We all know that besides our appearance, there is a long list of diseases associated with having a high body fat percentage (obesity), including some types of cancer, heart disease, asthma, dementia, and diabetes.
What most of us don’t know, however, is that besides obesity and high body fat percentage, there are other body composition types that can have negative health effects. A common example we see among our patients at the CCNM Integrative Cancer Centre is sarcopenic obesity, which is defined as having a low muscle mass combined with high body fat mass – the so-called “skinny fat”. This condition goes mostly undiagnosed and unsuspected as patients can be normal weight. In other words, these patients have a perfectly healthy BMI, and so their regular check-ups and weigh-ins would not catch this. This is why, at the CCNM Integrative Cancer Centre, we put all patients on an InBody770 body composition analyzer, which assesses their weight for the amount of body fat, muscle and water. We find that knowing our patient’s body composition results helps us to create their treatment plan and work towards their goals.
Knowing body composition is especially important for patients with cancer, both during and after treatment, as working to improve body composition is essential when working on improving prognosis and cancer prevention. A 2017 study (PMID: 28506965) of colon cancer connects colon cancer with obesity and sarcopenia and suggests that low muscle mass be used as cancer marker for the disease. In this study, low-muscle mass at diagnosis was linked with worse outcomes in people with colorectal cancer. In a 2018 study (PMID: 29621380) of women with breast cancer, researchers found that 1/3 of the women included in the study had low muscle mass (sarcopenia) at the time of their diagnosis and this was associated with a higher risk of dying compared with women who had ‘adequate’ muscle mass. For patients with cancer, improving muscle mass should be part of both disease prevention but also considered during and after treatment to improve survival.
While there is currently no magic pill for reversing sarcopenia, there are multiple things you can do to build muscle and preserve health. Whether you are actively trying to prevent muscle breakdown, or if you are already experiencing muscle breakdown, these factors might help delay its progression:
1) Strength/Resistance Training
Aerobic exercise focuses on cardiac training and includes exercises such as running, swimming, or biking, during which your heart and breathing rate increases. Resistance training, on the other hand, focuses on building muscle – this includes strength and weight training. While we all know aerobic exercise is important for your physical health, less of us prioritize building and maintaining muscle mass however it is equally important.
Where to start: begin with body weight training, such as push ups, squats, lunges and pull-ups and progress to adding additional weight as tolerated. For those of us who are new to strength training, consider joining a gym and hiring a trainer who can teach you how to properly lift weights and to design your own program. Aim for at least 30 minutes, twice to three times weekly. For patients with cancer who would like to build muscle, consider talking with your oncologist about a referral to physical therapy, which can help determine what is safe for you at this time.
2) Increase Protein Intake
Protein is essential for building and repairing muscle tissue. The current guidelines for protein is set at 10-35% of your daily energy/calorie needs. Whether you are eating animal, plant or whey protein, make sure each meal is focused on a healthy protein source that is not fried, barbecued or processed. You could consider using a food tracking app, like Cronometer, where you would input your diet and it calculates your total protein consumption and you can adjust accordingly.
3) Vitamin D Levels
Vitamin D deficiency has been correlated with muscle loss in women. The research suggests that avoiding Vitamin D deficiency is not just important for bone health, but also in the avoidance of age-related muscle loss. Most of us in Canada are vitamin D-deficient and require a supplement however consider having your blood levels tested with your naturopathic doctor, which can help determine what dose you should take.
Bottom line – for patients with cancer, it is critical to know your body composition and to work to not only get to a healthy body fat, but also a healthy muscle mass. The research indicates this could be helpful in more than just prevention – it could help with longevity.