Eating healthier and exercising more: lifestyle is a total package

Martijn Bours: "We know that it is difficult to change your lifestyle, but a serious illness such as colorectal cancer is often a trigger to get started. In recent years, our research has yielded many interesting results. For example, we now know that people who are more active (including those who do light physical activities, stand more often and sit less) feel better than people with a less active lifestyle. This also applies to people who eat more fruit and vegetables and fewer processed and energy-rich foods. They experience less fatigue, have a better quality of life and function better physically. We also encounter findings that are striking and initially seem contradictory, such as the observation that people who drink alcohol in moderation feel somewhat better. This cannot be explained by the biological effect of alcohol, and it is certainly not a licence to drink (more) alcohol. We believe this reflects a return to normal life after an intensive period of treatment, including social activities that sometimes involve a glass of wine, for example. So it does not actually work better physically, but seems to go hand in hand with picking up life after cancer. We saw something else striking in the use of dietary supplements. In the period after treatment, approximately 4 in 10 people used a dietary supplement, such as multivitamins or minerals. The same people were more likely to report symptoms of fatigue. This indicated that people were using supplements as a way to cope with their symptoms, but that they did not feel any better as a result. The use of dietary supplements is actually not recommended in general guidelines for people recovering from cancer, unless prescribed by a doctor or in accordance with national recommendations (e.g. vitamin D for the elderly). If you eat a healthy and varied diet, you don't really need vitamin tablets at all”.

“An important insight is that people can achieve something with just small changes. You don't have to completely change your lifestyle pattern: every little bit helps. Exercising more does not have to mean three intensive visits to the gym per week. People already benefit from sitting less and occasionally getting up to take a (short) walk. No big bang. There is also much to be gained from a combination of adjustments. If you only eat a little more fruit and vegetables, it won't have a spectacular effect, but if you also eat less processed meat and exercise a little more, it adds up and people can really start to feel better. It's all about the combination. Lifestyle is a total package”.

Martijn Bours: "A newer theme that we have been looking at in recent years in relation to nutrition, physical activity, and fatigue, among other things, is ‘timing’. In addition to what and how much you eat and do, it also matters when you eat or exercise, how often you do so and how regularly. People with more regular eating and exercise patterns seem to experience fewer fatigue symptoms and a better quality of life. What's more, a person's chronotype, i.e. whether they are more of a morning or evening person, also seems to play a role. It appears that it is better if your eating and exercise behaviour is roughly in line with your body’s natural rhythm, your biological clock. The timing of eating and exercising is an interesting and relatively new field that requires further research”.

Martijn Bours: "Unfortunately, most people have experiences with cancer in their personal circle of family and friends, and that is also true for me. I lost my mother to colon cancer at a young age. The impact of such a diagnosis is enormous. My mother became a different person from one day to the next. Her illness had a major impact on our family. I was in my early 20s when my mother died, and she was then only slightly older than I am now. That's a strange feeling. For me, this is a personal drive in the research I do. I hope that my research will contribute to the lives of people who have and have had bowel cancer. That they live healthier, better and happier lives after the cancer, together with their loved ones. I see it as my job to make people aware of the importance of a healthy lifestyle after cancer and to help them not to give up. That they really start to feel better and continue to feel better. I am proud that my research allows me to contribute to this”.

Martijn Bours: "My research is not about lifestyle as primary prevention aimed at the general population that is not ill. But primary prevention is crucial, because many cancers are preventable. Also hospitals have a role to play here. As far as I am concerned, hospitals should pay more attention to healthy lifestyles, such as projecting lifestyle advice for cancer prevention on screens. Such advice also helps to prevent other diseases by the way, such as diabetes and cardiovascular disease. Then you accomplish multiple things at once. When I go to teach, for example, I walk through the hospital and what strikes me every time is that you have to search for the stairs. These are small things, and of course the prevention message is even more necessary outside the hospital, but still: the hospital is a health centre. Promote that a little more!”.

Text: Eline Dekker
Photo: Joey Roberts

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