It’s discouraging to know that years after treatment, breast cancer can come back. The encouraging news is that there are things we can do that may make that less likely.
Among the most important is maintaining a healthy weight and low body fat, because studies have shown that people who are obese have a higher risk of a recurrence.
Cancer cells have tentacles. Their exact mechanisms aren’t fully understood, but studies have shown that body fat provides support for growth. If there are any breast cancer cells left in my body, I thought, they must be feasting on my fat.
I know that I need — and want — to lose weight; the question is how much and how. Tony Musto, a University of Miami physiologist, helped to provide some answers
I met Musto on Friday in his fitness lab at the UM Department of Wellness and Recreation’s Patti and Allan Herbert Wellness Center, where futuristic gadgets offer scientific support for people trying to reach their weight goals.
“The body uses fat to store excess energy that it cannot use right away,” he explained. “When a person exercises, the body turns fat into energy.”
In other words, the number of calories I consume and my level of activity will determine my weight loss.
I stepped on the scale and found out I’m three pounds lighter than I was two weeks ago. I have been eating less sugar and fat.
“How many calories do I need each day?,” I asked.
To answer that, Musto measured my resting metabolic rate (RMR) with the help of the Fitmate, a small machine that details how many calories I burn when I am not engaging in any activity.
Sitting still, I breathe into a plastic mask connected to the Fitmate for about 30 minutes. It measures my RMR as 1,062, the number of calories I would burn in a day if I did nothing but rest.
“How many calories should I eat to lose weight?”
Musto estimated that my fairly sedentary lifestyle (sitting at meetings, behind a computer, at the wheel of a car) requires 319 calories, and that 40 to 60 minutes of walking each day burns another 121 calories.
“Your caloric intake must be 1,252 a day,” he said. “To lose weight you must burn about 250 more calories a day.”
“How do I know if I am losing body fat and gaining muscle?”
Musto turned to a machine called the Bod Pod that assesses body composition using “a very precise scale.” I sat inside the egg-shaped, $37,000 machine, and he closed the door, leaving me to look out its large oval window. The Bod Pod uses air to measure body volume, so one has to wear as little clothing as possible. I wasn’t prepared, so there was a slight margin of error.
Musto explained that being less than “ultra lean” — with 15 to 18 percent body fat — is risky for women. I don’t have that problem. With about 40 percent body fat, I am at borderline risk of having too much.
“Fat plays an important role in maintaining strength and energy,” Musto said. “But too much fat can be a problem for cancer patients.”
Musto’s professional assessment: It would be healthy for me to lose 25 pounds of fat. He handed me a gross-looking yellow wax mass bigger than a football that he said represented five pounds of body fat.
“You have to increase your water intake,” Musto said. His formula: Divide your body weight in half and consume that many ounces of water daily. So at 157 pounds, I should drink 78.5 ounces.
He also suggested that I base my six daily meals — breakfast, lunch and dinner plus three snacks — on vegetables, fruits, nuts and lean proteins. Stay away from processed foods and simple sugars such as chocolate bars, he said, and return in two months.
This isn’t going to be easy.
“If you have to cheat on your diet, just practice sensible portion control,” Musto said. “Broccoli and carrots can be real filling.”