DALLAS — For the 22% of Americans who are exercising enough to reap some health benefits: You go!
For the rest of you: Well, it's safe to say that you, collectively, have stumped the brightest minds in fitness and preventive health.
The exercise physiologists, the nutritionists, the gerontologists, the cardiologists. You've baffled them all. These are the experts who make it their mission to encourage Americans of all ages to become physically active. But they acknowledge that they've failed.
They don't know how to make you get off your butts.
Top experts in the field met here in October under the auspices of the Cooper Institute and the American College of Sports Medicine to air their woes.
Efforts to get people moving "are not working as well as we would like," said Tom Baranowski, an exercise expert at the University of Texas in Houston. "We're too ready to jump into interventions before we understand what is going on with behavior. . . . This field would advance a whole lot faster if we had an Einstein."
Alas, there is no Einstein to tell us how to become physically active in a vigorous enough mode to reap health benefits when we'd rather sit on the couch, watch "Mad About You" and snack on Pringles.
To be sure, one of the very few things that fitness experts know for sure is that if "sedentary forces" are nearby, people are more likely to be sedentary.
And while there is still much that is not understood about motivating people to exercise, the conference recognized a few key findings:
* People are more likely to exercise if they are given a choice rather than being told exactly what to do. "Interventions tend to work when there is free choice and when the activity is of lower intensity," said Rod Dishman of the University of Georgia at Athens.
* While half of all children do not get the recommended amounts of exercise, an analysis of 22 studies showed that most kids can reduce their sedentary behaviors through school physical education programs if the curriculum is well-rounded, the teacher is well-trained and there is follow-up to make sure the program is working.
* Although there are few studies on ethnic minorities and the motivation to exercise--and no studies on people with quadriplegia, paraplegia, mental retardation or poliomyelitis--some research suggests those groups need to be involved in planning exercise programs.
"The more the community owns the intervention, the more effective the intervention will be," said Wendell C. Taylor of the University of Houston Health Science Center.
In contrast to what is known, many questions remain on the question of motivating people to exercise.
For example, experts are frustrated over how to reconcile the view of fitness created by the exercise industry--which emphasizes a thin, sculpted body--with their own image of fitness as a means to improve health and prevent disease.
"Our view of what physical activity is may be at odds with the images of physical activity already entrenched in the population," Dishman said. "We're trying to talk about healthy activity and healthy weight. But the public wants these other images."
Fitness researchers need to look at people's activity levels as they age, suggested Abby King of the Stanford University School of Medicine. "We need to look at the moments of transition when people's activity levels are going up or down and how can we use these opportunities to affect physical activity."
And people need more precise definitions of how much exercise they need at a particular age or time in life. "How much of what type of strength training, flexibility and endurance do we need to recommend?"
A debate has ensued among health professionals over the popular idea that people need only "moderate" amounts of physical activity, which can be accumulated in short bursts throughout the day, such as by using stairs instead of elevators or walking the dog.
"Individuals should be trying to accumulate moderate-intensity exercise every day throughout the week. The short bouts are easier for people to put into their lives," said Ross Anderson of Johns Hopkins University in Baltimore. One study found that shorter bouts of activity led to a higher accumulation of actual active minutes.
But other health professionals doubt whether that kind of recommendation is having an impact.
"The idea of 'exercise lite' has probably been misinterpreted by many, many individuals. We need to define 'light' and define how much light activity is enough," says John Jakicic of the University of Pittsburgh Medical Center.
Finally, there is deep concern that many Americans feel they don't have an area where they can become physically active. Some communities lack bike paths, sidewalks or safe parks.
Future studies on fitness must look much more closely at the typical barriers people face, King said. "We need to understand what peoples' daily lives are like, so we can understand what their opportunities for being physically activity are."