Diet and exercise for ADT

A Mediterranean diet is considered one of the best options.

Getting on the scale every morning, seeing what you weigh and eating based on, it can be the best way to control the weight.

Many large health care providers offer nutritional help for ADT patients. As @jeffmarc stated the Mediterranean diet works well for many. If you are doing radiation you will need to adjust your diet to a low gas diet for the timeframe during your radiation. I'm a big fan of Dr Robert Newton, an Australian doctor who has studied exercise and its effects on cancer for 30 years. He has a great video on YouTube from the 2025 PCRI Conference, search his name, Dr Moyad and PCRI together on YouTube and you should find it. He also has a tremendous book, "My Exercise Medicine for Cancer" available on Amazon. He recommends weight bearing/resistance exercises, cardio and impact loading exercises. You may find that your health insurance pays for a gym membership. Mine did, and with the money I saved on dues I booked 8 sessions, 2x a week for the first month with a very good trainer associated with the gym, and he helped me with the 6 weight bearing exercises that Dr Newton recommends along with 7 others. I hadn't been in a gym for 30 years, so I needed the guidance. I now do weights 3x a week, cardio 3x a week at the gym, and impact loading at home 7x a week. A typical day at the gym is about an hour, it really depends on how long I may have to wait for a particular machine. Good luck, I'm doing really well on Orgovyx after a little over 2 months, exercise has helped tremendously.

Diet:
Eat like your grandparents — cover 1/2 of your plate with vegetables, 1/4 with a starch like rice or potato (ideally not deep-fried), and 1/4 with a high-protein source like meat, beans, or tofu. Eat less-processed foods when possible, but that doesn't mean you can't have a hot dog at the church picnic (just don't eat processed meats every day or even every week). Go easy on sugar, or at least combine with fats and proteins to prevent blood-sugar spikes, since you're at elevated risk of type 2 diabetes on ADT.

Exercise:
Don't make it unnecessarily complicated. Get off the subway or bus a couple of stops early, park at the back of the parking lot, walk 15 min to the store for milk instead of driving, etc. Just keep moving. And for your bones/muscles/energy level, do some light resistance training 3x/week with weights or exercise bands, unless that's a natural part of your life already (e.g. farming, construction work, etc). 20 min/day 3x/week will do it. You're not trying to be Mr. Universe here, just sending a message to your body that it should keep investing in your muscles and bones even though the testosterone signal has faded out.

Like you, I was a big guy who worked in an office and didn’t exercise regularly. Then I met a woman…She persuaded me to join Weight Watchers, which was difficult because, more often than not, I would be the only man at the meeting. I had my doubts about losing weight because I had been obese for years and all my siblings are big people - I figured it was genetics. However, after two years, I lost 63 pounds simply by following the WW guidelines. And it’s not a restricted diet… it’s simply portion control and exercise.

I'm still sitting at a desk and never much for exercise at 76. I'm about to start radiation and ADT.

For exercise I'm going to pick up my mail more often and walk - we don't get home delivery so it will be almost 2 miles round trip. I'm going to see a physical therapist that specializes in resistance exercise for oncology patients. Just 6 times (they have a package price) to learn what to do and have someone watch me. I plan to transition to weights at home.

The diet is the challenge for me. The Mediterranean is most recommended. For the radiation I could eat the same meals every day and not care. For the ADT and beyond not so much. The Mediterranean has too many things I will not eat.

So, I am looking at sample Mediterranean diet recipes I will like or can change slightly. Luckily I do not like red meat that much except for burgers and really like fish. I'm also researching ingredients and alternatives to change meals I cook now. I'm eliminating processed meats.

I don't drink alcohol much now - less than 12 beers a year and don't drink anything other than water so no big deal.

I plan on rare cheat days in small portions. Like one slice of pepperoni pizza on rare occasions. I'm not going to eat like a rabbit the rest of my life.

@tbgb50 If you don't enjoy the Mediterranean diet, there are lots of other options (including no formal "diet" at all).

Author Michael Pollen (The Omnivore's Dilemma) wrote that really it comes down to three principles:

1. Eat food
2. Not *too* much
3. Mostly plants

He defines "food" as something your grandmother might have recognised when she was young, rather that the ultra-processed stuff available today.

Another simple rule I've heard is to do most of your shopping at the far sides of the supermarket (where you'll typically find the fresh produce on one side and fish and meat on the other) rather than in the middle aisles. 🙂

@tbgb50
Sounds like you really have your weight under control. Eating smaller portions really is the trick.

Red meat is not great for you, including hamburgers. Prostate cancer likes them, however. I’ve heard that turkey burgers taste really good. I eat red meat maybe once a month. When I have it I limit how much. I usually just eat chicken, turkey and fish.

I used to have wine or beer with every meal now I may have it once in a couple of weeks. Like you water is the trick. I like it with ice.

If you are on ADT, you really need to do weight exercises. ADT deteriorates your bones and your muscles so you need to do weight exercises to offset it. You don’t have to use heavy weights you can use lighter ones and do more reps.

@jeffmarc
Yup, I cut back on portion sizes and lost 45 pounds that I've kept off for 4 years and counting. I do need to find some chicken recipes that are not fried or cooked with fats. I can't just live on fish.

Weights arrived on Thursday so I am getting started.

There can be a lot of foreboding about exercise if it's not been part of your life before, seeming like a monster on your to-do list. But just wander into it to begin: Sweat a little, wind up a bit chuffed. Start where you are. Consistency is important, and that approach will make consistency possible. You'll improve physically, and ADT side effects will be reduced. Win-win.

Since you are not active and have a lot of extra weight and now have to deal with cancer it all might look and sound overwhelming and daunting. I would like to suggest that (if at all possible) you join some club or group of people that have the same goal. That can give you structured program and help with planning your meals and starting exercise routine. You have to start slow and find nice balance or you might feel overwhelmed and give up or not be able to sustain new regiments without being frustrated.

However - if you feel highly motivated now and are in gung-ho mood than it is possible to do it solo ! You might like to join "Loseit" program on internet (basic level is fee) and it will help you see caloric value of every single item that you consider eating and trust me , when you see how calories add up you will have easier time controlling portions and making healthier choices. When you have a choice to eat whole chicken leg or have a can of beer - believe me , you will choose a whole chicken leg lol ; ) !

For the beginning try to avoid sweets if at all possible. Second worst on a list are pasta, bread, white rice, potatoes and other starches . I guaranty you that if you just avoid those you will have weight loss seen in no time. Eat simple meals of protein and with all kind of veggies cooked, stewed, baked, roasted - try to avoid frying and eat home prepared meals if possible.

Exercise - if you were mostly sedentary please, please start slowly. Fast walking is excellent starting point and has multiple benefits ! Buy very good walking shoes - they are expensive but you really need good support and do not wish to end up with painful ankles or feet : (. When you feel that you can do more, buy some weights and you can start doing some weight training at home or join a gym. There are TONS of exercise videos online and many are free. Just always start with the beginner level and than slowly increase levels when you feel comfortable doing so .

Wishing you all the best and great success in achieving weight loss and better fitness level - it will help you tremendously with tolerating all PC treatments well 🍀✨.