The following story, which I wrote for the Charlotte Observer and The News & Observer of Raleigh, originally appeared in those papers on January 10. It appears here in expanded form, with links.

When Sidney Eagles Jr. went in for his annual physical a dozen years back, his physician reminded him that he was overweight, that his blood pressure was high, and that his cholesterol was up there as well. The reminders had become a perennial checkup ritual for Eagles, who at the time was 60 and Chief Judge of the N.C. Court of Appeals.

The annual ritual changed, though, when Eagles mentioned that he’d been short of breath recently. His doctor became alarmed, which in turn alarmed Eagles. A few days later he went to the hospital for some routine cardio tests and wound up having an operation to remove an aortic blockage. Eagles had never been big on exercise up to that point, but the event got his attention.

“I don’t have the willpower to [exercise] unless I’ve got some skin in the game,” says Eagles. With his skin literally in the game now, Eagles became devout, hitting the Rex Wellness Center three to four times a week. He still doesn’t like to exercise, but he can’t ignore the difference exercise has made in his life.

“I am — and this really sounds like braggadocio, but facts are facts — I think my balance is better and I know I’m stronger,” says Eagles, who is now 72 and in part-time practice with the Raleigh law firm Smith Moore Leatherwood. “I feel good almost all the time.”

In a state where 30 percent of all adults are considered obese and thus are at significantly higher risk of suffering a variety of maladies — from diabetes to a variety of cardiovascular-related problems — Eagles’ example is a model for the vast number of North Carolinians who have neither the inclination to exercise nor, in their minds at least, the time. Like Eagles, they don’t want to exercise, but they know they need to.

No time?

Think you don’t have the time to exercise? Can you find a half hour every day? That’s all you need to make a difference in your health, according to the National Institutes of Health. “Most adults need at least 30 minutes of moderate physical activity at least five days per week. Examples include walking briskly, mowing the lawn, dancing, swimming for recreation or bicycling.”

Those 30 minutes can come in bits and pieces scattered throughout your day.

“Start small,” suggests Kelly Roberts, wellness specialist with Carolinas Medical Center’s LiveWELL Carolinas program in Charlotte. “Take the stairs vs. the elevator — that’s five calories right there. “Get up from your desk as many times during the day as your job allows. Keep [walking] shoes under your desk: Even 10 minutes walking at lunch is better than nothing.”

Caveat: If you do the same thing at the same intensity level during those 30 minutes, you’ll only notice the health benefits for so long. “You either need to increase the intensity during those 30 minutes or extend the length of your workout,” says Logan Johnson, an instructor with the Rex Wellness Center in Raleigh.

“Otherwise,” he adds, “your body adapts and those same challenges are not enough.”

Four areas of focus

It’s also not enough to focus just on one area. Frequently, when people think of exercising to improve their health, they think of aerobic exercises, such as walking, bicycling or doing the treadmill. In fact, there are four areas you should concentrate on to improve your health:

• Strength training. Wellness experts suggest you consult one of their own before embarking on a strength training program. “You want to make sure you’re targeting the proper muscle groups, and that your form is good so you avoid injury,” says Johnson. A personal trainer can prescribe an appropriate workout program based on your time, needs and resources. (The cost of a personal training session varies. At Rex, non-wellness center members pay $45 for a half hour session, $65 for an hour session. The per session cost goes down if purchase multiple sessions.) Resistance training, using simple rubber bands available for $20 or less, is a popular home strength training option. Or, you can fashion an effective strength training program using your body weight for resistance. “The value of doing things with your own body weight” — wall sits, planks, curling a can of tomatoes — “can’t be underestimated,” says Roberts. “There are things you can do using three- and five-pound weights in the privacy of your own home while watching TV.” Exercises: For a rundown of resistance band exercises, visit About.com here.
• Flexibility. Stretching to improve your flexibility may be the easiest exercise to incorporate into your daily routine. For instance, the Mayo Clinic suggests seven quick stretches — shoulder stretch, upper arm stretch, chest stretch, chin tuck, head turn, side neck stretch, lower back stretch and standing thigh stretch — you can do at your desk. (See an instructional slide show here.)
• Balance. Of new clients, Rex’s Johnson says, “Where I find the greatest improvement is in their balance.” Strength training exercises can help improve balance, as can basic yoga poses. Exercises: To learn basic yoga poses, check out ABC-of-Yoga.com here.
• Aerobics. Walking may be the best elixir out there for improving your health. To make your walk really count, says Johnson, get your heart rate up to 75 to 80 percent of your age-predicted heart-rate maximum. To figure that out: Start with the number 220 and subtract your age. Multiply the resulting number by .75 (for 75 percent) or .80 (for 80 percent). For example, a 50-year-old person wishing to increase his or her heart rate to 75 percent would multiply 170 (220 minus 50) times .75 to come up with a target heart rate of 127.5 beats per minute. Take your pulse (your wrist or neck are the most common spots for an effective reading) for 15 seconds, then multiply by 4. To make sure that you walk regularly, Roberts is a big advocate of pedometers. “People who wear pedometers consistently are 27 percent more active during the day,” she says. Pay less attention to the actual mileage tally (pedometers are based on your average stride, which can vary considerably) and more on the number of steps you take. Shoot for 10,000 a day, Roberts says.

Payoff

Don’t expect results immediately, says Roberts. “We feel you should be feeling significant differences in within a couple weeks,” she says. “If you’re taking the stairs, for instance, within a couple weeks you shouldn’t be as winded.”

Give it another couple of weeks before really putting your new lifestyle to the test.

“After a month or so, go do something you haven’t been able to do in a while,” says Johnson. “I had one woman who began lifting a stack of plates over her head. She’d never been able to do that before.”

Again, he stresses that if you want to see continued progress you’ll need to increase either the intensity of your workout or work out longer.

Buddy up, muscle up

You’ve had a long day at work, you’re tired and — sniff! — is that a cold coming on? Maybe I’ll skip tonight’s workout, just this once.

And you likely will, unless a workout buddy is expecting you to show up.

“A support system is important,” says Logan Washburn, fitness director at UNC’s Meadowmont Wellness Center in Chapel Hill. “Someone to keep you accountable, whether it’s a trainer or someone who comes and works out with you.”

Studies have shown that people are more likely to remain true to an exercise program if there’s a little peer pressure, be it a workout buddy, a a group you train with, or simply a friend who likes to hear about your progress, and thus, someone you don’t want to let down.

“You’re not in this alone,” advises the Mayo Clinic in its “7 Tips for Staying Motivated.” “Work out with your partner or other loved ones. … Organize a group of neighbors to take fitness classes at a local health club.”

“If you’ve got a group environment for support,” agrees Washburn, “you tend to be more successful.”

Ultimate motivation

Non-exerciser Sidney Eagles Jr., who’s been exercising religiously for 12 years now, says the ultimate motivator for anyone in poor to marginal health is pretty simple:

“If you had been in my position and didn’t perceive it as a wake-up call, you’d either be foolish, slow or temperamentally doomed to be in trouble — soon.”

* * *

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Turns out, though, that interval training can benefit anyone, especially those who need to get the most out of their workouts: the obese

This was the conclusion of a study by the Montreal Heart Institute’s center for preventive medicine and physical activity, released last week. The study followed 62 participants in a 9-month program for the obese called Kilo-Actif. The program focuses on both better eating habits and being more physically active. For the latter, participants engage in two to three supervised 60-minute training sessions each week. A key component of those sessions: interval training. (On the nutritional side, fyi, participants meet with dietitians and follow a Mediterranean diet.)

At the end of the 9-month period, participants showed, on average, across-the-board improvement in their key stats. Among them: 5.5 percent drop in body mass, 5.15 percent reduction in waist circumference, 15 percent improvement in “effort capacity,” 7 percent drop on LDL (‘bad”) cholesterol and an 8 percent increase in HDL (“good”) cholesterol.

“It is proven that, compared to moderate-intensity continuous training, interval training is more appreciated by participants,” said Valérie Guilbault, a kinesiologist at the center who oversaw the participants’ training. “This type of training is also more effective, because alternating between short periods of intense effort and rest periods allows for a longer training time.”

* * *

For more on the study, go here.
For more on interval training in general — how it works, the benefits and how to incorporate it into your workout — go here.

Photo: Cheetahs are the ultimate interval trainers. And have you ever seen a tubby one?

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So is the solution as simple as not hanging out with big people, a solution that, presumably, would result in fewer and fewer big people to hang out with and, eventually, no big people to hang with?

No, according to University of Alabama at Birmingham obesity researcher David B. Allison. In another study, this one appearing in the Nov. 24 British journal “Proceedings of the Royal Society B,” Allison says it’s not even as simple as moving more or eating less. In fact, he claims, why we keep growing is a complex mystery.

Allison’s fascination with the obesity epidemic was piqued after checking out the marmoset population at the Wisconsin Non-Human Primate Center. He noticed that the entire population showed “pronounced weight gain” over time, yet after checking with staff at the center there was no obvious reason why. He began looking at other populations of mammals that lived with or around humans, from monkeys and chimps in research labs to feral cats in Baltimore. He wound up studying 24 sets of animals in all — and in all 24 sets the animals gained weight.

“The consistency of these findings among animals living in different environments, including some where diet is highly controlled and has been constant for decades, suggests the intriguing possibility that increasing body weight may involve some unidentified or poorly understood factors,” Allison told Science Daily.

Allison and Yann Klimentidis, Ph.D., a post-doctoral trainee in the School of Public Health and co-author of the study are investigating some of those “unidentified or poorly understood factors.” Among their initial suppositions, expressed to Science Daily:

Light. “Studies have shown that subtle changes in the amount of time spent in light or dark environments changes eating habits. Allison wonders if increased light pollution in our industrial society may play a role.”
Viruses. Infection with adenovirus-36 is associated with obesity, and the presence of antibodies to AD36 correlates to obesity in humans. Could AD36 or other infectious agents be contributing to obesity in populations?”
Epigenetics. “Genetic modifications brought about by any number of environmental cues such as stress, resource availability, release from predation or climate change.”

Again, Allison says the reasons behind our growing waistline are likely numerous and complex: don’t expect a silver bullet to emerge. Upshot for you: Keep eating well, keep moving.

Photo: What’s making this marmoset fat?

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A study in the December issue of Obstetrics & Gynecology reports that of 2,224 women taking part in an assessment of “perceptions of body weight and weight-related behaviors,” just one in four considered themselves overweight. In fact, when the 2,224 women had their BMI calculated, 1,162 — that’s over half — surpassed the BMI’s overweight barrier of 25.  (Curiously, of the 1,062 women who were normal weight, 16 percent perceived themselves as being overweight.)

The big problem here is that if you don’t recognize there’s a problem, you won’t try to correct it.

“They see overweight people everywhere they go,” Dr. Mahbubur Rahman, one of the authors of the study, told WebMD, “and this has become the new norm for them.” Rahman is Assistant Professor in the Department of Obstetrics & Gynecology at the University of Texas Medical Branch in Galveston.

For more on the study, “Self-Perception of Weight and Its Association With Weight-Related Behaviors in Young, Reproductive-Aged Women,” go here.

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As Take A Child Outside Week draws to a close and as we segue into National Childhood Obesity Awareness Month comes the disturbing news that the nation’s childhood obesity epidemic may be even worse than the numbers suggest. First, to recap those numbers: Nearly 20 percent (19.6) of the nation’s kids ages 6-11 were considered obese in 2008 (up from 6.5 percent in 1980), while 18.1 percent of 12- to 19-year-olds were obese in 2008, up from just 5 percent in 1980; In North Carolina, more than a third of our kids are either obese or overweight.

Bad as those numbers are, the National Council on Childhood Obesity Awareness Month says one of five parents may be guilty in under-reporting their child’s weight, thereby skewing the statistics. One of the goals of October’s inaugural National Childhood Obesity Awareness Month is to raise awareness about the problem and give parents and kids direction in trying to live a healthy life.

Now, perhaps you’re thinking that the issue is overblown, who cares if Dick isn’t on the track team, or Jane doesn’t do gymnastics: They need to focus more on their studies so they can compete in this increasingly competitive global climate. Which is exactly why they need to be active, according to a recent study that found a link between physical activity and brain development in 9- and 10-year-old kids. According to MRI results, kids who are more active tend to have a bigger hippocampus, the hippocampus being a device inside the brain associated with learning and memory, specifically with spatial reasoning and other cognitive tasks. So, which do you want for your kids: A bigger hippocampus or gluteus maximus?

And despite the rain, this is a great time to start bulking up your child’s hippocampus. As posted last week, this is Take A Child Outside Week and there are all sorts of programs going on aimed at getting your kids moving outdoors. Thursday, for instance, there’s a TACO event scheduled at the N.C. Museum of Natural Sciences’ Prairie Ridge facility in Raleigh.

Go here for more on TACO and where to find TACO-related events statewide.

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