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A Strong Leader Can Fire the Desire to Get Fit

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TIMES HEALTH WRITER

“Do you work out?”

The question caught me off guard. I was in an exam room with my doctor last winter for my annual checkup. But a doctor had never asked about my fitness habits as a routine part of a health exam.

“Well, um, uh,” I stammered. The truth is, I hadn’t been exercising regularly since my first child was born eight years ago. Caring for two kids, I had reasoned, was enough to keep me in shape.

But the question nagged at me long after I left the doctor’s office. I realized that I needed to begin exercising again. I took up jogging shortly after and have been at it since.

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What my doctor did is what the federal government had a chance to do last week but didn’t do.

When the government released the first-ever Surgeon’s Report on Physical Activity and Health, it could have asked all of us that pointed question, “Do you work out?”

The Feds had a chance to make us feel guilty. They had a chance to put us on the spot, to make us squirm, to motivate us to get up and get going.

But this long-awaited and highly hyped report fell very flat.

Here’s why: The report contained very little new information. That made it impossible for the news media to make much of it, although it was poised to play the story up big.

The main message of the document is that most Americans don’t get enough exercise even though studies show that every adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week.

But this information was officially reported back in February 1995 in the Journal of the American Medical Assn. and has been common knowledge for some time.

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“I’m pleased to see the report, but it’s not anything that new. We’ve known all this for a long time,” noted Dr. Kenneth Cooper, the Dallas-based fitness guru who has long chided Americans to get off their butts.

Last week’s report also contained no catchy slogans, no announcement of a large commitment of funds or resources for fitness programs. Yes, we know we should be exercising more. But how do we do that if we have arthritis or no time or our parks are unsafe?

It’s time to stop telling us we’re overweight and give us tools for changing our sedentary habits--programs such as the one Dr. Antronette Yancey, a UCLA faculty member, established in parks, churches, community centers and other sites in South Los Angeles to bring exercise to multiethnic groups.

“How do we translate the scientific knowledge into public behavior? We are going to have to value health promotion a lot more,” Yancey said.

Major health organizations are going to do just that, promised Dr. Terry Bazzarre, a staff scientist at the American Heart Assn.

“We’ve put together a very ambitious agenda to work hard on this for the next three to five years,” he said. “We want to put this message out every day. It’s got to be in front of your face.”

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But what the federal government did not do last week despite good intentions (Health and Human Services Secretary Donna E. Shalala even wore a sweat headband) was to get in our face.

There was no visceral image of a steaming Uncle Sam telling us what’s good or bad for us the way former Surgeon General C. Everett Koop looked when he brandished another of his influential reports on smoking and health in the 1980s. He was so authoritative in his military duds. When he said, “Stop smoking,” it had impact.

“I wish I could be optimistic that [last week’s] report will have an impact by coming out of the Surgeon General’s Office, but we don’t even have a surgeon general,” Cooper complained.

And therein lies the rub.

The seat of the once prestigious position is now being kept warm by Dr. Audrey F. Manley, acting surgeon general. There may be no permanent appointee until after the November election.

“If we had a strong Koop-like surgeon general coming out with this report and making public appearances and saying ‘this is important,’ it would make all the difference in the world,” Cooper says.

Surgeons generals’ reports have a history of influencing American health habits. Beginning with the first report on tobacco in 1964 and continuing with the report on nutrition in 1988 that led to more health information on food labels, the document usually catches our attention.

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But this one didn’t.

What we need is to get fired up about exercise.

Bazzarre suggests we should promote a slogan like “Adults need recess too.”

Cooper thinks we should emphasize how many people die each year due to causes strongly tied to being sedentary.

Yancey thinks we need a strong leader and role model to tout the message. “We need someone to step up and say this is important,” she says.

I think we all need someone to look us in the eye and ask: “Do you work out?”

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