The Elephant in the room

[Trek420]

Not to politicize the board and I don't care whether you're blue or red or Dem or Republican I think I have found something we all can agree or nearly agree on while different viewpoints will abound:

Question for the group: can bikes, running, exercise along with sensible healthy eating solve or at least help the US health care crisis?

http://www.nytimes.com/2009/09/10/opinion/10pollan.html?_r=1&scp=1&sq=big%20food%20pollan&st=cse


quote from the article "We’re spending $147 billion to treat obesity, $116 billion to treat diabetes, and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet. One recent study estimated that 30 percent of the increase in health care spending over the past 20 years could be attributed to the soaring rate of obesity, a condition that now accounts for nearly a tenth of all spending on health care."

[Tri Girl]

Yes, I think you are right. We should invest money in MUP's, bike lanes, and healthier cities (ie: not so spread out you need a car to reasonably get around). Maybe workplaces could offer benefit (insurance) discounts if you can provide documentation that you are active (or something like that).
I would LOVE to see us become healthier and have healthier cities. I live in one of the bottom 10 fattest states (last I checked) and we sure could use some "trimming down." We have hundreds of miles of proposed trails in our city, but very few have been built because of funding issues. :(

Honestly, tho, as much as I'd like to think that if you made it easy for people they'd become more active- in reality I think "we" are a lazy society and will always choose cars over healthier options. The fact that my co-workers are just flabbergasted and in awe that I ride 3 miles to work everyday (that's SO far- how do you do it?), and that they think that's so unattainable tells me most people are not ready/willing to make big changes. Change is hard.
In my heart of hearts I wish we could change, tho. Maybe one day...

[Trek420]

I have a theory, but no medical experience or training to bear it out.

I think we few, we happy few (active folk) are different. Stuff others think undoable, my 2 mile bike to work, walking the dog before and after work, any work out you do feels GOOD. We want to do this the way others want to sit and veg. Feel the burn, the burn feels good.

Part of my theory is that nearly all of my family does something in the way of a workout or just has an active lifestyle.

Where others strive to sit.

How many of the little things you do, not even the epic ride get a raised eyebrow from your peers? When I get off the elevator on the 2nd floor (no stairs from the 1st) to walk to the 6th and a coworker says "You do that on purpose? When the elevator works? :eek: :confused:"

[Jolt]

I definitely believe that healthier lifestyles would go a long way toward helping with our health-care problems. Given how much of the health care costs come from chronic diseases that seem to be fairly preventable, getting our society to be more active and eat a healthier diet should cut way down on those costs. The problem is motivating people to change their habits and making it easier for them to succeed. The way things are currently set up, there are some big obstacles: needing a car to get around many places because of the distance and/or road conditions, office jobs requiring one to sit at a desk all day, pressure to overschedule ourselves making it difficult to fit in exercise (since most of the physical activity has been taken out of our daily life) or the time to cook from scratch, the fact that processed junk foods tend to be significantly cheaper than a lot of healthier whole foods, safety issues in some neighborhoods making people afraid to get outside and walk/let their kids outside to play, and I'm sure some of you can think of others. To really solve the problem, there will have to be some major changes in the culture and that will take time. The ideas put forth so far about investing in cycling facilities and offering incentives for people to eat well/be active are good ones. In regards to encouraging cycling, I think an important part of that would be educating the public about sharing the road and following the same rules on a bike as in a car. I would also add community farms/gardens using a CSA model and offering discounts to people for putting in time helping out on the farm (and thereby getting some exercise to boot). Maybe those places could also offer cooking classes featuring whatever is in season and focusing on recipes that are quick and easy. I'm not sure what we can do about the office jobs so many people are stuck in...maybe there would be some way to get some physical activity into the job (and at least some people have the option to commute by bike or on foot).

[Selkie]

I agree with you 100%. It would be great for any sort of activity to be encouraged and I would LOVE to get discounts on insurance, a lower tax rate, etc., due to my active/healthy lifestyle. Maybe that would be a great incentive---lower your federal tax rate if you work out xxxx hours a week!

People are over-scheduled and stressed out. I think a lot more people would take the time to devote to fitness IF they had that luxury of time (which seems to get more precious with every passing year). The big house or even "affordable house" far from work and a 2 hour commute make it nearly impossible for a lot of people.

What is most worrisome is the large number of KIDS who are overweight. And young adults. I'm 46 and am in better shape/health than probably 97% of the females under 35 with whom I work. Of course, I don't have kids, so I ostensibly have more free time to devote to my athletics. [I do have a husband, 3 dogs, a full-time job, and a house, so it can be argued that I'm not completely unencumbered by obligations]. That said, I do so at personal sacrifice -- getting up at an ungodly hour to ride and swim so I can fit in work and home responsibilities.

[Crankin]

While I don't think this has anything to do with politics, I can already hear the people screaming that this would be "too much big government." Sorry, but I just saw the news tape of the protest in DC yesterday. I would like to ask those people what they would do if they lost their job and then got sick...
OK back on topic. This is something that is dear to my heart. But even my well educated, financially well off friends think I am weird for doing what I do. Perhaps some of us are hard wired to be active. My oldest son, while active in the sense of walking everywhere (up to 10 miles) and using public transportation a lot, has done nothing else for fitness. About a month ago, he started riding the old mountain bike we gave him, which is set up for commuting. He is now totally hooked, riding to work at least 3 days a week and once or twice on the weekends. Yesterday, we went to his place, to give him some lights, gloves, and a jacket (all of which we had "hanging around :eek:,") and when I heard him say "I have to ride tomorrow," I thought we have created a monster. But, I think it's in his genes and he sees the writing on the wall in terms of fitness.
It is hard to plan time for fitness or walking/riding to work. I am faced with this now with my new schedule. My day now consists of sitting down all day, and I really hate it. Even though I supposedly live in the second skinniest state in the country, we have virtually no MUTs compared to other places. Unless you live in the city, you need a car...

[Reesha]

There would be a lot of potential for abuse of the incentives program, I think, but I do feel that the way to go is to push for more bike lines, more pedestrian access, and more education all around. In cities, bicycling can certainly be an answer but in the suburbs designed around the car, people have to be fairly hardcore to get themselves from point A to point B because it IS farther. My rural experience says that there is ample opportunity to be active simply by being in the sticks, but many choose not to take these opportunities and use their car for everything.

I don't think that this 'active desire' is genetic, but I do feel that it is an environmental thing. I grew up surrounded by both obesity and activity. My brother and sister became obese and I watched them (and my mother) gain weight and decided that would not be me. Since, then, I've watched my brother take up road biking and track racing and he is gradually starting to change shape and slim down. I'm really proud of him because I know that it requires a near-complete reprogramming of habits he's developed over a lifetime. Also, as the youngest, he was enabled a lot when it came to food and sedentary lifestyle. We're trying to encourage our sister gently, but she really needs to see the writing on the wall on her own.

I agree with you Crankin, that in many ways New England is a bit of a conundrum. It's generally a fairly 'thin' cluster of states, but man are the roads NOT fit for cycling. We made the best of it, but NE roads simply weren't designed for other travel besides car travel. I'd love to see Boston shift its eye toward complete streets now that the Big Dig and the bridge are essentially complete.

Another interesting thing is that some cities that have a large bicycling population still aren't as bicycle-friendly as they ought to be. Madison, WI is a good example of this. I don't think I've ever been to a city with more bicyclists, but there were only as many bike lanes as there are in St. Louis. You'd think with such a flourishing bike culture, the city would try to do more for these people.

All I can say is vote vote vote and lobby for yourselves. I wish there was a way to donate my tax money to specific causes, we all know that that's not how it works.

[Medianox]

Everyone has very valid points and I agree with what I have read here so far.
As someone with many years in health care (RN since 1991 and was LVN for 10 years prior to that) I have seen many programs and improvements come and go.
What never changes and what needs to change first before anything is the fact that most americans are very ignorant of how their bodies work and what good health is in the first place. Its a cart before the horse situation if you throw tons of info at people explaining why exercise is good, or why eating better can prevent or improve certain conditions and diseases but if they have no understanding of what those diseases and conditions are in the first place-its very hard to make it stick.
Education is a huge part of my job and I can't tell you how many times I've started to teach someone the basics of how to manange something like diabetes lets say, and when I begin with, "The body has a special organ, the pancreas, that makes insulin that regulates blood sugar..." so many people don't even know that they have a pancreas, let alone where it is or what it does. These are not illiterate people. Most have at least a high school education, if not more. That is just one example, I could go on but the point is, until this country gets serious about health education from elementary school forward, all the reforms in the world won't make much of a difference. Its a matter of getting people as a society to care from the ground up about their own health and I just don't see that happening any time soon.
There are so many facets to this arguement that it well could be endless but we have to look at why it is cheaper in this country to eat poorly and be obese than it is to eat in a healthy manner and be fit. Also, to touch on a very sensitive subject we need to have a mature outlook on end of life and have realistic expectations of what that means.
Sorry for the rant.

[roadie gal]

I completely agree with everyone that exercise and better eating would go a long way to cutting down on so many health issues. But it's not just Americans. I recently read an article that compared exercise to non-emergent angioplasty in stable angina. The article, from somewhere in Scandinavia (Norway I think), showed that they were equally effective. The interesting thing to me, though, is that they had to stop the study early because they couldn't recruit enough people into the exercise arm of the study. Most people wanted the quick fix of the angioplasty rather than the long term commitment of exercise. It's a problem in all of the first world countries.

[skhill]

More bikes and more/better bike infrastructure would help, sure, but...

One obvious thing that no one seems to be talking about (probably because it's even more politically dangerous to address) is changing agricultural policies, so that we're no longer producing mountains of cheap corn ready to be turned into cheap junk food. Might it not be better for our nations health if real food were cheaper than the junk? And if the crappy groceries in poor neighborhoods carried real food?

And it's so retro, but how about home-ec for all kids? If their parents don't cook, and their grandparents don't cook, they're not learning just how easy and cheap (if maybe time-consuming) it can be to put together a tasty, healthy meal... I recently took a loaf of home-made bread to a neighbor who's been having a rought time, and her 11 year old daughter had never even seen a loaf of home-made, not pre-sliced bread. Somehow, I don't think that's all that unique. There's something wrong with this situation...

Anyway, my 2 cents...

[Trek420]

.... we have to look at why it is cheaper in this country to eat poorly and be obese than it is to eat in a healthy manner and be fit.

I agree. You see ads for fast food billed as the friend of the busy and or working poor. "Got a buck, you're in luck". Don't get me started on subsidies to corn farmers so we can have cheap high fructose corn syrup (the first item in the label of most junk) while farms producing other produce struggle and many neighborhoods can't get fruits and vegies at all.

It's cheap now but there are long term costs of that Happy Meal are vast. I don't want to pay for for an entire nations angioplasty nor your long term care from the stroke. :(


People want good food. Read below where a Christian Community Group finds a way to bring fresh produce to the community with 26 liquor stores and only one grocery store:

http://www.madamethejourney.com/2009/08/detroit-peaches-greens-produce-truck.html

And it's been proven over and over that where a safe option exists people prefer to bike or walk for work or errands.

This is why when asked "how much does your bike cost?" I say that I think of it as an investment in my health.

Support your local bike advocacy group, help solve the health care crisis. :cool:

[Jolt]

While I don't think this has anything to do with politics, I can already hear the people screaming that this would be "too much big government." Sorry, but I just saw the news tape of the protest in DC yesterday. I would like to ask those people what they would do if they lost their job and then got sick...


And the kicker is that a lot of the stuff being discussed here doesn't even have to (and often shouldn't) be done by the government! Sure, things like changing the infrastructure and agricultural policies will require government intervention, but incentives for healthy habits can be provided by employers and insurance companies. Education about exercise (including safe cycling), healthy eating and as Medianox said, about what good health is and how the body works can be carried out by other organizations and individual health workers (I happen to be a nurse as well, and working on becoming a nurse practitioner). For example, churches could (and some do) have parish nurses whose role includes educating and providing information about health topics; I am trying to work on getting something like that started in my church since we have a good number of nurses. Cyclists in a community could get together and do a presentation on utility cycling and road safety in a place like a YMCA or community center. Grassroots activities have a lot of potential to help this situation.

[Jolt]

I completely agree with everyone that exercise and better eating would go a long way to cutting down on so many health issues. But it's not just Americans. I recently read an article that compared exercise to non-emergent angioplasty in stable angina. The article, from somewhere in Scandinavia (Norway I think), showed that they were equally effective. The interesting thing to me, though, is that they had to stop the study early because they couldn't recruit enough people into the exercise arm of the study. Most people wanted the quick fix of the angioplasty rather than the long term commitment of exercise. It's a problem in all of the first world countries.

Would you mind posting a link or reference to that article? It sounds really interesting (speaking as a nurse with an interest in cardiology)!

[shootingstar]

And the kicker is that a lot of the stuff being discussed here doesn't even have to (and often shouldn't) be done by the government! Sure, things like changing the infrastructure and agricultural policies will require government intervention, but incentives for healthy habits can be provided by employers and insurance companies. Education about exercise (including safe cycling), healthy eating and as Medianox said, about what good health is and how the body works can be carried out by other organizations and individual health workers (I happen to be a nurse as well, and working on becoming a nurse practitioner).

Designing communities with neighbourhoods, transportation infrastructure and services that encourage more use of non-car transportation should be encouraged...as one piece of the whole big solution.

Nothing wrong with incentives by employers and other organizations to encourage healthy habits and lifestyles, but...real long lasting change also must begin early in life and at home, with parents/at home where eating habit, activities and diet have a profound influence on children's foundational health ...for their future.

It is hard work and patience here that demands serious dedication and consistency by parents and other adults to provide to children reasonably healthy food day after day, week after week, year after year and finds ways to encourage them to eat it.

[Crankin]

I read that article (the one about angioplasty), and while I really do agree that for the majority of people with these symptoms, lifestyle changes would probably eliminate the need for angioplasty, it doesn't apply to everyone. My DH was dealt the card of horrible genetics and despite the fact he was a already a fit cyclist who ate well, he still had 2 80% blockages. It's true that if he had started cycling 10 years earlier and had started medication before he did (about a year before the surgery), maybe they would not have developed. But, he was not inactive, was not overweight, and ate better than most people.
I guess I just don't want people to think that lifestyle changes is the whole thing...

[Trek420]

I agree. Where is the jersey that says "eat right, exercise, die anyway" :(

Working with the disabled community I'm made aware every day that I am only temporarily able bodied. Often I hear this "I never thought this would happen to me, I was active, working, suddenly I had ________ ".

My feeling is do what I can do, take care of what I have control over. Even with injury/illness focussing on wellness can help.

For years I banged my head on the walls of doctors offices asking why I hurt so much. Finally a diagnosis, severe arthtritis :( Again I staged a hissy fit. Simply knowing was not enough. I wanted it to hurt less and still be able to stay active.

Several appointments later the orthopedic surgeon for both the 49'ers and the Raiders told me "there's no pill, no surgical option. You have this choice:

:( change your lifestyle to fit your knee (he meant go sedentary)
:) change your joints to fit your lifestyle (build the muscles around the knee)"

He suggested cycling ..... here I am :rolleyes: For me I don't so much focus on wellness to live to be 116, it's about being able to open the peanut butter jar in my 80's, being able to just keep doing what I want to, need to do as long as I can. It's about quality of life.

[tulip]

I'm happy to live in an economically-disadvantaged part of the city that really has wonderful grass-roots efforts to improve the educational and nutritional outlook for kids. The Neighborhood Resource Center has a community garden and a kitchen, where kids grow their own food and then learn to cook it. They also have chickens for eggs. Kids had no clue where food came from, and they are so into the gardening and cooking.

I agree that Home Ec should be taught in schools again, too. And yes, people taking responsibility for their health will go a long way in improving society in general, and the health care issue as well.

[Reesha]

They should be teaching life skills in general! Basic cooking skills, balancing check books, paying bills on time, understanding basic financial stuff. People stumble out into the real world these days barely equipped to survive.

[roadie gal]

For Jolt: Here's the article. It's from one of my subscribed sites, so I have to post it this way. Sorry it's so long.

BTW, I never meant to imply that exercise is the total answer. Some people have crappy genetics (myself included). Some people need emergent intervention. My point was that they had to stop the study because they couldn't find participants for the exercise group.


September 8, 2009 (Barcelona, Spain) - Investigators for the multicenter PET study were keen to build on the surprising findings from their pilot trial: that 12 months of exercise training was just as good as PCI for myocardial perfusion and symptom relief in patients with stable angina and even better in terms of preventing cardiovascular events. Those hopes, however, were dashed when the multicenter PET study ground to a halt due to a lack of enthusiasm among patients and enrolling centers.

But in new findings presented by Dr Rainer Hambrecht (Klinikum Links der Weser, Bremen, Germany) at the European Congress of Cardiology 2009 Congress, combined data from the PET pilot study and the aborted PET multicenter trial suggest that regular exercise training is superior to PCI at preventing subsequent cardiovascular events.

The original PET study [1] randomized 102 patients to either exercise or PCI and reexamined patients after 12 months using coronary angiography, technetium-99m scintigraphy, and ergospirometry, as well as a range of clinical end points. Results, which were published in Circulation in 2004, showed clear and comparable improvements in symptoms and myocardial perfusion from baseline with both treatment strategies, and a trend toward better event-free survival in the training group at both 12 and 48 months.

"Our expectation was that exercise training would not be inferior to PCI; however, what we saw after 12 months was a clear, significant improvement in exercise over PCI in patients with stable CAD," Hambrecht told heartwire .

Exercise benefits

Inspired by the PET pilot, Hambrecht et al launched the PET multicenter trial at four hospitals in Germany, Austria, Switzerland, and Romania. By design, patients were randomized either to PCI or to two weeks of a supervised exercise training program every day, made up of five short periods of exercise daily. Patients were then given bicycles at home and asked to exercise on them every day, plus attend a supervised exercise program one or two times per week. The bikes, Hambrecht told heartwire , were equipped with sensors that monitored the amount and duration of exercise and ensured that it was actually the study participant--and not another family member--who was using the equipment.

But according to Hambrecht, the trial had major problems recruiting and was halted with just over 100 of the original 400 patients it had hoped to enroll. The study had plenty of funding; enrollment problems lay with both the recruiting centers and the patients themselves, he said. "There was some reluctance among the centers to join us in performing this study and also difficulties recruiting patients for the study" and explaining the randomization process. "If you get the stent you are free of symptoms within a few minutes, [whereas] in the training group, you have to work a lot, for several months, to reduce the angina threshold."

As with the pilot study, there were striking improvements with both PCI and exercise training in angina class and improvements in event-free survival that were nonsignificantly better for the training patients.

However, when the patients from both the multicenter and pilot studies were combined for a total of 202 patients with two-year follow-up, investigators achieved the statistical significance not met in the multicenter trial, Hambrecht reported. In a pooled analysis of event-free survival, 21 events occurred in the training group as opposed to 32 events in the PCI group (p=0.039). The differences speak to the direct benefits of exercise on the cardiovascular system globally, as opposed to the palliative, more localized benefits of PCI. Whereas both strategies improve myocardial perfusion, angina threshold, and exercise capacity, only exercise improves endothelial function and slows disease progression, he noted. Moreover, he stressed, improvements in both arms were seen on top of optimal medical therapy.

Forces work against exercise

In an interview with heartwire , Hambrecht acknowledged that there are multiple forces working against a scenario in which regular exercise is prescribed instead of stenting. For one, patients are not motivated to take responsibility for improving their own cardiovascular health--even if it means better event-free survival. For another, encouraging exercising is financially less appealing for hospitals, Hambrecht observed: "That was my feeling, that hospitals were reluctant to participate in this study, because they derive revenue from PCI procedures."

Hambrecht believes his data support calls to take the time between the diagnostic angiogram and the revascularization procedure to discuss the options with the patient, rather than stenting every patient.

"We have enough evidence from several studies, including COURAGE and our PET studies, comparing PCI vs more conservative strategies, and the data are quite convincing that PCI is not superior" in stable angina, he concluded.

[Trek420]

I'm just going to stumble in here and ask "who's they"? Parents? Teachers? Both? The entire village that it takes?

We ask a lot of our teachers: teach the kid to read who's been babysat by the TV and not read to, teach morals, values, calculus, French literature ..... I've been stumbling in the real world for decades, tons of schooling, raised in the wild by a pack of teachers :rolleyes: and I've found I have lots to learn still. :rolleyes:

So I'll just ask this question for the group: In a society/culture that does not reward or teach a healthy lifestyle or healthier choices how did you learn? Was it in the home, in the kitchen? Classes? Community? A little of both?

[Kris]

Like a previous poster, my aching arthritic knees got me into cycling, and eventually into Weight Watchers and yoga. Between the three, I feel much better and I can walk down hills (which was almost impossible). I'm thinner too. It is definitely worth it, but it is not easy. I have food issues, and there is temptation at every turn. Yes, I belong to a CSA and eat organic a lot of the time, but I still struggle with cravings. David Kessler's book The End of Overeating, shed some light on that for me. Apparently humans are programmed to want sugar, fat and salt, things that were rare for millenia, but all to common now, and the multinational corporations are making Big Bucks from our propensity for those three things. Although I still struggle, I'm proof that it is possible to change a lifestyle and develop a desire to exercise, not just because it's "good for me" but because I really want to get out and ride. And I had quite a few years of bad habits behind me when I started.
There are some things a good health system could do, like make WW-style support groups available for less $$$, and make it possible to ride or walk to places. Our town recently acknowleged that it's impossible to safely get to some places people need to be without a car, due to the car-centered planning they did in the past. It's not just distance. There are places where you cannot cross the 6 lane highway. And healthy food should not be more expensive than sugary, fatty, salty junk.

[DarcyInOregon]

I'm just going to stumble in here and ask "who's they"? Parents? Teachers? Both? The entire village that it takes?

So I'll just ask this question for the group: In a society/culture that does not reward or teach a healthy lifestyle or healthier choices how did you learn? Was it in the home, in the kitchen? Classes? Community? A little of both?

I took a nutrition course as a science requirement in college, and that helped me a lot to understand about how the body needs nutrients, how nutritional deficiencies are the cause of many disease, and how nutrition interacts with exercising the body. Then in the 1990s, the community hospitals really got proactive with putting together classes to educate patients and the community at large with respect to cardio health, preventing diabetes, minimizing arthritis, maximizing the fitness level, nutrition for weight loss without dieting, and so on, classes in just about every hospital in North America, either free or low cost. Like other people in this thread have said, it is about education, but you have to seek out the knowledge for yourself, learn what is fact and dismiss the inaccurate fad diet type of books. Mostly though, the person has to come to a realization that their health has to be balanced with the other top priorities in their life and to make time to gain the knowledge, to make the dietary changes, and to embrace exercise as being critically important. Taking classes at the local hospital can be the first step in the right direction.

Ignorance of nutrition and fitness isn't just in the poor neighborhoods. I am appalled at the number of people I encounter who have hypertension, yet know nothing about the Dash Diet, the diet that the USDA Food Pyramid is based on, and thus know nothing about eating the low-fat low-sodium low-sugar fresh portions from each food group every day for maximum health that is proven effective at normalizing the blood pressure without medications, along with daily cardio exercise. I know of people who are educated professionals, who take double or triple medications for blood pressure, and their blood pressure is still high, like 170/100, and they won't give up the high-sodium fast food meals or the highly processed packaged grocery store meals. They rarely eat fresh fruits and vegetables or whole grains, and they don't exercise at all, not even an evening walk around their neighborhood. Meanwhile they are getting hardening of the arteries, kidney damage and the other ailments that high blood pressure brings about, and our health care costs go up as a nation.

With respect to obesity, what is most important is to get rid of the fat that you can't see, that is inside the body cavity, squeezing itself between the organs, invading the liver and heart, pushing up the lungs so that a person can't even take a full breath. The rule is that the waist needs to be 50% or less than your height in inches, and if the waist is over 50%, then the person is at high risk for internal fat that will lead to diabetes, coronary disease, liver disease, kidney disese, and so on. However the rule is not always applicable because a person of normal weight who never exercises can have this internal fat that brings on all of these medical conditions, as cardio exercise is what burns the inside fat.

Just one final thought, and that is a growing number of nutritionists and people in the medical community believe that the gaining of excess body fat is actually brought about by continually eating food that has no nutritional value. The body becomes nutritionally deficient, becomes hungry, and so the person eats more, but more of the same fast food non-nutritional garbage. The hunger really isn't about emotional problems, or being scarred in childhood, or eating to fill a void, but the hunger is caused because there are nutritional deficiencies in the body. The insides of the intestines, where the food is absorbed, might be thickly coated with sludge due to a lack of soluble fiber in the diet and so the person can't absorb the nutrients, or the person is just eating garbage day-after-day, and their diet is devoid of entire food groups that contain essential nutrients to maintain health. When the person cleans up their digestive system and makes it healthy, focuses on eating their portions from each food group every single day, and exercises, the hunger dissipates and the strange cravings disappear entirely. Thus, over time the person will lose body fat without engaging in unhealthy fat diets.

[Jolt]

Thanks, Roadie Gal, for the article. Too bad they had to stop the study because of recruitment problems, hopefully somebody else can do something similar and have better luck. This has a lot of potential in terms of improving outcomes and reducing costs, if the exercise program is confirmed to have equal or better results than angioplasty for stable angina.

As for "how I learned", that's kind of hard to answer. I was always an active kid (often too much so!), so I think that part came pretty naturally. I enjoyed riding my bike (including on a paper route at one point) and rollerblading as well as other outside activities. My sisters and I were on swim teams for a number of years, which is what really got me into the habit of working out on a daily basis; the running was something I took up in college and found I liked once I learned to pace myself and started to develop endurance. After college, I decided to buy a used bike to ride on errands etc. to save on gas and incorporate some of my exercise into trips I would have to do anyway; besides, being stuck in the car drives me nuts! As far as the healthy eating, I didn't really learn that at home--we did have our share of junk food growing up although my mom did and does cook from scratch the majority of the time and she taught me to know my way around the kitchen. I think that came more from having always had an interest in health, deciding to go into health care, and realizing that it is much better to prevent illness when possible rather than waiting to treat it after it happens. Being out on my own and doing my own grocery shopping helped too, and then I moved into my current apartment (in a three-decker) where there are pear trees and a vegetable garden in the yard that I got involved in helping with.

[Crankin]

I learned most of my cooking skills from my mom, who only cooked from scratch. We did eat things that would be considered unhealthy, but hey, everyone else ate raspberry danish and frosted flakes for breakfast in the 50's and 60's! I was an active kid, always outdoors and spent a considerable time on my bike. That ended when we moved to Florida, I got my license, and never walked anywhere. After college I gained a lot of weight. The sedentary life style caught up with me, along with my love of food. I studied a lot on my own, became a vegetarian, and started exercising (walking, aerobics). Although I started eating meat again after a year or so, I lost the weight and have never gained it back.
The ignorance of people about health and fitness amazes me. I have a very good friend who has been overweight for years. She lost 30 pounds by eating grapes and nothing else until dinner time...

[Medianox]

"How I learned..."
I'm not really sure. I'm the only person in my immediate family that has never smoked. Grew up in a household where both parents smoked heavily (mom still does), drank more than casually and potato chips (and junk food in general) were a food group. In my family, no one has ever intentionally been physically active or worked out or exercized for fun, or been involved in a sport beyond being an observer.
In high school, I would get up very early, pack a light breakfast (granola bar and an apple) and hike in the woods/fields near my house until it was time for school, then I walked to the bus stop. I played tennis (not competively) every summer, swam often and rode my bike everywhere.
About nutrition....to my mom, it had to be store-bought or packaged to be any good. I was a throwback *hippie* kind of kid and was always trying to make stuff from scratch, bake my own bread, etc. Now, at age 70 my mom calls me and tells me about the bread she is baking herself so I guess it finally caught on-lol! I'm still trying to get her to quit smoking though.
Then I went to nursing school, and formally learned about nutrition science and realized I was pretty much on the right path all along.
I was living in a small town and literally walked everywhere (a bike would have been a luxury!) and was in great shape...it never occurred to me to get a car....
Anyway, I was always the oddball and I can't say for sure where I learned positive habits-I just gravitated towards them naturally. Not perfect but...better than my family's habits for sure.

[mayanorange]

And the kicker is that a lot of the stuff being discussed here doesn't even have to (and often shouldn't) be done by the government! Sure, things like changing the infrastructure and agricultural policies will require government intervention, but incentives for healthy habits can be provided by employers and insurance companies.

This is one of the reasons I switched insurance to Fallon- they reimburse $400/yr for my hubby and I to do pretty much any organized fitness- not just gyms. They cover town sports, the Y, even our fave indoor cycling classes! I think it's great. Hopefully people will be encouraged to actually use it and maybe other companies will follow suit.

[Trek420]

This is one of the reasons I switched insurance to Fallon- they reimburse $400/yr for my hubby and I to do pretty much any organized fitness- not just gyms. They cover town sports, the Y, even our fave indoor cycling classes! I think it's great. Hopefully people will be encouraged to actually use it and maybe other companies will follow suit.

Not health insurance but this is one reason I switched from AAA to Better World for roadside assistance which pained me for sentimental reasons.

I've used AAA since I learned to drive :o. BW gives a public transit discount because we use that most often, they have a bike assistance option (not signed up for that yet) and they lobby FOR cycling.

I get a low mileage discount on my auto insurance. By being car-light (not car free) I drive far less than the national average.