Doc Moyad’s What Works and What is Worthless – Also Known as “No Bogus Science” Column

“New Year = No Rust?!”

It is that time again when we all subject ourselves to exercise and dieting goals, which sounds good for a few days, and then suddenly they take a back seat to the latest Netflix movie or perhaps libation at your local outside bar (who doesn’t like an occasional margarita?). Yet, I promise you this year could be very different, and it already feels different, not just because Michigan beat Ohio State late last year in football (finally … I thought I would never be able to experience such football bliss again … I really do love Ohio State except for one day every year). 

What do I mean by different? There is a different vibe in the cancer world now and if you do not feel it then let me convince you that you need to start looking for it, and then feeling for it, and then please go out there and do something about it! Researchers in the U.S. and Canada published a wonderful study on January 6, 2022.1 They looked at 1535 cancer survivors during a follow-up time of up to nine years (median of 4.5 years) and found being physically active was associated with a 66% reduction in dying younger from all causes (including cancer) compared to those who were inactive! They also found sitting for more than eight hours per day was associated with a higher risk of dying compared to sitting less than four hours per day. In other words, a higher risk of dying from any cause, including cancer, in those that were not physically active and spent a large portion of their day sitting. 

So, what is the big deal? The big deal here was 340 of the 1535 cancer survivors studied were diagnosed with prostate cancer, and this was the most represented tumor type in the entire study (breast cancer was second with 328 individuals). So, even though 28+ different cancer types were included in the research, prostate cancer had the largest representation in this general cancer study. It is probably one of the reasons it did not make a “splash” (Get it? Swimming exercise reference?!) in the prostate cancer medical literature, because one had to really search to get this answer and, since I have no life and I like to dig deep into the research, it was an interesting and wonderful discovery! However, what is concerning was approximately 33% of survivors reported no leisure-time physical activity and less active or not active survivors with the longest sitting times had as high as a 5-times increased risk of dying from all causes, noncancer, and cancer. It is possible something called “reverse causation” was also at work here, to be fair and completely objective. This is when participants with more serious or aggressive cancers are not able to be more physically active, which can give the perception that not exercising is the cause of the problem, but the reality could be that simply having a more aggressive cancer was the reason for the worse prognosis and inactivity. 

HOWEVER, the researchers tried to account for this phenomenon by, not only doing a prospective study, but they statistically attempted to reduce the risk of the “reverse causation” phenomenon. Thus, the researchers believed the data pointed more toward being physically inactive (despite being able to be active) as a reason for the poor outcomes in these cancer survivors. Personally, I believe part of the answer lies in the dangers of being physically inactive, and part of the answer is that some individuals with more aggressive cancers or side effects from treatment have trouble exercising (reverse causation). It is possible that both reasons (cause and effect and reverse causation) could explain these results. 

The researchers of this paper also (wonderfully) point out the abundance of evidence suggesting being physically active increases the odds of someone living longer and better in general. For example, we know being physically active reduces the risk of dying from cardiovascular disease (CVD). We also know the amount of positive evidence suggesting mental health benefits when being active continues to accumulate. Interestingly, the day after this paper was published one of the first studies to demonstrate later in life physical activity with something called improved “synaptic integrity” was also published.2 In other words, it appears being physically active as we get older has an “anti-aging” impact on the brain and allows it to function better and stronger. A few weeks earlier in 2021 a novel study from the Netherlands demonstrated how aerobic exercise appears to improve brain function and could help some Parkinson’s disease patients’ potentially slow part of the disease process.3 

I believe 2022 will be a landmark year for exercise research. You see, 30 years ago we were begging for this kind of research and now it is, not only here, but shouting at us to do something … anything … on a regular basis … walk, garden, vacuum (I like to do that for some odd reason), swim, water aerobics, bike, hike, chase squirrels (just the not so nice ones), jog, elliptical, tai chi, pilates, qi gong, move, move, move, please! Please do not let another year go by where the Peloton or treadmill becomes the family coat rack! We/I have waited 30 years for this kind of research! Humans were meant to move! We are wonderful machines meant to move, but just like any other machine, if we sit around too long then we can get very rusty! I hope you have an incredibly wonderful and Happy New Year … sans rust, of course!

References: 

1. Cao C, et al. JAMA Oncol January 6, 2022; doi:10.1001/jamaoncol.2021.6590 

2. Casaletto K, et al. Alzheimer’s & Dement 2022; January 7th; doi: 10.1002/alz.12530

3. Johansson ME, et al. Annals of Neurology December 24, 2021; doi: 10.1002/ana.26291