For Your Health: Keep active in winter with an eye toward spring

For Your Health Graphic 2020








We’ve made it past Groundhog Day — again — but whether Punxsutawney Phil sees his shadow or not, winter can often feel unending this time of year.

Across the country, we’ve had long stretches of cold temperatures and bad weather. And even when things start to defrost, the days can feel too short and the nights too long. This combination can make it harder to keep up with regular routines, including being physically active.

But there are many good reasons to work on staying active through winter. On top of the health and wellness benefits, maintaining our routines can also prepare us to enjoy springtime activities when the days finally turn nicer. We’ll have energy and fitness for long walks around the neighborhood, family bike rides to check out daffodils at the local park or pick-up ball games with our kids or grandkids.

Almost any type of movement can have benefits. But given the ongoing winter weather, indoor activities and exercises can often be the simplest — and safest.

Indoor sessions can feel a bit bland compared to getting outside, especially when you’re inside week after week this time of year. That makes it important to find activities you really enjoy. If one activity doesn’t click, try another. Be creative and keep experimenting. There are many options that count as physical activity, and you’re likely to find some — and maybe many — you really like.

Local recreation centers can have stretching and cardio classes, open gym hours and exercise equipment, like treadmills, bikes and ellipticals. Malls or big box stores can offer special hours for walking groups. And streaming sites can have a huge variety of online exercise videos that can be followed at home.

If none of these sounds good, just taking regular standing breaks throughout the day can have benefits.

One good way to stay consistent with our activity through winter is to set an accessible and specific goal to slowly work toward. Maybe that’s building from one gym class per week up to three a week by the end of March. Or building from 20 minutes of walking on the treadmill three days a week to walking 40 minutes three days a week. Or moving from doing little or no planned activity to streaming two stretching and core classes per week. And, of course, if you ever have any questions about fitness or health, contact a health professional.

It can also really help to have the support of friends and family. This can mean going to the gym or streaming a class together or simply sharing our goals and the progress we’re making. The activities themselves can be more fun when we’re with others, and it can help keep us on track since we know others are also following our progress.

And the more regular we can be with our activities, the easier it can often be to fit into our schedules. When our treadmill time or basketball games become a normal part of our weeks, we’re less likely to skip them when work and family life get busy.

While winter may feel like it’s on a loop right now, before long the days will get noticeably longer and the temperatures will warm. And the activity we’ve put in through the coldest months will help us really enjoy some great springtime outings.

Dr. Graham A. Colditz Headshot

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention and the creator of the free prevention tool YourDiseaseRisk.com.

Using genetics to prevent lung cancer

Genetic information is often used to guide precision cancer treatments. In the future, genetics could guide personalized efforts to stop smoking and prevent lung cancer.

343,000+. That’s the number of cigarettes Chris Kneibert, 65, has probably smoked over his lifetime.

Chris Kneibert 2 Using Genetics To Prevent Lung Cancer

“I basically smoked a pack a day for 47 years,” he said. “And there are 20 cigarettes in a pack. I smoked when I woke up or when I got bored. I smoked in the mornings and socially. It seemed like the thing to do when I first went to college, and I never really stopped — or couldn’t.”

The Centers for Disease Control and Prevention estimates that 49.2 million people in the U.S. — one in five adults — use tobacco products. Add e-cigarettes/vaping, cigars and smokeless tobacco products, and the number rises. With today’s average cost of cigarettes at more than $8 per pack, that means Kneibert and other smokers dole out almost $3,000 annually to support a pack-a-day habit.

The bigger problem comes when individuals want to quit smoking. Tobacco products contain nicotine, a known addictive chemical. When people smoke, the nicotine absorbs into the bloodstream and increases dopamine levels in the brain. Smokers then start craving the “hit” of nicotine, ingesting it more and more, and rapidly become addicted. Trying to quit causes withdrawal symptoms, and about half the people who want to quit, can’t.

“I really thought I could quit on my own, but I enjoyed it too much,” said Kneibert. “Even when news came out that smoking was bad for you and could cause cancer or heart attacks and stroke, I didn’t stop. It really was an opportunity for me to step outside and smoke a cigarette and temporarily get out of whatever I was doing.”

In the 1980s, the U.S. Food and Drug Administration (FDA) approved a nicotine gum, Nicorette, as the first medication to help people quit. Over-the-counter sales of Nicorette were authorized in 1996. Along the way, a plethora of other treatments became available, including hypnosis and behavioral therapy as well as phone and web-based counseling services to support those who wanted to quit. Still, many people can’t stop smoking.

“I tried the nicotine gum and was successful for only one to two months, said Kneibert. “I was not optimistic I could succeed and stop smoking.”

Using Genetics to Quit Smoking

Last year, Kneibert was told about a new clinical trial underway at Washington University School of Medicine in St. Louis. The study focuses on gathering genetic information from individuals identified as smokers to better understand the mechanisms behind their smoking addiction as a tool for identifying optimal treatment options.

“I am very interested in how we can motivate people to have healthy behaviors,” said Washington University psychiatrist and physician scientist Li-Shiun Chen, MD, MPH, ScD, director of the Tobacco Treatment Program at Siteman Cancer Center at Barnes-Jewish Hospital and the School of Medicine. “Precision medicine is used in cancer treatment but not used in cancer prevention. We wanted to know if we could use precision medicine to affect behavior and lower the risk of health problems stemming from smoking. We, therefore, could shift the paradigm from cancer treatment to potentially cancer prevention using genetics and targeted therapies.”

Two years ago, Chen, along with organizational psychologist Alex Ramsey, PhD, and their colleagues in Washington University’s Precision Prevention and Treatment Lab received grants from the National Institutes of Health to see if individualized counseling along with a personalized genetics report highlighting the percentage of cancer risk would result in more effective treatment and smoking cessation rates. The first trial, PRECISE, focused on identifying the level of risk for lung cancer and counseling on the benefits of lung cancer screening for each study participant. In the second trial, MOTIVATE, researchers added information related to genetic markers that identified optimal smoking cessation treatments for each participant.

“Like an ACT test for college, a genetics ‘score’ can tell you your own individual lung cancer risk and, significantly, how difficult it may be to actually quit smoking,” Chen said. “We analyzed DNA and created a report that not only showed the benefits of quitting smoking but, significantly, also showed which smoking cessation products might be better for a person to try based upon their own genetic profile.”

In the MOTIVATE trial, the team analyzed more than 50,000 biomarkers linked to elevated cancer risk in 100 study participants. A report then was shared with both primary care physicians and patients to see if it would motivate individuals to stop smoking.

The report identified genetic markers and noted whether a person had a high or low nicotine metabolism level. “If you have a slow metabolism, you could use an other-the-counter nicotine patch to help you quit,” Chen explained. “But if you have a fast metabolism, nicotine patches or gum are less likely to work. In those cases, individuals would be more successful if they used a prescription medication.”

See an example of a personalized report here.

For Kneibert, an early participant in the MOTIVATE trial, he had a genetic marker that pointed toward a fast metabolism. His report also showed that he had a very high risk for developing lung cancer. “It was in the red zone, which was bad,” he recalled. He agreed to try Varenicline, one of seven FDA-approved prescription medications to help adults quit smoking. To his surprise, it worked.

“I started with one pill a day and still smoked,” he said. “But when I got to two pills a day, the medicine stopped my nicotine receptors from working. I would smoke and think to myself, ‘That was very unappealing.’ I quit about a month later and I’ve been smoke-free ever since.”

Chen and her colleagues still have a long way to go before they say their research will make a huge impact in the field of cancer prevention. The MOTIVATE trial is still underway, and they plan to recruit 800 participants to continue testing whether the genetics report motivates people to change behavior, stop smoking and get regular screenings for lung cancer. Still, publication last year of their early research is gaining attention.

“I believe we are at the forefront of innovation, and Siteman Cancer Center is really leading the country by using genetics for cancer prevention,” stressed Chen. “Patients and their doctors are more motivated when we can offer evidence-based risk assessments and smoking cessation treatment suggestions. I predict that we can move the needle on effective addiction treatment and, therefore, prevent some cancers because of our work.”

Kneibert now steps outside often to enjoy nature instead of smoking a cigarette. He also got a lung cancer screening, testing negative for any cancer. “I’m glad I found out why the nicotine patch didn’t work before,” he said. “That report was eye-opening and made me want to try to quit again because it really wasn’t my lack of willpower that caused me to fail.”

“I’m proud of myself for quitting,” he added. “And my kids are proud of me, too.”

To learn more about the MOTIVATE trial call 314-273-3826.

# # #

Chen, Tony et al. Genomic insights for personalised care in lung cancer and smoking cessation: motivating at-risk individuals toward evidence-based health practices. eBioMedicine. December 2024.

For Your Health — Ultra-Processed Foods: A Growing List of Possible Health Risks

Scc 2025 For Your Health Digital Banner

Ultra-processed foods. It’s not a term many of us heard 10, or even five, years ago. But that’s starting to change. We now see it in news stories and posts on social media. And there’s good reason for that.

Even as more ultra-processed foods fill grocery store shelves, we’re also learning more about their possible health risks.

So, what are these foods exactly? While a precise definition can vary a bit depending on who’s talking about them, there are a few simple ways to identify many ultra-processed foods.

“Put simply, if you don’t see a food’s main ingredients in their natural forms — like grain, vegetables and meat, it is highly likely to be an ultra-processed food,” said Yikyung Park, professor in the Division of Public Health Sciences at Washington University School of Medicine in St. Louis. “Ultra-processed foods are highly manipulated and contain many added ingredients and additives. In most cases, we cannot make ultra-processed foods at home.”

Examples include: soda (sugary and diet), lunch meat, instant noodles, instant soup, sausage, hot dogs, frozen meals (including pizza and burritos), many store-bought cakes and sweets, and even most breakfast cereals.

Eating higher amounts of ultra-processed foods is associated with a higher risk of several serious conditions, including obesity, diabetes, heart disease, stroke, poor sleep, poor mental health — including anxiety and depression — and premature death, Park continued.

How ultra-processed foods increase these risks likely relates to their collection of ingredients. They tend to be high in those ingredients we should limit in a healthy diet and low in those we should focus on.

They can be high in calories, salt, unhealthy fats and added sugar and sweeteners, which can cause long-term inflammation in the body, disrupt the normal function of our metabolism and impact the development and release of neurotransmitters that play roles in mood disorders, such as depression, Park said.

Ultra-processed foods also tend to be very low in fiber, another potential negative. Higher fiber diets help promote a healthy microbiome, which is the collection of bacteria and other microorganisms in our gut that helps keep many processes in the body working normally, Park said. Eating lower-fiber, ultra-processed foods can have the opposite effect.

Switching from pre-packaged or fast foods to less-processed choices is one easy way to cut back on ultra-processed foods. Instead of frozen French fries or chips, choose a bag of nuts or buy raw popcorn and pop it in a pan at home. Instead of a frozen bean burrito, buy some tortillas, beans and cheese and make your own. In place of breakfast cereals, which can have refined, processed grains and many other ingredients, choose oatmeal, which is a simple whole grain.

These switches may take some extra effort at first, but it gets easier the more we do it, and often we can find that the less-processed options taste just as good — maybe even better — than the more processed foods.

Start with a small goal of cutting back on a couple of ultra-processed foods. Then, build from there. Small changes have real health benefits and can also lead to bigger changes and improvements down the road.

Whether we’re new to cutting back on ultra-processed foods or have been doing it for a while, Park shared one quick way to identify the types of foods we should try to steer clear of to improve our overall health. And all it takes is a glance at the food label.

“If the ingredient list is very long and you don’t recognize those ingredients, it’s better not to eat that food,” Park concluded.

For Your Health: Making time for our health during the holidays

For Your Health Graphic 2020








We’re entering one of those special times of the year — the winter holidays.

It’s a concentrated few weeks that give many of us the chance to spend extra time with friends, family and colleagues, celebrating the past year while looking toward the possibilities of the next.

And though the season’s colder weather and shorter days may make us feel like hibernating, we often find ourselves surprisingly busy. Kids are out of school. Work may have end-of-year deadlines, and there are preparations for holiday gatherings and family visits.

It’s a season to look forward to — and one that can also make it harder to look after our own health and well-being. But taking time for ourselves is still an important goal, no matter how busy we are. It’s not only good for our long-term health, it can also give us the physical and mental energy to enjoy all the holidays have to offer.

Try these four tips to help your holiday health:

1.) Focus on sleep.

It’s easy to cut back on healthy sleep when we feel a time crunch, but we really shouldn’t. Sleep is important for both our daily and long-term health, so we should do what we can to get the seven or more hours a night that most adults need. Of course, getting a healthy amount of sleep can be difficult no matter the time of year. So, don’t stress about it, but do what you can to find sleep success. Try to give yourself the time to sleep; don’t overschedule your nights or early mornings, which can easily happen during the holidays. Putting away electronics and avoiding large meals near bedtime can also help, as can keeping to a regular sleep and wake-up time.

2.) Get out for a walk — or other activity.

Along with sleep, this is another one that’s easy to skip when our days get busy. But making time to go for a walk or take a gym class has amazing benefits — providing a boost to energy and mood, and even helping with better sleep. It’s not always easy to get started, especially in winter, but those first few minutes of an activity are often the hardest; once past those, the rest usually comes easier. And, if you’re heading outside, be sure to be prepared for the weather, and go with a friend.

3.) Remember to choose healthy foods — mostly.

The holidays are a time to celebrate, and that can mean enjoying food without worrying about how healthy it is. It’s good, though, to not totally do away with our healthy eating habits this season. Still try to take an overall healthy approach to eating that focuses on fruits, vegetables and whole grains, and is low in red and processed meat. At special meals and other gatherings, choose what you enjoy but try to balance less-healthy, higher-calorie foods with healthier choices.

4.) Relieve stress in healthy ways.

As great as the holidays can be, they can also, as we know, be stressful. And that makes it important to have healthy ways to deal with moments of stress. Walking and similar activities are really good for this. So, too, are stretching, yoga and breathing exercises. Taking some time alone can be helpful, finding a quiet place to read or stream that movie you’ve been wanting to see. Spending time with friends can also provide support. While alcohol may be part of many holiday celebrations, choose healthier options for dealing with the stress of the season. And if you or anyone you know is in a mental health crisis, call 988 — the Suicide and Crisis Lifeline.

These can feel like simple things, and in many ways they are. But during such a busy season, it can be good to focus on some of the basics. And the benefits of keeping up with even small, healthy steps are real — in our daily lives and the years ahead.

That’s a great gift. Happy Holidays and Happy New Year.

For Your Health: A painless test for lung cancer that saves lives

For Your Health Graphic 2020








Our progress against lung cancer is something to celebrate. Millions of lives have been saved in the U.S. alone since rates of smoking began to drop in the mid-1960s. And as smoking continues to become less common and treatment improves, we expect to gain even more ground against the disease.

One key tool helping to make that happen is yearly lung cancer screening with low-dose computed tomography, or low-dose CT.

A low-dose CT scan is a quick and simple screening test recommended for people ages 50-80 who are at increased risk of lung cancer because they smoke or have smoked within the past 15 years. People are eligible if they’ve smoked what amounts to one pack a day for 20 years, or half a pack a day for 40 years.

Like other recommended cancer screening tests, low-dose CT helps find cancer earlier when it’s more treatable. Studies have found that yearly screening can lower the risk of dying of lung cancer by up to 20%. That’s a large benefit — similar to what we see with mammograms and breast cancer.

It’s also a major advance. Becoming widely available for lung cancer screening about 10 years ago, low-dose CT is the only screening method that’s been found to lower the risk of dying of lung cancer. While other types of tests, like standard chest X-rays, can be good at helping find many types of health problems, they are not effective for lung cancer screening.

Even with its benefits, low-dose CT does have some potential risks that are important to know about. Potential harms can include experiencing short-term stress and anxiety about unclear scan results. There can also be the need for follow-up tests of suspicious findings that turn out not to be cancer. And there can be low amounts of radiation exposure from a scan. This amount is more than a standard X-ray but less than the level of radiation people are exposed to during a normal year.

Overall, the benefits of lung cancer screening are thought to outweigh the harms, though it is a personal balance. This makes it important for people thinking about screening to discuss the benefits and drawbacks with a doctor — and together decide if it’s right for them. If it is, the doctor can then make a referral for a screening appointment.

Most health insurance plans cover low-dose CT screening, but it’s good to check with your plan, medical center or doctor’s office. Those without insurance can contact their local or state health department about possible options to help with the cost of testing.

Once you get screened, it’s also important to keep getting tested each year for as long as you’re eligible. This increases the chances of catching a cancer early – again, when it’s more treatable.

And getting smoke-free or staying smoking-free is another key step to look after lung health. Quitting smoking lowers not only the risk of lung cancer but also many other diseases, including stroke, diabetes, heart disease, bronchitis, emphysema, macular degeneration and many other cancers. The benefits begin soon after stopping and build over time. For tips and resources on quitting, call 1-800-QUIT-NOW (1-800-784-8669), or visit smokefree.gov.

Even with the progress we’ve made against lung cancer, it remains all too common, killing more people each year than any other cancer. Annual lung cancer screenings help save lives. Plus, it’s quick, easy and painless. That’s a great combination and, if you think you’re eligible, a great reason to call your medical center or doctor’s office to schedule an appointment.

It’s your health. Take control.

For Your Health: Breast density and why it matters

Just in time for Breast Cancer Awareness Month, many women will begin to see important new information about their breast health on their mammogram reports.

A new federal rule now requires that women be informed about the density of their breasts following their mammograms. Breast density is a measure of how much breast tissue and connective tissue is in the breast compared to how much fat tissue. Higher-density breasts have higher amounts of breast and connective tissue. Lower-density breasts have more fat tissue.

“Having dense breast tissue is very common, affecting almost half of women getting screening mammograms,” said Dr. Debbie Bennett, chief of breast imaging at Washington University School of Medicine in St. Louis. “And dense breast tissue is not a cause for worry or concern. It can, however, mean your mammogram is harder for the radiologist to read, and it also slightly increases your overall risk for developing breast cancer at some point.”

With the new rule, women will get a message on their mammogram results that says either, “Your breast tissue is dense” or “Your breast tissue is not dense.”

Because denser breasts may make it harder to see abnormal areas on a mammogram, some women may get extra screening tests that can provide other images of the breasts.

“Depending on how dense your breast tissue is and whether you have any other risk factors for developing breast cancer – such as family history of breast cancer – your doctor may recommend that you have additional imaging tests done to screen for breast cancer,” Bennett said. “This could include MRI, ultrasound or contrast-enhanced mammograms.”

Such testing can be covered by insurance, but it can vary from plan to plan. So, it’s important to talk to your insurance company or health-care provider about specific costs.

Mammograms, and any additional screening tests, can help find breast cancer early when it can be more effectively treated. While breast cancer is the second most deadly cancer in women, when found and treated in its earliest stage, it can have a very high rate of survival, with over 99% of women living at least five years after being diagnosed.

No matter their level of breast density, all women should get a mammogram every year, with most starting at age 40. Women at higher risk of breast cancer may need to begin screening earlier, so it’s important to talk to a doctor about your risk factors for breast cancer. There are benefits of doing this at any age, but ideally it should be done by age 30.

Taking healthy steps to help prevent breast cancer is also important, regardless of breast density, Bennett said.

Around half of breast cancer cases could be avoided with healthy behaviors. Most of these may sound familiar, but they can have an important impact on risk – and even small changes can lead to large benefits over time. These healthy behaviors include:

  • Keeping weight gain in check
  • Eating a diet rich in fruits, vegetables, whole grains and beans
  • Not drinking alcohol
  • Being physically active
  • Staying smoke-free or getting smoke-free

Breast cancer touches many of us to some degree, whether it’s personally or through family or loved ones. A positive note, though, is that there are steps to help manage or lower the risk. And Breast Cancer Awareness Month is a great reminder of that and the benefits of working toward better breast health.

It’s your health. Take control.