Join Dr. Heather Greenlee
Tuesday, Jan. 26, noon–1 p.m. PST for
a virtual researcher roundtable
Fred Hutch experts will share best practices to reduce risk of disease, get the exercise you need wherever you live, and stay healthy as we hunker down for the pandemic homestretch.
Traditionally, the first month of the year is when many of us think purposefully about rebooting our health. We embrace dry January, dive into the diet du jour or sign up for a year’s worth of prance-aerobic classes.
This year? The combination of stress, loss and upheaval has some of us jumping off the wagon before even climbing on. One survey found a measly 15% of Americans planned to make a food or beverage resolution (three times less than last year). Another study hinted we’re becoming coronavirus couch potatoes. We’re sitting in cars less but on chairs and couches more. And while a lot of us are cooking at home, comfort foods have trumped all else.
“People are suffering right now,” said Dr. Heather Greenlee, a public health and clinical researcher with Fred Hutchinson Cancer Research Center and the director of Seattle Cancer Care Alliance’s integrative medicine program. “There’s a lot of stress and anxiety. We know diets are changing. We know there have been big disruptions to people's physical activity. We know people are drinking more alcohol and gaining weight.”
From a public health perspective, that’s bad news, she said. Weight gain, alcohol use and sedentary activity increase the risk of cancer, cardiovascular disease, diabetes and many other diseases. It doesn’t do much for our mental health, either.
Greenlee and her team research the best strategies to keep cancer patients and their caregivers on a disease-prevention path — for the long haul. But the advice serves us all.
“In general, when people eat a good diet, are regularly physically active and get enough sleep, they feel better,” she said. “Even just doing some very basic things will help. Self-care is really important right now.”
It’s likely going to be several months before vaccines, good health practices and herd immunity bring us back to normalcy. Some simple, science-based tips to see you through:
Sleep is healing to the human body, but researchers at the National Institutes of Health said we’re not getting much of it these days. We’re going to bed at weird times, sleeping too long or too little, leaving many of us bleary-eyed, foggy-brained and unable to fend off disease at a time when it’s needed most.
Greenlee said COVID-19 has been “incredibly stressful” for people, disrupting sleep for many. Unfortunately, lack of sleep can compromise your body’s ability to mount a strong immune response to infection or a vaccine.
“Sleep deprivation is one of the most potent ways of suppressing the immune system,” said Hutch physician-scientist Dr. Gary Lyman. “Everybody has a different threshold, but if you’re not getting a minimum of six or seven or, ideally, eight hours of sleep a night, there’s demonstrable scientific evidence that the immune system may be compromised.”
Greenlee recommends setting up a peaceful sleep space that’s soothing, dark, quiet and cool, and establishing a sleep routine. “We establish bedtime routines for our kids,” she said. “Now is the time to do the same for ourselves.”
Regular exercise improves sleep, but intensive exercise right before bed can keep you awake, so do it earlier in the day. And cut back on stimulants like coffee, sugar, alcohol and blue screens. Doomscrolling will stress you out and the blue light from your smartphone will suppress the production of melatonin, a hormone that regulates sleep and wakefulness.
As for nightcaps — of the alcoholic variety, anyway — Greenlee said “some people may use alcohol to wind down, but there’s a rebound effect. It can actually disturb sleep.”
— Dr. Heather Greenlee, Fred Hutch researcher and director of the integrative medicine program at Seattle Cancer Care Alliance
“Physical activity is key to good health,” Greenlee said. Every bit counts, too, and you don’t have to do all that much of it.
Guidelines from the American Institute for Cancer Research call for 150 minutes of moderate to vigorous physical activity per week for average adults. Cancer survivors, Greenlee said, may want to bump that to 300 minutes per week (a brisk hour-long walk five days a week), if feasible.
The pandemic has created countless challenges to exercise. Many have pivoted to online classes or home equipment, but Pelotons are pricey and it’s hard to maintain a tree pose — much less sanity — with the whole family underfoot.
“Get outside,” Greenlee said. “Both for your physical health and your mental and emotional health.”
Walking every day will not only give you a soothing blast of nature, it will help you sleep, give you a chance to safely socialize with others (just mask up and keep your distance) and help you get to and maintain a healthy weight.
That in turn fends off diseases associated with extra weight like cancer, diabetes, stroke, high blood pressure and high cholesterol. Even something as simple as walking functions as medicine. Greenlee said she tries to get out every day, even in the rain.
“I’ve recently discovered Walking with Leslie videos on YouTube,” Greenlee said. “They’re super fun, high-energy, and they can be done inside, too.”
Just as important as moving is finding a moment to be still. Take a few deep slow breaths. Quiet the brain and think about the biological machine that’s housing you. These types of techniques where you mindfully check in with yourself are proven to reduce stress.
“We teach mind-body techniques to many of our cancer patients,” Greenlee said. “The important thing is to get into the parasympathetic state via mindful breathing, meditative walking or yoga.”
“I’m cooking so much more at home and thought I was eating healthier than before COVID, but I somehow managed to gain five pounds,” Judith Rixner, 64, wrote on the private Facebook group Knowledge is Power Breast Cancer Tribe. “Is a sleeve of double-stuffed Oreos considered too much?”
Calorie-rich, nutritionally empty processed foods may be tempting, especially during, say, a plague, but they are not our friends.
Plants are. They provide our bodies with a slew of phytonutrients and some, like brassicas, also known as cruciferous vegetables, actively fend off cancer.
“Cruciferous vegetables like arugula, bok choy, broccoli, cabbage, cauliflower, kale, radishes and swiss chard have high carotenoid content, vitamins C and K, folate, manganese and potassium,” said Kate Ueland, a registered dietitian who works with Greenlee and sees cancer patients at SCCA. “They’re an excellent source of fiber and contain a group of phytonutrients known as glucosinolates, which inhibit cancer in all kinds of ways.”
Greenlee pointed to a recent study in Nature emphasizing how our gut microbiome is shaped by what we eat. The findings, from the long-running PREDICT study, show that “a diet rich in nutrient-dense, whole foods supported the growth of beneficial microbes that promoted good health.”
What you put in your mouth matters. So, if stress-eating and/or snacking is your downfall, Greenlee said at least try to make it healthy.
Her snack of choice is kale chips, a recipe she took from Cook for Your Life, a healthy cooking site for cancer patients, survivors, caregivers and anyone else interested in learning more about what a healthy diet is, and how to achieve and maintain it. Greenlee is director of the site.
“These chips are incredibly easy to make — baked with a little olive oil and salt,” she said. “You get the crunch and the saltiness but you’re eating kale.”
Greenlee and Ueland work with patients at SCCA and via Cook for Your Life, recently relaunched after being acquired by the Hutch. Greenlee and her research staff use the site to test out interventions and educate people about food.
Her studies have shown people can change their eating habits for the better — and for the long term — if you give them the right tools and resources.
Cook for Your Life provides them: a thousand-plus recipes, 400 blog posts on nutrition and cancer, hundreds of how-to-cook videos, food myth-busting, easy substitutions and more. Tools help with online grocery shopping; special menus are available for those going through treatment. Read more about the site here.
They even teach you how to use a knife properly.
“In one of our first studies, we found that if we taught people how to shop for fruits and vegetables and how to prepare them and eat them, we could change their taste preferences,” she said. “People were more likely to make a long-term increase in fruit and vegetable intake and they increased their snacking of fruits of vegetables. That’s a good habit to have.”
While there are thousands of food websites out there, few are science-based or bilingual, Greenlee said. Cook for Your Life highlights the nutrition research coming out of the Hutch and even offers a chance to participate in research studies.
“There are a lot of recipes out there that taste great but they’re not healthy,” Greenlee said. “We want to provide support and we want people to feel better. This is a way for people to learn to cook at home in an easy, accessible, cost-effective, joyful and healthy way.”
Even with vaccination underway, it’s going to be months before the country reaches herd immunity. On top of that, scientists still don’t know if the COVID-19 vaccines protect against transmission.
So, continue to mask up, keep your distance and wash your hands regularly.
“At this point, we do not know — even with the high efficacy reported in reducing symptomatic disease — whether after vaccination individuals are still infectious,” Dr. Larry Corey, Hutch president and director emeritus and co-leader of the COVID-19 Prevention Network’s vaccine testing program, wrote in a recent blog post.
And don’t put off those cancer screenings and wellness checks that are traditionally part of the January reboot.
“People should absolutely schedule their cancer screenings and wellness checks,” said Dr. Rachel Issaka, a Hutch health services researcher and SCCA gastroenterologist. “In the midst of a pandemic, we cannot and should not abandon chronic disease management or disease prevention.”
Greenlee said it’s also important for our health to stay connected — even when apart.
“Maintaining connection with people is really important,” she said. “We may have to do it virtually but it’s still important for people to pay attention to what makes them feel good and to support the people around them.”
Diane Mapes is a staff writer at Fred Hutchinson Cancer Research Center. She has written extensively about health issues for NBC News, TODAY, CNN, MSN, Seattle Magazine and other publications. A breast cancer survivor, she blogs at doublewhammied.com and tweets @double_whammied. Email her at email@example.com. Just diagnosed and need information and resources? Check out our patient treatment and support page.
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