By now, we’ve all heard of the enormous benefits of physical exercise and activity to health and well being, including lowering the risks of coronary artery disease, stroke, diabetes, high blood pressure, and even depression. Weight loss and physical activity have gained tremendous media attention in recent years, with shows like The Biggest Loser showing dramatic personal transformations. However, in the October 2010 issue of American Journal of Preventive Medicine, two studies demonstrate how few Americans engage in regular vigorous activity and that little progress has been made over the last decade.
Catrine Tudor-Locke et al. present the results of the American Time Use Survey. This is a telephone-based survey performed by the Bureau of Labor Statistics. It asks people all of the activities they do on a given day and how much time is involved in each task. The study looks at all activities outside of work and sleep and then determines the intensity of the most frequent activities performed by Americans.
Eating and drinking were the most common sedentary activities, with watching television and movies not far behind. Among the top light-intensity activities were driving a car or truck and personal grooming, including washing and dressing. Food and drink preparation was the most commonly reported moderate-intensity activity. The most commonly reported vigorous activity was using cardiovascular equipment for exercise. What is most surprising about the American Time Use Survey is that overall only 5.07% of the respondents reported doing any vigorous-intensity activity on any given day.
In the second study, Susan A. Carlson et al. reviewed the data from the 1998- 2008 National Health Interview Survey to estimate what percentage of the population meets the 2008 Physical Activity Guidelines for Americans. The Guidelines, released by the US Department of Health and Human Services, offered recommendations at certain levels to attain certain health benefits. In order to decrease the risk for premature death, stroke, coronary artery disease, hypertension, and type 2 diabetes, the 2008 Guidelines recommend that adults engage in at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity activity per week. For increased health benefits, including decreasing the risk for colon and breast cancer and preventing weight gain, adults should participate in more than 300 minutes of moderate-intensity activity or 150 minutes of vigorous-intensity activity per week. It also recommends that adults perform muscle-strengthening activities two or more days a week for bone and muscle health.
Unfortunately the results of this study are not encouraging. In 2008, 43.5% of American adults were considered aerobically active, with only 28.4% considered highly active. Only 21.9% achieved the muscle-strengthening guidelines of two or more days of muscle-strengthening activities per week. Finally, only 18.2% of American adults met both the muscle-strengthening recommendations and the criteria for being aerobically active.
Certain demographic groups were more likely to be considered physically active according to the survey. Males, younger adults, non-Hispanic whites, adults with higher levels of education, and adults with lower BMI were more likely to be aerobically active, while women, older adults, non-Hispanic blacks, and adults with lower levels of education were more likely to be less active. (And despite Charleston being what I consider a fairly active city – at least judging by the huge numbers of people you see running and biking over the Cooper River Bridge everyday – the South has much room for improvement. In this study, 41.3% of adults from the South fell into the inactive category.)
I don’t really know where to start in order to summarize these two articles. The benefits of physical exercise have been documented in so many research studies and discussed so frequently in the media that I almost feel no need to repeat them in this post. I don’t think there’s any question about regular cardiovascular exercise helping to decrease high blood pressure, type 2 diabetes, coronary artery disease, and other major medical issues. Muscle-strengthening exercise has been demonstrated to increase bone density, which can decrease the chance of falls and fractures.
While I’m not a public health expert by any means, I do feel that physicians, insurance companies, and employers can do more to improve these statistics. First of all, I feel that overall patients still trust and respect their doctors, so encouragement from physicians to get their patients started on physical exercise programs is essential. The benefits of exercise to overall health, which likely can lead to decreased numbers of sick days by employees, should encourage employers to help with the costs of exercise programs for their employees. Just off the top of my head, it seems like employers having a gym in their facilities, bringing in physicians or other health and wellness speakers to promote healthy lifestyles, or even giving salary bonuses for employees who achieve certain physical exercise goals could all be beneficial ideas. Finally, insurance companies could offer discounts based on minimum guidelines for physical exercise. While such an idea might be difficult to administer, some insurance companies are already levying penalties and increasing insurance rates for what is considered unhealthy behavior, such as smoking. Regardless, I think these studies should be seen as wake-up calls to adults in the United States.