Exercise, Diet and Weight Management for Cancer Patients

I. Introduction In China and around the world, there are very many cancer patients who, after receiving standard treatment, will try to find various ways, including diet, health supplements or exercise, expecting to reduce the metastasis recurrence of tumors and improve their prognosis. Cancer patients also often have many questions, such as: What should I eat? How should I do exercise? Should I get fatter or thinner? Do I need to take health supplements? What kind of supplements are best to take? There is an abundance of diet and exercise advice for cancer patients (sourced from the Internet, books, or family and friends), but unfortunately, most of it has not been proven to be effective. In 2007, the American College of Physicians gathered a group of experts in nutrition, exercise, and oncology survival to develop nutrition and exercise guidelines for cancer patients. In this paper, we refer to the guidelines and combine the experience of experts in our department to answer the above concerns of patients and provide them with the best life coaching measures currently available to help them promote good health and live a better life. II. Importance of Life Guidance Measures Cancer patients must understand that in addition to the risk of metastasis and recurrence, cancer has an increased risk of cardiovascular disease, osteoporosis and second primary cancer. Appropriate exercise, diet and weight management can reduce the adverse effects associated with cancer treatment, improve patients’ physiological functions, reduce fatigue and improve quality of life, and most importantly, significantly reduce the risk of metastatic recurrence, especially in breast and intestinal cancer patients, and may even reduce the risk of death by up to 40-50%. Life coaching measures include three aspects: exercise, diet and weight management Specific measures: Exercise for oncology patients There have been at least 20 prospective observational studies that have shown that patients who exercise have a lower risk of tumor recurrence, and current evidence encourages patients to engage in safe exercise as early as possible, which can increase bone health, muscle strength, reduce the risk of cardiovascular disease and osteoporosis This can increase bone health, muscle strength, reduce the risk of cardiovascular disease and osteoporosis, and reduce the risk of second primary cancers, even during chemotherapy and radiation therapy. The ACSM (American College of Sports Medicine) 2008 guidelines recommend that patients must engage in regular exercise as soon as possible: patients between the ages of 19 and 64 should engage in at least 150 minutes of moderate-intensity exercise or 75 minutes of high-intensity aerobic exercise, or a combination of both, per week. Each exercise session should last at least 10 minutes and preferably last the entire week. Adults should strength train, trying to include all major muscles, at least 2 days a week, and those over 65 years of age should try to follow the same approach if they are able, or adjust if chronic disease limits exercise. What is moderate intensity exercise and high intensity exercise? Moderate intensity exercise (talking but not singing during exercise): bicycling on flat or lightly sloped ground, gardening such as loosening soil and pruning trees, basketball, volleyball, etc. with little running, doubles tennis, brisk walking, dancing, aerobic exercise in water, etc. High-intensity exercise (only a few simple words can be said during exercise): aerobic dance, cycling at speeds over 16 km/h, fast dancing, heavy physical exercise (digging and digging), cycling up hills, jumping rope, karate, etc., race walking, jogging and fast running, running a lot playing basketball or soccer, fast swimming, doubles tennis. Diet (American Heart Association) recommends a recipe for the nutritional composition of adults: fat: 25-35% of calories, carbohydrates 50-60%, protein 10-35% of calories, minimum 0.8 g/KG. We recommend the following diet for patients: no smoking and limited alcohol consumption. Low-fat diet: eat less fried food and greasy food. Less red meat: red meat mainly refers to pork and beef and lamb. Drinking green tea 3 times a week can reduce the risk of gastrointestinal tumors. Recommend foods rich in omega-3 fatty acids (such as fish and nuts). Lean meats, poultry without skin, eggs, fat-free or low-fat milk products, nuts, seeds and legumes are recommended. Recommended whole grain diet: rich in multiple compounds and antioxidants with hormonal and antioxidant effects, affects lipid metabolism, reduces the risk of tumor development and progression, and reduces the risk of cardiovascular disease. Recommended vegetables and fruits: Vegetables and fruits contain many nutrients that have the potential to inhibit tumor progression, such as essential vitamins and trace elements, biological phytochemicals and fiber. Vegetables and fruits are low in calories and can be consumed to help control weight. All-natural juices and cruciferous vegetables are recommended. A diet high in sugar does not increase tumorigenesis and progression. However, excessive consumption can lead to reduced intake of other nutrients and weight gain. Therefore, it is recommended to limit the use of foods that contain too much sugar. In conclusion: No smoking and no alcohol, low-fat, high-protein and high-vegetable-fruit diet, green tea (not bottled green tea), whole grain diet, fish and nuts are recommended, and excessive high sugar, high fat and red meat are not recommended. Vegetable oils are recommended, animal oils are not recommended. Dietary supplements (or called supplements): include various vitamins, trace elements, amino acids, etc. For example: folic acid, selenium, vitamin C. Long-term use has not been observed as a survival benefit and may even be harmful, so they must be used with caution. Dietary supplements are not recommended for cancer patients in general, and try to obtain as many nutrients as possible from food. Supplementation is only recommended when a patient is found to be deficient in a certain vitamin or trace element. Weight management Achieving and maintaining a healthy weight is the main goal. Healthy weight, defined as BMI 18.5kg/m2 to 25Kg/m2. BMI definition: height in kilograms divided by weight in meters squared. Patients are recommended to measure their weight at fasting once a week, i.e. after waking up in the morning, and calculate BMI, which helps to adjust diet and exercise. IV. Other considerations: Family members of cancer patients are also at higher risk of having tumors and are also encouraged to follow the ACS nutrition and exercise guidelines for cancer prevention. Exercise is not appropriate when you are severely fatigued, and high-intensity exercise is not appropriate when you have progressive weight loss. For patients with impaired mobility, low-intensity activities such as stretching and slow walking are appropriate and can be slowly increased in intensity. In elderly patients or those with bone metastases, osteoporosis, severe arthritis, and peripheral nerve disease, greater care must be taken for balance and safety. In severe anemia, patients should delay exercise and simply do activities of daily living until the anemia improves. Patients with immunodeficiency should avoid gyms or public pools until white blood cell counts return to normal range. Patients who have completed a bone marrow transplant should not be exposed to the public until at least 1 year after transplantation. Exposure to chlorine during radiation therapy should be avoided, such as swimming in pools. Internal catheters and nutrient tubes should be placed without contact with ponds, lakes, seawater or other bacterial materials to avoid infection, and catheter-related muscles should be protected from resistance exercise and strenuous exercise to avoid catheter prolapse. In case of multiple or uncontrolled complications, exercise is recommended after consultation with a physician.