Tuesday, June 3, 2003

What you eat and whether you exercise are strictly private decisions. Or are they? What Americans may not realize is that public policies have helped engineer active living and sensible eating right out of American life. Now, there's a new move afoot to engineer them back in.

Here are seven inter-linked ideas, plans and programs that could change U.S. society into one where daily physical activity and healthier eating are promoted and supported. These changes, experts say, would take 10 to 50 years to have a real impact.

CULTURAL
Old idea: If you aren't thin and fit, it's nobody's fault but your own
New idea: We're all in the same boat - and it must be turned around.
Emphasize vigorous activity in daily life rather than separate exercise time.
Encourage citizens to demand communities that make it a pleasure to be active.
Address time-management issues that lead to sedentary living and poor cooking and eating habits.
Keep encouraging people toward living actively, not perfect bodies.
Spread messages that public policy changes today will benefit future generations even if they won't make you personally fit into a size 6 by next Tuesday.

For more information: U.S. Centers for Disease Control, www.cdc.gov; Healthy People 2010, www.healthypeople.gov; International Obesity Task Force, www.iotf.org.

FOOD
Old idea: Lots of unnutritious food at low prices.
New idea: Lots of opportunities for Americans to eat better.
Label fast-food packages so shoppers know how many calories they're consuming.
Publicize the redesigned food pyramid, due out in 2005.
Work with the food industry to inspire new "reality sized," smaller portions and good-tasting healthier alternatives to popular snacks.
Use small tax on "junk" food to pay for promoting fruit and vegetables.
Get healthier food into markets and food banks in low-income neighborhoods.
Disallow the use of food stamps for junk food.

For more information: U.S. Department of Agriculture, www.usda.gov; Center for Science in the Public Interest, www.cspinet.org.

FITNESS
Old idea: Nag Americans to exercise.
New idea: Help Americans to get active daily lives.
Expand state or federal tax breaks for fitness or weight-loss programs.
Do more to publicize good programs already in place.
Influence insurance industry and employers to give active employees lower rates on health insurance.
Increase physical education programs in schools by funding local or state initiatives.
Keep promoting daily exercise for Americans, but stop confusing the public on how much is needed.
Get Americans to buy into moving 10,000 steps a day during the course of their daily activities.

For more information: National Coalition for Promoting Physical Activity, www.ncppa.org; PE4Life, www.pe4life.org; President's Council on Physical Fitness, www.fitness.gov; CDC State Based Physical Program Directory, apps.nccd.cdc.gov/DNPAProg/; Internal Revenue Service Publication 502 Tax deduction for weight-loss programs, www.irs.gov/pub/irs-pdf/p502.pdf.

HEALTH CARE
Old idea: Don't say too much to patients about fit/fat issues.
New idea: Don't just say something - do something.
Educate doctors to help patients with weight and fitness issues, and give them the tools to do it.
Spend more money on health promotion research to find out what works.
Research whether constant follow-up techniques used to help people stop smoking would work with diet or fitness.
Get doctors to think about taking a community approach, especially if success with individual patients is low and frustrating.

For more information: ClinicalTrials.gov of the National Institutes of Health, www.clinicaltrials.gov/ct/gui/action.htm; American Obesity Association, www.obesity.org; North American Association for the Study of Obesity, www.naaso.org; National Center for Chronic Disease Prevention and Health Promotion, www.cdc.gov/nccdphp/dnpa/index.htm

EDUCATION
Old idea: Nutrition and fitness starts at home.
New idea: Put nutrition and fitness back on the report card.
Banish vending machines in schools, but help schools replace the money they lose.
Reward schools that improve nutritional offerings.
Redesign federally funded child nutrition school lunch program.
Encourage more gardens at schools in moderate climates.
Encourage states or localities to value physical education as much as academics and mandate it daily for lifetime fitness.
Develop safer routes to school to encourage kids to walk or bike to schools.
Develop sensitive, effective obesity intervention in schools.

For more information: American School Food Service Association, www.asfsa.org; U.S. Dept. of Agriculture Child Nutrition Division, www.fns.usda.gov/cnd/; National Gardening Association school gardens list, www.kidsgardening.com/School/searchform.asp; National Coalition for Improving Safe Routes to Schools, www.saferoutestoschools.org

TRANSPORTATION
Old idea: You can drive there.
New idea: You can walk, bike ... or drive there.
Stop building roads that encourage urban sprawl.
Make walking paths with a destination so they can be used daily, not just for recreation.
Make traffic patterns and street design friendly to both vehicles and pedestrians.
Put a greater proportion of federal transportation dollars into funding mass transit, pedestrian and bike transit to encourage active movement.

For more information: Surface Transportation Policy Project, www.transact.org, Association of Pedestrian and Bicycle Professionals, www.apbp.org

ZONING/CITY PLANNING
Old idea: Nice neighborhoods are far from cities, retail and businesses.
New idea: Businesses are in nice neighborhoods.
Change zoning laws to allow for residential and commercial building, so people can live near where they work and walk to stores and amenities near where they live.
Make new housing developments and cities pedestrian-friendly and gradually retro-fit old suburbs and cities.
Change zoning laws to corral and curtail urban sprawl.

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