A very big-deal cancer study just dropped

Welcome back to One Day Better, where I share small steps that can help make today just a little better than yesterday. This week, I’m writing about:

• A blockbuster cancer study

• Tea, berries, apples, dark chocolate, oh my!

• Joyscrolling!

The cancer study blowing everyone’s mind

A blockbuster cancer study in the New England Journal of Medicine made headlines this week, but I thought the media coverage failed to do it justice. This was a soul-rattling, history-making, WTF-this-changes-everything moment in cancer.

So what just happened?

A major randomized trial of colon cancer patients found that a simple exercise program led to a 37% lower risk of death and 28% lower risk of cancer recurrence or new cancers.

The last time we saw a 37% drop in cancer deaths from a non-drug, low-cost, zero-side-effect intervention was ... never.

Let me break it down. This study is a big deal because ...

• Exercise (yes, just exercise!) improved survival in colon cancer patients.
  Other observational studies have linked exercise to better cancer outcomes, but this was a randomized, controlled clinical trial — the gold standard of scientific research. This study showed that exercise causally improved both disease-free and overall survival in colon cancer patients. That’s huge.
  

• The magnitude of the survival benefit rivaled drug therapies.
  The improvements from exercise were comparable to — or better than — many standard chemotherapy regimens, without the toxicity or cost.
  

• It was a walking program!
  Participants didn’t need a gym — brisk walking four days a week was enough. “When we saw the results, we were just astounded,” said study co-author Dr. Christopher Booth, a cancer doctor at Kingston Health Sciences Centre in Kingston, Ontario, in an interview with the Associated Press.
  

• Almost everybody in the study could do it.
  Adherence was excellent — 83% attended all coaching sessions in the first six months of the program. The study enrolled 889 patients (445 were in the exercise group), mostly with Stage III colon cancer. The patients, ages 19 to 84, were enrolled within six months of completing surgery and chemotherapy and came from six countries, primarily Canada and Australia.
  

• There may be broader cancer implications beyond colon cancer.
  The study also tracked whether the patients developed new cancers during the study period. The exercise group had fewer of them, particularly breast and prostate cancers.

I need to emphasize that there is still a lot of work to be done in conquering cancer. The research should not be used to blame or judge people who get cancer from not exercising. Fit people who exercise are diagnosed with cancer every year — so exercise is not a cure. And exercise may be a limited treatment option for many patients who are very sick and don’t have the energy to exercise.

But there are some very important takeaways about the power of exercise that we should all pay attention to. Let’s start with what the exercise program in the study actually looked like:

• Brisk walking for 45 minutes, four times a week: Patients picked their activity — walking, biking, swimming, kayaking — as long as it got their heart rate up. But most chose walking.

• A commitment of three years: The program lasted for three years and began shortly after patients completed chemotherapy.

• Regular check-ins with a coach: Each patient worked with a physical activity consultant who helped them stay motivated.

• No weight loss required: The benefits weren’t tied to losing weight. The positive effects came from the movement itself.

All of this means that exercise should no longer be viewed as a 'lifestyle’ option. It’s a powerful medical intervention. And for those of us lucky enough to be healthy right now, the research is a compelling call to action to get moving.

An easy-to-miss lesson from this study is the impact of accountability. The study’s success was likely linked to support and behavioral coaching. That doesn’t mean you need to hire a personal trainer. Just find yourself a walking buddy, a fitness group, a class, even a dog — to help you stick to a daily moving routine.

A new food mantra

Food advice can be so complicated and confusing. Who can remember it all?

That’s why I was taken by a press release headline about a new study on the link between food and longevity. It boiled down the results to a deceptively simple mantra:

What do these foods have in common? They’re all rich in flavonoids — natural compounds found in plant-based foods that have powerful health benefits.

The study wasn’t limited to just those four foods. What it really found is that people who eat a wide variety of flavonoid-rich foods — like fruits, vegetables, tea and even a little dark chocolate — may live longer and have lower risks of diseases like type 2 diabetes, heart disease and cancer.

The lesson of this study was not just to eat those four foods or even to eat more flavonoid-rich foods. The study matters because it's the first-of-its-kind to suggest that eating a variety of flavonoids matters as much or more than eating a lot of them.

Published in Nature Food, the study tracked the flavonoid consumption of over 120,000 participants, from ages 40 to 69, for over a decade.

In the study, eating around 500 mg of flavonoids a day — about the amount you would get in two or three cups of tea — was associated with a 16% lower risk of dying during the study — as well roughly a 9% to 13% lower risk of heart disease, diabetes and respiratory disease — all compared to the lowest group of flavonoid eaters.

But there was another group that got their 500 mg of flavonoids from a variety of foods — tea, berries, apples, dark chocolate. Eating the same amount of flavonoids but from a variety of sources conferred extra benefits. In addition to getting all the benefits enjoyed by the first group, diabetes risk dropped by 20% and cancer risk dropped by 8% compared to the lowest group.

The best results for brain health came from a combination strategy — focusing on both very high quantities (1,400 mg) and variety. In addition to all the original benefits, that group saw a 20% lower risk of neurodegenerative diseases.

Flavonoids are found in a wide variety of colorful, plant-based foods, including fruits (especially berries and citrus), vegetables, tea, dark chocolate, red wine, herbs and whole grains.

Here are three easy ways to get more flavonoids and more variety into your diet. Flavonoid content can vary, but these plans will get you in the ballpark.

Quantity = 500 mg
2 to 3 cups of tea a day

Variety = 500 mg
Blueberries (1 cup) + 1 apple + a few squares of dark chocolate + one cup of green tea

High quantity + Variety = 1400 mg
Breakfast: 1 cup of tea, 1 orange, ½ cup blueberries
Lunch: 1 apple, a handful of grapes, 1 cup of tea
Dinner: 1 glass of red wine, ½ cup cooked kale, ½ cup black beans
Dessert: 1 cup mixed berries, 3 squares of dark chocolate

To make it easy, just remember this mantra when you go food shopping this week: Tea, berries, apples, dark chocolate.

Joy scroll with me!

Here’s my weekly roundup of good news and interesting links to counteract the gloom.

Good news: Cold plunges are a bad idea. Now we don’t have to do it! Read more from Gretchen Reynolds in the Washington Post.

9 curious questions: Nice News has a chat with curiosity expert Scott Shigeoka, who keeps a “Powerful Questions List.” Here are nine of them (and you can watch Shigeoka’s Ted Talk here on practicing curiosity).

• What made you laugh today?

• What was a challenging thing you did this month?

• When did you feel proud of yourself recently?

• What’s something new you’d like to try?

• What is life teaching you right now?

• How can I be here for you in a way that’s meaningful?

• What’s putting a smile on your face these days?

• Who are you missing right now?

• Who makes you feel like you matter in your life?

Hungry elephant walks into a store, and helps itself to snacks. Watch the video.

Banksy’s Instagram: I just learned today that the elusive artist is on Instagram. He has a new creation — a lighthouse that says “I want to be what you saw in me.” The BBC wrote about it.

The healthiest places on earth: Super Age has an interesting article on 10 longevity cities. Instead of a pricey wellness resort this summer, just plan a trip to one of these cities and immerse yourself in local food and culture. It’s worth reading, but if you don’t feel like clicking, here’s the list: Seoul, Madrid, Zurich, Quebec City, Melbourne, Singapore, Copenhagen, Tokyo, Oslo and Boulder. Read more in Super Age.

Download these free feeling wheels: The practice of naming your feelings — being real with yourself and saying exactly how you feel — really works to manage stress. But sometimes it can be hard to find the right word. During a work project this week I came across some great free templates of visual feeling wheels for small children, simple words for elementary school kids and one with more complex feeling words for older teens and adults. A large body of research shows that naming your emotions — something scientists call “affect labeling” — can calm your brain and reduce stress. I wrote about it for the NYT a while back if you want to learn more.

Thanks for reading, and see you next week. Let’s keep the conversation going! Send me your comments and ideas. Drop a note in our subscriber chat or message me directly on Substack!

Every week, the One Day Better newsletter celebrates the power of small steps. If you enjoyed reading, please share it with a friend. This newsletter is free and reader-supported. If you’d like to support my work, you can make a contribution here.

Tara Parker-Pope, MPH is an Emmy Award–winning journalist who shared in the Pulitzer Prize for Public Service for coverage of the COVID-19 pandemic. She has an MPH from the Yale School of Public Health and is now the Chief Content Officer at Thrive Global. This newsletter represents her personal views. Learn more at taraparkerpope.com