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Originally published Tuesday, August 28, 2012 at 6:30 AM

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Changing our tune on exercise

Personal Health: Decades of messages that regular physical activity is necessary for health have cast exercise as a pill to be swallowed. Now experts recommend a new approach that portrays exercise as "an elixir of life."

The New York Times

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What would it take to persuade you to exercise?

A desire to lose weight or improve your figure? To keep heart disease, cancer or diabetes at bay? To lower your blood pressure or cholesterol? To protect your bones? To live to a healthy old age?

You'd think any of those reasons would be sufficient to get Americans exercising, but scores of studies have shown otherwise. It seems that public health experts, doctors and exercise devotees in the media — like me — have been using ineffective tactics to entice sedentary people to become, and remain, physically active.

For decades, people have been bombarded with messages that regular exercise is necessary to lose weight, prevent serious disease and foster healthy aging. And yes, most people say they value these goals. Yet a vast majority of Americans — two-thirds of whom are overweight or obese — have thus far failed to swallow the "exercise pill."

Now research by psychologists strongly suggests it's time to stop thinking of future health, weight loss and body image as motivators. Instead, these experts recommend a strategy marketers use to sell products: portray physical activity as a way to enhance current well-being and happiness.

"We need to make exercise relevant to people's daily lives," Michelle L. Segar, a research investigator at the Institute for Research on Women and Gender at the University of Michigan, said in an interview. "Everyone's schedule is packed with nonstop to-do's. We can only fit in what's essential."

REFRAMING THE MESSAGE

Segar is among those who believe that people will not commit to exercise if they see its benefits as distant or theoretical.

"It has to be portrayed as a compelling behavior that can benefit us today," she said. "People who say they exercise for its benefits to quality of life exercise more over the course of a year than those who say they value exercise for its health benefits."

Her idea for a public service advertisement to promote exercise for working women with families: A woman is shown walking around the block after dinner with her children and says, "This is great. I can fit in fitness, spend quality time with my kids, and at the same time teach them how important exercise is."

Based on studies of what motivates people to adopt and sustain physical activity, Segar is urging that experts stop framing moderate exercise as a medical prescription that requires 150 minutes of aerobic effort each week. Instead, public health officials must begin to address "the emotional hooks that make it essential for people to fit it into their hectic lives."

"Immediate rewards are more motivating than distant ones," she added. "Feeling happy and less stressed is more motivating than not getting heart disease or cancer, maybe, someday in the future."

In a study of 252 office workers, David K. Ingledew and David Markland, psychologists at the University of Wales, found that while many began to exercise as a way to lose weight and improve their appearance, these motivations did not keep them exercising in the long term. "The well-being and enjoyment benefits of exercise should be emphasized," the researchers concluded.

Segar put it this way: "Physical activity is an elixir of life, but we're not teaching people that. We're telling them it's a pill to take or a punishment for bad numbers on the scale. Sustaining physical activity is a motivational and emotional issue, not a medical one."

Other studies have shown that what gets people off their duffs and keeps them moving depends on age, gender, life circumstances and even ethnicity. For those of college age, for example, physical attractiveness typically heads the list of reasons to begin exercising, although what keeps them going seems to be the stress relief that a regular exercise program provides.

The elderly, on the other hand, may get started because of health concerns. But often what keeps them exercising are the friendships, sense of community and camaraderie that may otherwise be missing from their lives — easily seen among the gray-haired women who faithfully attend water exercise classes at my local YMCA.

In a recent study of 1,690 overweight or obese middle-aged men and women, Segar found that enhancing daily well-being was the most influential factor for the women in the study. Men indicated they were motivated by more distant health benefits, although Segar suspects this may be because men feel less comfortable discussing their mental health needs.

"What sustains us, we sustain," Segar said. "We need to promote what marketers call 'customer loyalty.' We need to help people stay engaged with movement by teaching them how it can help sustain them in their lives."

VALUE BEYOND WEIGHT LOSS

Many people, if not most, start exercising because they want to lose weight. But very often they abandon exercise when the pounds fail to fall off. Study after study has found that without major changes in eating habits, increasing physical activity is only somewhat effective for losing weight, though it helps people maintain weight loss, and shedding even a few pounds, especially around one's middle, can improve health.

For example, researchers in Brisbane, Australia, and in Leeds, England, studied 58 sedentary overweight or obese men and women who participated in a closely monitored 12-week aerobic exercise program. Weight loss was minimal, but nonetheless the participants' waistlines shrunk, their blood pressure and resting heart rate dropped, and their aerobic capacity and mood improved.

"Exercise should be encouraged and the emphasis on weight loss reduced," the researchers concluded. "Disappointment and low self-esteem associated with poor weight loss could lead to low exercise adherence and a general perception that exercise is futile and not beneficial."

I walk three miles, or bike 10 miles and swim three-quarters of a mile daily. If you ask me why, weight control may be my first answer, followed by a desire to live long and well. But that's not what gets me out of bed before dawn to join friends on a morning walk and then bike to the Y for my swim.

It's how these activities make me feel: more energized, less stressed, more productive, more engaged and, yes, happier — better able to smell the roses and cope with the inevitable frustrations of daily life.

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