Health Of The Nation: Obesity Up, But 'Notable' Decline In Physical Inactivity

In our house, when there's good news and bad news, we usually start with the good. So here goes:

According to a new national health statistics report out today analyzing five key health behaviors among U.S. adults — sufficient sleep, smoking, drinking, obesity, and physical activity — there are several bright spots. For instance, the survey found that fewer young people (18-24) are smoking and the number of adults who report they're completely aerobically inactive showed 'notable' declines in recent years, from 39.7% inactive between 2005-2007 to 33.9% in the years 2008-2010.

O.K., now the bad news: Heavy drinking has increased, except among the senior set over 75, smoking prevalence remains virtually unchanged (beyond the youngsters) and obesity is up.

My first reaction is: Huh? Is anyone out there listening to Michelle Obama and all those other Get-Out-There-And-Move and Cut-The-Sugar advocates?

But then I talked to Dr. Eddie Phillips, director of the Institute of Lifestyle Medicine and an assistant professor of Physical Medicine and Rehabilitation at Harvard Medical School, who insisted on highlighting the positive.

A little background: Dr. Phillips' focus is on physical activity, the link between health and exercise and on educating physicians about how to more seamlessly incorporate physical activity into the practice of medicine.

His takeaway from the CDC report is this: "People are starting to move."

What's truly promising, he says, is that the 'notable decline' in aerobically inactive adults comes on the heels of a global campaign to have doctors assess physical activity as a vital sign and then "prescribe" exercise as they would any other medication. This suggests that both practitioners and patients are starting to get the message.

Dr. Phillips adds that his overall gestalt on the topic is that "this is not an all or nothing" prospect: "It's not like you're 'healthy' or you're 'not healthy.' "If you make small changes, it makes an impact."

So, for instance, he says, even if you don't meet the federal guidelines for physical activity — 150 minutes per week of moderate-intensity physical activity, like brisk walking — it still helps to do something. "Seventy-five minutes is OK," Phillips says. "Anything you do short of sitting on the couch is beneficial."

Dr. Phillips even has something upbeat to say on the CDC finding that obesity is up, noting that, while he's not an obesity expert, studies have found that being physically active is somewhat protective against the medical conditions associated with obesity. "So if we have a lot of heavy people walking briskly, we may be ahead of the game," he says.

On an individual level, Dr. Phillips adds: "The challenge is not about getting the information out: people know they're supposed to be moving and eating less junk food. This is a translational issue; it's about encouraging them to make modest, sustainable changes." On the overall statistics, he says: "This is a report card, so while there are some bad marks, there are also places where, as students, there's hope."

Here are more of the bottom line numbers, from the CDC report:

•About 6 in 10 (64.9%) U.S. adults were current drinkers in 2008–2010; about 1 in 5 adults (20.9%) were lifetime abstainers.

•About one in five adults (20.2%) were current smokers and over one-half of adults (58.6%) had never smoked cigarettes. Less than one-half of current smokers (45.8%) attempted to quit smoking in the past year.

•Nearly one-half (46.1%) of adults met the federal guidelines for aerobic physical activity, about one-quarter (23.0%) of adults met the federal guidelines for muscle strengthening physical activity, and about one in five adults (19.4%) met both guidelines.

•About 6 in 10 adults (62.1%) were overweight or obese (BMI ≥ 25), with about 4 in 10 (36.1%) adults being of healthy weight (18.5 ≤ BMI < 25).

•About 7 in 10 adults (69.7%) met the Healthy People 2020 objective for sufficient sleep.

The report is massive and you could spend the day wading through it, comparing men and women, racial groups and income levels. (For instance: "Adults who had family incomes four times the poverty level or more (57.8%) were nearly twice as likely as adults with family incomes below the poverty level (32.4%) to have met the 2008 guidelines for aerobic physical activity through leisure­ time activity.")

Here are some notable changes since the government last conducted the survey:

•Since the last report, the percentage of adults who had five or more drinks in 1 day at least once in the past year increased from 20.5% (2005–2007) to 23.6% (2008–2010)— with increases in every age group except adults aged 75 and over.

•Adult smoking prevalence remained unchanged between 2005–2007 (20.4%) and 2008–2010 (20.2%) although declines were seen among adults in the youngest age group (aged 18–24) from 23.5% (2005–2007) to 21.2% (2008–2010)

•With the introduction of new national physical activity objectives since the last report, direct comparisons of the percentage of adults meeting most physical activity goals are not possible; however, the goal of reducing the percentage of adults who are physically inactive in terms of aerobic activity remains comparable. The percentage of adults who were completely aerobically inactive had remained at 38%–40% between 1997 and 2004. However, in subsequent years the percentage of adults who were aerobically inactive showed a notable decline from 39.7% (2005–2007) to 33.9% (2008–2010). This decline coincides with the release of the 2008 federal guidelines for physical activity and major public health initiatives to promote physical activity.

•Yet despite declines in physical inactivity, the percentage of adults who were obese increased from 25.4% to 27.4% during this time period; the percentage of adults who were overweight but not obese, on the other hand, remained stable at about 35%.

•For ages 25 and over, the percentage of adults who got insufficient sleep remained essentially unchanged between 2005–2007 and 2008–2010.