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Walk to School Day, Scituate, MA Fighting the Epidemic No One is Talking About! A.A.A.S. Understanding Obesity and Childhood Nutrition Town Meeting Boston,

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Presentation on theme: "Walk to School Day, Scituate, MA Fighting the Epidemic No One is Talking About! A.A.A.S. Understanding Obesity and Childhood Nutrition Town Meeting Boston,"— Presentation transcript:

1 Walk to School Day, Scituate, MA Fighting the Epidemic No One is Talking About! A.A.A.S. Understanding Obesity and Childhood Nutrition Town Meeting Boston, MA Feb. 2008

2 My comments: Restating the problem and brief rant about the epidemic. Answering, How much is enough? Overcoming the stickiness problem. Creating stickier schools. Hear from you!

3 US Obesity Epidemic Ogden et. al. (JAMA 288, 14; Oct. 2002) Americas looming chronic disease apocalypse...

4 Supersize Me?

5 Diabetes Prevention Program (DPP; New.Eng.J.Med., Feb. 7, 2002) Compared three treatments for nationwide cohort (3,000+) at risk for developing diabetes (elevated fasting glucose). 1.Control: Standard exercise and nutrition counseling; placebo. 2.Standard plus drug treatment: Metformin 3.Intensive lifestyle change: Nutritional training, 150 min./week physical activity.

6 Diabetes Risk Reduction (Diabetes Prevention Program; NEJM, Feb. 7, 2002)

7 A thought: Change the conversation. Its not just an obesity epidemic. Its an epidemic of physical inactivity and poor nutrition.

8 My somewhat unique perspective...

9

10 How much physical activity is recommended by the US Surgeon General for adults to reduce risk for chronic disease and an early death? min. at least 3 days a week min. every day min. at least 5 days a week min. at least 4 days a week min. at least 3 days a week min. most days of the week

11 The Activity Diamond Health: 30 min. a day. Fitness: 20+ min. hard, 3+ days. Weight loss: 60+ min., 5+ days. ACSM fitness recommendation, USDA Dietary Guidelines, Surgeon Generals Report on Physical Activity & Health, 1996.

12 Physical activity recommendation for adolescents: (Pediatric Exercise Science 6(4), 1994) Physically active every day as part of lifestyle (at least 60 minutes, variety, moderate intensity). Some vigorous activity; at least 20 minutes, three days/week.

13 For a pedometer-wearing adult, how many steps per day are recommended for long term health? 1. 5, , , , , ,000

14 20% Boost Pedometer Approach From Pedometer Walking by Fenton & Bassett (2006) < Like this, level and in line with the knee. Not like these. > Wear your pedometer all day, every day:

15 SMTWThFSa 20% Boost Pedometer Approach From Pedometer Walking by Fenton & Bassett (2006) Key to Success: Keep a record!

16 SMTWThFSa 3,2543,7593,5884,5062,1273,9018,316 20% Boost Pedometer Approach From Pedometer Walking by Fenton & Bassett (2006) Total = 29,451Daily average = Total / 7 = 4,207 Daily average x 1.2 = 5,048 5,048 = Next weeks daily goal!

17 How many steps? Health: ~10,000 steps/day. Fitness: 3,000 steps fast. Weight loss: ~12-15,000 steps/day.

18 Have you experienced any of the following examples of the stickiness problem in your life? (pick for yourself or someone close to you) 1. Joined a health club, but dont go often. 2. Bought a treadmill or bike, but dont use it much. 3. Joined walking program, but stopped walking when program ended. 4. Signed up for walk/run event; didnt keep at it. 5. Lost 10 pounds, but gained it back. 6. Got a Wii; now family spends more time inside.

19 Exercise Participation Study Effect of Short Bouts, Home Treadmills (Jakicic et.al., JAMA 282, 16) ?

20 First 6 months: Prizes, reminders, support. Months 6-18: Subjects left to their own devices.

21 Self-help vs. Commercial Weight Loss Programs (Heshka et.al., JAMA 289, 14; April 9, 2003)

22 Did these people exercise? Its about dramatic decreases in routine, daily physical activity! Lowell Natl Hist. Park, Lowell, MA Plimouth Plantation

23 So, what makes stickier places? Answer yes to four questions: Destinations within walk & bike distance? Sidewalks, trails, bike lanes, crossings? Inviting settings for routine activity? Is it safe?

24 Stickier for kids: Safe Routes to School. Engineer safer facilities; sidewalks, paths, crossings. Educate for safe bike, pedestrian, & driver skills. Enforce safe speeds, better behavior, pick-up/drop-off. Encourage. Walking school busses, bike trains. Walks at school: before, after, & recess. Evaluate and improve.

25 Speed table, Berkshire St., Cambridge

26 Which of the following would you most favor implementing in your school or community? 1. Rewards for walk, bike, transit to work 2. Walking school buses 3. Improved sidewalks, pathways, bike racks 4. Warm-weather clothing donations for kids 5. No withholding recess as a punishment 6. Build physical activity into curricula 7. Physically active field trips 8. More regular PE classes 9. Reverse lunch and recess 10. Extending the school day

27 Massachusetts pilot program: Extended Learning Time schools. 19 E.L.T. schools in 2007, lengthening day by about 90 minutes. Increased contact time; project based, hands on learning. More time for exploration: languages, electives, art, music, drama. More planning, collaboration, advising. Schedule flexibility for PE, recess, physical activity in the curriculum.

28 Are you in favor of increasing the program of extending the school day by 60 to 90 minutes (now a pilot program) to more schools in Massachusetts? 1. Yes 2. No

29 Stickier Communities Sticks: Costly parking & roadway fees, congestion charges. Transportation carrots: Underwrite transit, improved, sidewalks, crossing, & bike lanes, worksite incentives (e.g., health insurance discounts).

30 Which of the following cutting edge policies would you most favor for the city of Boston to enhance physical activity in the population at large? 1.Improved open space, parks, & playing fields 2.Performance based health insurance 3.Reduced or free transit for active commuters 4.Increased parking costs 5.Privatize major roadways (e.g. tolls) 6.Peak hour congestion charges 7.Adopt a complete streets policy 8.More pathways, bicycle parking, safety education 9.Reduced price health clubs

31 School board Planning & Zoning Parks, Recreation Historical Society Public Health & Safety Chamber of Commerce Economic Development Neighborhood Associations Conservation Commission Get out of the comfort zone, attend other meetings, learn, & speak up! Bridgewater T station

32 Build activity into your life (esp. walk & bike). Invite others; get people to simply move. The simple prescription? Make your community activity-friendly.

33 Why it really matters...


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