Plan takes steps toward reducing obesity
Simple strategy: Take a few more steps, eat a few less calories
DENVER (AP) -- A year ago, Dr. James Hill took a deliberate step to change
fat America: Every day, he declared, people should walk a little more and
eat a little less to prevent weight gain.
It's a deceptively simple strategy to attack a huge and complex problem.
Being overweight contributes to several killer diseases, especially
cardiovascular disease and cancer. Two out of every three people are too
heavy, and kids are growing extra-large at a rate even faster than their
flabby parents.
It was a risky step, too. Hill and his colleagues launched an initiative
called America on the Move with great fanfare but not much scientific data.
Now some early results are trickling in. While far from conclusive, these
initial studies support Hill's idea that walking as little as 2,000 more
steps a day and eating 100 fewer calories will create some good habits to
prevent weight gain. With more exercise, many participants report they
begin to lose weight, too.
Meanwhile, America on the Move has spread from its Colorado origins to
chapters in 20 states with more than 300,000 registered participants. The
nonprofit program also is gathering some big-name corporate and medical
partners, including the Mayo Clinic and American Academy of Family
Physicians.
It's an example of how hungry people are for an easy solution to the
nation's fastest-growing health issue.
"You can't just tell people to triple their physical activity overnight,"
said Hill, who is aiming for 1 million participants. "You have to make
small changes or they will fail."
Hill published his first research paper in the Journal of Physical Review
and Health, a small quarterly launched in January by leading researchers in
obesity and exercise science.
The study used pedometers to track physical activity over a 14-week period
of 298 people at their jobs and more than 100 worshippers at churches in
Denver.
In both groups, about half of the people who reported their daily activity
increased their steps by 2,000 or more steps, which translates to burning
80 to 100 extra calories.
The study's initial phase did not measure participants' weight gain or
loss. Nor did it include a control group with people who did not take part
in the pedometer program. That will come later.
Also, many participants did not consistently track and report their walking
during the 14-week period, leading to data gaps.
Hill acknowledged the shortcomings and described the slow pace of the
research as frustrating. Still, he said, the preliminary results show that
people will stick to regular physical activity programs that are not too
ambitious.
For example, last year the Centers for Disease Control and Prevention
recommended that people walk 10,000 steps a day, or about five miles.
Hill calls that goal "unattainable" considering that most Americans
regularly walk a fraction of that distance. Even in Colorado, the nation's
leanest state, the average person walks fewer than 3,000 steps per day.
Obesity rates here have more than doubled since 1990.
"Government hasn't moved the needle on this issue," said Hill, who is
director of the Center for Human Nutrition at the University of Colorado
Health Sciences Center in Denver. "Using this small change method, we can
increase total physical activity."
Other researchers believe obesity has more to do with an individual's
metabolism, as well as the body's ingrained tendency since prehistoric
times to survive famine by storing fat and conserving energy. Many
experiments are trying to find drugs to effectively curb the body's natural
inclinations or even genetic alterations to change metabolism.
"When it comes to quitting smoking, we've got tons of resources and we
agree on the strategy," Hill said. "But with obesity, we're still arguing
about what to do."
Even without mountains of data, groups nationwide are embracing the
low-tech walking initiative. A national online "pledge" day for people to
try walking more and eating less is scheduled for Nov. 5.
In Indiana, 2,000 members of the state extension homemakers association, a
group that provides continuing education and community service projects,
joined the program in May.
The University of Tennessee plans to subsidize the cost of pedometers for
Knoxville campus employees and is promoting the program during halftime on
its televised football games. And in a friendly challenge between the
state's two senators, Lamar Alexander's staff walked a total of 5.3 million
steps to the 4.1 million steps tallied by the staff of Senate Majority
Leader Bill Frist, a heart surgeon.
In Saratoga Springs, New York, Mayor Mike Lenz has lost 10 pounds walking
3,000 extra steps every morning. The American Society of Family Physicians
is collaborating with America on the Move in a program called Americans in
Motion to launch walking programs for the office staffs of its 93,000
members. If it succeeds, recommendations for their overweight patients
would follow.
In Denver, Colorado, the pharmacy in the city's central public hospital is
stocking pedometers so that physicians can prescribe them, reducing the
cost for insured patients.
In Rochester, Minnesota, Hill's team is creating a worksite walking program
at the Mayo Clinic headquarters this fall.
Not everyone has joined. The program contacted McDonald's, which instead
launched its own "Go Active" salad meals with a pedometer and exercise
booklet last May.
Blue Cross and Blue Shield, the largest health insurance network,
established WalkingWorks, urging 89 million subscribers to wear pedometers
and take a brisk walk everyday. It suggests adding 500 steps every two
weeks until you are walking 10,000 steps.