What’s the best exercise for each age group?

1. Teens

2. Young adults

3) Middle-aged adults

4. Older adults

Regular physical activity before a cancer diagnosis may lower the risks of both disease progression and death, suggests research published online in the British Journal of Sports Medicine.

And even relatively low levels of physical activity may be advantageous, the findings indicate.

There is compelling evidence that physical activity has a key part to play in lowering the risk of death from cancer, but the evidence isn’t as conclusive for its role in disease progression, explain the researchers.

To explore this further, they analysed anonymised data from the Discovery Health Medical Scheme (DHMS), linked to the Vitality health promotion programme. The DHMS is the largest open medical plan in South Africa, covering approximately 2.8 million beneficiaries.

All Vitality programme participants are rewarded for adopting healthy lifestyle behaviours, earning points for physical activity, recorded by activity trackers, logged gym attendance, or registered participation in organised fitness activities.

Activity type, frequency, duration and intensity are recorded and translated into weekly minutes of exercise.

In all, 28,248 Vitality programme members with stage 1 cancers, and comprehensive physical activity data for the year preceding diagnosis, were included in the study, which spanned the period 2007 to 2022. 

Breast and prostate cancers were the most common cancers, comprising 44% of the study total. 

The length of time between initial diagnosis and disease progression, death, or exit from the study ranged from 1 month to nearly 13 years. 

Cancer didn’t progress in nearly two thirds of the total sample (65.5%), but in just over a third (34.5%) it did. And while 81% survived, 19% died before the end of the study. The average time to death was 20 months and the average time to progression was 7 months. 

Levels of physical activity in the year before diagnosis were categorised as none recorded (17,457; 62% of participants); low, equal to 60 or fewer weekly minutes (3722;13%); and moderate to high, equal to 60 or more weekly minutes of moderate intensity physical activity (7069; 25%).

After accounting for potentially influential factors, including age at diagnosis, sex, economic and social position, and co-existing conditions, rates of cancer progression and death from any cause were lower among those who were physically active in the year preceding their diagnosis.

The odds of disease progression were 16% lower for those who had engaged in low levels of physical activity in the preceding year than among those who hadn’t recorded any physical activity, while the odds for those who had engaged in moderate to high levels were 27% lower.

Similarly, the odds of death from any cause were 33% lower among those who had engaged in low levels of physical activity compared with those who hadn’t recorded any, and 47% lower for those who had managed moderate to high levels.

Two years on from diagnosis, the likelihood of no disease progression among those with no recorded physical activity in the year before diagnosis was 74%, compared with 78% and 80%, respectively, for those achieving low and moderate to high levels of physical activity. 

While the likelihood of disease progression increased as time went on, it was still lower for those who had clocked up some level of physical activity in the year preceding their diagnosis.

After 3 years, the likelihood of no disease progression was 71%, 75%, and 78%, respectively, for none, low, and moderate to high levels of physical activity. And after 5 years, it was 66%, 70%, and 73%, respectively.

Similar patterns were evident for death from any cause. Two years after diagnosis, the probability of survival among those with no documented physical activity in the year preceding diagnosis was 91% compared with 94% and 95%, respectively, among those who had recorded low and moderate to high levels.

The equivalent probabilities of survival 3 years after diagnosis were 88%, 92%, and 94%, respectively, and 84%, 90%, and 91%, respectively, after 5 years. 

This is an observational study, and as such, can’t establish cause and effect. And the researchers acknowledge that they weren’t able to account for other potentially influential factors, such as smoking and alcohol consumption, while the data on weight (BMI) were incomplete.

But there are several plausible biological explanations for the findings, they suggest, chief among which is the way in which physical activity strengthens immunity by increasing numbers of natural killer cells, lymphocytes, neutrophils and eosinophils.

Physical activity may also lower the progression risk of hormone sensitive cancers, such as breast and prostate cancers, by regulating oestrogen and testosterone levels, they add.

“Physical activity may be considered to confer substantial benefits in terms of progression and overall mortality to those diagnosed with cancer,” they write. 

“In a world where cancer continues to be a significant public health burden, the promotion of physical activity can yield important benefits regarding the progression of cancer as well as its prevention and management,” they conclude.

Fitness challenges, meal plans, daily inspiration — the new Start TODAY app has it all!

The app, which launched on Dec. 26, 2024, was inspired by our Start TODAY community, which came together during the pandemic as a way to improve physical and mental health.

The app’s “Chief Motivation Officer” is a man who has inspired TODAY fans for decades — Al Roker. He’s joined by Stephanie Mansour, TODAY Fitness Contributor, and a team of best-in-class personal trainers and dietitians to help you make your health goals a reality with step-by-step routines and workouts, meal plans, expert advice and more.

There are three main pillars in the app:

• Fitness
• Nutrition
• Inspiration

Here’s what to know, plus how to sign up and get started!

Fitness in the Start TODAY app

Our fitness experts have created 7-day, 14-day and month-long challenges across 12 disciplines to fit any type of lifestyle and schedule.

“Over the last eight years, we’ve been creating workout challenges with TODAY.com and the TODAY show and using a fine-toothed comb to see what our viewers love and what they want more of,” Mansour said. “Our viewers and Start TODAY members have told us that they love walking, walking workouts, accessible strength training routines, workouts with modifications, stretch routines to help reduce pain and increase flexibility, as well as using simple equipment like a yoga mat, dumbbells, or resistance bands.”

The Start TODAY app customizes the categories to match your interests, whether you’re a beginner or more advanced. They also are tailored so that they do not require a ton of space — you can do them at the gym, at home or even outside.

You can jump right in with our January indoor walking challenge, which can help make exercise a habit in just 13 minutes a day.

“The January workout challenge is a walking challenge to get you moving anywhere, anytime, even when it’s freezing outside!” Mansour said. “Because our walking workout challenges have been so popular among our Start TODAY community and on TODAY.com, we’ve stepped it up with daily workout videos that you can follow along with directly in the app.”

In this month’s challenge, Mansour leads Al Roker through moves like forward kicks and hammer curls — and features two popular Start TODAY members demonstrating modifications and adjustments so you can get the most out of your workout.

A big focus is to take the guesswork out of your daily workout and avoid boredom to keep you on track for your fitness goals. Many of the challenges include guided audio walking workouts with Al, Stephanie and other trainers.

The fitness workouts and challenges on the app are across all the following categories:

• Yoga
• Meditation
• Mobility
• Walking
• Barre
• Dance cardio
• Strength
• Resistance bands
• Core
• Flexibility
• Cardio
• HIIT

Personal trainer Lacee Green, known as The Curvy Girl Trainer on social media, gave a glimpse at some of the workouts on TODAY on Jan. 2. She shared her special brand of enthusiasm and inspiration that will help get you moving in 2025.

“It’s all about fitness for everybody and every body,” Green said. “Finding the joy and dropping the judgment. It’s just starting where you are, loving who you are right where you are as you work on who you’re becoming.

“When you think about 10 years from now, you’re not going to be thinking about a number on a scale or a pant size,” she continued. “You’re going to be thinking about, ‘I’m so grateful that I put the habits in place to lead a happy and healthy lifestyle with movement that feels good.’ Whenever fitness is fun, that means you’re doing it right.”

Meal plans on the Start TODAY app

Led by registered dietitian and TODAY nutrition editor Natalie Rizzo, the Start TODAY app takes the frustration out of healthy eating by doing the work for you.

Proper nutrition is key to reaching your health goals. “Fitness is a crucial part of a health journey, but it’s impossible to reach all your health goals without a well-balanced diet full of healthy foods. As a matter of fact, nutrition plays a pivotal role in your fitness journey. Food supplies energy for exercise and help the muscles recover and grow stronger after a workout,” Rizzo explains.

The meal plans are broken down into five categories based on individual goals:

• Budget-friendly
• Heart-healthy
• Quick and easy
• Mediterranean diet
• Weight loss

Each week, Rizzo analyzes hundreds of recipes to bring you the ones that will best fit your plan and take the guesswork out of healthy eating.

“For example, for the heart-healthy plan, as a dietitian I know that you want to look for things high in fiber, high in omega-3s and ingredients like potassium, so I go through the recipes to find those types of ingredients.”

The meals in the quick and easy plan can be on the table in 30-minutes or less, while the budget-friendly plans may include potatoes, ground beef or canned beans that are relatively inexpensive.

Each week’s plan includes three breakfasts, four lunches, and seven dinners to give you variety while keeping things manageable. Additionally, each recipe comes with a brief explanation of why it’s included and the health benefits it provides. Each weekly meal plan comes with a shopping list to make healthy eating even easier.

“My nutrition knowledge is put into these meal plans so people don’t have to do this research themselves,” Rizzo said.

Inspiration on the Start TODAY app

Of course, you might need some words of wisdom to help you fit that workout in or eat that healthy meal on a day when everything feels like a struggle.

Our inspiring personal trainers, meditation experts and dietitians will share some ways to get up and moving when you’re stuck in a rut. And Al Roker has you covered with daily inspiration and advice about how he’s stayed on track during tough times.

Another important component of the app is helping you build healthy habits with daily prompts to take small actions that can add up to big improvements over time.

Whether it’s taking a deep, cleansing breath, starting the day with a smoothie or drinking more water, these simple goals can give your day a boost.

To join the Start TODAY community and get walking workouts and podcasts with Al Roker, download the Start TODAY App! Subscribe for $65.99 + tax per year (or $9.99 + tax per month) auto-charged until canceled. But if you subscribe to an annual plan today, you’ll automatically get 30% off the first year. That’s less than $5 per month for the first year! Terms apply. Offer ends 1/12/25. After the discount ends, you will be automatically charged $65.99 (plus tax)/year for an annual subscription or $9.99 (plus tax)/month for a monthly subscription until you cancel. Cancel anytime through Apple under Profile Settings.