Diets: Standing up for health

United Press International surveyed 84 specialists for a 15-part series weighing in on the causes, consequences and costs of a global gain in girth and measures to curtail the corpulence. Part 8 runs with some moving proposals.

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SAN FRANCISCO (UPI) -- With a lack of locomotion lulling 75 percent of the adult population into a laid-back lifestyle that too often decrees disease and even death, specialists are calling for men and women to stand up for their health.

"(Physical activity) has gotten relatively little attention in this epidemic (of the overweight) compared to food and diet," said JoAnn Manson, professor of medicine at Harvard Medical School and chief of preventive medicine at Brigham and Women's Hospital in Boston.

"There should be a very clear message that we really need to get off our duffs," she told a national summit on obesity, sponsored by Time and ABC News, last week.

Though a half-hour workout on most days is suggested for general good health -- and many adults need twice that much for optimal weight and well-being -- even 10 minutes of brisk walking, paced to cover a mile in under 20 minutes, can help stave off diabetes, heart disease, certain cancers and other chronic diseases.

"Americans need to understand that overweight and obesity (typically 30 excess pounds) are literally killing us," said Health and Human Services Secretary Tommy Thompson. His remarks were timed to coincide with the recent release of a government study forecasting by 2005 the number of corpulence-related fatalities would top those blamed on smoking.

"To know that poor eating habits and inactivity are on the verge of surpassing tobacco use as the leading cause of preventable death in America should motivate all Americans to take action to protect their health."

For the best fit and to measure up in the long run, the strategy selected to trim away sedentary habits should be tailored to an individual's tastes and preferences.

"People who want to improve their health ... need to look at the behaviors that impact health and make changes they can stick with," said University of California, Berkeley, nutrition specialist Joanne Ikeda. "In terms of physical activity, hire a personal trainer if you have lots of money; if not, there's nothing complicated about going out for a walk," said Ikeda, who focuses on minority culture research and serves as scientific adviser to the National Association to Advance Fat Acceptance.

What approach works best will depend on the weight watcher's girth, goals and appetite.

"You need to account for many individual differences: some people load up on higher-fat and higher-sugar foods, and others have no desire to overeat," Gail Woodward-Lopez, a UC Berkeley expert on obesity and overweight prevention, said in a telephone interview.

"Some people are hungrier than others, and some have less of a drive to eat; some are susceptible to weight gain, and others are not, like with alcoholism," she added. "Who you are and what you want will determine the course you should take."

Before running off to join a fitness movement, however, couch potatoes over age 35, or harboring conditions such as high blood pressure or cholesterol, obesity, heart, bone or muscle trouble or unexplained exhaustion should get the green light from their doctor.

For those desiring to improve muscle strength and endurance and/or reduce the risk of orthopedic injury or low-back pain, weight training may be the right prescription, concluded an April 16 study published in the Mayo Clinic Women's Health Source. However, the researchersfound, lifting weights typically will not burn enough calories to drop weight. They also reported most circuit weight-training programs fail to stimulate the cardiovascular system sufficiently to be considered aerobic exercise -- activity that raises the heart rate for at least 20 minutes.

Some swear by such specialized strategies as the Curves Program, which, with 7,700 locations and 3 million members worldwide, bills itself as the world's largest fitness center franchise. The approach of strength training and cardiovascular activity, which combines 30-minute workouts with 30-minute weight-management classes, specifically targets women and particularly the proverbial "soccer mom" who is too busy chauffeuring young athletes to become one herself.

The plan got a boost from eight recent Baylor University studies, which showed it can raise the metabolic, or calorie-burning, rate of sedentary, overweight women. Richard Kreier, professor and chairman of health, human performance and recreation, reported at the Experimental Biology 2004 meeting in April that participants who subscribed to the high-protein, low-carb, low-fat diet and exercise regimen for 10 weeks could down as many as 2,600 calories a day without putting on the pounds during the maintenance phase of the program.

Other examples of moves that can whip the body into shape:

-- Running, swimming, walking, jogging, gardening, raking, mowing the lawn, dancing, bicycling, rowing, playing tennis or basketball, cross-country skiing and other aerobic exercise to burn off fat, beef up endurance and buck up the cardiovascular system to better pump blood and deliver oxygen throughout the body. The conditioning can help reduce the risk of such potentially deadly disorders as heart disease, stroke and high blood pressure.

-- Walking; stair climbing; working with free weights, dumbbells and bars stacked with plates; performing calisthenics, such as chin-ups, pull-ups, push-ups and sit-ups, and other resistance or strength training to build bones, boost muscle strength and battle osteoporosis. The workouts can lead to improvements in body image and self-esteem, levels of high-density lipoprotein, or HDL, the "good" cholesterol and heart and muscle health, which begins to deteriorate after about age 35. Studies with elderly men and women have shown 10 weeks of exercise had a positive bearing on the septuagenarians' and even octogenarians' flexibility, strength and mobility.

In addition, a recent study of 39 post-menopausal women, conducted by the U.S. Department of Agriculture's Human Nutrition Research Center at Tufts University in Boston, found thickened bone mineral density in the hip and spine of the group following the regimen.

Sylvia Moore, a registered dietitian and professor of family medicine and director of the Division of Medical Education and Public Health at the University of Wyoming in Laramie, recommends walking every day and resistance training three times a week for keeping fit and trim.

Too often, however, time runs short for a formal workout.

"People are supposed to work in 60 minutes a day of moderate physical activity, but given the way our society is now, we don't have a lot of extra time on our hands to go out and jog," said Gladys Block, professor of epidemiology and public health nutrition at UC Berkeley's School of Public Health.

She suggested employing daily tasks for expending energy, including:

-- Take the stairs instead of the elevator.

-- Park at the end of the lot and walk.

-- Get off the bus a few blocks from the intended stop.

-- Replace coffee breaks with walking takes.

-- Satisfy hunger with a jog.

-- Speed up work around the house and yard.

-- Use restrooms on a different floor.

-- Wash the car or the house windows or floors.

-- Shovel snow.

-- Paint a room, or the entire house.

-- Go dancing, golfing, fishing, swimming, bicycling.

Easy, safe, affordable, requiring only a good pair of shoes, walking is considered one of the best bets.

Shane Bilsborough, an Australian fitness guru and researcher, recommends using a pedometer, an instrument that counts steps -- of which there are some 2,500 in a mile -- and calculates distance.

"I work with the largest corporate companies in Australia, and implement physical activity programs using pedometers to get people taking between 12,000 to 15,000 steps each day," Bilsborough said. "This is the first and most important stage."

A study by Shape Up America, a national coalition of industry, medical, health, nutrition, physical fitness and related experts promoting increased physical fitness for healthy weight, indicated a typical person in the course of an ordinary day takes between 900 to 3,000 of the recommended 10,000 steps. The rest put will power and creativity to the test.

"We should make exercise social and enjoyable," said Dr. Linda Stern, an internist at the Philadelphia Veterans Affairs Medical Center who has started leaving her car in the garage and footing the 3 miles to 4 miles each day to and from the train station.

"These walks have brought me much more sanity and better health," she said in an interview. "You have to make it a top priority, though little in society makes it easy."

Safe, clean, inviting recreational areas should be created to lure more drivers and passengers out of their vehicles, Ikeda agreed.

"Every neighborhood should have a park with safe equipment for children and something to occupy the adults while the children are at play," she said.

In the end, it becomes a matter of personal choice, said Ted Federa, a clinical psychologist in Sao Paulo, Brazil, who has spent a quarter century studying obesity, particularly in children and adolescents.

"We believe that in the long run, only the recognition that nutrition and physical activity must be a part of the daily life of all will help change the direction we are currently going in," he said. "Gyms, clinics, even schools are important but only when learning what is healthy nutrition and only when physical activity becomes part of the culture will the battle of the bulge be won."

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Next: The making of an obesogenic society

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UPI Science News welcomes comments on this series. E-mail sciencemail@upi.com