You're heading up to the next floor in a shopping mall, and you approach an escalator alongside a staircase. Which do you choose?
If you're like 95% of the people observed by researchers at Johns Hopkins Medical Center in Baltimore, you glide onto the escalator. In our push-button culture, most people automatically choose the path of least physical effort.
Yet ordinary "lifestyle activity"--such as climbing stairs and walking to do errands--can significantly boost health, say public health officials who are campaigning to activate our sedentary, overweight society. In the Johns Hopkins study, published in a recent issue of the Annals of Internal Medicine, signs reminding people that activity boosts health increased stair use by 5% to 7%.
"The sign gave people the added motivation of doing something good for their health," says Yale University obesity expert Kelly Brownell, who performed similar research 20 years ago. In his now-classic study, which has been replicated numerous times, the percentage of stair users tripled when Brownell posted a sign at the "choice point" that read: "Your heart needs the exercise, here's your chance!"
Lifestyle activity is more important now than ever before, Brownell says, "because we live in an increasingly toxic food and physical activity environment."
The reason America is getting fatter isn't laziness or gluttony, Brownell contends, but this toxic environment that encourages consumption of high-fat foods and discourages physical activity.
"Society has long placed responsibility for obesity squarely on the sufferer, when we need to consider our environment as the real cause," he says. "In the past decade, the prevalence of obesity has increased by 25%. Do we have less willpower than we did 10 years ago? Has the gene pool changed in 10 years? No, evolution takes millions of years. We ignore the obvious."
Examples of this toxic environment include:
* Moving walkways, automatic doors, remote controls, drive-through windows and other conveniences that make it less necessary--or possible--to move our bodies throughout the day.
* Fast food is everywhere--schools, convenience stores, gas stations and even some airline flights and hospitals.
* Stairways in new buildings are often hard to find and inaccessible, while in old buildings may be poorly lit and unsafe.
* Deceptive practices allow "voodoo advertising," potato chips trumpeting the fact that they're "cholesterol free" even though they're loaded with saturated fat.
* Food commercials bombard us--the average child sees 10,000 per year, with 95% of them being for candy, fast food, soft drinks and sugared cereals.
* Walking or biking is difficult in many towns, which often have no pedestrian or bike paths.
* Fear of crime keeps many children--and adults--from playing actively outside.
* Portion sizes in American restaurants are large (in most other countries there's no such thing as a doggy bag), and even kids recognize the word "supersize" as a verb.
* Computers make it possible to communicate, shop, play games and socialize without lifting more than your fingers.
Yet despite this enormous environmental pressure to eat junk food and be inactive, Brownell says, "our culture still assumes people are overweight because of personal failings."
That's why he's been lecturing to professional groups on this toxic environment topic in recent years and is writing a book on the subject. The solution, he says, "is to develop a militant attitude about it, like we have about tobacco."
Cigarette smoking is responsible for 500,000 premature deaths annually, he says, while diseases related to diet account for 300,000 premature deaths. His specific proposals include government subsidies for healthy foods, so that they cost less, increasing the cost of "bad foods," regulating food advertising aimed at children and developing more opportunities for people to be physically active.
While these ideas may seem farfetched, he says, "20 years ago if you said we should ban smoking in public places, people would have thought you were crazy. Yet today we recognize Joe Camel as dangerous, but we still think of Ronald McDonald as cute."
The first step in making our toxic environment healthier, he says, is raising awareness about the pressures to overeat and underexercise. "People need to learn how to resist these pressures and demand change," says Brownell. "Most people don't realize how little physical activity they actually get and how important it is for them to use every opportunity they have to be active."
Americans expend about 800 fewer calories per day than our parents did, says Dallas epidemiologist Steven N. Blair, who served as senior scientific editor of the 1996 U.S. surgeon general's "Report on Physical Activity and Health." Much of this is due to our toxic physical activity environment, says Blair, who calls Brownell "one of my heroes."
Societal changes are needed to help people become more active, says Blair, president of the 3-year-old National Coalition for Promoting Physical Activity. City planners need to incorporate walking and biking paths and recreation areas into their designs, he says, and building planners need to make stairways well-lit and accessible.
Individuals also can take action by reducing the amount of time they're sedentary. Blair advises people to figure out how many hours they sit each day, then try to decrease that number by substituting active pursuits, like walking with a friend, for sedentary ones, like watching TV.
And whenever you reach an activity "choice point," he says, choose the path of physical activity and health.
Fitness runs Monday in Health.