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Food & Nutrition

Dosage of Exercise for Men on Androgen Deprivation Therapy (ADT) – AUA

High impact exercise is most important for men on Androgen Deprivation Therapy (Hormone Therapy) for prostate cancer


ADT Exer

Men with prostate cancer (CaP) undergoing androgen-deprivation therapy (ADT) are recognized to gain fat mass, lose muscle, and be subject to a series of adverse effects from the therapy.

Dr. Robert Newton, an exercise scientist from Australia gave a brilliant presentation at the AUA conference on the benefits of properly done exercise in reducing side effects from ADT (hormone treatment) for prostate cancer.

In the research Dr. Newton and his team,  two important findings were observed:

1. Six month of supervised exercise resulted in improved cardio vascular and repiratory fitness, lower-body physical function, self-reported physical functioning and mental health, and muscle strength compared with standard public health recommendations on physical activity

2. These benefits were largely sustained in the following 6 mo with a home-based maintenance program.

The exercise routine included the following:

Approximately 60 minutes in duration, involving moderate to high intensity aerobic and resistance exercises as well as standard warm-up and 8 cool-down periods.

The aerobic exercise component included 20– 30 minutes of cardiovascular exercise using a variety of modes such as walking or jogging on a treadmill, cycling or rowing on a stationary ergometer or exercising on a cross trainer machine.

Target intensity was set at approximately 70-85% of estimated maximum heart rate. The resistance exercise component involved 8 exercises that targeted the major upper and lower body muscle groups (leg press, leg extension, leg curl, calf raise, chest press, lat pulldown, biceps curl and triceps extension). Cormie et al. 2014

Dr. Newton made an important point that stuck in my head. He said, “Exercise is not a single medicine and how it’s prescribed make all the difference.”

My Take On This

Wow! You can imagine how excited I was listening to Dr. Newton’s presentation. I have clinically found that men on ADT for prostate cancer still experience suboptimal quality of life when only doing aerobic exercises and no weight resistance.

And not only is weight resistance important, the proper amount is also critical. The prostate cancer book I am currently writing , the CaPLESS Wellness Method,   emphasies the dosage on everything from broccoli consumption to exercise to supplements.

Another words, it’d be useful to know what is the minimal effective dose of every aspect of a targeted lifestyle program to get maximal results.


Doggy Bag Message

Well, now we know that men on ADT (hormone therapy) for prostate cancer should practice weight resistance, 3 to 4 times a week, 30 minutes at a time,  while including aerobic exercises the rest of the time. The amount of total time of exercise per week should be 3 to 4 hours. Nothing less.



AUA 2014, Orlando, Florida

Cormie P1, Galvão DA, Spry N, Joseph D, Chee R, Taaffe DR, Chambers SK, Newton RU.Can Supervised Exercise Prevent Treatment Toxicity in Prostate Cancer Patients Initiating Androgen Deprivation Therapy: A Randomised Controlled Trial. BJU Int. 2014 Jan 27.

Delicious & Protective Recipe of the Week: Kale Salad



Created by Marti Wolfson

Kale Salad

Kale has been the comeback kids of the vegetable kingdom over the last few years. No longer garnish on catering platters, this king of the cruciferous family is loaded with cancer fighting properties as well as high in calcium, Vitamin A, C and K. Kale is a wonderful vegetable to bring into your weekly  repertoire since it goes well in salads, soups, sautees, and green smoothies. Kale salad is easy to make and lasts in the fridge up to 5 days.

Serves 4-6

  • 1 bunch Tuscan kale, de-stem the leaves and chop into bite-sized pieces
  • 1-2 garlic cloves, minced
  • juice of 1 lemon
  • Pinch of red pepper
  • 1 oz. grated Parmesan or Drunken Goat cheese (optional)
  • 3-4 T. olive oil
  • Sea salt to taste
  • black pepper to taste
  • ½ cup grape or cherry tomatoes, halved
  • 1/3 cup toasted pine nuts or sunflower seeds.


Wash the kale and drain.  In separate bowl combine the garlic, lemon, pepper, olive oil salt and pepper, and whisk.  Pour the dressing onto the greens and massage for about 5 minutes. Gently mix in the cheese and tomatoes. Refrigerate a few hours to marinate the greens. When ready to eat garnish with nuts or seeds.

Bon Appétit !

Walnuts Protective Against Prostate Cancer



Quick Doggy Bag Points

  • New mouse study shows walnuts to be protective against prostate cancer
  • One small human study in 2008 suggest walnuts (Spaccarotella et al. 2008)
  • Walnuts may be protective against breast cancer as well (Vanden Heuvel et al. 2012)
  • Mouse studies do not always translate to humans but the reason why we study them is because they are biologically similar to humans
  • How much or how often to eat walnuts to get the most benefit seems to be unclear. However, a handful a day would likely be a good idea.

Details of the Study

  • 32 mice received the control diet and 16 mice were given the walnut diet to eat.
  • Cancer cells were inoculated with LNCaP cells
  • LNCaP cells are androgen-sensitive prostate cancer cells derived from a metastatic site of humans
  • The tumor size in the mice eating a walnut-enriched diet remained small and essentially stable throughout the experimental period
  • The tumors in the mice consuming the control diet began to grow more rapidly; at 60 days after their appearance and thereafter, the tumors in the control-diet mice were always larger than the tumors in the walnut-diet mice.
  • At the conclusion of the study, the calculated volume of the tumors in the control mice was much larger than those of tumors in animals consuming walnuts in their diet (Reiter et al. 2013)

My Take On This

Walnuts contain high levels of omega-3 fatty acids, gamma-tocopherol Vitamin E and carotenoids. Although its been purported that Vitamin E and lately Omega 3 fatty acids promote prostate cancer, the type of vitamin E used in SELECT trial was not gamma-tocopherol but synthetic alpha tocopherol. I have written about this at length HERE. By now, you also know my thoughts on Omega 3 fatty acids and prostate cancer. Just in case – see HERE.

A nice protective  and delicious breakfast would include: oatmeal mixed with almond milk, crushed walnuts and blueberries.

More on Walnuts and Male Health HERE


Reiter RJ, Tan DX, Manchester LC, Korkmaz A, Fuentes-Broto L, Hardman WE, Rosales-Corral SA, Qi W. A Walnut-Enriched Diet Reduces the Growth of LNCaP Human Prostate Cancer Xenografts in Nude Mice. Cancer Invest. 2013 Jun 11.

Recipe of the week – Mineral rich salad


By Marti Wolfson

Seaweed is oftentimes the underdog in the culinary world. It has enormous benefits on our health, including the thyroid, liver and cellular metabolism, but it often goes unrecognized and underutilized. Asian cultures and coastal regions of the world have been using sea vegetables for centuries. There are a lot of varieties, many of which can now be found at your nearest health food store. This salad will get your taste buds singing from the sweet and sour notes of Asian flavors. 

Serves 6


½ cup pre-cut wakame*

2 T. tamari

1 tsp. toasted sesame oil

2 T. brown rice vinegar

½ tsp. honey

¼ cup grated daikon

½ cup carrot cut into matchstick

¼ cup diced red pepper

1 scallion, thinly sliced

2 T. toasted sesame seeds

2 cups watercress



Rehydrate wakame in room temperature water for 10 minutes. Drain well and set aside in a bowl. If the wakame is not already cut, chop it into bite-size pieces.

Mix the tamari, toasted sesame oil, vinegar, and honey together until well combined and pour over the wakame. Add the daikon, carrots, peppers, and scallions and mix well. Garnish with seeds and serve over watercress.

*if the wakame does not say “ready to use”, you may need to soak the seaweed longer in warm water.