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What 'Counts' When Exercising to Prevent Breast Cancer?


It's week 4! We're making progress. I'm actually excited for this week's post because a reader contacted me after the week 2 post on exercise and asked 'How do you know if the exercise is vigorous or moderate?'


Given that I'm a bit ahead of the AICR.org on physical activity, instead of trying to add 5 to 10 minutes this week, I'm going to focus on nailing the 75 minutes of vigorous activity goal.


Okay, so here's a quick recap on what I concluded in week 2 was my ultimate exercise goal. Though, we did learn that MORE IS BETTER!

  • 150 minutes moderate OR 75 minutes vigorous (defined as breathing fast/difficulty speaking)

  • 2 days a week do strength

  • 2 days a week improve balance


Not too surprisingly, the reader who asked the question is a SUPER AWESOME, but SUPER BUSY, mom. So, what I'm guessing was the real thinking behind her question was, 'How can I allocate only 75 minutes a week instead of 150 minutes a week, but still make sure I'm getting the intended benefit?'


Let's dig into that.


I'm going to start with a really basic assertion, but it's really an important point. I think the level of intensity for a given exercise is different for different people. Therefore, I cannot simply say running at a 12 minute pace for 1 mile is vigorous exercise. (However, I totally get that researchers typically have to create some cut off like this to do their research.)


I'm basing this on my life experience, but I just know that the intensity of a given exercise is fully dependent on how in shape a person is at any given time.


Example 1: Three different people

In this scenario we have 3 different people, let's say my mom (74), myself (39) and my accountability buddy (34). Now my mom is in amazing shape for a 74 year old, but she couldn't run a mile in 9 minutes right now, it would be extremally exhausting for her. I on the other hand could totally run a 9 minute mile, but I'd be breathing hard and would be about 30 seconds per mile faster than my personal comfort zone. Now, my accountability buddy, she's the one who ran 63 miles in 12 hours. For her, a 9 minute pace is a comfy recovery jog. She'll chat the whole time, hardly breaking a sweat.


So no. There isn't a simply rule I'd apply to everyone.


Example 2: 1 Person over time


People don't have an inherent and fixed capability. Nope, we improve or decline over time based on the effort we've put in. It's the whole basis for athletic training. Last spring, when I did my first 3 mile training run I had a very different level of ability than last fall when I completed my most recent marathon. So, even for a single person (me) there isn't a fixed rule on what counts as vigorous.


Now, this is the era of quantified self, and you can totally buy a device that would track this for you. I have one- it's an Apple watch. But, I still don't use it to determine if something is vigorous or not.


Nope, I still use the same test that I've used for 20+ years. Can I talk? It's so simple, and you don't have to remember to charge anything! Nope. Simply ask yourself while exercising, 'Can I talk?' If the answer is 'No...pant...pant...talking is hard.' than you're in VIGORUS territory. If the answer is 'OMG, I have SOOOOOOOO much to say. Where do I start?' than you're in MODERATE, or maybe even LIGHT territory.


Conveniently, the American Institute for Cancer Research uses the same method. (I'm not surprised, this is very widely used because it is so easy and costs nothing.) This beautiful little chart is from AICR.org.



Hmm, but maybe you're thinking this just doesn't seem precise enough. Or, maybe you're feeling this lacks scientific backing. Well... don't worry... I got you.


Insert the Borg rating for perceived exertion (RPE).


The Borg Rating of Perceived Exertion (RPE) is a way of measuring physical activity intensity level. Perceived exertion is how hard you feel like your body is working. It is based on the physical sensations a person experiences during physical activity, including increased heart rate, increased respiration or breathing rate, increased sweating, and muscle fatigue. Although this is a subjective measure, your exertion rating based on a 6 to 20 rating scale, may provide a fairly good estimate of your actual heart rate during physical activity* (Borg, 1998). - Center for Disease Control

Okay, so now we're really leaving the world of cancer prevention, and entering the world of SUPER UPTIGHT A-TYPE ATHELETES (Yeah, also me). If you are unfamiliar with this world, than I applaud you, because it is seriously full of endorphin junkies.


This chart came from the Bowen Sports Performance site. They offer lots of explanatory details, but I think the chart really does a good job of summing it up.

We can really sum it up as, if it's easy it doesn't count. If it's uncomfortable, but not impossible, it's vigorous.


Today, I was doing a 45 minute HITT & HILLs ride on my Peloton and Robin (the instructor) said, "If you're thinking about you're grocery list, than your not working hard enough." I thought that's actually a pretty good measure. Do you have to focus on the effort to keep it up? If no, it's probably not moderate or vigorous. Now, in her class, we really did spend a good amount of it in the very hard to maximal effort categories.


Here's roughly where I fall at my current fitness level:

  • walking with my kids = very light

  • walking alone/ with my husband = light

  • walking up hill = moderate

  • running slower than a 9:30 minute pace = moderate

  • running faster than a 9:30 minute pace = vigorous

  • running faster than a 7:00 minute pace = very hard/maximal effort

So, if I were to rely only on the 75 minutes of vigorous exercise a week approach, I'd run for 25 minutes a week sub 9:30 pace (plus a warm up and cool down).


You know what that sounds an awful lot alike? The Hal Higdon Intermediate 2 Half-Marathon training program. I took a screenshot of the 12 week program here, but his site offers a lot more free information. Also, note this is an intermediate program. That's because this would be a really aggressive place to start off, and would likely end someone up with an injury.




Here's another screenshot from his page- he's a wealth of information and I've used his trainings for all 10 of my marathons.


Below he talks about a few intermediate/advanced 'types' of runs. See, in the crazy world of intense athletes, there aren't just runs, there are types of runs. But, seems like they're good for cancer prevention too.



Now, all of this has been very running focused because that's one of my preferred sports. However, the convenient thing is that the talk test can apply to any type of activity. So, just be honest when listening to your body and you'll know if it counts or not.


Don't trust yourself? Get a heartrate monitor. Just remember to charge it!


 

The Save 1 Challenge


For every 100 women who embrace this knowledge, we can prevent 8 future cases of breast cancer and likely save 1 woman from dying of it. Help get the word out.

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