Exercise And Cancer
What I will here describe should be life-changing stuff; a powerful argument for tracking and improving your HDL; oh, and by “all-natural” means only.
Over 40 years ago Dr. Cooper, he of the Cooper Clinic and The Institute for Aerobics Research in Dallas, advocated exercise as protection against not only heart disease but cancer. The early epidemiological data supporting his position was carefully dismantled over the years. Later work cast into doubt some of his claims about exercise’s effectiveness at preventing even heart disease. For those who follow my approach to exercise this is not surprising because his early work focused too exclusively on ‘aerobics.’ Aerobics is actually a rather vague term not specific for any particular kind of exercise but often understood in a way that made marathon running seem to be the apotheosis of true aerobics. And this is where the story got off track as we now know that excessive ‘aerobics’ as the term is usually understood depresses some of the things we first associated with the benefits of exercise; like HDL. And here is where a new study in “The Journal of the American College of Cardiology” makes an interesting contribution to the discussion of exercise and cancer. The June 14th issue reports a study; another of those ‘meta-analysis’ where many studies were combined to see if there are things in the data that were not appreciated within each separate study. This was a big bunch of numbers to crunch: “researchers performed a meta-analysis of all lipid-intervention randomized, controlled trials with more than 1000 person-years of follow-up and baseline HDL-cholesterol levels and rates of incident cancer. They identified 24 clinical trials, among them the 4S, WOSCOPS, CARE, GISSI, ALLHAT-LLT, CORONA, and JUPITER studies, with more than 625 000 person-years of follow-up and 8185 cases of incident cancer.”
What they found, and boy is this wonderful, what they found is, and again this is a quote: “An inverse and significant association exists between levels of high-density lipoprotein (HDL) cholesterol and the risk of incident cancer, according to the results of a new analysis. Researchers report that even after adjustment for multiple variables, there was a 36% lower risk of cancer for every 10mg/dL increase in HDL cholesterol.”
Before I get into the important issue of exercise and cancer let me clear up a few points about the study. None of the intervention trials involved medications that might substantially affect HDL, nor was any effort made to determine the effect of any kind of HDL intervention like exercise or niacin. They simply took baseline and trend HDL and looked across all of the patients, all of the years of follow up and at all of the related variables in the data. So, important caveat, no one can make claims that the effect of raising or changing HDL will result in a known effect on cancer incidence.
Well, put that way I, nor anyone else, could have much to say so let me make a few adjustments and you be the judge of whether or not they are justified and whether then we can make some comments on the relationship between HDL, Cancer, and Exercise.
Two preliminary points:
- No well done study has shown much effect of diet on cancer incidence. Now I happen to think that though the studies were well constructed they simply did not understand enough about the diet variables to have actually addressed this important question, nevertheless this is the current state of knowledge about the relationship between diet and cancer. There are dozens of poorly done epidemiological studies that support a relationship but most of them are pretty obviously ideological in design and results.
- There is ample to overwhelming evidence to link low LDL levels to an increased cancer incidence and also an increased stroke incidence. Now this is usually deconstructed by those selling or apologizing for statins as a mere statistical quirk showing that people who are already ill have low cholesterol numbers; which is true. Still there it is: low LDL is associated with an increased incidence of cancer…and stroke.
OK, those two points in the background will clear the field to let me address the HDL, exercise and cancer link. First of all let this sink in: a 36% reduction in cancer for every additional 10 mg/dL of HDL! There is almost no known genetic marker linked to cancer that has that statistical power to show genetic vulnerability to known cancers. 36%!!
We know for example that those with the Insulin Resistance Syndrome have low HDL, high LDL, high triglycerides, more mesenteric fat and more cancer and heart disease. They also have high insulin levels which we know helps deregulate cell reproduction which leads to cancer. Hmmm…this makes sense of some of the HDL/cancer link but not all by a long shot. What else affects HDL? Well diet does for a large part of the population. It has been repeatedly shown that a diet higher in protein, I did not say “High”, raises HDL. It has been further shown that diets rich in carbs lowers HDL mediated by carbs effects on triglycerides: largely as simple as triglycerides and HDL are inversely related. There is a genetic sub-group in whom carbs do not spill over as either high insulin or high triglycerides and for whom a higher carb diet does not lower HDL; this is a small minority but one not to be discounted. OK, diet can affect HDL and in light of the study under discussion may affect cancer incidence.
What else raises HDL? Exercise, of course. Now we are talking! Not all exercise and not for everyone. There are two large elements to the exercise and HDL relationship:
- First keep in mind the genetic, diet, stress and exercise power over the liver, the liver, the liver, to make the HDL particle to begin with.
- Next, remember, the power of the rest of the body, not the liver, not the liver, to convert the HDL into a mature or activated form. Without such conversion the liver does not get the message to up-regulate, i.e. produce more, HDL nor has the HDL done its job.
So what is wanted is diet, exercise, stress management and, oh lovely thought, genetics such that we have high HDL. Or we could hope for medications to raise HDL. Problem is the last one that did this killed people and it never made it past clinical trials. Niacin is out there and does raise HDL but as it also raises insulin its HDL effect may be misleading. We have the further experience of seeing folic acid lower homocysteine and yet wind up increasing kidney disease, stroke incidence and, so far, prostate cancer. Ooops. Maybe ‘supplements,’ be they sold by a pharmaceutical company or the local health food store, are not the way to go.
Can’t change genetics(yet), diet is what it is, better stress management is important but another story so let’s focus on exercise. In Tempus in our first study done on the first 50 patients at 6 months we averaged over a 10 mg/dl improvement in HDL. Sure there was a spread but no one got worse and some did substantially better. Later data done on clients who were intensely aerobic found that decreasing their amount of aerobic work increased their HDL; i.e. they were suppressing their HDL by excessive aerobic work. Of course they introduced Olympic lifting into their routine as well which brings up the other component of how to drive HDL and that would be HDL 2b or ‘mature HDL.
Without increasing the HDL 2b fraction the liver does not get the message that it needs to increase the production of total HDL. Now another wonderful aspect of HDL 2b is how it demonstrates the ‘reverse cholesterol’ properties of cleaning out arteries of old debris. It has served as a scavenger and here is where the cancer fighting probably comes in: the activated HDL is an arm of the immune system helping it to clear out the detritus of infection in the arteries and the oxidative by-products of white cell death in the walls of the arteries in the white cells’ attempts to take away the infectious trigger for damage to the walls of the arteries.
HDL fights cancer. Period. Look no matter how you spin it or how one attempts to smooth the data this wonderful HDL/HDL 2b which is wildly under the control of proper exercise is a powerful anti-cancer marker. Can I tell you I know that raising HDL/HDL 2b by wholly natural means will lower your risk of cancer? No, I cannot. But I would bet my life on it. I recommend you do too.
Make sure you benchmark your HDL/HDL 2b and then additionally make sure the type, amount and intensity of your exercise is raising these life saving numbers.
Have Fun and God Speed,
Dr. Mike
