A Big Fat Crisis (28 page)

In the United States, garnering support to invest in parks is challenging because local resources are limited. The tug-of-war between “We’re all in this together” and “You’re on your own” plays out in local politics—with “You’re on your own” prevailing in economic downturns. Generally, the public has a favorable view of parks and recreation, but funding them often seems to be considered a luxury, secondary to other services like police and education, rather than an investment in health and well-being. Furthermore, the health benefits from increasing physical activity would be accrued by individuals, their employers, and insurance companies, and not directly by the departments whose budgets would be most affected.

Nevertheless, getting people to be active in the park may not cost a lot of money. I recently completed a study in which we tried to get
parks to expand their outreach and marketing to encourage more people to engage in physical activity. We offered a few training sessions and a small incentive of $4,000 to each park that was serving an average of forty thousand people in a one-mile radius. We found that just putting up banners and signs letting people know that something was going on at the park resulted in more people engaging in moderate-to-vigorous activity within the park. The impact was very cost-effective, and we estimated it helped hundreds more people to exercise in parks every week.

Even when municipal funds are limited, there are many businesses, community-based organizations, and faith groups that might be willing to partner with parks to support more physical activity programs and events. In addition, lots of people may be willing to volunteer to run free exercise classes. I was very surprised to find out that nearly all the exercise classes at my local YMCA are taught by volunteers. Why couldn’t we organize this type of system in public settings to supplement existing services?

Activating parks will likely yield multiple benefits beyond physical activity. When more people are out, the parks become safer. Neighbors are more likely to meet one another and have the opportunity to interact in a relaxed and fun atmosphere. Such interactions can promote familiarity and tolerance, and can help build what has been called “weak ties”—relationships that support sharing beneficial information without the burden of heavy obligations.
²²
For example, many people hear from casual acquaintances about job opportunities, events, programs, or services that might meet their particular needs, but they would not be expected to owe any debt for receiving this information.

Another promising approach to leisure-time physical activity is through novel events and happenings that draw people into the streets, where they can be active. Street fairs, concerts, dances, and
ciclovías
—bicycling events scheduled when streets are closed to automobiles—attract tens of thousands of people to take to the streets and become physically active.

In Bogotá, Colombia, the main streets are closed every Sunday, and two million pedestrians and bicyclists (30 percent of the population) come out to play. Stages are set up in city parks, and aerobics instructors,
yoga teachers, and musicians lead people in exercise and dance across more than 120 kilometers of car-free streets.

Wherever
ciclovías
are held in the United States, thousands participate. The main problem is that such events are few and far between, and no city has yet been able to match the weekly
ciclovías
of Bogotá. The demands on police and traffic safety professionals make weekly or even monthly
ciclovías
difficult and expensive. But their success suggests that we must develop cost-effective solutions so they can become a regular feature of city life. And we may find out that over the long run, getting the population active is actually worth whatever it costs to make it happen.

One of the most revealing events demonstrating the role of novelty in increasing physical activity was
The Gates
exhibit in New York City’s Central Park during the winter of 2005. The artist Christo draped a series of bright orange banners over twenty-three miles of walkways, creating an amazing and glorious sight. The installation attracted four million visitors to the park, about four times the usual number, and they walked through Central Park in the dead of winter, with snow and ice on the ground.

Did the visitors think they were just going to get some exercise? Probably not. They just wanted to be part of something that was unique and novel. Did they get exercise? Definitely.

Mitigating the Harms of Sitting in All Venues

The entertainment industry dominates leisure time in America, with most people watching television or videos upwards of four hours per day.
²³
If we believe that worksites should mitigate the harm from sedentary jobs, shouldn’t we expect the entertainment industry to also mitigate the harm it might contribute to? Should there be an exercise break during all spectator events? If a movie makes you sit for two hours, shouldn’t there be an intermission midway to allow people to stretch and move? Should television broadcasters build in a ten-minute break with an exercise or Instant Recess video transmission every two hours? Why not?

Certainly, the more reminders we have to exercise and move, the
more we are likely to do it. Right now television reminds us to eat and drink several times an hour, even though we have built-in hunger and thirst mechanisms that would no doubt take care of the situation. We really don’t need any special reminders to eat. But we do need reminders and cues to exercise, because we have no inherent internal signals that stimulate physical activity.

Physical Activity in Finland

Finland is one of the few Western countries where physical activity has been increasing substantially over the past thirty years. This is despite its extreme weather conditions, with only six hours of daylight in the winter and temperatures below freezing for five months of the year. In Helsinki, it rains or snows about 175 days a year—almost every other day. Yet somehow, its citizens are very active and often commute to work and school by foot or bike, and engage in sports and exercise frequently in their leisure time—all year round.

Finland’s success is partly attributable to the deliberate steps taken by the central government since the 1970s, when it developed a National Sports Council that had some clout with respect to policy and resources.
²⁴
In 1980 the government mandated that every municipality elect a Sports Board to oversee the planning of physical activity services and maintenance of sports facilities. In 1981 there was a mandate to hire a manager to develop services for people with disabilities to engage in physical activity.

Almost twenty years before Michelle Obama launched “Let’s Move” to prevent childhood obesity in the United States, Finland initiated a “Finland on the Move” campaign on behalf of all its citizens to support local physical activity projects with seed money.
²⁵
Rather than focus only on children, the government also developed “Fit for Life” in 1999, a program targeting adults over age forty, and subsequently expanded this to target seniors as well.

Furthermore, a lot of attention is paid to the construction and maintenance of sports facilities there. There is one physical activity site for every 176 Finns, and these are used by 90 percent of the population. There is one public swimming pool for every eighteen thousand
citizens, and they are used by 70 percent of the population. Few Finns report barriers to exercise, like distance or lack of money.

In my studies of park use, where we surveyed residents who lived within a half mile of their neighborhood park in Albuquerque; Philadelphia; Los Angeles; Chapel Hill, North Carolina; and Columbus, Ohio, the percentage who
never
visit it ran between 40 percent and 60 percent.
²⁶
In general, about half our citizens don’t know what programs or facilities are available in our local parks.
²⁷

The way to increase leisure-time physical activity in America is, in large part, to help people take advantage of opportunities and facilities that already exist in their local communities and by developing and promoting “happenings” like the
Gates
exhibit along with interesting programs and events on a regular basis.

In general, we should not expect everyone to spontaneously exercise on their own, as if the conditions they live in had no influence. Instead, we should dedicate more resources to change the conditions that keep us sedentary.

12

In the Meantime: What Individuals Can Do

Until all the necessary impulse control policies are in place and all the grocery stores and restaurants stop encouraging customers to buy food that increases their risks of chronic diseases, individuals still have to face the onslaught of foods and food cues that lead them to eat too much. Not only was Rome not built in a day, but it took a hundred years before we had solid alcohol control laws and more than fifty years before we started making progress on tobacco control. It is certainly going to take time to create a groundswell of support for widespread regulation of food sales and harmful marketing practices. So what can we do in the meantime?

Here is my advice:

       
1)
  
Don’t go out to eat.

       
2)
  
Don’t go into supermarkets.

       
3)
  
Stop watching TV.

       
4)
  
Spend your leisure time in a park.

Right!

This is highly unlikely to work for any but the most fanatical. Not
everybody wants to make avoiding the food environment a centerpiece of his or her life. Not everybody has the inclination to cook every night. Not everybody lives near a supermarket with delivery service.

Dieting has been the mainstay of our approach to obesity for decades, though its general failure for the majority of people should make us question its efficacy. Many dieting behaviors that are believed to protect us from eating too much don’t hold up to scrutiny. For those who have already tried dieting without success, I would not recommend going that route again. There are many reasons why dieting fails, and often it makes some people even fatter.

The Problem with Dieting

One difficulty we might face when trying to reduce food intake is trying to limit our thoughts about food. It may seem like a good idea when we go on a diet to avoid thinking about food, because when we start thinking about food, we typically end up going to the refrigerator or the store to get something to eat. As sensible as it seems to try not to think about food, this is a very big mistake. The moment we try to forget about food, it seems that it’s all we can think of. This phenomenon has been dubbed the “ironic process of mental control” by researcher and professor Daniel Wegner of Harvard University, who has devoted quite some time to understanding why, when we are asked not to think of a polar bear, that’s exactly what we think of.
¹
If only someone hadn’t told us
not
to think of a polar bear, the image would never have crossed our minds.

Wegner noted that people have deficiencies in their ability to control their mental activities, and our conscious thoughts are often the opposite of what we really want. Again, the dual system of effortful and automatic processing comes into play. It takes a lot of effort not to think about something because we have to distract ourselves. But our automatic processing system constantly checks our consciousness to determine if we have achieved our goal.

We are wired to be hard on ourselves, to notice mistakes, so we can strive for perfection. Studies of brainwaves indicate that a specific release of “event-related brain potential” occurs when we make mistakes.
It occurs only one-tenth of a second after the onset of electric activity of the muscle that is about to make the mistake—indicating its automaticity and our inability to stop ourselves from checking for errors. When our goal is to avoid or ignore something, our monitoring system is looking for the exact thing we are trying to forget, which makes forgetting impossible.

Being on a diet increases our sensitivity to food cues. Some begin to notice foods they otherwise would have ignored. Thus dieters become “restrained” eaters, and resisting food may become increasingly difficult to the point where they are more likely to lose self-control than if they had not been trying to diet.

Can Eating Slowly Help Reduce How Much We Eat?

One typical piece of advice about dieting is to take smaller bites and eat more slowly. Eating more slowly is supposed to enhance the taste and enjoyment of food and increase the ability to feel full, which may otherwise be delayed until one has already eaten too much. Some believe that eating slowly will help obese people feel satisfied with smaller amounts of food.

This advice was examined in a laboratory setting by Dr. Theresa Spiegel and her colleagues in 1993.
²
She invited nine obese women and nine lean women to participate and told them the purpose of the study was to observe their reactions to the taste of food to be provided in a lunch meal under different conditions. The researchers hooked up electrodes to the chewing muscles of the women’s cheeks so they could precisely count the chews and measure the speed of eating.

The food the women were given consisted of tuna or turkey rolled in a piece of bread and sliced like sushi rolls into pieces weighing five, ten, or fifteen grams. They were also given bite-size pieces of bagels and cream cheese. The five-gram pieces were relatively small bites, but the fifteen-gram pieces were a big mouthful. Ten grams was considered the most comfortable size to put in the mouth. Each person was given a plate of twenty pieces, a cup, and a pitcher of water. The women were instructed to eat and drink as much as they wanted; but whenever they took any food, they were instructed to put the whole piece in their
mouth at once. This way the scientists could differentiate between big and little bites. The scientists then analyzed the rate of chewing, the time between bites, and the total amount of food consumed.