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Cancer

Liquid biopsy (cancer screening) featured article

Introduction

Cancer is the second leading cause of death worldwide. Successful treatment hinges on early detection, but conventional screening and diagnostic approaches, often relying on tissue biopsies, come with limitations that hinder their effectiveness.

One promising solution is liquid biopsy, a groundbreaking technique that analyzes bodily fluids, such as blood, urine, lymph, and cerebrospinal fluid, for signs of cancer. When these fluids circulate near a tumor, they can acquire shed tumor cells and their components, such as DNA and RNA.

Liquid biopsies are innovative, non- or minimally-invasive medical procedures that detect and analyze these tumor-derived cells and components for cancer screening, treatment guidance, and follow-up care, potentially revolutionizing early detection and personalized treatment strategies. This article delves into the importance of early cancer detection, the shortcomings of existing screening methods, and the potential of liquid...

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Doing THIS Could Cut Your Cancer Risk Significantly

Posted on April 1st 2025 (about 2 months)

In this clip, Drs. Rhonda Patrick and Kerry Courneya discuss how exercise significantly reduces cancer risk—even in higher-risk individuals.

cancer

How Exercise Enhances Chemotherapy, Radiation, & Immunotherapy Effects

Posted on April 1st 2025 (about 2 months)

In this clip, Drs. Rhonda Patrick and Kerry Courneya discuss how exercise supports chemotherapy effectiveness and impacts cancer cell behavior.

cancer

The Science of Exercise for Cancer | Kerry Courneya, PhD

Posted on March 3rd 2025 (3 months)

Dr. Kerry Courneya and Dr. Rhonda Patrick discuss the remarkable science behind exercise oncology.

Topic Pages

  • Alcohol

    Alcohol is one of the most widely used and abused drugs and is associated with several health conditions.

  • Autophagy

    Autophagy, or “self-eating,” is a response to stress in which a cell destroys damaged or dysfunctional components in order to adapt to external conditions.

  • Breast milk and breastfeeding

    Breast milk is a complex, dynamic fluid containing nutritional and non-nutritional components that support infant development. Breastfeeding benefits both infants and mothers.

  • Liquid biopsy (cancer screening)

    Liquid biopsies, a non-invasive cancer screening technology that includes GRAIL's Galleri test, could transform early detection and treatment by analyzing tumor-derived cells and components.

  • Neu5Gc

    Neu5Gc is a sialic acid produced in many mammals but not in humans. It is found in red meat and other animal products and has been found to accumulate in some human tissues.

  • Nicotinamide mononucleotide

    Nicotinamide mononucleotide is a precursor of NAD+, a coenzyme necessary for cellular energy production and DNA repair. It is available as a supplement.

  • Omega-3 fatty acids

    Omega-3 fatty acids play critical roles in human health and may be beneficial in ameliorating symptoms associated with chronic health conditions and in combating aging-related diseases.

  • Polyphenols

    Polyphenols are bioactive plant compounds with a wide range of health benefits.

  • Sirtuins

    Sirtuins play a key role in healthspan and longevity by regulating a variety of metabolic processes implicated in aging.

  • Sugar-sweetened beverages (SSBs)

    Sugar-sweetened beverages such as soda, juice, and sports drinks provide large doses of rapidly absorbable sugar, posing a unique risk to health.

  • Sulforaphane

    Sulforaphane is a bioactive compound that exerts potent antioxidant and anti-inflammatory properties and may be beneficial against a wide range of chronic and acute diseases.

  • Vitamin C

    Vitamin C is an essential nutrient, widely recognized for its antioxidant properties and its roles in many critical processes and pathways.

  • Whole-body hyperthermia

    Hyperthermia stresses the body, activating its repair mechanisms. Whole-body hyperthermia is a therapeutic strategy used to treat various medical conditions.

News & Publications

  • Morning-only coffee drinkers demonstrate a 16% lower risk of death from any cause and a 31% lower risk of cardiovascular death—benefits that exceed all-day coffee consumption, regardless of whether it's caffeinated or decaffeinated. academic.oup.com
    Cancer Coffee Caffeine Cardiovascular

    That morning cup of coffee might do more than boost alertness—it might promote longevity. While many studies link moderate coffee drinking to better health, the timing of those effects is less clear. However, a recent study found that morning-only coffee drinkers were more than 30% less likely to die from cardiovascular disease.

    Researchers analyzed data from more than 40,000 adults in the National Health and Nutrition Examination Survey and 1,400 adults in the Women’s and Men’s Lifestyle Validation Study. They searched for patterns in the timing of coffee consumption and tracked participants for an average of nearly 10 years to monitor deaths from all causes, cardiovascular disease, and cancer.

    Two coffee-drinking patterns emerged: a morning-only pattern (4 a.m. to noon) and an all-day pattern. Compared with people who didn’t drink coffee at all, those who drank coffee only in the morning had a 16% lower risk of dying from any cause and a 31% lower risk of dying from cardiovascular disease, indicating that the health benefits of drinking more coffee were strongest among morning-only drinkers. Surprisingly, caffeine didn’t explain the difference. When the researchers adjusted for both caffeinated and decaffeinated coffee intake, the timing of coffee drinking still mattered.

    These findings suggest that drinking coffee earlier in the day offers more health benefits than drinking it over the course of the day. Coffee induces autophagy–a critical process that helps reduce the risk of cancer and other chronic diseases. Learn more in this clip featuring Dr. Guido Kroemer.

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  • Sunburns remain common, with younger adults and higher-income individuals more likely to experience multiple episodes each year, particularly when consuming alcohol. journals.sagepub.com
    Cancer Alcohol Skin

    Sunburns are a major contributor to skin cancer risk, yet many people continue to get sunburned, with some experiencing multiple episodes each year. A recent study found that more than 30% of adults reported between one and five sunburns in the past year, and alcohol consumption was linked to an increased risk, with 21% of people who got sunburned having consumed alcohol at the time.

    Researchers analyzed data from the 2022 Health Information National Trends Survey, which included more than 6,200 participants. They used statistical analysis to identify associations between sociodemographic factors, cancer risk perceptions, sun exposure behaviors, and the number of sunburns reported in the previous 12 months.

    They found that 2.1% of participants reported more than six sunburns, 30.3% had between one and five, and 67.6% experienced none. Alcohol consumption was a contributing factor, with 21.5% of those who reported a sunburn also having consumed alcohol. Younger adults (aged 18 to 39) were more likely to experience sunburns than older adults, and men were at higher risk than women. Additionally, higher-income participants were more likely to get sunburned, with people in the highest income bracket more than four times as likely to report at least one sunburn in the past year.

    These findings suggest that public health interventions should focus on groups most at risk for sunburns, including younger adults, men, and higher-income people. Addressing alcohol consumption during sun exposure could also help reduce sunburn incidence. Sunscreens can protect against sunburns, but some carry health risks. Learn more in this Q&A featuring Dr. Rhonda Patrick.

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  • Regular blood donation promotes beneficial stem cell mutations while minimizing disease risk by inducing genetic changes that preferentially support healthy red blood cell production. ashpublications.org
    Cancer Stem Cells Immune System Genetics

    Donating blood is an act of generosity that saves lives, yet few donors think about how it affects their own health. Each donation triggers a surge in blood cell production, a process that could subtly shape the long-term health of blood-forming stem cells. A recent study found that frequent blood donation promotes the expansion of specific blood stem cell mutations that support healthy red blood cell production.

    Researchers analyzed blood samples from 217 older men who had donated more than 100 times and compared them to 212 men who had donated fewer than 10 times. They looked for clonal hematopoiesis, a condition where blood stem cells acquire genetic changes that allow specific cell populations to expand. They also used gene-editing techniques to study how particular mutations behaved when exposed to erythropoietin, a hormone that increases after blood loss.

    They found that the overall rate of clonal hematopoiesis was similar between frequent and infrequent donors. However, mutations in the DNMT3A gene showed distinct patterns in frequent donors. Some of these mutations responded to erythropoietin by expanding, while others, known to be associated with leukemia, were more likely to grow in response to interferon-gamma, a protein involved in the immune response. Further analysis revealed that the erythropoietin-responsive mutations tended to push blood stem cells toward making more red blood cells rather than leading to abnormal or harmful changes.

    These findings suggest that repeated blood donation encourages the expansion of specific blood stem cell mutations, but the effects support normal blood cell production rather than increase disease risk. Blood donation also lowers levels of iron—a key nutrient that, in excess, harms the brain. Learn more in this episode featuring Dr. Gordon Lithgow.

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  • Melatonin supplementation may heighten DNA repair in night shift workers during daytime sleep, potentially reducing cancer risk. oem.bmj.com
    Cancer Sleep DNA Damage Circadian Rhythm Melatonin Supplements

    Working night shifts may increase the risk of cancer by disrupting the production of melatonin, a hormone essential for DNA repair. This disruption can impair the body’s ability to repair oxidative DNA damage, potentially contributing to cancer development. A recent study found that melatonin supplementation could improve the repair of oxidative DNA damage in night shift workers.

    The researchers conducted a four-week randomized, placebo-controlled trial with 40 night shift workers, providing them a 3-milligram dose of melatonin before their daytime sleep periods. They collected urine samples during daytime sleep and nighttime work periods, measuring 8-hydroxy-2′-deoxyguanosine (8-OH-dG), a marker of DNA repair capacity.

    They found that melatonin supplementation nearly doubled 8-OH-dG excretion during daytime sleep, indicating improved DNA repair. However, they observed no difference in 8-OH-dG excretion during the night shift. Although the melatonin group experienced a slight decrease in wakefulness after falling asleep, the researchers found no differences in total sleep duration or sleepiness levels between the two groups.

    The findings from this small study suggest that melatonin supplementation enhances oxidative DNA repair in night shift workers, offering the potential for reducing cancer risk. More extensive studies may identify optimal dosages and the long-term effects of melatonin supplementation in this population. Learn about the pros and cons of melatonin supplementation in this clip featuring Dr. Satchin Panda.

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  • Higher muscular strength and cardiorespiratory fitness can help reduce the risk of premature death in cancer patients by up to 46%. bjsm.bmj.com
    Exercise Cancer Muscle Mortality Cardiovascular

    Cancer remains one of the leading causes of death globally, with millions of new cases and deaths each year. Despite treatment advancements, cancer patients are at a greater risk of death due to muscle loss, heart complications, and inadequate physical activity. A recent study found that higher muscle strength and cardiorespiratory fitness reduce the risk of death in cancer patients, with a 31% to 46% lower likelihood of premature death.

    Researchers conducted a systematic review and meta-analysis of 42 studies involving more than 47,000 cancer patients across various types and stages to examine how muscle strength and cardiorespiratory fitness influence survival rates. They sought to determine whether higher fitness levels were associated with better outcomes in terms of overall and cancer-specific death.

    Their analysis revealed that patients with higher muscle strength or cardiorespiratory fitness were 31% to 46% less likely to die prematurely from any cause than those with lower fitness levels. Each increase in muscle strength was associated with an 11% lower risk of all-cause mortality. Furthermore, patients with advanced cancer stages, as well as those with lung and digestive cancers, saw significant reductions in death risks—ranging from 8% to 46% lower for all-cause mortality. Increments in cardiorespiratory fitness were particularly important, with each improvement in cardiorespiratory fitness linked to an 18% reduced risk of dying specifically from cancer.

    These findings suggest that boosting muscle strength and cardiorespiratory fitness can improve cancer patients' survival rates. Given the strong connection between physical fitness and mortality risk, health professionals should prioritize fitness assessments for cancer patients as part of their treatment strategies. Learn more about the role of exercise in cancer prevention and recurrence in this episode featuring Dr. Kerry Courneya.

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  • The incidence of advanced-stage prostate cancer in California increased by nearly 7% over ten years, leveling off previous declines in deaths from the disease. jamanetwork.com
    Cancer Mortality Prostate

    Prostate cancer is the most diagnosed cancer among males in the U.S., but its progression varies widely, with some cases remaining harmless and others turning deadly. In recent years, concerns have grown over a rise in advanced prostate cancer, potentially linked to changes in screening recommendations. A recent study found that in California—a racially, ethnically, and geographically diverse state—the incidence of advanced-stage prostate cancer increased by nearly 7% over the past decade, while death rates, which had been declining, leveled off.

    Researchers analyzed data from nearly 388,000 prostate cancer cases diagnosed in California between 2004 and 2021. Using data from state and national cancer registries, they examined trends in incidence and death rates based on cancer stage, age, race, ethnicity, and geographic region. They used statistical models to measure how these rates changed over time, focusing on patterns before and after shifts in screening guidelines.

    They found that between 2011 and 2021, cases of advanced-stage prostate cancer increased by an average of 6.7% per year, with similar trends across racial and ethnic groups and nearly all regions of California. Meanwhile, prostate cancer death rates declined by 2.6% per year from 2004 to 2012 but remained steady through 2021, marking an end to previous declines in deaths from the disease.

    These findings suggest that more men in California are being diagnosed with advanced prostate cancer, and the progress in reducing deaths has stalled. The gold standard for prostate cancer screening is the prostate-specific antigen (PSA) test. The U.S. Preventive Services Task Force recommends PSA screening for prostate cancer in men aged 55 to 69, but only among those at high risk for the disease. This screening can potentially reduce death but also carries risks such as false positives and treatment complications, including incontinence and erectile dysfunction. For men 70 and older, PSA screening is not recommended due to the greater likelihood of harms outweighing benefits.

    Sulforaphane, a bioactive compound derived from broccoli, may reduce the risk for some types of cancer, including prostate cancer. Learn more in this episode featuring Dr. Jed Fahey.

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  • Regular exercise nearly halves the risk of cancer death. bjsm.bmj.com
    Exercise Cancer Mortality

    Cancer is the second leading cause of death worldwide, claiming the lives of nearly 10 million people yearly. A recent study found that people who exercise regularly are nearly half as likely to die of cancer than those who are inactive.

    Researchers assessed the physical activity of more than 28,000 people diagnosed with stage 1 cancer in the year before their diagnosis based on data gathered from fitness devices, gym logs, and organized fitness events. They categorized the participants' activity as none, low (less than 60 minutes weekly), and medium to high (60 minutes or more weekly). Then, they measured their time to cancer progression and death rates.

    They found that participants with low physical activity were 16% less likely to experience cancer progression and 33% less likely to die than those who were inactive. However, those with medium to high activity levels were 27% less likely to experience progression and 47% less likely to die than those who were inactive.

    These findings highlight exercise’s protective role in reducing cancer progression and improving survival. Exercise boosts the body’s immune system, helping it to combat cancer. It also promotes shear—the frictional drag exerted by blood flowing against the inner walls of blood vessels. Shear damages cancer cells, driving their death. Learn more in this clip featuring Dr. Rhonda Patrick.

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  • Food antigens, proteins in meat and milk that trigger allergic reactions, activate immune responses that reduce the risk of small intestinal tumors. www.frontiersin.org
    Cancer Diet Immune System Allergies Protein

    Proteins in milk, meat, and other foods can trigger allergic reactions in some people. However, these proteins—called antigens—can also interact with the immune system to suppress small intestinal tumors. A recent study in mice found that food antigens help activate immune responses in the small intestine, potentially reducing the risk of tumors.

    Researchers fed mice genetically prone to developing intestinal tumors—similar to the genetic predisposition to familial adenomatous polyposis in humans—an antigen-free diet to pinpoint the role of food components in immune activation. They also depleted immune tissues in the animals' small intestines called Peyer’s patches to investigate how food antigens trigger immune cells.

    They found that food antigens activate immune cells in Peyer’s patches, suppressing small intestinal tumor formation. This immune response is crucial for maintaining a tumor-suppressive environment in the gut.

    These findings suggest that food antigens help protect against small intestinal tumors in mice by activating immune cells that promote tumor suppression, highlighting their potential as a protective factor in gut health. The microbiome plays a key role in gut health, too. Learn more in this episode featuring Dr. Eran Elinav.

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  • People with tattoos have a 21% increased risk of malignant lymphoma, with laser tattoo removal further amplifying the risk to 163%. www.thelancet.com
    Cancer Immune System

    Body art is more popular than ever, with roughly one-third of people in the U.S. having at least one tattoo. However, tattoo inks often contain harmful chemicals, including carcinogenic pigments and metals. A recent study found that people with tattoos are 21% more likely to develop malignant lymphoma.

    Researchers conducted a case-control study among roughly 1,400 people diagnosed with malignant lymphoma (“cases”) in people aged 20 to 60 over 10 years. They matched the cases with age- and sex-matched people without cancer (“controls”) from the general population. Then, they gathered information about the participants' tattoo exposure and assessed the relationship between tattoos and lymphoma risk.

    They found that overall, participants with tattoos were 21% more likely to develop malignant lymphoma than those without. The risk of lymphoma among those who had received their first tattoo within the previous two years was 81% higher than those without a tattoo. Risk decreased nearly to baseline between three and 10 years after the first tattoo but increased again to 19% after 11 years, suggesting that long-term exposure to tattoo-related chemicals contributes to a delayed but persistent risk of developing lymphoma.

    Undergoing laser removal of tattoos increased the risk of lymphoma by 163%. Oddly, greater tattoo surface area did not increase risk, with the highest lymphoma risk among people with tattoos smaller than the size of a deck of cards.

    These findings point to potential links between tattoos and an increased risk of lymphoma. The tattooing process involves injecting ink into the skin through repeated punctures, breaching the skin’s protective barrier and triggering an immune response. As the ink enters the body, immune cells called macrophages attempt to engulf and isolate the foreign substance, driving the movement of pigment to nearby lymph nodes. Lasering tattoo ink induces the formation of toxic, carcinogenic substances that can persist in the body.

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  • Chronic cold exposure reduces tumor growth by 80 percent and doubles survival rates in mice. www.newscientist.com
    Cancer Cold Stress Brown Fat

    Cancer treatments often target glucose uptake to impede tumor growth, primarily through pharmaceuticals, many of which exert considerable side effects. However, cold exposure is emerging as a potential alternative to these drug-based therapies. A recent study in mice found that cold exposure reduced tumor growth by 80 percent and increased survival rates twofold.

    Researchers conducted a two-part study in mice and humans. First, they exposed mice with cancer to cold (4°C, 39°F) or thermoneutral (30°C, 86°F) temperatures for about three weeks. They found that the cold exposure activated the animals' brown fat, depleting the energy supply available to the tumors. The cold-exposed mice exhibited marked tumor growth inhibition and a nearly twofold increase in survival rates relative to the thermoneutral mice. Interestingly, when they fed the cold-exposed mice a high-glucose diet, the animals did not experience the same extent of tumor growth inhibition, suggesting that glucose scarcity was pivotal in suppressing cancer growth.

    In the second part of the study, they exposed healthy people to cool temperatures (16°C, 61°F) for two to six hours per day for 14 days and found that the participants experienced brown fat activation similar to the mice. Then, they exposed a person with Hodgkin’s lymphoma to cool (22°C, 71°F) temperatures for seven days and found that the participant exhibited activated brown fat and their tumor showed diminished glucose consumption, suggesting the findings in mice translate to humans.

    These findings suggest that cold exposure activates brown fat, reducing blood glucose and impeding tumor growth. Brown fat is a thermogenic (heat-producing) tissue. Studies in animals and humans suggest that brown fat can improve glucose and insulin sensitivity, increase fat oxidation, and protect against diet-induced obesity. Cold exposure increases brown fat volume and metabolism and drives glucose uptake. Learn more about cold exposure and its effects on brown fat in our overview article.

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  • Ovarian cancer tumors, even at advanced stages, may be effectively targeted and eliminated by CAR-T immune therapies, a new study in mice suggests. www.sciencedaily.com
    Cancer Genetic Engineering Immune System

    CAR-T, or chimeric antigen receptor T-cell therapy, is an immunotherapy approach that involves genetically modifying a person’s own T cells so they can recognize and target specific proteins on cancer cell surfaces, enhancing the immune system’s capacity to seek out and destroy malignant cells. CAR-T therapies have been successful against blood cancers, such as leukemia, lymphoma, or myeloma, but have largely failed with solid tumors. Now, a new study in mice demonstrates that CAR-T is effective against ovarian cancer, nearly doubling survival time.

    Researchers identified a unique carbohydrate present only on the surface of solid tumor cells, not healthy ones, and engineered CARs with a strong affinity for the carbohydrate. Then, they delivered the CAR-T therapy via intravenous injection to mice with ovarian cancer. Because ovarian cancer treatments delivered directly into the abdominal area are particularly effective, they also administered the CAR-T therapy into the animals' abdomens.

    They found that the CAR-equipped T cells effectively located and eliminated the cancer cells, promoting tumor shrinkage or elimination with just one dose. The genetically engineered cells maintained their effectiveness for several months, with no evidence of toxicity or adverse effects. Intravenous injection of CAR-T cells increased survival to 145 days, but direct delivery into the animals' abdomens extended survival to 270 days.

    These findings demonstrate that modified CAR-T cells show promise as a potential treatment for ovarian cancer and other solid tumors. Future studies are needed to assess the treatment’s effectiveness in humans. Learn more about genetic engineering in this episode featuring Dr. George Church.

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  • Many cancers are influenced by excess body fat, with overall accumulation playing a larger role than fat distribution, despite sex-specific difference www.eurekalert.org
    Cancer Fat

    Excess body fat increases a person’s risk for many types of cancer. However, body fat distribution patterns tend to be sex-specific, with males carrying more fat in the upper abdomen and females carrying more in the hips, thighs, buttocks, and lower abdomen. A new study has identified differences in obesity-driven cancer rates between males and females.

    Researchers drew on data from more than 440,000 adults enrolled in the UK Biobank study. They used statistical analysis to determine how various measures of body fat, such as body mass index (BMI) and waist circumference, influenced the risk of developing 19 types of cancer over a follow-up period of about 13 years.

    They found that nearly all 19 cancers were associated with excess body fat, except brain, cervical, and testicular cancers. They also found that overall body fat had a greater influence on cancer risk than fat distribution. However, they noted sex-specific effects of body fat on colorectal, esophageal, and liver cancer rates between males and females. For example, excess abdominal fat increased the rates of esophageal cancer in females but not males. Similarly, excess overall fat increased the rates of liver cancer in males but not females.

    These findings suggest body fat plays important but differential roles in cancer risk between males and females. Evidence suggests a ketogenic diet promotes weight loss and reduces cancer risk. Learn more about ketogenic diets and cancer in this episode featuring Dr. Dominic D'Agostino.

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  • Higher omega-3 intake may reduce breast cancer risk by half. www.verywellhealth.com
    Nutrition Cancer Diet Breast Cancer Omega-3

    Higher intake of omega-3 fatty acids may reduce the risk of breast cancer, a 2022 study found. Women with the highest omega-3 intake were as much as 49 percent less likely to develop breast cancer than those with the lowest intake.

    Researchers conducted a study that included more than 3,200 women, roughly half of whom had breast cancer. The women provided information about what they typically ate, including foods rich in omega-3 fatty acids, and whether they were pre- or postmenopausal.

    The researchers found that a higher intake of omega-3 in the form of alpha-linolenic acid reduced breast cancer risk by 49 percent; a higher intake in the form of eicosapentaenoic acid reduced risk by 32 percent. The links between omega-3s and breast cancer risk were strongest among premenopausal women and women with hormone-sensitive tumors. Interestingly, higher omega-3 intake markedly reduced the risk of breast cancer among women who had obesity or overweight but not among those who had healthy weights.

    These findings suggest that omega-3s reduce the risk of breast cancer, the second leading cause of cancer-related death among women. Inflammation plays a key role in the pathogenesis of many cancers, including breast cancer. Learn how omega-3 fatty acids reduce inflammation in this clip featuring Dr. Bill Harris.

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  • Many types of leisure time activity may lower risk of death for older adults www.cancer.gov
    Exercise Cancer Aging

    Older adults who engage in leisure time physical activities have lower risk of premature death.

    Leisure time physical activity is a broad term that refers to physical activities performed outside work or typical household responsibilities. Examples include exercise, sports, dancing, gardening, and walking. Findings from a recent study suggest that certain leisure time physical activities are associated with a lower risk of death from all causes of premature death, including cardiovascular disease and cancer, in older adults.

    Most public health organizations recommend that adults of all ages should engage in at least 150 minutes of moderate-intensity aerobic physical exercise or at least 75 minutes of vigorous-intensity aerobic physical exercise each week, or an equivalent combination of both. The bulk of the research focused on the benefits of physical activity has been in younger people, the findings of which might not be translatable to older adults.

    The investigators drew on data from 272,500 older adults (average age, 70 years) enrolled in the National Institutes of Health-AARP Diet and Health Study, an ongoing study of associations between diet and cancer. Participants provided information about their demographics, height, weight, smoking status, mood, educational level, and alcohol consumption. They also answered questions about the average amount of time they spent per week during the previous year engaging in cycling, swimming laps, playing racquet sports, playing golf, walking for exercise, jogging or running, and other aerobic exercises. The investigators calculated the participants' average leisure time activity levels in terms of metabolic equivalents, or METs, a measure of the rate of energy expended per unit of time.

    They found that playing racquet sports was associated with a 16 percent reduction in the risk of death from any cause and running was associated with a 15 percent reduction. The other activities conferred protection as well, but to a lesser extent. Achieving the recommended amount of physical activity through any combination of the seven leisure time activities reduced the risk of death by 13 percent. The protective effects of leisure time physical activity were dose-dependent to a degree, with greater duration conferring greater reduction in risk, but levels beyond those recommended showed diminishing returns.

    These findings suggest that older adults who meet physical activity guidelines through leisure time physical activities, especially aerobic activities such as racquet sports or running, have a reduced risk of premature death from all causes. Learn about the benefits of aerobic exercise in our overview article.

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  • First trial to prove a diet supplement can prevent hereditary cancer www.ncl.ac.uk
    Cancer Diet

    Resistant starch reduces the risk of certain hereditary cancers by roughly half.

    Lynch syndrome increases a person’s risk of having several types of cancer, particularly colorectal cancer. It is an inherited condition, affecting one out of 279 people worldwide and accounting for 2 to 4 percent of all colorectal cancer cases and 2.5 percent of endometrial cancer cases. Findings from a recent study suggest that supplemental resistant starch reduces the risk of cancer among people with Lynch syndrome.

    Resistant starch is a type of carbohydrate that resists digestion in the small intestine. Instead, resistant starch undergoes microbial fermentation in the colon, providing nutrients for the microbes, and producing butyrate, a short-chain fatty acid that supports the health of colonocytes – the cells that line the colon and rectum (the end portion of the colon). Foods that contain resistant starch include breads, pasta, legumes, nuts, seeds, bananas, and starchy vegetables, such as potatoes. A 3-ounce portion of baked potatoes typically provides 3.6 grams of resistant starch. Evidence suggests that resistant starch consumption alters microRNA expression, potentially moderating the cancer risks associated with red meat consumption.

    The study was part of the CAPP2 trial, an ongoing investigation to identify strategies that reduce the risk of certain hereditary cancers. The study involved nearly 1,000 adults (average age at recruitment, 45 years) who had Lynch syndrome. Half of the participants took 30 grams of resistant starch daily for an average of two years, while the other half took a placebo. The investigators tracked the participants for up to 20 years to see if they developed Lynch syndrome-related cancers.

    They found that resistant starch did not reduce the incidence of colorectal cancers, but it did reduce the incidence of other Lynch syndrome-related cancers (especially those of the upper digestive tract) by roughly half. The protective effect of resistant starch on cancer incidence endured for approximately 10 years after discontinuation of the supplement.

    These findings suggest that resistant starch protects against certain forms of hereditary cancers and underscores the role of diet in preventing cancer. For example, some evidence suggests that ketones exert anti-tumor effects. Learn more in this clip featuring Dr. Dominic D'Agostino.

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  • Inhibiting the Mfsd2a transporter that brings omega-3 DHA into the brain promotes leakage of brain barrier www.sciencedaily.com
    Brain Cancer Aging Omega-3 Blood-Brain Barrier

    Impaired transport of DHA disrupts the blood-brain barrier.

    Lipid rafts – cholesterol-filled “bubbles” found in the cell membrane – serve as staging areas for many cellular activities. One type of lipid raft, called caveolae, facilitates the transport of substances across the membrane of endothelial cells. Findings from a 2017 study demonstrate that suppression of caveolae-mediated transport in brain endothelial cells protects the integrity of the blood-brain barrier.

    The blood-brain barrier is a highly selective semi-permeable barrier made up of endothelial cells connected via tight junctions. This barrier separates the circulating blood from the brain’s extracellular fluid and prevents the entry of substances that may be neurotoxic. Disruption of the blood-brain barrier has been implicated in the pathogenesis of neurodegenerative diseases, including Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, and multiple sclerosis, among others.

    The investigators' previous research showed that a critical player in blood-brain barrier function is Mfsd2a, a transmembrane protein found exclusively on the endothelial cells that line blood vessels on the barrier. Mfsd2a participates in lipid transport and is the sole means by which lysophospholipid DHA, the brain’s preferred form of DHA (a type of omega-3 fatty acid) is delivered to the brain.

    Using mice that carried a mutation that blocked Mfsd2a’s capacity to transport DHA, the investigators assessed blood-brain barrier function as well as caveolae formation and activity in the animals' brains. Then they compared the lipid composition of brain endothelial cells to lung epithelial cells, which lack Mfsd2a.

    They found that mice that lacked Mfsd2a function had leakier blood-brain barriers and greater caveolae formation and activity than normal mice. They also found that brain endothelial cells had higher lipid concentrations than lung epithelial cells. The most abundant lipid in the brain endothelial cells was DHA, which was found in concentrations that were two to five times higher.

    These findings suggest that Mfsd2a-mediated transport of lipids, particularly DHA, impairs caveolae activity, thereby preserving blood-brain integrity. Learn more about links between Mfsd2a, DHA, and brain health in this open-access peer-reviewed article by Dr. Rhonda Patrick..

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  • Butyrate receptor in colon functions as tumor suppressor. aacrjournals.org
    Cancer Butyrate

    Butyrate, a short-chain fatty acid, may suppress colon cancer growth.

    Colon cancer is one of the leading causes of death in developed nations. Health experts attribute much of the risks associated with colon cancer to dietary patterns, especially those that are high in red meat and low in fruits, vegetables, and fiber. Findings from a 2009 study suggest that butyrate, a short-chain fatty acid, activates a protein called GPR109A in the colon to suppress colon cancer.

    Short-chain fatty acids are produced by the gut microbiota during the fermentation of dietary fiber. In turn, these fatty acids provide energy to cells in the colon and play key roles in maintaining gut health. Butyrate, in particular, functions as a tumor suppressor by inhibiting enzymes called histone deacetylases, which drive tumor growth.

    The investigators assessed the production of GPR109A in the colon tissues of mice and humans (with and without colon cancer) using monoclonal antibodies that targeted the protein. Then they determined whether butyrate bound to GPR109A and how the fatty acid influenced tumor growth. Finally, they gauged the effects of butyrate on cancer cell growth and progression.

    They found that GPR109A was present on the surface of cells in the colons of both mice and humans, where it recognized and bound with butyrate. In the setting of cancer, GPR109A activity was silenced, effectively shutting down its activity. Supplying butyrate switched on the activity of GPR109A, which in turn promoted the death of cancer cells and suppressed the activity of nuclear factor-κB, a transcription factor that drives inflammation and tumor growth.

    These findings suggest that GPR109A mediates the tumor-suppressive effects of butyrate in the colon. Interestingly, evidence indicates that beta-hydroxybutyrate, a type of ketone, also binds with GPR109A, suggesting that the compound exerts anticancer properties in the colon. Learn more about the beneficial health effects of butyrate and beta-hydroxybutyrate in our overview articles.

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  • Alcohol consumption may increase the risk of several types of cancer. www.ncbi.nlm.nih.gov
    Cancer Alcohol

    Alcohol is a group 1 carcinogen, the highest classification of a substance known to cause cancer in humans – and the same classification as asbestos, formaldehyde, and tobacco smoke. Epidemiological data indicate that nearly three-quarters of a million new cancer cases worldwide are directly attributable to alcohol consumption00279-5/fulltext). Findings from a 2015 meta-analysis suggest that alcohol consumption increases the risk of several types of cancer.

    Scientists do not fully understand how alcohol drives cancer, but evidence points to a variety of mechanisms related to how the body metabolizes ethanol, the form of alcohol present in alcoholic beverages. Evidence indicates that the processes and products associated with ethanol metabolism exert genotoxic effects; promote oxidative stress; alter vitamin metabolism (especially folate and vitamin A-related compounds); increase estrogen levels; and drive inflammation.

    The investigators reviewed data from 572 studies involving more than 480,000 cancer cases. They calculated site-specific cancer risk for light, moderate, and heavy drinkers versus non-drinkers.

    They found that cancer risk increased for every category of drinking in a dose-dependent manner. As such, risk was greatest for heavy drinkers (more than four standard drinks per day). For example, compared to non-drinkers, the risk that heavy drinkers would develop cancer oral and pharyngeal cancer was 5.13 times higher; esophageal cancer, 4.95 times higher; laryngeal cancer, 2.65 times higher; breast cancer, 1.61 times higher; and colorectal cancer, 1.44 times higher. Heavy drinkers were also more likely to develop cancers of the stomach, liver, gallbladder, pancreas, and lung.

    These findings suggest that alcohol consumption markedly increases cancer risk in a dose-dependent manner. Alcohol consumption is just one of many lifestyle behaviors that influence cancer risk. Learn how modifying lifestyle behaviors can reduce the risk of breast cancer, for example, as well as other chronic diseases, in this clip featuring Dr. Ruth Patterson.

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  • Long-term weight-loss reduces cancer risk in adults with obesity and type 2 diabetes. www.sciencedaily.com
    Cancer Obesity Diabetes

    Obesity and type 2 diabetes cause perturbations in metabolism and immunity that increase the risk of cancer. Bariatric surgery is the most effective intervention for substantial and enduring weight loss in those with obesity and has been shown to [reverse type 2 diabetes](​​https://pubmed.ncbi.nlm.nih.gov/33485454/) and reduce cancer risk. Findings of a recent report demonstrate a lower risk of cancer in patients with obesity and diabetes up to 31 years following bariatric surgery.

    Weight gain occurs when the body stores excess calories in the form of fat in adipose tissue depots around the body. As the amount of energy stored increases, the body’s tolerance for glucose and other fuels decreases, leading to insulin resistance and type 2 diabetes. The high circulating levels of glucose, insulin, insulin-like growth factors, and inflammatory proteins observed in type 2 diabetes increase cancer cell proliferation and suppress apoptosis (programmed cell death). Reducing energy stores through bariatric surgery or other weight-loss therapies restores insulin sensitivity and reduces cancer risk.

    The authors collected data from an ongoing trial with over 4,000 participants investigating the long-term effects of bariatric surgery in adults with obesity and type 2 diabetes. At their baseline visit, participants underwent a physical exam, gave a blood sample, and completed questionnaires regarding health and lifestyle factors. Participants chose to undergo bariatric surgery or receive conventional obesity treatment during the years of 1987 and 2001. They continue to provide additional questionnaire data and blood samples as the study remains ongoing. The investigators followed participants in the current sample for an average of 21 years.

    Participants who chose to undergo bariatric surgery lost an average of 60 pounds two years after the baseline visit, compared to just 7 pounds in participants who received standard obesity treatment. These levels of weight loss remained stable 10 years after the baseline visit. At two years follow-up, 70 percent of participants who underwent surgery had diabetes remission, compared to 34 percent at 10 years follow-up. Bariatric surgery reduced cancer risk by 48 percent in women and 37 percent in the whole group. Participants who underwent surgery and maintained diabetes remission after 10 years had 55 percent reduction in cancer risk compared to participants with diabetes at 10 years follow-up. Participants who did not undergo surgery but achieved diabetes remission had an even greater risk reduction of 60 percent at 10 years follow-up.

    These findings support long-term weight-loss, including bariatric surgery, as a strategy to reduce type 2 diabetes and cancer risk among adults with obesity.

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  • Muscle produces tumor-suppressing compounds during exercise in men with prostate cancer. www.ecu.edu.au
    Exercise Cancer IL-6

    Exercise oncology is an emerging branch of medicine that studies the application of exercise medicine in the treatment of cancer. Although there is a strong base of epidemiological research that supports a relationship between increased physical activity and decreased cancer severity and death, the molecular mechanisms that underlie this relationship require further research. Findings of a recent report identify myokines that suppress tumor growth in patients with prostate cancer.

    Myokines are molecules released from muscle cells that signal to non-muscle tissues that the body is physically active. Studies in non-human animals have shown that myokines such as oncostatin M, decorin,, and interleukin (IL)-6 suppress cancer growth; however research in humans is lacking.

    The investigators recruited 10 men (average age, 73 years) with prostate cancer who were undertaking androgen deprivation therapy, which includes drugs that block the action of testosterone and other male hormones. Participants completed 12 weeks of exercise training that included three sessions-per-week of supervised resistance training and daily self-directed moderate-to-vigorous physical activity. The investigators measured the participants' muscle strength, body composition, and serum myokine concentration before and after the exercise training intervention. They also grew prostate cancer cells in vitro, exposed them to serum from participants taken before and after exercise training, and observed the effects on cancer cells directly.

    Participants lost about six pounds of fat and eight pounds of total body weight during the intervention period. Participants significantly increased their strength, measured during the leg press (57 pound increase) and chest press (16 pound increase). Serum concentrations of oncostatin M increased by 82 percent while other myokines did not increase or could not be measured. Finally, prostate cancer cells incubated with serum taken post-exercise training reduced cancer growth by 22 percent compared to serum taken prior to exercise training.

    These results show that exercise induced the expression of myokines with tumor-suppressing ability in patients with prostate cancer. Future research is needed to refine the prescription of intensity, frequency, and type of exercise in cancer treatment.

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  • Magnesium reduces pancreatic cancer risk. www.sciencedaily.com
    Cancer Magnesium

    Pancreatic cancer is a rare, aggressive cancer, expected to claim the lives of more than 48,000 people this year. The lack of reliable screening tests and the vague, non-specific symptoms associated with pancreatic cancer make diagnosing the disease difficult and often late. Even when diagnosed early, pancreatic cancer has a poor prognosis, with only about 8 percent of people who develop the disease surviving longer than five years. Findings from a 2015 study suggest that magnesium reduces the risk of pancreatic cancer.

    Magnesium is an essential mineral and a cofactor for hundreds of enzymes. It is involved in many physiological processes, including energy production, nucleic acid and protein synthesis, ion transport, and cell signaling. Magnesium deficiency is linked with increased risk of cardiovascular disease, osteoporosis, hypertension, and type 2 diabetes. Current magnesium intakes among people living in the United States are below the recommended dietary allowance (RDA) of 400-420 milligrams per day for males and 310-320 milligrams per day for females.

    The study involved more than 66,000 adults between the ages of 50 and 76 years of age. The authors drew on data from the VITamins and Lifestyle Study, a cohort investigation of the associations of supplement use with cancer risk over an eight-year period.

    Compared to study participants who met the RDA for magnesium, those who obtained 75 to 99 percent of the RDA were 42 percent more likely to develop pancreatic cancer, and those who obtained less than 75 percent of the RDA were 76 percent more likely to develop pancreatic cancer. For every 100-milligram-per-day decrease in magnesium intake, pancreatic cancer occurrence increased 24 percent. This association held true regardless of age, gender, body mass index, or non-steroidal anti-inflammatory drug use.

    These findings suggest that magnesium reduces the risk of pancreatic cancer. They also underscore the importance of obtaining sufficient magnesium from supplemental or dietary sources, such as green leafy vegetables, unrefined grains, legumes, beans, and nuts. To bolster your magnesium intake, try this magnesium-rich smoothie.

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  • A ketogenic diet may be beneficial for people with brain tumors. www.sciencedaily.com
    Cancer Ketosis Ketogenic Diet

    Glioma is a collective term for tumors that arise from the glial cells in the brain. Astrocytoma, the most common form of glioma, arises from star-shaped cells in the brain called astrocytes. The the survival rate for glioma, including astrocytoma, is low. Findings from a recent study suggest that a ketogenic diet is beneficial for people with astrocytoma.

    Ketogenic diets are low in carbohydrates and high in proteins and fats. They cause the body to oxidize fats to produce ketones for energy. For many years, ketogenic diets have been used in the clinical setting to reduce seizures in children. They are currently being investigated for the treatment of cancer because evidence suggests that cancer cells cannot use ketones for energy.

    The eight-week intervention study involved 25 people with astrocytoma whose disease was stable following chemotherapy. Participants followed a weekly dietary protocol consisting of five days of a ketogenic diet (consuming 20 grams or less of carbohydrates per day) and two non-consecutive days of fasting (consuming less than 20 percent of their estimated caloric needs). Participants kept food diaries and provided weekly blood and urine for measuring ketones, insulin, glucose, hemoglobin A1c (a measure of long-term blood glucose control), and IGF-1. They underwent brain scans at the beginning and end of the intervention.

    About half of the participants adhered to the dietary intervention, which was well-tolerated and elicited few adverse events. Despite the relatively low compliance, all the participants had ketones in their urine, with 80 percent achieving moderate levels. Participants' hemoglobin A1c, insulin, and fat body mass decreased, but their lean body mass increased. No changes were noted in glucose or IGF-1 levels. The brain scans showed that ketone concentrations increased in the brain (including the tumor tissue) and correlated with ketone levels in the urine.

    These findings demonstrate that a ketogenic diet is safe for people with astrocytoma and may be beneficial as adjunctive therapy. Learn more about how a ketogenic diet, combined with fasting and the standard of care treatment, may help treat aggressive cancers in this clip featuring Dr. Valter Longo.

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  • High sugar intake increases cancer risk. academic.oup.com
    Cancer Sugar

    Current dietary guidelines for people living in the United States recommend limiting calories from sugar intake to less than 10 percent of total daily calories. Despite these recommendations, evidence indicates that some people living in the United States consume as much as 23 percent of their daily calories in the form of added sugars. Findings from a recent study suggest that high dietary sugar intake increases a person’s risk for cancer.

    Cancer is the second leading cause of death in the United States. Unlike normal cells, cancer cells preferentially rely on glycolysis (the breakdown of sugar) to produce energy. This altered metabolism, widely recognized as a hallmark of cancer, promotes cell proliferation and cancer metastasis.

    The authors of the study drew on data from more than 101,000 participants enrolled in NutriNet-Santé, an ongoing observational cohort study based in France. Participants completed online 24-hour dietary records detailing their usual consumption of more than 3,500 food and beverage items. The authors of the study performed statistical analyses to identify associations between sugar intake and cancer risk, taking into account known risk factors, such as socioeconomic status, body size, lifestyle, medical history, and nutritional factors.

    They found that higher dietary sugar intake increased the overall risk of developing cancer 17 percent. The risk of breast cancer increased 50 percent with high sugar intake. These findings suggest that reducing dietary sugar intake decreases a person’s risk of developing cancer and highlight the importance of policies and interventions to reduce intake.

    The effects of sugar extend to longevity, as well. In fact, consumption of sugar-sweetened beverages is associated with dramatically accelerated telomere shortening – equivalent to as much as five years of a person’s life. Watch this clip in which Dr. Elissa Epel discusses the harmful effects of what she calls a “toxic lifestyle,” one that includes the consumption of sugary drinks.

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  • Exercise exploits the immune system to fight cancer. www.sciencedaily.com
    Exercise Cancer Lactate

    Exercise is a critical component of public health recommendations to prevent cancer. A growing body of scientific research demonstrates that engaging in exercise after a cancer diagnosis can improve outcomes, but the mechanisms that mediate these effects are not fully characterized. Findings from a new study demonstrate that exercise alters the metabolism of cytotoxic T cells to improve their ability to attack cancer cells.

    Cytotoxic T cells play key roles in the body’s immune response. They destroy malignant cells by triggering apoptosis – a type of cellular self-destruct mechanism that rids the body of damaged or aged cells.

    The authors of the study placed mice with cancer into one of two groups. Half of the mice exercised on a treadmill, but the other half remained inactive. They transferred cytotoxic T cells from the mice that exercised into the inactive mice. Then they isolated T cells, blood, and tissues from the exercising mice. Finally, the authors injected both groups of mice with antibodies that would destroy the animals' cytotoxic T cells.

    The mice that exercise exhibited slower cancer growth and reduced death rates than those that remained inactive. The inactive mice that received the cytotoxic T cells from exercised mice showed marked improvements in their disease status. The exercising mice had high blood levels of lactate, which altered the T cells' metabolism and increased the cells' activity. Destroying the animals' cytotoxic T cells negated the beneficial effects that the exercise had in terms of cancer growth and survival.

    Taken together, these findings suggest that exercise alters cytotoxic T cells to mediate exercise-induced cancer suppression. Treatment protocols that incorporate exercise might improve outcomes by activating the immune system.

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  • Sulforaphane reduces biochemical recurrence in men who have had prostate cancer. pubmed.ncbi.nlm.nih.gov
    Cancer Prostate Sulforaphane NRF2

    Prostate cancer is the second most common cancer among men, affecting more than 1.3 million men worldwide. Many men undergo radical prostatectomy to treat their cancer. Findings from a 2015 study demonstrated that sulforaphane reduces biochemical recurrence in men who have had prostate cancer.

    Biochemical recurrence is a phenomenon in which serum levels of prostate specific antigen (PSA) levels increase. It is an indicator of localized or metastatic disease. As many as 40 percent of men treated with radical prostatectomy experience biochemical recurrence; 34 percent of these will develop metastatic disease.

    The double-blind, randomized, placebo-controlled study involved 75 men (average age, 69 years) who had undergone radical prostatectomy and were experiencing increased PSA levels. Roughly half of the men took a supplement providing 60 milligrams of sulforaphane for six months; the other half took a placebo. The authors of the study measured the men’s PSA levels before and two months after the treatment ended.

    Increases in the average PSA levels were much lower among the men who took the sulforaphane. The PSA doubling time among men who took sulforaphane was ~29 months; doubling time among the men who took the placebo was ~16 months – an 86 percent difference. The effects of sulforaphane remained up to three months after the intervention.

    These findings suggest that sulforaphane shows promise as a strategy to prevent biochemical recurrence among men who have had radical prostatectomy for prostate cancer. Additional studies are needed to confirm these findings.

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  • Scientists find molecular link between meat and dairy diets and colorectal cancer. pubmed.ncbi.nlm.nih.gov
    Nutrition Cancer

    Currently selected for this coming member’s digest by team member Melisa B.

    The World Health Organizations classifies red meat as a carcinogen based on epidemiological studies showing positive associations between eating red meat and developing colorectal cancer as well as strong mechanistic evidence. Multiple components present in red meat likely contribute to this risk, including saturated fat and heme iron. New research suggests that Neu5Gc, a type of sugar, provides another possible mechanism to explain the cancer-promoting effects of diets high in red meat and dairy products.

    Neu5Gc is a carbohydrate produced by non-human mammals and found in red meat and dairy products. Humans cannot produce Neu5Gc so the body recognizes it as foreign and produces antibodies against it called “anti-Neu5Gc IgG.” Research has demonstrated a link between high anti-Neu5Gc IgG levels and increased colon cancer risk; however, no direct correlation between diet and blood levels of anti-Neu5Gc IgG has been shown.

    The authors of this report collected data from nearly 20,000 participants enrolled in NutriNet-Santé, an ongoing observational cohort study based in France. Participants self-reported their diet using a 24-hour recall method and gave blood for biomarker measurement. After reviewing the diet record data for Neu5Gc content, the authors chose a subset of 120 participants with varying levels of estimated Neu5Gc consumption and measured the anti-Neu5Gc IgG concentration of their banked blood samples.

    The authors reported a distinct dose-dependent positive association between dietary content of Neu5Gc and blood concentrations of anti-Neu5Gc antibodies. Men consumed significantly more Neu5Gc in their diets, especially from red meat, and exhibited corresponding increases in anti-Neu5Gc IgG levels. In addition to the link between diet and antibody concentrations, the authors also report a link between increased meat and dairy consumption and the diversity of anti-Neu5Gc IgG. Antibodies vary slightly in structure so that one antigen may produce many different antibodies. Consuming more Neu5Gc increased the variety of anti-Neu5Gc antibody types in the blood, which may lead to a stronger immune reaction.

    These findings are the first to demonstrate a link between dietary intake of Neu5Gc and anti-Neu5Gc IgG response. This novel observational research may have important implications for colon cancer risk; however, controlled trials are necessary to explore any causative role of Neu5Gc in disease.

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  • Combining aerobic exercise and strength training may be the best strategy for improving healthspan. www.bmj.com
    Exercise Cancer Heart Disease Aerobic Strength

    Current public health guidelines recommend that adults engage in regular physical activity for optimal health. Findings from a new study suggest that a combination of both aerobic and strength activities reduces the risk of death from all causes as well as specific causes.

    According to the guidelines, adults should engage in at least 150 minutes of moderate-intensity aerobic physical activity or at least 75 minutes of vigorous-intensity aerobic physical activity each week, or an equivalent combination of both. They should also engage in muscle-strengthening activities of moderate or greater intensity on two days or more each week.

    The population-based cohort study, which involved nearly 480,000 adults, drew on data from the National Health Interview Survey, an ongoing, cross-sectional survey of people living in the United States. The study participants reported how much leisure time aerobic and strength physical activity they engaged in each week. Then the authors of the study categorized them as having insufficient activity, aerobic activity only, strength activity only, and both aerobic and strengthening activities, based on the guidelines.

    The authors found that the participants who engaged in recommended amounts of aerobic or muscle-strengthening activity had a lower risk of death from all causes, and these benefits were even greater if they engaged in both types of activities. They noted similar reductions in risk of death from cardiovascular disease, cancer, and chronic lower respiratory tract diseases.

    These findings suggest that adherence to public health guidelines for exercise reduce the risk of disease and death and provide support for interventions to improve compliance.

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