When Lifestyle Becomes a Deathstyle
and Nobody Seems to Care

by Dr. Martin Collis

People in North America are committing sedentary suicide. I receive almost daily information about the deadly double whammy of inactivity and careless food consumption. We know what's happening, we know it's costing billions and billions of dollars and causing untold misery, we know the solutions and yet we seem to lack the political will at almost every level to address the problems. We also seem to lack the personal will to take matters into our own hands and move.

In December 2001 the Surgeon General of the U.S. released a report stating that the epidemic of overweight and obesity is threatening to wipe out the gains made by other medical advances. "In 1999 an estimated 61% of U.S. adults were overweight. Obesity among adults has doubled since 1980, while overweight among adolescents has tripled. Less than one-third of Americans meet the federal recommendations to engage in at least 30 minutes of moderate physical activity at least 5 days a week, while 40% of adults engage in no leisure-time physical activity at all." The following figures from the Center for Disease Control vividly illustrate the speed and inclusiveness of the spread of obesity and overweight in the last decade of 2000.

The picture is similar in Canada with children and adults getting fatter and less active year by year. I don't have a graphic province by province picture but analysis of national surveys reveals a familiar pattern. The following graph shows the increase in obesity in Canada for adults and children in the 15-year period between 1981 and 1996.

It's worth noting that people don't plan to get fat and unfit. They don't go to college courses on how to get Type 2 diabetes or how to increase their vulnerability to heart disease, cancer and hypertension. They are learning their death-styles from the relentless advertising of the multinational corporations. They learn to supersize their meals, they learn not to miss 'must watch t.v', they learn there are emails and special offers to respond to on their computers and that there are superstores to drive to. They learn to live a life for which their bodies and minds were not designed.

If fatness were a communicable disease there would have been billions of dollars spent to deal with the epidemic, but the fact that it is largely related to inappropriate choices seems to draw little interest from politicians and school administrators. Writing in the Ardell Wellness Report E-AWR #108 Don Ardell had the following observations about political and institutional support for fitness. "It's discouraging that we have lost nearly all the support for fitness that was in place decades ago. For example, many do not realize that fitness was once important enough for presidents to lead the way. President Eisenhower established the President's Council on Youth Fitness; President Kennedy broadened the mandate of the Council to become the President's Council on Physical Fitness and Sports (PCPFS) and for a while things were going well. Thirty two states had Governor's Councils on Physical Fitness and Health, worksite health and fitness programs were in place and two national organizations promoted healthy lifestyles, namely, the National Association of Governors'Councils on Physical Activity and Sports and the American Association for Fitness in Business and Industry. Even the feds had their own fitness and health program called the Federal Interagency Fitness and Health Council (FIFHC). All this is basically gone now. The President's Council is down to four employees, most of the other organizations mentioned are gone, or drastically reduced and underfunded, and only the State of Illinois still requires fitness in the grade schools."

I was interested to see whether President Bush would recognize the significance of the problem in his recent State of the Union address. When I last spoke to Dr. Kenneth Cooper, just before the election, he told me that if George Bush were elected he would be the fittest president he had tested. His physical fitness has probably served him well in challenging times, but unfortunately the fattening of America didn't make it on to the Presidential agenda for his address on January 29th. To paraphrase Shakespeare 'There's something rotten in the states of the States' (Not to mention Canada). The danger lies not just in other lands, in the form of rogue regimes and fanatical terrorists. A nation's might and sense of purpose can be quietly eroded from within by an overfed, underexercised populace.

I've always liked the writing of Rudyard Kipling and can remember the essence, though not the exact wording, of one of his poems.

Nations have passed away and left no traces.
And history gives the single cause of it.
In different times and many different places
They failed because their people were not fit.

Canada reflects the same type of blinkered thinking. Federal funding for the superb Participaction organization has been reduced to such a paltry level as to make it inoperable. (In response to the public outcry I wouldn't be surprised if the feds do come up with some face-saving dollars.) The Federal Government Department of Fitness Canada has long since disappeared, as have numerous other Federal and provincial fitness initiatives. In my own province of British Columbia there used to be more than 20 supervisors of physical education to service all the major school districts, today there are none. Physical education is no longer required in grades 11 and 12 and the Quality Daily Physical Education concept is fighting a losing battle in many school districts.

It's almost an Alice in Wonderland situation in which the costs of inactivity are threatening to bankrupt health care plans, and yet governments withdraw funding and support for fitness and physical activity. The purse strings can be loosened to treat the sicknesses that result from inactivity, but not for programs of prevention or high level wellness.

There's an old poem about people falling over a cliff and being killed or badly injured. The final verse goes as follows:

'The people said something would have to be done.
But their answers did not at all tally.
Some said put a fence round the edge of the cliff,
Some, an ambulance down in the valley.'

Right now we are spending over 90% of our health care dollars on "ambulances down in the valley" when fence building is the only practical solution. As an example, type 2 diabetes is closely linked to lifestyle and the cost of treatment in Canada is currently estimated at $10 billion with an expected doubling in the next ten years. Extrapolating from these figures, the cost of diabetes in the U.S.A. will currently be in excess of $100 billion with more to come as the nation continues to get fatter.

Even the conservative, bottom-lined focussed Wall Street Journal is aware of the problems associated with inactivity. In May 2000 they issued a 20-page report headed by the following statement.

In the Fall edition of 'Well' I reported on the work of econometrics company Health Management Associates in estimating the fiscal impact of a sedentary lifestyle on the states of New York and North Carolina. They wrote, "Overall, the combined $5 billion cost estimate for physical inactivity in N. Carolina and New York is very conservative, perhaps only one third to one fourth of the actual cost of all types of medical claims associated with inactivity."

Whether the total cost of inactivity in North America is $200 billion, $300 billion or $400 billion it's an obscenely high figure and money is just the measurable side effect of the problem. What is less easy to calculate is the misery, sickness, pain, stress, family upset and overall diminished performance associated with hypokinetic (lack of movement) disease. The frustrating factor is that so much of the financial cost and mind/body misery is preventable.

Better to run in fields for health unbought.
Than fee the doctor for nauseous drought.
The wise for cure on exercise depend
God never gave his work for man to mend

John Dryden

Solutions

In a brief article we can't deal with all the dimensions of fitness, so let's stay with the Surgeon General's recommendation of 30 minutes of activity/day.

It is vital that anyone who wants their body/mind to function well sets aside at least 30 minutes each day for purposeful exercise. That is about 1/50th of each 24 hour period. If you feel you're too old, too embarrassed, too busy, too tired, or too committed to find 1/2 hour in a day to look after the needs of your body/mind take a careful look at your priorities and life balance. (Incidentally, TOO is a blocking word for Totally Out Of the question.) Try not to TOO yourself out of exercise. If you think you're too old look at Mavis Lundgren who did her 1st marathon at 70 years of age, and is shown here with my friend Mike Suminski, ready to start her 62nd marathon at age 92 1/2.

10,000 Steps

There is an intriguing program called "10,000 Steps" in which taking 10,000 steps becomes your target each day. One thing we quickly discovered at Speakwell is that doing10,000 steps takes considerably more than 30 minutes. We tended to walk at about 120 steps/minute giving us 3,600 steps for each 1/2 hour. This leaves another 6400 steps to be found during the rest of the day. Which is a lot. To attain 10,000 steps it seemed more realistic to do one hour of purposeful walking leaving only about 3,000 for the rest of the day's activities. The 10,000 steps concept points out that you can accumulate the benefits of physical activity throughout your day. You might get 3,000 to 7,000 steps by purposeful walking from 1/2 to 1 hour, but need to find other movement opportunities during the day. Try to build some activity into your daily commute, use stairs whenever possible (I count each riser as 3 steps), walk rather than sit while waiting at airports, look at physical tasks as exercise opportunities rather than inconveniences.

Have a look at the slideshow that explains this in more detail. (Slides courtesy of leading epidemiologist Dr. Stephen Blair of the Aerobic Institute in Dallas.)

In caloric terms you burn approximately 50 calories for each 1,000 steps which means 10,000 steps makes a 500 calorie difference in your day, in addition to giving you a good cardiovascular work out. A good rule of thumb is:

5,000 steps - minimum acceptable level

10,000 steps - health maintenance/enhancement

15,000 steps - health enhancement and weight loss if combined with some caloric restriction

When walking, I often think it's like having 3 hearts, 1 in your chest and 1 in each leg, gently assisting the circulation with every step. Walking is a mind clearing, stress reducing, energizing activity. To walk you don't need expensive equipment, you don't have to pay membership dues, there's no need for special clothing, you can do it almost anywhere and any time and, unless you're really clumsy, you tend not to get injured. The rhythmic, meditative aspect of walking can make it a wordless religion.

Counting steps is not a problem with the use of a pedometer. At Speakwell we've been road-testing some pedometers and find them functional and very reinforcing. I am currently wearing a matchbook-sized pedometer which registers steps, calories and distance traveled. Even on busy days and travel days I have a non-negotiable minimum of 10,000 steps which, on a couple of occasions, has prompted a few late night circuits of my house or hotel. If you'd like to own a pedometer contact us at Speakwell (email mcollis@speakwell.com or phone toll free 1-866-721-6940) where we can get one for you or point you to a supplier. For information about walking check out http://walking.about.com/ and for information about the 'Walking Counts' program check out http://walkingcounts.com/home.html. For a free 'Walking Connection' internet magazine check out http://www.walkingconnection.com/.

Recent issues of the Berkeley and Tufts newsletter (see 'Some of our Favorite Things' article in this issue) both referred a study that appeared recently in 'Circulation.' Doctors at the University of Texas re-tested 5 men whom they had previously tested 30 years earlier. Not surprisingly, the men had gained weight and were less fit. The men, now in their 50's, were given a 6 month exercise program in which they could choose from walking, jogging and cycling. Over the course of 6 months they worked up to about 4 1/2 hours training a week, almost 40 minutes/day. The result of this fairly modest training enabled the men to recover 100% of their age-related decline in cardiovascular fitness.

In the original study in 1966 the subjects were given 21 days complete bed rest to see its impact of health and fitness. The 3 weeks bed rest proved to be more detrimental to their cardiovascular fitness than 30 years of aging.

YOU MUST FIND TIME TO MOVE.

In the words of the Eagles, "Did you get tired, or did you just get lazy." We've become lazy, and we are paying a high price.