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You know exercise is key to better living with diabetes. It enhances insulin sensitivity and lowers blood sugar levels. But if you have diabetes, you need to take extra safety precautions whenever you work out.

Check with your doc. If you’re overweight or have high blood pressure, a heart condition, or vision or foot problems, talk to your doctor before starting an exercise routine. Ask which kind of exercise — and how much — is safe for you. To prevent you from overdoing it, your doctor may ask you to break up your daily workout into mini sessions.

Measure your blood sugar level around exercise. If your blood sugar is too high or too low, or if you have ketones in your blood or urine, avoid strenuous physical activity. In some people with diabetes, exercise can actually worsen high or low blood sugar. Ask your doctor if you should measure your blood sugar around exercise.

Fuel up. Eat something light before you exercise. Keep a carb-rich snack, such as fruit, crackers, or rice cakes (or glucose tablets) on hand in case your blood sugar drops too low.

Hydrate. Diabetes can inhibit the brain’s signal for thirst and lead to dehydration. Be sure to drink extra water before, during, and after exercise.

Avoid hot weather workouts. Some folks with diabetes lose the ability to regulate body temperature. (This is caused when diabetes disrupts the body’s autonomic nervous system, which inhibits normal blood flow to the skin and the ability to sweat.) Avoid heat exhaustion by exercising indoors on very hot days.

Take care of your feet. Diabetes can cause numbness and decreased blood circulation. Wear shoes that fit well, never exercise barefoot, and inspect your feet before and after every workout. Treat any blisters, abrasions, or injuries promptly.

Wear a medical ID tag whenever you exercise. If an emergency arises, it will alert caregivers that you have diabetes.

Sourcing: Harvard Medical Center, American Diabetes Association, National Institutes of Health, Cleveland Clinic  

Back to Diabetes

How can you tell if the goals of your diabetes management plan are working to hold your blood sugar in range? The easiest way is to monitor your blood sugar at home.

Daily testing with a computerized glucose meter tells you whether your diet, exercise regimen and medication are working or need adjustment. At-home blood glucose tests can also alert you to dangerous spikes or dips in your blood sugar level.

When to test your blood sugar

Your testing frequency depends on the type of diabetes you have, how long you’ve had it and how well it’s controlled. Your doctor will advise how often you need to test and will help you set up a personalized schedule. That might entail:

There are certain times when testing might need to be more frequent, such as during pregnancy, while quitting smoking and using other nicotine-containing products or when you start taking new medications, such as steroids. You’ll also likely need to test more often when there’s a change in your diabetes treatment program.

How to test your blood sugar

Keep a daily log of your readings, follow the instructions in your user’s manual and use these guidelines to ensure accurate readings:

Types of blood glucose meters

You can choose from a variety of glucose meters. They’re all fairly equal in accuracy, but vary in cost, ease of use and features. You need to maintain a log of your blood glucose measures and some meters have memory to store your results. Others require fewer steps to get a reading.

Some meters provide an automated log for insulin doses and blood sugar level readings, along with software that tracks your progress and transmits your readings to your doctor. These features can save you the trouble of recording your results yourself. Ask your doctor for a recommendation and check with your insurance company to make sure the meter you buy is covered under your plan.

Another alternative is a continuous glucose monitor. These devices provide round-the-clock monitoring through an ultra-thin needle sensor inserted under the skin. If blood sugar falls out of your target range, an alarm goes off.

Although continuous monitoring can offer better diabetes control with reduced risk for low blood sugar, it carries some disadvantages. Depending on the model, the needle sensor may need to be replaced every 6 to 14 days. The devices are also costly. And bear in mind that you still have to perform finger sticks to confirm accuracy.

Sourcing: Harvard Medical School, National Institutes of Health, American Diabetes Association

Back to Diabetes

What if one in three American adults had a condition that put them at higher-than-normal risk of developing diabetes? What if the vast majority of them were unaware that they were sitting on this ticking time bomb? And what if their doctors knew they had this condition, but didn’t tell them or didn’t provide treatment—or just plain missed the diagnosis?

Those are a lot of ifs—but they form the basis of questions that a team of researchers from the University of Florida asked themselves when they started thinking about the number of Americans living with prediabetes. According to the Centers for Disease Control and Prevention (CDC), 86 million have prediabetes and nine in 10 don’t know it. Another team of researchers, writing in JAMA Internal Medicine in October 2016, estimate that about 58.7 percent of people over 40 were at high risk of prediabetes. For those over 60, it jumps to 80.8 percent.

Why is that, and what role do doctors play? In search of answers, the University of Florida researchers, whose findings were published in the Journal of the American Board of Family Medicine in March 2016, analyzed data from a 2012 government survey of random doctors. Specifically, they looked at patients age 45 and up who’d had an A1C blood test, used to measure average blood sugar, within 90 days of their doctor visit. The scientists found that 34 percent had blood sugar levels in the prediabetes range. Of these, only 23 percent were in treatment, either via medication or lifestyle changes.

The question remains: Why did three out of four people with prediabetes not receive treatment? We went to endocrinologist Jack Merendino, MD, a Sharecare Advisory Board Member, best-selling author and Assistant Clinical Professor at the George Washington University School of Medicine and Chief of the Endocrine Section at Suburban Hospital, Johns Hopkins Medicine, for his take.

Breaking bad habits

Dr. Merendino believes that more people aren’t treated for prediabetes because many doctors don’t see the condition as an immediate cause for concern. “Doctors tend to look at treatment as medication. There’s a lot of evidence that doctors are not good at recommending lifestyle changes,” he says. “In the physician’s mind, what’s going on is that there’s an impending problem, but it’s not yet bad enough to need medication.”

One reason doctors don’t often recommend lifestyle modification—such as eating a healthy dietand exercising regularly—is the perception that patients don’t follow doctors’ orders. Even so, Merendino thinks doctors often underestimate the influence they have with their patients. “A fair number of patients do make changes when recommended by doctors,” he says. Though not every patient will be able to modify their diet and exercise habits, Merendino says enough will make the changes for the recommendations to be valuable.

Perceived lack of urgency

Another reason for the low numbers of diagnoses, Merendino says, is that some doctors don’t see prediabetes as urgent. Controlling diabetes often means getting getting A1C levels down to under seven percent, which is still above the level considered prediabetes. “Physicians are saying it’s not as much of a big deal, rather than thinking that if the patient is prediabetic then they might develop diabetes.” And, progressing from prediabetes to diabetes usually takes years, according to Merendino. “It’s an issue, but an issue for the future,” he says.

Still, a diagnosis of prediabetes should be taken seriously. “Prediabetes is not a benign condition,” Merendino says. For example, many people already have neuropathy, or nerve damage, when they’re diagnosed with diabetes. That means at least some people have picked up neuropathy while they were in the prediabetes stage, he explains. “It’s not like you’re fine with prediabetes and then you get complications when you reach diabetes levels.”

Should you be tested?

Prediabetes usually has no obvious symptoms, which is why it’s important to be proactive. If you’re 45 or older (the age when risk increases), consider being tested for diabetes, especially if you’re overweight or obese. You should also consider being tested if you’re under 45, overweight or obese and have additional risk factors such as family history of diabetes, physical inactivity, high blood pressure, low HDL cholesterol or polycystic ovary syndrome.

Reversing prediabetes

Having prediabetes doesn’t necessarily mean you’ll get diabetes. Between 15 percent and 30 percent of people will eventually develop the condition within five years of a prediabetes diagnosis, but the longer you have elevated blood sugar, the more likely it becomes, Merendino says. “Patients should be asking, how do I prevent myself from progressing to diabetes?” Merendino says. “Doctors’ recommendations should be lifestyle modifications: weight loss and physical activity.” In fact, according to the CDC, eating smart and being active can cut the risk of type 2 diabetes in half if you have prediabetes.

The Diabetes Prevention Program, a major study that followed more than 3,200 people in 27 clinical centers for about three years, showed that lifestyle changes were about twice as effective as medication at preventing the development of diabetes. People in the study, which was published in the New England Journal of Medicine in 2002, saw success even at modest levels of weight loss. Exercise does double-duty: Not only does it help to keep the weight off, but it also helps the body use insulin more efficiently.

“[For exercise] to do twice as good as drugs—that was really major,” says Merendino. “If there’s a failure here, it’s a failure on the part of physicians to internalize the powerful effect that lifestyle intervention can have.”

Sourcing: UpToDate, National Institutes of Health, American Diabetes Association, CDC

Back to Diabetes

Colon cancer is the second leading cause of cancer death in the U.S., with about 50,000 people dying due to colon cancer each year. This disease is so often deadly because it’s frequently discovered after it’s already reached a late stage.

“Colon cancer is potentially very curable if we screen for it according to guidelines,” says Steven Goldin, MD, a surgical oncologist at Fawcett Memorial Hospital in Port Charlotte, Florida.

Here’s how to recognize the signs of colon cancer, when to book your next screening appointment, plus tips to lower your risk.

Symptoms of colon cancer

Colon cancer begins in the lower part of your intestine. “Most colon cancers, especially the smaller tumors, have no symptoms at all,” says Goldin. “People will be walking around with no idea that they have multiple tumors. Often, they don’t get tested until there’s not much that can be done to treat them.”

By the time symptoms show, the disease has usually already spread outside of the colon. Yet, between 70 to 90 percent of colon cancers are diagnosed after symptoms appear because of the tendency to put off screening.

If symptoms are present, they may include:

Internal bleeding can also cause you to feel weak, exhausted or dizzy. If you’re experiencing any of these symptoms, make an appointment with your HCP immediately.

Colon cancer screening

If you’re at an average risk for colon cancer, you should begin screening at age 45. People who are at a higher risk should talk to their HCP by age 40 to determine an appropriate screening regimen for them, says Goldin. You’re at a higher risk and may need to start screening before age 45 if you:

There are a number of tests available, but the gold standard for colon cancer screening is the colonoscopy, explains Goldin. For a colonoscopy, a gastroenterologist, a doctor specializing in the stomach and intestines, will advance a long tube with a camera through your colon to search for polyps. Polyps are little growths on the colon lining, which may eventually grow into tumors.

If you have polyps, your gastroenterologist will remove samples and send them to a lab to determine if you have cancer, called a biopsy. He or she may be able to completely remove polyps or even small tumors during the colonoscopy as well.

What can you expect if you’re scheduled for a colonoscopy?

The night before, you’ll need to complete a bowel prep, which involves drinking a liquid medication that causes short-term diarrhea. The goal of bowel prep is to clean out your lower intestine so the lining of your colon is easier to see on camera. You may also need to avoid solid foods ahead of time. Most people are instructed to only consume clear liquids like chicken broth and Jell-O the day before.

Right before your colonoscopy, you’ll be given a sedating medication, or a drug that will make you feel calm and sleepy. You may still be groggy afterwards, so bring a friend or family member along to help you get home safely.

If you’re at an average risk for colon cancer, your next colonoscopy should be done in ten years.

How colon cancer is treated

Most labs will know your biopsy results within two weeks, but many will notify you sooner. If your biopsy reveals that you have cancer, the treatment that you receive will depend on how aggressive the cancer is.

Small tumors may be completely removed during your initial colonoscopy. If it’s not possible to completely remove the cancer at that point, you may need surgery as well. Your surgeon will take samples of lymph nodes during surgery to determine whether the cancer has spread outside of your colon.

If the cancer has reached your lymph nodes, he or she may recommend chemotherapy. Chemotherapy is a type of medication that kills off cancer cells that may be left in your body after surgery. Chemo for colon cancer typically involves intravenous medication that’s given in a series of doses, spread out over about six months.

Ways to lower your risk for colon cancer

There’s no surefire way to prevent colon cancer, but there are a few lifestyle changes that can help lower your risk:

The most important thing you can do to avoid a late-stage colon cancer diagnosis is to follow routine screening guidelines.

“Think about the costs of treatment, the worry and everything you’d go through with a colon cancer diagnosis,” says Goldin. “If you detect polyps early and remove them before they become cancer, you can prevent a great deal of pain and worry.”

Sourcing: American Cancer Society, National Cancer Institute, US Preventive Services Task Force

Back to Colorectal Cancer

Drinking is associated with a laundry list of health risks—more than 200 if you’re keeping track. The more you drink, the greater your risk for one or more of these issues, which range from digestive problems and infection to liver or heart disease. Your DNA, medical history, weight and lifestyle will also make you more or less likely than someone else to develop an alcohol-related disease or condition.

Overall, health experts recommend that limiting alcohol intake to moderate levels (no more than two drinks per day for men or no more than one for women) can help keep these health risks to a minimum. But there is at least one exception: cancer.

When it comes to cancer prevention, avoiding alcohol entirely is best, advises Keith Roach, MD, Sharecare’s Chief Medical Officer and Associate Professor in Clinical Medicine in the division of general medicine at Weill Cornell Medical College and New York Presbyterian Hospital.

Even light drinkers are at slightly increased risk of some cancers, Dr. Roach explains. “The damage from less than one drink a day is small, but it’s not zero,” he says. “The risk goes up exponentially once you pass that threshold.”

What research shows

In August 2018, a team of scientists reviewed more than 1,000 existing studies to estimate the effects of alcohol on the risk for 23 different related health issues, including seven types of cancer. The comprehensive review, which was published in The Lancet, showed that even one alcoholic drink per day could increase the risk breast, colorectal, esophageal, pharynx, and oral cancers. The researchers also found that the risk for these diseases increases along with alcohol consumption.

For the purpose of cancer prevention, the World Cancer Research Fund asserts that it’s “best not to drink alcohol.” The U.S. Department of Health and Human Services also includes “alcoholic beverage consumption” on its list of known human carcinogens.

A 2013 study published in the American Journal of Public Health, which was based on data from 2009, found that alcohol consumption resulted in an estimated 18,200 to 21,300 cancer deaths, or up to 3.7 percent of all cancer deaths in the United States. The researchers concluded that there is “no safe threshold” when it comes to drinking and the risk for cancer.

Red wine is no exception

All types of alcoholic drinks are associated with cancer—no exceptions. Here’s why.

Most evidence supporting the link between cancer and alcohol points to one culprit that’s found in every single alcoholic beverage from fine wine to whiskey: ethanol. So, how much you drink and how often matters regardless of what’s in your glass.

If you’re sipping a pinot noir or cabernet while perusing these worrisome statistics, all the while assuming that the potential harms of the alcohol may be outweighed by possibly beneficial phytochemicals found in red wine, like resveratrol, think again.

Researchers have searched but have yet to find a clear association between moderate red wine consumption and a lower risk for cancer. Drinking for slight or unproven health benefits isn’t a wise decision, considering that the very clear risks associated with drinking escalate with every sip you take, Roach cautions.

“The data on resveratrol has been very disappointing,” he says. “But, by all means, you can get all the resveratrol you’d like with a glass of grape juice a day.”

How ethanol is harmful

Understanding what happens to alcohol once it’s in your system could help put these stark findings and statistics into perspective.

Once you start drinking, your body begins metabolizing the alcohol almost immediately. As the ethanol in your drink is broken down, a toxic byproduct called acetaldehyde is formed. Acetaldehyde could not only damage cells but also cause changes in your DNA, which can lead to cancer. DNA controls how your cells grow and function. When this genetic information is damaged, cell growth could spiral out of control and cause tumors to form.

The harmful effects of acetaldehyde are particularly noticeable in the liver, where most alcohol metabolism occurs. But it’s also evident in other parts of the body, including the pancreas, brain and along the digestive tract.

There are some other ways that drinking alcohol and cancer risk may be connected:

Some cancer-causing contaminants, such as nitrosamines, asbestos fibers, phenols and hydrocarbons could also result from the fermentation and production processes used to make certain alcoholic drinks.

Meanwhile, all the extra calories in wine, beer and mixed drinks can lead to weight gain. And obesity is a known risk factor for several forms of cancer.

Risks can add up

Alcohol—even a single drink—can also impair your decision-making, Roach cautions. “The second drink is an awful lot easier than the first, and then you can have much poorer judgment,” he says. “Not only might you have more alcohol, but you might choose less healthy foods. You might be more likely to engage in other risky behaviors.”

You may, for example, be more tempted to smoke—a double whammy when it comes to cancer.

“A family or personal history of cancer is going to put you at risk. If you have other risk factors, particularly smoking, then you’re going to have additional risk,” Roach says.

Alcohol is an irritant that can damage cells in the mouth and throat, in particular. “It’s direct damage to the lining of the esophagus by the alcohol,” Roach explains.

This could allow harmful chemicals found in tobacco smoke to enter cells more easily. Alcohol could also make it harder for your body to get rid of the toxic chemicals in smoke and for your cells to repair the DNA damage they cause.

The stronger the alcohol, the worse the damage, Roach notes.

In the United States, a single drink contains roughly 0.6 fluid ounces of pure alcohol, which is the equivalent of 5 ounces of wine, 12 ounces of beer or 1.5 ounces (a shot) of liquor, such as gin or vodka. But the alcohol content of even similar drinks may vary. For example, beer can range from about 5 to 9 percent alcohol; wines range from about 12 to 17 percent alcohol and liquors can range from about 40 to 60 percent alcohol.

Your size and sex also matter. Alcohol will likely affect a 110-pound woman much differently than it will affect a 170-pound man, according to Roach. “Women tend to have lower body size and, consequently, a higher level of alcohol in the blood per amount that’s been drunk,” he says.

Compared to men, women’s livers have less alcohol dehydrogenase (ADH), an enzyme that breaks down alcohol, Roach adds. Research suggests the ADH in men’s livers is also more active. Men’s stomachs also have more ADH than women’s, enabling them to clear more alcohol before it enters the bloodstream.

Rethinking your drinking

Even if you never took another sip of alcohol, your risk for cancer may not immediately drop to the level it was before you started drinking.

Studies investigating the effects of abstinence on cancer risk—which have primarily focused on cancers of the head, neck and esophagus—have found that it takes time for your risk to return to pre-drinking levels.

“It happens over time. That’s the case with anything that happens in the body,” Roach notes. In many cases, however, the body is able to reverse much of the damage that’s done by alcohol, he points out.

So, if you’re a moderate drinker, is it time to go “cold turkey”? Unfortunately, this question doesn’t have a one-size-fits-all answer.

If you don’t already drink, it’s probably best not to start. No level of drinking is completely risk-free. And the more you drink, the higher the risks. You can track your alcohol intake with the Sharecare app (available for iOS and Android).

But whether or not it’s okay for you to drink moderately (no more than two drinks for men, or one for women), on occasion or never really depends on you—your age, medical history, genetics, weight, lifestyle, and other individual risk factors for cancer or other health issues.

It’s tough to make the case for even moderate drinking, given the health risks involved. But within these limits, the absolute risk for cancer is small, and some people may simply enjoy life a bit more if they have an occasional glass of wine, Roach admits. It’s important to weigh your personal preferences against the risks involved. Talk to your doctor about what’s right for your personal situation.

Sourcing: American Institute for Cancer Research, American Cancer Society, National Institutes of Health, CDC, National Cancer Institute

Back to Colorectal Cancer

Being diagnosed with colorectal cancer, a type of cancer that starts in the colon or rectum, can be devastating—and startling—news. These types of cancers don’t usually cause obvious symptoms, like blood in the stool or abdominal pain, until they’re advanced. The good news is that if caught early enough, the five-year survival rate is as high as 90 percent. This is due in part to advancements in colon cancer treatment, as well as preventative screenings. More cancers are caught at an early stage thanks to colonoscopy, flexible sigmoidoscopy and other tests.

What is colon cancer staging?
Once you’re diagnosed with colon cancer, you’ll meet with an oncologist to determine how much the cancer has spread. This is called staging. The stages range from 0 to 4, with 0 being the least severe and 4 being the most serious.

Determining your stage

To make an accurate assessment, your doctor will take biopsies and perform one or more imaging tests, such as CT, MRI, x-rays or PET scan. Based on the results of these tests, your doctor may operate to remove the tumor and get a more accurate look at how far it has spread.

Understanding treatment options

While treatment choices depends on each individual’s case, the range of options is typically based on the stage and location of the cancer. These include the following.

Some people with advanced colorectal cancer may also be candidates for immunotherapy, during which medication is used to help a patient’s immune system destroy cancer cells. There are multiple FDA-approved drugs available for this purpose, including pembrolizumab (Keytruda) and bevacizumab (Avastin), with many more in development.

What to expect after treatment

If you have surgery to treat colon cancer—even minor surgery—you’ll likely experience some pain (which can be managed with medication) and eating problems for a few days. Depending of your form of treatment, side effects may include rectal bleeding or blood clots in your legs. You’ll likely feel especially tired. In rare instances, the external incision may open up and become an open wound, or the anastomosis in the colon may leak, leading to an infection.

Some people may also need a temporary or permanent colostomy, where the colon is brought through an incision in the abdomen and a pouch is attached to collect waste. Colostomy is typically needed if so much of the colon is removed that the remaining bowel can’t function properly. A colostomy may be temporary if bowel function returns after the colon has healed.

Radiation for colon cancer can cause skin irritation, nausea, bowel incontinence and fatigue. Radiation may also cause impotence in men and irritation of the vagina for women.

Chemotherapy for colon cancer can cause hair loss, mouth sores, nausea, vomiting, fatigue and increase your chances of infection.

Your doctor will discuss with you the possible side effects before a treatment plan is put into place.

Life after colon cancer

There are now more than 1 million colorectal cancer survivors in the U.S.—and you can be one of them. For some people, no further treatment is required once the cancer is removed, especially if it’s removed in the early stages. For others, the cancer may never go away completely; for those patients, chemotherapy and radiation are required to control growth and keep the cancer from spreading.

Your doctor will want to keep a close eye on your health, requiring follow-up exams every three to six months. These exams may extend to two years after treatment, depending on the stage at which you were first diagnosed.

Regardless of where you fall in the spectrum after treatment, taking steps such as eating a nutritious diet, keeping stress levels under control and exercising can drastically improve your chances of staying healthy.

Medically reviewed in August 2019.

Sources:
American Cancer Society: “Survival Rates for Colorectal Cancer,” “Colorectal Cancer,” “Key Statistics for Colorectal Cancer,” “Colorectal Cancer Stages,” “Treatment of Colon Cancer, by Stage,” “Surgery for Colon Cancer,” “Immunotherapy for Colorectal Cancer.”
Cancer Research Institute: “Immunotherapy for Colorectal Cancer.”
Drugs.com: “Medications for Colorectal Cancer.”
National Cancer Institute: “Treatment Clinical Trials for Colon Cancer.”

Back to Colorectal Cancer

Colorectal cancer is the third leading cause of cancer-related deaths in American men and women separately, according to the American Cancer Society. The good news? Early detection and regular screenings can help prevent the disease and often cure it. In fact, colorectal cancer death rates are declining, and have been for a few decades.

What is colorectal cancer?

Colorectal cancer is cancer that starts in the inner lining of the colon (the large intestine) or rectum. The cancer usually begins as a polyp, and eventually cancer cells can break free and spread to other parts of the body. It’s important to remember that polyps are often benign, but some may lead to cancer. Watch Dr. Oz on the discovery of his pre-cancerous polyps.

Who’s at risk?

Both men and women are at risk for colorectal cancer. Men have a 1 in 22 chance of developing the cancer; women, a 1 in 24 chance. Experts aren’t sure why, but African American men and women have an even higher risk.

What causes colorectal cancer?

Studies show that certain factors may increase your risk of developing colon cancers, but why and how they affect the disease is still unknown. Being overweight or inactive, eating a diet rich in red or processed meats, smoking and heavy drinking can all increase your risk. Those over 50 or those with inflammatory bowel disease have an increased risk, too.

Most instances of colorectal cancer are found in people who do not have a history of colorectal cancer. But, up to 20 percent of people with colon cancer have a family history of it.

“Patients who had family members with colon cancer, rectal cancer or polyps are most at risk,” says colon and rectal surgeon, Theodoros Voloyiannis, MD,FACS FASCRS of Clear Lake Regional Medical Center in Houston, Texas.

Are there any symptoms?

Colon cancer is sometimes called a “silent killer” because it often has no symptoms until the disease has progressed. “The symptoms can sometimes be confused with other conditions, and in general, many patients have no symptoms or warning signs until the cancer has advanced,” says Dr. Voloyiannis. Here are some symptoms that may indicate cancer:

What are the screening options?

Screening can help doctors find the polyps and remove them early on, or diagnose and suggest treatment. The U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society recommend screenings for people with average risk beginning at age 50. “A colonoscopy is the preferred method of screening and it should start at the age of 50 and be repeated every 10 years for the general population, says Voloyiannis. Earlier screenings may be recommended for those who have an increased risk of colorectal cancers, he adds.

Here are some of the most common types of screenings:

Unfortunately, many people put off the screening process for fear that it will be uncomfortable and lengthy. Once you’ve finished prepping, the actual procedure is short and usually painless. “Nowadays, the bowel preparation and fluid you drink to clean up the bowels prior to the colonoscopy is much less and more tolerable than it used to be. You don’t have to drink as much fluid and you can drink water in between,” explains Voloyiannis. And most colonoscopies today are being done under IV anesthesia. “You’re completely asleep so you don’t feel the pain or cramps, then you wake up right after the procedure, and only have to take one day off of work.”

4 common treatment options

The cancer’s stage, location and type will all dictate which treatment option is right for you. Options include:

6 ways to lower your risk

While you can’t control your genes, you can take care of your body. Besides the recommended screenings, here are steps you can take to lower your risk of colon cancer:

If detected early, polyps can be removed so they don’t turn into cancer. Sticking to your own personal screening recommendations is the easiest way to prevent colorectal cancer. And taking care of your health can lower your risk, too.

Back to Colorectal Cancer

You might think of colorectal canceras a condition that only affects older people. While it’s true that the risk shoots up the older you get, an increasing number of younger people are developing the disease.

“People can get colon cancer under 50,” says Rya Kaplan, MD, a gastroenterologist with Trident Medical Center in Charleston, South Carolina. “It’s not the norm, but it can happen.” That’s part of the reason the American Cancer Society (ACS) updated its screening guidelines in May 2018. It now recommends beginning at age 45, rather than age 50.

Colorectal cancer is the third most common cancer among US men and women, and of cancers that affect both men and women, this type is the second leading cause of death. However, about 90 percent of people live five or more years if their colorectal cancer is found early.

Evidence for younger screening
According to a February 2017 study in the Journal of the National Cancer Institute, while colorectal cancer has declined in people over the age of 55 since the 1970s and 80s, it has jumped for people younger than 55. “We are certainly seeing younger patients [with colorectal cancer] more frequently,” says Keith Roach, MD, Sharecare’s chief medical officer.

For people aged 20 to 39 years, colon cancer rates increased by 1 to 2.4 percent every year since the mid-80s. In 40- to 54-year-olds, colon cancer rates increased from 0.5 to 1.3 percent since the mid-90s.

Rectal cancer rates have also increased:

Another study, published in the journal Cancer in March 2016, found that of more than 258,000 people with colorectal cancer, about one in seven developed colorectal cancer before age 50.

Too much red meat and too little fiber might increase a person’s risk of colorectal cancer, as can insufficient exercise and excess body weight. In fact, an October 2018 study published in JAMA Oncology suggests obesity and weight gain in young adulthood can increase the risk of early onset colorectal cancer in women under 50.

Researchers tracked more than 85,000 women between 25 and 42 years old for a period of 22 years, during which time 114 women under 50 developed the disease. Compared to women of a “normal” weight—a body mass index (BMI) between 18.5 and 22.9, according to the study—those in the obesity range (a BMI above 30) had a 93 percent higher risk for colorectal cancer. Weight gain beginning at age 18 was also associated with a higher disease risk; a gain of 44 to 88 pounds was linked to a 65 percent greater disease likelihood than those who gained fewer than 10 pounds.

The study doesn’t prove that gaining weight in early adulthood causes colorectal cancer—only that the two appear to be linked. More research is also needed to see if men are at the same risk. However, this is another step in figuring out why colorectal rates are rising among younger patents.

Current screening guidelines

Without screening, most people under the age of 50 won’t know they have colorectal cancer until symptoms show up, and by then it has probably already spread, says Dr. Kaplan. At later stages, younger people who undergo colorectal cancer surgery are more likely to get potentially debilitating chemotherapy after the operation, but are no more likely to survive, according to a January 2017 study published in JAMA Surgery.

While the ACS did lower their recommended screening age for people at average risk, the US Preventive Services Task Force guidelines still recommend starting screenings at age 50. Those at a higher risk may require earlier screening. “People with a family history of colon cancer or people with polyps will probably be screened earlier than age 50 anyway,” says Kaplan.

They’re not the only ones. “Higher rates are seen in people of lower socioeconomic status, possibly due to lower physical activity, unhealthy diet, smoking, obesity, and lower screening rates,” says Julia Saylors, MD, a medical oncologist with Trident Medical Center. And, African Americans have the highest rates of colorectal cancer of any ethnic group in the US. That could be partially due to genetic factors, but also because they’re less likely to be screened, says Saylors.

The ACS says the most important thing is to get screened, no matter which test you choose, and there are several options.

What you can do

If you have an increased risk of colorectal cancer or other types of cancer, talk to your doctor about when you should start screening. Also, be aware of colorectal cancer symptoms and see your doctor if you have:

No matter your age, healthy habits can reduce your risk of colorectal cancer. Physical fitness is a good start. One study found that the most physically fit participants were 44 percent less likely to get colorectal cancer than the least physically fit participants. Other ways to reduce your risk of colorectal cancer include:

Take the first steps to growing younger and healthier with the RealAge Test.

Sourcing: American Cancer Society, CDC, American Medical Association, US Preventive Services Task Force, National Cancer Institute

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Nearly 5 million American children—some 15 percent of all kids aged 10 to 17—were obese in 2017-2018 according to an October 2019 report from the Robert Wood Johnson Foundation (RWJF). These findings suggest the childhood obesity epidemic isn’t really improving. In 2016, the national obesity rate among this age group was 16 percent—a statistically insignificant change.

Even young children are affected. The Centers for Disease Control and Prevention reports that about 13.7 million children and young adults aged 2 to 19 were obese in 2015-2016, increasing their risk for a slew of chronic health issues down the road.

Conditions, including high cholesterol, asthma, a weaker immune system, arthritis, cancer, heart disease, diabetes and even complications after surgery can develop if the body is carrying extra weight. There are emotional health effects associated with childhood obesity as well. Many overweight or obese children, for example, are often bullied or teased and may experience low self-esteem or depression.

Taking some steps early on to help your child shed excess weight could not only protect their long-term health but also improve their quality of life, according to Uwe Blecker, MD, a pediatric gastroenterologist at Tulane University Medical Center in New Orleans, Louisiana.

Know the warning signs

It’s “baby fat,” or “just a stage,” some parents will say. But ignoring your child’s weight problem won’t help it go away. Make an appointment with your pediatrician if you notice these signs:

Your pediatrician will help you understand if your child is an unhealthy weight for his or her age and height and the severity of the problem. “We look at their age on the BMI chart,” explains Dr. Blecker. BMI, or body mass index, is a measure of body fat for adults based on height and weight. The American Academy of Pediatrics recommends that this ratio can also be used for children older than age 2.

“A child is overweight when his or her BMI is above the 85th percentile, and obese if their BMI is at or above the 95th percentile,” Blecker explains.

Develop a weight-loss plan

Helping your child lose weight should begin and end with your pediatrician, says Blecker. He points out children’s age and how much growing they still need to do should be taken into consideration.

“We look at three age categories: 2 to 5 years, 6 to 11 years and 12 to 18 years. Children ages 2 to 5 have a very significant amount of growth in front of them,” Blecker says. And because they have a lot of growing to do, being overweight may not be a permanent problem. “When we have an obese child in that age group, we don’t work on losing weight necessarily, we just try to decrease or stop the weight gain.”

Once children hit age 12 or is going through puberty, working on weight loss becomes a larger issue. They need to make changes, Blecker says. “The big things are avoiding fried food and sugary drinks and adding in more fruits and vegetables.”

The proper exercise plan will also depend on your child’s age and weight. “We really can’t ask kids who are severely overweight to do significant physical activity because they weigh too much,” says Blecker. He recommends a gradual approach, starting with walking. As children lose weight and become more fit, their level of physical activity may increase.

Be a role model

Once you’ve identified that your child has a weight problem, setting a positive example with diet and exercise is key. “Obesity interventions do not work if the parents don’t participate,” Blecker emphasizes. He notes that he’s seen teenage patients who want to lose weight, but their parents continue to buy and serve them chips and soda. “That is not going to work,” he warns.

Sugary beverages, in particular, are a dietary pitfall that should not be overlooked, especially when it comes to kids. Sweet drinks remain a staple in many children’s diets. In fact, in the United States alone, beverages with added sugar or artificial sweeteners made up 62 percent of children’s drink sales in 2018, according to an October 2019 report from the University of Connecticut’s Rudd Center for Food Policy & Obesity. Meanwhile, only slightly healthier alternatives, such as 100 percent fruit juice and juice diluted with water, accounted for 38 percent of kids’ beverages. Researchers gathered this data by assessing the top-selling brands of children’s drinks, which included fruit drinks, flavored waters, drink mixes,100 percent fruit juice, juice-water blends and sparkling water.

It’s important to avoid the sugary drinks that pack on pounds, Blecker advises. “If children aren’t exposed to sugary drinks, they typically don’t want them,” he adds. It may be unrealistic to assume that your child or teenager won’t try a soda or a sugar-laden latte once in a while when they’re out with friends, at a birthday party or another event, he adds. Just be sure they aren’t in the habit of drinking them at home. Instead, try offering water with real fruit slices or unsweetened soda water, coconut water or teas.

Maintaining a healthy weight can become a family goal, inspiring some group activities. When you are together, try cooking a wholesome meal as a family, or make a habit of walking around the neighborhood every evening. You’ll spend more time with one another, and work together to shed extra pounds and improve your health and wellbeing.

Sourcing: CDC, Nemours, American Medical Association

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Nearly 40 percent of US adults—more than 93 million Americans—are obese, according to the Centers for Disease Control and Prevention. In addition, over 71 percent of adults are considered overweight. It’s well established that carrying an excessive amount of body fat increases the risk for a slew of chronic health conditions, including blood pressure, high cholesterol, type 2 diabetes and heart disease, which is the leading killer of US men and women.

“There’s not one medical discipline that obesity doesn’t touch,” says Michael L. Green, Jr., MD, the bariatric medical director with Medical City Fort Worth in Fort Worth, Texas.

What some people may not realize is that obesity can also take a toll on your mental and emotional health, making daily activities like socializing, dating and even traveling more challenging. Taking steps to lose weight by making lifestyle adjustments could help ease the mental and physical burden associated with the condition.

The emotional toll of obesity

“We need to understand all of the social, physical and mental components of obesity,” Green says.

Anxiety, for example, is a mental health issue that affects about 19 percent of US adults each year—and it’s thought that obesity may raise your risk for the condition. An October 2016 study of nearly 76,000 adults between 18 and 85 years of age found that obese adults are more likely to be diagnosed with anxiety than those who are a normal weight.

Green attributes this to the “the social stigma placed on individuals, which may make them feel uncomfortable in their own skin.” Obese people may fear being humiliated by doing things like going to the mall, working out at the gym or flying, where they may have to request a seatbelt extender or be asked to purchase two airline seats.

Anxiety disorders are frequently associated with depression, which affects about 16 million US adults every year. In fact, roughly 43 percent of adults with depression are also obese, according to the U.S. Centers for Disease Control and Prevention.

People affected by depression feel sad or hopeless and might lose interest in activities they once enjoyed. They may also be irritable, restless, have trouble sleeping and lose interest in activities they once enjoyed.

“Sometimes people don’t feel good about themselves, because they’re fatigued and can’t get around to do what they want to do,” suggests Green. “Or, they’re short of breath from walking, so they can become depressed.”

Genetics could play a role. Researchers in the UK analyzed 73 genetic markers linked to a high body mass index (BMI) to investigate the causal relationship between obesity and the mood disorder. The November 2018 study, which was published in the  International Journal of Epidemiology, involved about 49,000 adults between 37- and 73-years old with depression and more than 290,000 similar people who did not have the condition. They found that genes associated with high BMI but low risk for metabolic diseases, like diabetes, were associated with greater odds for depression, particularly among women. These findings suggest that excess body fat is associated with an increased risk for depression, even in the absence of inflammation and other physiological effects of obesity.

How weight affects relationships

Your weight, along with the emotional toll of being obese, may impact relationships with those closest to you. Anxiety and depression can make social activities less desirable. Just leaving the house may be a challenge. This can cripple your ability to grow and maintain connections with the people you love.

Your intimate relationships may suffer as well. Feelings of inferiority related to your weight may:

Physically, excess body weight can also lower your libido, as well as up a man’s risk for erectile dysfunction, making sex very difficult. This can contribute to anxiety, depression and low self-esteem.

A 2013 study of 408 women bolsters the connection between appearance, including weight, and self-esteem. Low self-esteem was more prevalent among participants who felt their body type did not fit the norm, or mimic the “ideal.” Lower rates of healthy eating were also reported among women with low levels of self-confidence. This creates an unhealthy cycle of feeling down, eating poorly and continuing to pack on the pounds.

What you can do about it

According to 2013 guidelines released by the American Heart Association (AHA), American College of Cardiology and The Obesity Society, obesity is considered a disease, and healthcare providers (HCPs) are urged to treat it as such.

If you’re struggling with either depression, weight loss or both, start by speaking with your HCP. They will be able to help you figure out what the next steps towards treating both conditions.

A March 2019 study published in JAMA found that integrating weight loss treatment and problem-solving therapy with as-needed antidepressant medication led to reductions in both weight and depressive symptoms compared with usual care. While the availability of integrated therapy and weight loss programs is limited, it’s important to keep each one of your healthcare professionals informed about the various treatments. They can better work as a team to treat both conditions.

A doctor may suggest implementing a few lifestyle changes, including but not limited to:

“Don’t let someone get in the way of you becoming a healthier you,” says Green. “Get out and be confident, then we can start finding solutions for you.”

Sourcing: National Institutes of Health, CDC, International Journal of Epidemiology

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