Walk to School Day, Scituate, MA

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Walk to School Day, Scituate, MA

• Fighting the Epidemic No One is Talking About!
• A.A.A.S. Understanding Obesity and Childhood
  Nutrition Town Meeting
• Boston, MA
• Feb. 2008

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My comments

• Restating the problem and brief rant about the
  epidemic.
• Answering, How much is enough?
• Overcoming the stickiness problem.
• Creating stickier schools.
• Hear from you!

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US Obesity EpidemicOgden et. al. (JAMA 288,
14 Oct. 2002)
Americas looming chronic disease apocalypse . .
.
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Supersize Me?
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Diabetes Prevention Program (DPP
New.Eng.J.Med., Feb. 7, 2002)

• Compared three treatments for nationwide cohort
  (3,000) at risk for developing diabetes
  (elevated fasting glucose).
• Control Standard exercise and nutrition
  counseling placebo.
• Standard plus drug treatment Metformin
• Intensive lifestyle change Nutritional training,
  150 min./week physical activity.

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Diabetes Risk Reduction(Diabetes Prevention
Program NEJM, Feb. 7, 2002)
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A thoughtChange the conversation. Its not just
an obesity epidemic. Its an epidemic of physical
inactivity and poor nutrition.
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My somewhat unique perspective . . .
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(No Transcript)
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How much physical activity is recommended by the
US Surgeon General for adults to reduce risk for
chronic disease and an early death?

• 20 min. at least 3 days a week
• 20 min. every day
• 30 min. at least 5 days a week
• 45 min. at least 4 days a week
• 60 min. at least 3 days a week
• 60 min. most days of the week

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The Activity Diamond
ACSM fitness recommendation, 1978-2000.
Fitness 20 min. hard, 3 days.
USDA Dietary Guidelines, 2005.
Weight loss 60 min., 5 days.
Surgeon Generals Report on Physical Activity
Health, 1996.
Health 30 min. a day.
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Physical activity recommendation for
adolescents(Pediatric Exercise Science 6(4),
1994)

• Physically active every day as part of lifestyle
  (at least 60 minutes, variety, moderate
  intensity).
• Some vigorous activity at least 20 minutes,
  three days/week.

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For a pedometer-wearing adult, how many steps per
day are recommended for long term health?

• 5,000
• 10,000
• 12,000
• 15,000
• 20,000
• 24,000

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20 Boost Pedometer Approach From Pedometer
Walking by Fenton Bassett (2006)
Wear your pedometer all day, every day
lt Like this, level and in line with the knee.
Not like these. gt
www.pedometers.com
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20 Boost Pedometer Approach From Pedometer
Walking by Fenton Bassett (2006)
Key to Success Keep a record!
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20 Boost Pedometer Approach From Pedometer
Walking by Fenton Bassett (2006)
Total 29,451
Daily average Total / 7 4,207
Daily average x 1.2 5,048
5,048 Next weeks daily goal!
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How many steps?
Fitness 3,000 steps fast.
Weight loss 12-15,000 steps/day.
Health 10,000 steps/day.
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Have you experienced any of the following
examples of the stickiness problem in your life?
(pick for yourself or someone close to you)

• Joined a health club, but dont go often.
• Bought a treadmill or bike, but dont use it
  much.
• Joined walking program, but stopped walking when
  program ended.
• Signed up for walk/run event didnt keep at it.
• Lost 10 pounds, but gained it back.
• Got a Wii now family spends more time inside.

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Exercise Participation StudyEffect of Short
Bouts, Home Treadmills(Jakicic et.al., JAMA 282,
16)
?
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First 6 months Prizes, reminders,
support.Months 6-18 Subjects left to their own
devices.
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Self-help vs. CommercialWeight Loss Programs
(Heshka et.al., JAMA 289, 14 April 9, 2003)
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Did these people exercise?
Plimouth Plantation
Lowell Natl Hist. Park, Lowell, MA
Its about dramatic decreases in routine, daily
physical activity!
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So, what makes stickier places? Answer yes to
four questions

• Destinations within walk bike distance?
• Sidewalks, trails, bike lanes, crossings?
• Inviting settings for routine activity?
• Is it safe?

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Stickier for kidsSafe Routes to School.

• Engineer safer facilities sidewalks, paths,
  crossings.
• Educate for safe bike, pedestrian, driver
  skills.
• Enforce safe speeds, better behavior,
  pick-up/drop-off.
• Encourage. Walking school busses, bike trains.
  Walks at school before, after, recess.
• Evaluate and improve.
• www.saferoutes.org

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Speed table, Berkshire St., Cambridge
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Which of the following would you most favor
implementing in your school or community?

• Rewards for walk, bike, transit to work
• Walking school buses
• Improved sidewalks, pathways, bike racks
• Warm-weather clothing donations for kids
• No withholding recess as a punishment
• Build physical activity into curricula
• Physically active field trips
• More regular PE classes
• Reverse lunch and recess
• Extending the school day

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Massachusetts pilot program Extended Learning
Time schools.

• 19 E.L.T. schools in 2007, lengthening day by
  about 90 minutes.
• Increased contact time project based, hands on
  learning.
• More time for exploration languages, electives,
  art, music, drama.
• More planning, collaboration, advising.
• Schedule flexibility for PE, recess, physical
  activity in the curriculum.

www.mass2020.org/elt
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Are you in favor of increasing the program of
extending the school day by 60 to 90 minutes (now
a pilot program) to more schools in Massachusetts?

• Yes
• No

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Stickier Communities
Transportation carrots Underwrite transit,
improved, sidewalks, crossing, bike lanes,
worksite incentives (e.g., health insurance
discounts).
Sticks Costly parking roadway fees, congestion
charges.
www.completestreets.org
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Which of the following cutting edge policies
would you most favor for the city of Boston to
enhance physical activity in the population at
large?

• Improved open space, parks, playing fields
• Performance based health insurance
• Reduced or free transit for active commuters
• Increased parking costs
• Privatize major roadways (e.g. tolls)
• Peak hour congestion charges
• Adopt a complete streets policy
• More pathways, bicycle parking, safety education
• Reduced price health clubs

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Get out of the comfort zone, attend other
meetings, learn, speak up!

• School board
• Planning Zoning
• Parks, Recreation
• Historical Society
• Public Health Safety
• Chamber of Commerce
• Economic Development
• Neighborhood Associations
• Conservation Commission

Bridgewater T station
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The simple prescription?
Make your community activity-friendly.
Invite others get people to simply move.
Build activity into your life (esp. walk bike).
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Why it really matters . . .