Combination of muscle strengthening and aerobic exercises can reduce cancer mortality

Meta-analysis by researchers at the Federal University of São Paulo in partnership with universities in Spain and Chile supports the idea that muscle strengthening can not only reduce cancer incidence and morality but also yield even greater benefits when it is associated with aerobic activities.

By Maria Fernanda Ziegler  |  Agência FAPESP – Regular muscle strengthening exercises associated with aerobic activities can reduce cancer mortality, according to a systematic review of epidemiological studies. Workouts with squats, rowing, planks, weight training and so on can reduce the probability of dying from cancer by 14%. When these exercises are combined with aerobic activities, the benefit is even greater, potentially reducing mortality by 28%.

“Physical activity has been associated with a reduced risk of several types of cancer, but it was unclear what kinds of exercise had the best results. In our study, we found evidence that muscle strength training can not only reduce cancer incidence and mortality but also have an even better effect when associated with aerobic activities, such as walking, running, swimming and cycling,” Leandro Rezende, a professor in the Department of Preventive Medicine at the Federal University of São Paulo’s Medical School (EPM-UNIFESP) in Brazil, told Agência FAPESP. 

Rezende is last author of the meta-analysis, published in the International Journal of Behavioral Nutrition and Physical Activity. 
FAPESP supported the study by awarding a scientific initiation scholarship to co-author Wilson Nascimento, who collaborated with researchers at the University of Harvard, Spain’s International University of Valencia (VIU) and Public University of Navarre (UPNA), and Chile’s University of Santiago.  

Epidemiological research using demographic data has shown that physical activity in general reduces the risk of breast, endometrial, stomach, throat, kidney and bladder cancer. The EPM-UNIFESP study found that muscle strengthening exercises can reduce the risk of kidney cancer by 26%. Statistically significant correlations were not found between muscle strengthening exercises and tumors primarily located in the colon, prostate, lung, pancreas, bladder, esophagus and rectum, as well as melanoma, multiple myeloma, lymphoma, leukemia and cancers of the digestive system, owing to the limited number of studies.

Regular exercise

The study also corroborated the recommendations of the World Health Organization (WHO) regarding regular aerobic exercise for adults: 150-300 minutes per week if moderately intense, 75-150 minutes of vigorous exercise, or an equivalent combination. The WHO also recommends twice-weekly strengthening exercises. 

“The WHO’s recommendations are based on a number of benefits to health from physical activity, and our review of the literature showed that a reduced risk of dying from cancer is another benefit,” Rezende said. 

The researchers analyzed 12 studies involving 11 cohorts and a control case, with participation by a total of 1,297,620 people, who were monitored in studies lasting between six and 25 years. The analysis suggested that strength training twice a week can protect against cancer.

Rezende was supported by FAPESP via doctoral and postdoctoral scholarships. He has conducted a great deal of research using census and public health survey data to find links between exercise, diet and reduced incidence of chronic diseases, especially cancer, as well as modeling the impact of interventions and public policies to foster healthy eating habits and physical activity with the aim of combating disease and reducing healthcare expenditure.

Most studies of exercise and cancer prevention focus on aerobic activities, Rezende noted, while muscle strengthening is typically part of workouts designed to build muscle mass or treat specific health problems such as high blood pressure or cardiovascular disorders. 

“Four years ago, we conducted a study that associated strength training with a reduced risk of cancer. Meanwhile, other studies have been published, and we thought it would be interesting to undertake a systematic review of this literature in order to appraise all the evidence on this relationship,” he said. “However, we went further to show that the benefits of muscle strengthening exercises in terms of reducing cancer incidence and mortality can be magnified when they’re combined with aerobic exercises.” 

The article “Muscle-strengthening activities and cancer incidence and mortality: a systematic review and meta-analysis of observational studies” (doi: 10.1186/s12966-021-01142-7) by Wilson Nascimento, Gerson Ferrari, Camila Bertini Martins, Juan Pablo Rey-Lopez, Mikel Izquierdo, Dong Hoon Lee, Edward L. Giovannucci and Leandro F. M. Rezende is at: https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-021-01142-7.