20 a.m. on weekday mornings, I often get no more than five or six hours of sleep – just enough to get by on but pushing my mental and physical limits.
Research has shown that regular physical activity and sleep boost immunity and reduce cancer risk. If I carry on at this rate it’s possible that no amount of green tea or beetroot soup will save me from myself.
So recently, I got thinking: “If I am still struggling with exercise and stress-management, how can I advise clients and readers to adopt an anti-cancer lifestyle? Am I capable of following my own advice?” And thus was born the idea of the Anti-Cancer Challenge.
I have decided to spend the next 365 days adhering to a correct and complete anti-cancer lifestyle revolving around three principal elements – optimum nutrition, regular exercise and adequate rest – and to blog on my experience. The blog has its own dedicated site here and a selection of posts will appear on my 'Psychology Today' blog, Nourish.
The aim of thisproject is not to “prove that I didn’t get cancer” after my year of anti-cancer living, but to really understand what it’s like to practice what I preach: holistic disease-prevention through an all-round healthy lifestyle. I want to show that it is possible – and even enjoyable! – for an ordinary person with a job and a family to live healthily without spending a fortune on personal trainers or nutritional supplements.
Swapping old habits for new ones is never easy; I feel more than a little nervous at the thought of making these changes. I am counting on your support and hope that others will join the Anti-Cancer Challenge too, making it a place where we can support and encourage each other on our journey to a fuller life and optimum health.