Physical Activity Monitoring Devices Can Play A Role In Integrative Oncology

Physical Activity MonitoringMost Americans are lazy when it comes to walking. We walk about 30-40 minutes less every day compared with the Swiss, Australians and the Japanese (from a 2003 study.) Based on number of steps per day, Americans barely walk more than than the “sedentary” rate of 5,000 steps per day:

  • United States: 5,117 steps per day
  • Japan: 7,168 steps per day
  • Switzerland: 9,650 steps per day
  • Australia: 9,695 steps per day

On average, 2,000 steps is equivalent to one mile of walking. It may seem like a lot, but the health community recommends that to maintain good health we should take at least 10,000 steps (about 5 miles) each day.

My personal test was an eye opener:

For an entire day, I used a free iPhone app (Moves) that measures your steps, distance, and walking time. The cool thing about this app is that you don’t need to have anything but your phone to capture your activity. You just drop it in your pocket and forget about it. This obviously will not work for everyone, so a wearable strap or clip on device might be better for you. A phone-based app is convenient for me since I’m able to keep my phone in my pocket (pants, suit jacket, shorts) throughout the day.

My work day consists mainly of short walks from my office to the exam rooms. I also drive to and from my office to my home. So, before I found out my actual activity level I guessed it was going to be low…but not this low. Studies shows that most of us overestimate how active we think we are, so wearing an activity monitor makes sense.

The information I learned by the end of the day was embarrassing. I only walked 0.6 miles, took 1,816 steps and my cumulative walking time was a measly 25 minutes!!…Awful. It’s time to hit the gym.

If I didn’t also exercise and eat small (by American standards), healthful meals I’d grow as big as a house (or a typical American.)  One reason why we gain weight and have a hard time losing it, even though many of us ‘try’ to be active and eat better, is because the majority of us have no idea how many calories we burn during different activities and we majorly overestimate the number of calories we actually expend.

A poignant study asked participants to walk on a treadmill until they burned a specific amount of calories (the participants were not informed of the amount of calories they expended.) Once the participants completed the walk, the investigators asked them to 1) guess how many calories they thought they burned and they presented them with a food buffet, and 2) told them to eat the amount of food they guessed was equivalent to the amount of calories they believed they burned on the treadmill. The participants were way off on both. They overestimated their calorie expenditure by 300-400% and they overate their calorie expenditure by 200-300%.

Staying Active Throughout The Day:

Many studies suggest that being sedentary can fuel the growth or recurrence of your cancer (read more about this in a previous IOE blog post.)

The amount of time you sit every day has recently been spotlighted as a significant risk factor in cancer development, recurrence and death (independent of whether you are or are not otherwise physically active.) One recent study found that among colorectal cancer survivors who sat for periods of time of greater than 6 hours a day (compared to less than 3 hours a day), they had a 60% greater risk of dying from their cancer.

**If you have no medical contraindications for being physically active, get moving! **

The most recognized anti-cancer advice regarding physical activity is to aim for at least 30 minutes of ‘moderate intensity’ physical activity 5 days per week (total of 150 minutes per week.)

Don’t get lulled into thinking that you only need to be active for a 30 minute period each day to stay healthy. A journalist recently reported that after jogging for 3.5 miles (in 32 minutes), his pedometer measured only 5,227 steps…far less than the healthy goal of 10,000 steps per day. Without the pedometer device he stated that with his jogging routine and daily walking he would have assumed that he had been physically active enough by the end of the day to meet this goal. Nope. After looking at the number of steps he had taken he was surprised to learn that he was only half-way to the goal of 10,000 steps. He needed to add additional walking throughout the rest of the day to reach that goal.

fitbit-flexThe 10,000 step goal is somewhat arbitrary, since it clearly doesn’t apply to everyone. Nevertheless, it serves to indicate that even among those who perform the recommended 30 minutes of ‘moderate intensity’ physical activity (5 days per week), this is simply not enough. Over the last few years, numerous studies have concluded that the amount of sedentary time we spend each day is directly associated with increased risks of cardiovascular disease, cancer, and diabetes.

The bottom line is that we need to be active throughout the day, not just during a brief 30 minute daily time slot.

Activity Tracking/Monitoring Gadgets May Be HelpfulBodyMedia

If you are serious about keeping track of your daily activity (which I am starting to recommend more and more to my patients), consider investing in a pedometer or other type of activity monitoring device. These devices are far from perfect, as they all have limitations. If you don’t walk or run as your primary physical activity (i.e. weight training, spin classes, yoga, etc.), the current generation of many of these devices may not be very useful as they typically detect movements related to walking and running. That said, most of the research linking physical activity and cancer outcomes comes from populations of cancer patients and survivors who predominantly walked as their main activity.

If you are going to start looking into these devices, you probably don’t need to go out and buy the most expensive one with every bell and whistle.

Most importantly, I recommend that you try them on and see how they fit. They need to be comfortable. You also want one that is very easy to operate (preferably, you just put it on and forget about it.) Many of the devices have a software program or mobile phone app that they communicate with so that you can analyze your data and enter other information (i.e. foods consumed, activity types, etc.)

I recommend using these devices as an educational and motivational tool to help you become more physically active. Unfortunately, many of the cancer patients and survivors I see live sendentary lives, they are out of shape, overweight, suffer from other chronic medical conditions and eat unhealthfully. It is very challenging (both physically and psychologically) for them to make lasting healthful changes in their lifestyles.

So anything that can help our patients make these lasting changes is welcome. Although the old fashioned paper log books are cheap and simple to use, studies report that compliance in entering information, adherence, accuracy and achieving health goals (i.e. weight loss) are significantly inferior to what is achievable with the electronic devices.

As an integrative oncologist, one of the most important things I can do for my patients is to help identify these cancer-promoting factors and counsel them on how to make changes based on their limitations, abilities and goals. In my practice, I am starting to incorporate these fun, motivational and educational gadgets (i.e. activity monitors, weight/body composition scales, food intake apps, etc.) to help patients lower their risks of cancer growth and recurrence and improve their overall health. These electronic gadgets give both of us an idea on how they are doing in reaching those anti-cancer lifestyle goals.

It’s not about making big, short-term changes…it’s about lifelong commitments to small, consistent improvements in health and fitness.

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