April 27, 2016

Getting People to Move More

In 2010, a group of public and private organizations banded together to develop and release the first National Physical Activity Plan, a blueprint for getting Americans to move more.

Among its recommendations were that every schoolchild be allowed and encouraged to participate in frequent — and preferably daily — physical education classes; that employers find ways to reduce sitting time at the office; and that municipalities both create and promote parklands, bike paths and other places for people to be active.

But since the release of the plan, by an alliance that includes the American Heart Association, American Cancer Society, Centers for Disease Control and Prevention, and the Department of Health and Human Services, physical activity levels in the United States have barely budged, and for many people, they have declined. According to a recent report, only eight states require recess every day for elementary school students and only Oregon and the District of Columbia mandate that all children in elementary and middle school participate in at least 30 minutes of physical education every day, the minimum desirable level of daily P.E. that experts recommend.

Meanwhile, according to the C.D.C., barely 20 percent of American adults meet the minimum national exercise guidelines of at least 150 minutes per week of mixed aerobic workouts and strength training. The percentages are even lower for many minority groups, including Hispanic adults. Only about 15 percent of them manage to meet the exercise recommendations.

More disquieting, a health study published last month concluded that, over all, fewer than 3 percent of American adults live the kind of comprehensively healthy life that we all know we should, with a diet rich in fruits and vegetables, no smoking, a normal weight and regular exercise. Of these, the factor that was most likely to keep someone from joining the small group of health-wise Americans was exercise. Almost no one in the study did much.

In the face of this seemingly intractable tug toward physical stillness, the alliance today released a new National Physical Activity Plan, with updated priorities, a broader focus on minorities with the addition of a diversity committee, and more recommendations and advice for how people might encourage physical activity in their communities and schools.

To find out more about the new plan and why so many of us remain so resolutely sedentary, I spoke with Russell Pate, a professor of public health at the University of South Carolina in Columbia and chairman of the National Physical Activity Plan Alliance. Here are edited excerpts from our conversation.

Q.
The most obvious question about the National Physical Activity Plan is why do we need one? Why is it still so hard to get people to exercise, when we all know that we should?

A.
In fairness to people, we have made it so easy to be inactive. Once, stairs would have been the first thing that you saw in a building. Today, elevators are front and center. You have to hunt around for the stairs. And we can drive everywhere. In today’s world, it’s activity that is unusual, not inactivity. Being active requires commitment, and for some people, that commitment can seem too much. A single mother of three kids working two or three jobs may well feel like working out is a luxury that she can do without.

Q.
Is that why the plan emphasizes physical activity rather than exercise?

A.
Many people think of exercise as something that is planned and high-intensity and a lot of work. Physical activity is a more inclusive term. Any movement can be considered physically active and beneficial, even if you just walk around the house instead of sitting on the couch. We want to convey the idea that you don’t have to exercise, just move more.

Q.
But how, in a concrete way, can a national plan increase activity? How could someone use the plan to, for instance, get more P.E. classes added to the curriculum of their child’s elementary school?

A.
There is a section devoted to education. It includes a series of evidence-based strategies and tactics. You can find information there about why schools should meet national and state standards for physical education and how to accomplish that, such as encouraging shared-use agreements so that schools can use community facilities if they don’t have their own resources. This plan is meant to be practical. A parent could print out that section, take it to a school board meeting and say, ‘Look, I didn’t dream up the idea that we need P.E. It’s right here in the National Physical Activity Plan.’

Q.
Are you optimistic?

A.
We are swimming upstream. We know that. The social conditions that promote inactivity have been building for decades. It is so easy now not to move. But the consequences are also becoming more obvious. Inactivity is associated with so many health problems and premature death. I believe that as people consider what it means to have a high-quality life, there will be a shift in behavior. Do we want to spend our lives on the couch surrounded by empty pizza boxes? Sure, some people might. But I think that most of us want healthy workplaces, schools and homes. We want our children and loved ones and ourselves to be well. To achieve that, we must move more.

(Source: well.blogs.nytimes.com)



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