How to Get People Active

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While there is great agreement on the benefits of physical activity, there is still a big challenge in getting people to increase physical activity. The environment we have constructed is not one that encourages physical activity, and in fact many technological advances of the last decades have likely caused substantial declines in physical activity [27].

Increases in physical activity can be promoted in different ways. In general this can be though promoting planned physical activity or exercise, and through promoting increases in lifestyle physical activity. The latter involves showing people how to increase physical activity (i.e. walking) throughout their usual day without the need to set aside planned exercise time. For individuals maintaining a significant weight loss, both strategies will likely be required in order to achieve sufficient physical activity. For prevention of the 0.45-0.90 kg of weight gained each year by the average American, either strategy alone could be sufficient.

Walking may be one of the best ways to get people to increase physical activity. A study by Hu et al. [28] suggests that vigorous exercise is not required to reduce the risk of type-2 diabetes. They found that walking was negatively associated with the risk of developing diabetes. In a prospective study,

DiLoreto et al. [29] evaluated the impact of walking on patients with type-2 diabetes. They proscribed walking for their patients and, in a post hoc analysis, found significant health and financial benefits to increased walking. These included improvements in blood pressure, lipids, and glucose. Further, the yearly cost of medications decreased with increased walking. While any amount of walking was beneficial, the greatest benefits occurred with increases in physical activity of >10 metabolic equivalents (METs)/h/week.

This is consistent with the idea of helping people make small rather than large behavior changes. Step counters (pedometers) have been used effectively to produce gradual increases in physical activity. While physical activity levels of >30min/day may be desirably, any increases in physical activity can benefit health and help in the maintenance of a healthy body weight.

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