NiCole Keith, an associate professor of physical education at Indiana University, set out to examine how physical activity is influenced by a range of factors for city-dwellers. Her study involved 998 people aged 49 to 65 living in St. Louis. She looked at the condition of sidewalks, the presence of outdoor lighting, and other environmental characteristics believed to affect an individual’s decision to be active. The result, she says “was not at all what we expected.” The interior condition of people’s houses turned out to be the only factor linked to their level of physical activity.

“If you spend your day dusting, cleaning, doing laundry, you’re active,” Keith said. Indeed, studies have shown that many household chores and gardening tasks burn enough calories to constitute moderate exercise–the equivalent of a brisk walk.

Keith thinks her findings could help health experts shape recommendations that people are actually willing to follow. While people may be reluctant to take 30 minutes to go for a walk, they may be willing to spend the same time cleaning.

For the study, a team at Canada’s McMaster University asked one group of women to drink a tall glass of nonfat milk immediately after doing a resistance workout and then another glass an hour later. A second group of women drank a look-a-like sugar-based energy drink after their strength-building workout.

Twelve weeks later, the milk drinkers showed better changes in body composition than the non-milk drinkers.  

“The women who drank milk gained barely any weight because what they gained in lean muscle they balanced out with a loss in fat,” said Stu Phillips, a professor of exercise science at McMaster, in a press release issued by the university. “Our data show that simple things like regular weightlifting exercise and milk consumption work to substantially improve women’s body composition and health.”

What gives milk drinkers an edge? Phillips speculates that the combination of calcium, high-quality protein and vitamin D may somehow increase fat burning.

House-hunting? Try walking around the neighborhood before you sign on the dotted line.

People who live in older, more “walkable” neighborhoods, researchers at the University of Utah report, are less likely to be overweight or obese than those in newer areas. The investigators used census data and height and weight information from 453,927 residents of Salt Lake County. People who lived in more walkable neighborhoods—typically built before 1950—weighed between 6 and 10 pounds less than those in more modern areas where people have to drive to get where they want to go.

The design of a neighborhood can even affect how much television people watch. Women living in walkable communities, Australian researchers report, watched significantly less TV than did those in pedestrian-unfriendly areas. (Men, however, were just as likely to be glued to the screen no matter where they lived.)

It’s hardly surprising that living in a neighborhood where you can step out the door and walk encourages people to be more active. In a study published in 2007 in Stanford Medicine Magazine, which looked at people who had resolved to get more exercise, 67 percent of those in pedestrian-friendly neighborhoods reached their goal of at least two-and-a-half hours of exercise a week, compared to only 30 percent in car-centric areas.

For more information, including a great checklist of the features that make a community pedestrian friendly, check out the FAQs at Walkable Communities, a non-profit consulting group based in Orlando, Florida.

Intrigued by the fact that several monkey species use skin redness to trumpet their good health and sexual attractiveness, the researchers decided to test whether the same holds true for humans. They began by measuring how skin color varies depending on the amount of blood and oxygen carried in the blood. Skin is laced with tiny blood vessels which carry more oxygen-rich blood in people who are physically fit and healthy.

Using a computer graphics program, the scientists then asked volunteers to adjust the color of faces in a series of photographs to make them look as healthy as possible.

For all the faces, volunteers added more oxygen-rich blood color to make the faces look healthier. “Our evaluators all thought that bright red blood with lots of oxygen looked healthier than darker, slightly bluer blood with lower oxygen levels,” said Dave Perrett,  director of the University of St Andrews Perception Lab, which participated in the research. “It is remarkable that people can see this subtle difference.”

The findings are published in the free-access online journal PLoS One, where you’ll find a comparison of facial colorings perceived as unhealthy versus healthy.

The take-home message: Toned muscles and a slim waistline aren’t the only benefits of getting fit. By subtly changing your skin coloration, oxygen-rich blood may actually make you more attractive in subtle but powerful ways.

© 2009 PDQhealth

Dieters have a new way to motivate themselves to shed excess fat: betting money on it. Thanks to a growing number of websites that enable people to make bets and track their progress, hopeful weight losers are betting against one another to see who can lose the most weight.

The new trend, featured in today’s New York Times, first surfaced about six months ago. By now, at least three websites facilitate dieting bets: StickK.com, fatbet.net and makemoneylosingweight.com.

Research shows that betting on losing weight can be surprisingly effective. People may begin with the the goal of losing weight, but before long winning the bet becomes the big motivator. In some cases, lots of money may be at stake. The Times describes one example of a winner-take all weight loss competition among nine employees, each of whom put in $100. The biggest loser netted $900.

Richard B. McKenzie, an economist and frustrated dieter, placed a bet with a friend that he would pay her $500 if he didn’t lose the stubborn last ten pounds that had always eluded him. Writing in the Wall Street Journal, he described how effectively the bet nudged him to get serious. “After signing the contract, I was equally amazed at how the looming $500 payment affected my behavior. While on my diet, I judged practically everything I ate in terms of how much it would ultimately cost me,” he wrote. “After gaining a pound on the first day after signing the contract, I joined a gym, perfectly happy to pay the steep rates. Why? Because the price of the gym membership went down with my pact. The membership could, and did, help me reduce the probability that I would have to make the $500 payment. I also extended my exercise walks through the woods because, I figured, I was being paid, effectively by myself, to go the extra miles.”

A study at the Philadelphia Veterans Affairs Medical Center, published in the December issue of the Journal of the American Medical Association, found that dieters with an economic incentive were far more successful at shedding pounds. After 16 weeks, a control group lost just under four pounds, compared to 13 to 14 pounds in the two groups with monetary incentives. About half of those with money at stake met their 16-week goal, compared to only about 10 percent of those with no financial incentive.

The strategy isn’t new. In the United Kingdom, a bookmaker names William Hill has been taking bets since around 1993 from people who want to gamble on their ability to lose significant amounts of weight, according to a recent report on NPR. In about 80 percent of cases, the betting house wins and the dieter loses.

Even for successful losers, the trick remains keeping the weight off. The Philadelphia VA study showed that seven months after the 16-week weight loss program, many successful losers had begun to gain the weight back again. Still, putting money at risk can be a powerful motivator. You can literally bet on it.

© 2009 PDQhealth

Many randomized trials show that exercise effectively eases chronic back pain, improves function, and minimizes disability. Yet when researchers at the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill surveyed almost 700 individuals with chronic back pain by telephone, less than half had been prescribed exercise. Of those who were, 46 were given an exercise prescription by a physical therapist, 27 percent by a physician, and 21 percent by a chiropractor.

As the researchers note, “who you see is what you get.”

“Considering current evidence of the efficacy of exercise,” they conclude, “these findings demonstrate that exercise is being underutilized as a treatment for chronic back and neck pain.”

How effective is exercise for back pain? And what’s the best form of exercise to do? Therapeutic aquatic exercise appears to help many sufferers, according to a 2009 analysis of dozens of studies. Other research shows benefits both from resistance exercise and aerobic workouts. For more details, check out “Fitness and Low Back Pain,” by Len Kravitz and Ron Andrews of the University of New Mexico’s Department of Exercise Science. You’ll find useful practical advice from the International Fitness Professionals Association. If you need more help, ask you doctor to refer you to a physical therapist.

© 2009 PDQhealth

Consider the relationship between breast cancer and exercise. While some studies have found that physical activity protects against the disease, others haven’t turned up any link at all. Now several new findings have begun to untangle these contradictions.

Results from a newly-published study by researchers at the German Cancer Research Center (the Deutsches Krebsforschungszentrum, or DKFZ) suggest that physical activity does lower breast cancer risk by as much as 30 percent. But the investigation, which compared 3,464 breast cancer patients with 6,657 healthy controls, also found that not all women benefit equally, and not all forms of breast cancer respond equally to exercise. Physical activity after age 50 appears to offer more powerful protection than exercise earlier in life, according to the results. The protective effects appeared up most clearly for hormone receptor positive forms of the disease. Other forms, including HER2, did not show the same strong association. Because weight gain, total energy intake, and BMI did not have any influence, researchers speculate that physical activity may protect by way of a hormonal mechanism.

There are still mysteries to untangle. In another study published this month, researchers at the National Cancer Institute in the U.S. found that active women had a 13 percent lower risk of the breast cancer than their sedentary counterparts. Women who were overweight or obese seemed to get more protection from exercise. So did those with a family history of breast cancer. But in this study, exercise seemed to protect more powerfully against estrogen receptor negative forms of the disease.

Despite the lingering puzzles, the sum of the evidence now strongly suggests that being physically active can lower the danger of breast cancer. And protecting yourself doesn’t require turning your life upside down. The German Cancer Research Center study found that even everyday activities–gardening, walking to the grocery store, pushing a lawnmower–offer protection. Said Karen Steindorf, MD, who headed up the analysis and is an associate professor at the DKFZ: “Our advice to all women is therefore to stay or become physically active also in the second half of your life.”

True, the aches and pains of middle age and beyond can make it hard to be active. But that’s also a time in life when health and longevity become all the more treasured. The latest findings should offer an additional nudge to get up and get moving. 

© 2009 PDQhealth 

And the residents of Recife have been flocking to join in. Since the program began, more than 100,000 have been enrolled each year and have been taught 888,000 exercise classes. That’s impressive enough. But a new study of the program also shows that current and past participants are three times more likely than those who never participated to continue leading physically active lives. The free classes, in other words, seem to inspire people to make lasting changes for the better.

“This is the first thorough evaluation of a program of its kind and highlights the importance of renewing public spaces and providing physical activity classes,” says Washington University professor Ross C. Brownson, PhD, who led the study. The Recife program, he believes, could serve as a model for similar programs in the U.S.

Eduardo J. Simoes, MD, director of the Prevention Research Centers at the U.S. Centers for Disease Control and Prevention, which helped fund the study, agrees. “We think this project is an effective strategy to stimulate life-long exercise. Coupled with healthy eating, physical activity can help prevent and control diabetes, hypertension, and heart disease, resulting in improved quality of life and health.”

Fine words, those. Unfortunately, given the sorry state of many municipal and state budgets at the moment, it’s hard to imagine many locales offering free exercise programs–even if such initiatives would end up paying off in better health and lower medical care costs.

Until economic indicators perk up, we may have to rely on approaches that encourage people to take the initiative themselves, such as Live Healthy America. For more information about the program–and to track the progress of our favorite participating team, check out PDQhealth’s on-going series Good Luck, Ms.Fits!

© 2009 PDQhealth

Researchers at Loyola University Health System compared African-American women in metropolitan Chicago with African women in rural Nigeria. By any measure, their lifestyles could hardly have less in common. Certainly one distinction was plain to see. The Nigerian women weighed an average of 127 pounds, compared to 184 for their counterparts in Chicago—a whopping 57 pound difference.

Yet something unexpected turned up when scientists compared physical activity. The two groups of women differed hardly at all. The Chicagoans burned an average of 760 calories a day doing physical activities. The Nigerians tallied up 800 calories. The variance was not statistically significant.

Exercise has plenty of benefits. But when people burn more calories by exercising, studies generally show, they compensate by eating more–a basic survival mechanism.  ”We would love to say that physical activity has a positive effect on weight control,” said Richard Cooper, PhD, co-author of the study and chairman of the department of preventive medicine and epidemiology, “but that does not appear to be the case.”

Tellingly, the study, which included 149 women from two Nigerian villages and 172 women from Chicago and its suburban neighbor Maywood, did turn up dramatic differences in diet. The Nigerians eat foods high in fiber and carbohydrates and low in fat and animal protein. The Chicagoans–like the average American–ate a diet top heavy in processed foods, with precious little fiber and 40 to 45 percent of calories from fat.

The new findings don’t come as a complete surprise. In a previous study of volunteers from Jamaica, Loyola researchers detected no association between activity levels and weight gain over a six-year period. Other research has shown little connection between activity and body weight.

None of this implies that gettig off the couch isn’t important. It decidedly is. But so is watching what you eat, all the more so in a world of processed foods and oversized portions. “Evidence is beginning to accumulate that dietary intake may be more important than energy expenditure level,” said Loyola nutritionist Amy Luke, PhD, who co-authored the paper. “Weight loss is not likely to happen without dietary restraint.”

©2009 PDQhealth

But the publisher of The Big Skinny: How I Changed My Fattitude, A Memoir, by Carol Lay (Villard Books, 2008) kindly sent me a review copy, perhaps mistaking me for someone else. I figured the least I could do in return was give it a quick browse.

From the first page, I was charmed.

Heaven knows there are more than enough weight-loss books to tip the scale. (I’ve helped to write one or two myself.) Most recycle the same basic advice in different guises. With self-effacing humor, antic drawings, and an insider’s knowledge of the pratfalls of shedding pounds, Lay uses the comic book format to make the familiar advice fresh, personal, convincing, and even fun.

“You want to lose weight?” her cartoon character asks. “The experts all agree that it’s tough, but that it IS possible. So!–Make a decision, take action, be honest, and stick to it! Be all that you can be, baby. Just not so much of it.”

The Big Skinny covers most of the essential territory, from theories about why some people get fat and others don’t to emotional triggers for eating. “What?! You’re dumping me?! The night before Valentine’s Day?!! No–Don’t go!! Ben!” a character cries as her boyfriend slams the door. “Ben!!” she sobs, as a series of frames transports her from the door of her apartment to the door of the refrigerator, where “Ben!” becomes “Ben and Jerry!” And she buries her face in a pint of ice cream.

No sooner, in another sequence, does the narrator vow that “not even the sexiest man on earth bearing gifts of food could tempt me now” than who should show up bearing a sack of sausage biscuits with eggs and hash browns but George Clooney. “That’s what I get for living in Hollywood,” her character says.

There’s little new in the advice Lay offers–but then there’s very little that’s new in any weight-loss tome. A few of her points are debatable. She vilifies liquor, for instance. (”They say a glass of wine a day is good for your heart, but it’s not good for your butt!”) In fact, there’s evidence that people who drink moderately with meals weigh less than those who don’t drink. Liquor itself may not be the reason. People who drink wine with dinner also tend to eat healthier meals. But still…

Even here, however, Lay casts her advice in the form of her own personal experience, which gives the book a confiding rather than prescriptive tone. Indeed, the real pleasure (and value) of The Big Skinny is Lay’s exuberant humor and the many clever ways her cartoon narrative takes the evergreen advice and makes it personal and specific. You’ll come to identify with her cartoon persona and to like her a lot. Dieters who hit a snag may find themselves returning to a few of the episodes she narrates to console themselves and renew their commitment to losing weight. A colorful compendium of calorie charts and recipes at the back of the book should prove useful to anyone who’s trying to shed some pounds.

The good fun of The Big Skinny doesn’t change the fact that it’s damned hard to lose weight and keep it off. But by offering plenty of laughs along the way, this is one diet book that will help you keep your spirits up as you try to bring your weight down.

©2009 PDQhealth