27 May 2013

HEALTH - When It Comes to Exercise, Let's Move More Than Our Lips!















So here’s the thing: when it comes to physical activity, we seem to move our mouths more than our feet. But talking about physical activity is not established as a health-promoting form of exercise. So, really- let’s move! And in particular, let’s move our kids.
The immediate stimulus for this column is a new report by the Institute of Medicine advising that all kids gets 60 minutes of moderate to vigorous physical activity daily. The report calls for at least half that total during regular school hours, and asks that schools make the rest available after hours.
We could, I suppose, merely welcome the report as a timely dose of good sense based on good science, nod our heads, and voice our platitudinous support. But I’m not inclined to do that. Maybe I’m just cranky because my wife was away from home visiting family in France this past week while I tried to keep hearth and home from falling apart in her absence. Or maybe I’m just getting to be too much of a curmudgeon to put up with cycles of well-intentioned chatter, leading nowhere.
Did we really need another report to tell us that our kids need and deserve daily physical activity? Do we have any reason to think another report is why it will actually happen this time?
On the first of these, the answer really should be a decisive “no.” This IOM report is only just icing on a well-baked cake of devilish details, long known and reliably established.
We already knew that sitting too much shortens our lives; and that sitting a bit less each day can extend them. And still our prevailing cultural inclination is to send our naturally rambunctious kids to school and bolt them to chairs all day, until they grow up to become adults we can’t get off couches with crowbars. And if, along the way, that rambunctiousnessever rebels against the incarceration- well, we’ve got medication for that.
We already knew that sedentariness now counts as a leading cause of premature death globally. We already knew that lack of physical activity was established among the top three causes of premature death in the United States, and that going from sedentary to routinely active could reduce the lifetime risk of all major chronic disease by 50%.
We already knew that routine physical activity also turns up on the very short list of factors that exert so profound an influence on medical destiny that they actually alter the behavior and expression of our genes, nurturing our nature at the level of DNA.
We already know that 20 minutes of physical activity 5 times a week could defend a high percentage of at-risk kids from developing type 2 diabetes.
We also already knew that good physical activity programming in schools reliably preserves or enhances, rather than compromising, academic achievement. We have evidence, in other words, that the right kinds of recess are complementary at worst, synergistic at best, with reading, writing, and ‘rithmetic.
We even knew that fitting fitness in could be...fun.
We like to contend that knowledge is power. But the gap between what we know, and what we do with what we know, about the potential for lifestyle to add years to life and life to years- for ourselves as well as our children- belies that wishful thinking.
We might, I suppose, chalk the status quo up to complexity. Perhaps we know how important daily physical activity is- but we don’t know how to get ourselves, or our kids, there from here. I don’t really buy that argument for most adults- and I certainly don’t buy it for kids in schools. I recently wrote about our capacity to bog down in talking about moving while failing to do the obvious and just get off our backsides! Our kids are subject to much the same inertia.
Dr. Tony Yancey, whose untimely death is a source of grief for me and her many friends and colleagues, developed a program called “Instant Recess.” Dr. Yancey was such an important force for health promotion for the very reason that she looked beyond theory and rhetoric, and devised actionable solutions for real-world settings. Her particular focus was churches, but whatever the setting, the only response warranted to a program that helps move people toward health by getting them to move their bodies is: amen!
My shop has mimicked Dr. Yancey’s laudable example. We, too, have programming for the places adults and kids spend our days. Our ABC for Fitness program has proven benefit; is easily implemented by essentially any school; requires no special resources or training; and is available for free. Totally free. And, by the way, we designed it with input from experts in education so that teaching can even occur during the activity bursts, potentially increasing daily teaching by 30 minutes or more. And, on the chance I didn’t mention it, it’s free. It’s in thousands of schools- but why isn’t it, or something like it, in all of them?
ABC for Fitness is, of course, not ‘the’ solution. But it’s a good example of ‘a’ solution, and a demonstration that we can put actual programming where our mouths are, and move more than electrons through cyberspace, reports across bookshelves, and our lips over our teeth. We could, really, move our kids-daily-if we decided it mattered enough to bother. And the IOM report reminds me how much it bothers me that so far we have failed to do so.
As for the second question- it would certainly be nice to think that a report from the influential IOM would help us past our cultural inertia. But then again, we are several years into a campaign overseen personally by the influential First Lady of the United States, and very explicitly named “Let’s Move”- and that hasn’t done the job. True, “Let’s Move” has shone a spotlight on the issue, attracted attention, effort, and innovation. But even while the program has been playing out, many schools have been reducing rather than augmenting their physical activity offerings. Nothing remotely like giving every child in the U.S. 30 minutes of daily physical activity, let alone 60, has occurred.
We knew before this IOM report that our kids should move every day to increase their chances for more years in life and more life in years. Now we know, again. We cannot invoke ignorance as an excuse for inaction. We know we should, we know we can, and we even know how we can.
This time, let’s prove we aren’t all talk and no action. This time, let’s demonstrate we aren’t hypocrites. This time, let’s prove we really are a nation of loving parents and grandparents, concerned and responsible adults. This time, let’s move more than our lips- and do what it takes to move our kids toward the health they deserve.
Dr. David L. Katz; www.davidkatzmd.com