Social influences on fitness behavior

Physical fitness is maintained by a range of physical activities. Physical activity is defined by the World Health Organization as "any bodily movement produced by skeletal muscles that requires energy expenditure."[1] Human factors and social influences are important in starting and maintaining such activities. Social environments can influence motivation and persistence, through pressures towards social conformity.

Obesity
Main article: Obesity

Obesity is a physical marker of poor health, increasing the likelihood of various diseases.[2] Due to social constructs surrounding health, the belief that being skinny is healthy and discrimination against those perceived to be 'unhealthy',[3] people who are considered overweight or obese on the BMI scale face many social challenges. Challenges can range from basic things such as buying clothes, pressure from society to change their body, and being unable to get a job. This can lead to various problems such as eating disorders, self-esteem issues, and misdiagnosis and improper treatment of physical ailments due to discrimination.

Adult

Obesity has become a serious health risk throughout the developed world.[4] More than 1 billion adults are overweight, and more than 300 million of them are clinically obese.[4] Furthermore, 40% of adults in the United States in 1997 reported engaging in no physical activity, while 59% do not engage in vigorous leisure-time physical activity. Although these percentages and occurrences of inactivity among older adults may vary by racial and ethnic group, and by gender, it's stated that inactivity appears, "From 47 percent among woman age 75 and older to 59 percent in older black males and 61 percent in older black females" (Hughes et al. 55).

Children

Nearly one in five children in the United States are overweight. Ogden et al., studied 3,958 children and adolescents between the ages of 2–19 from 2003–2004.[5] The study was a part of the NHANES which is the National Health and Nutrition Examination Survey. It showed that 17.1% of the 3,958 children were overweight, with over 35% percent of children ages 6–19 being seriously overweight.[5] Ogden et al., had results showing 37.4% of this group was considered to be seriously overweight. Another age range where there are a high percentage of children who are overweight, are the range from 6–11. Ogden et al., was a study which was conducted in 2003–2004. The data collected was arranged into different age ranges. It showed that 18.8% of children ages 6–11 are overweight.[5] Research has shown that obesity in children has increased from 1999 to 2004. The 1999 study showed that 28.2% of children from the ages of 2–19 were overweight. In the 2004 study, that amount was 33.6%. The age range that was the most affected was children from the ages of 6–11, for which the percentage rose 7.4 points from 29.8% to 37.2%.[5]

Obesity can be responsible for lowering an individual's views on themselves as well as their self-respect. Sweeting et al., conducted a test on children ages 11–15.[6] 2,127 students were surveyed on who was obese, who needed to slim down, and who was becoming obese. Of these students, 9.6% of males and 10.5% of females were considered obese at age 11. At age 15 10.5% of males and 11.6% of females were obese. 3.5% of the total students surveyed needed to slim down and 4.5% are becoming obese. The test revealed that obesity has a great effect on changing moods and lowering of self-esteem.[6]

Inactivity is one of the biggest reasons for obesity in children. Berkey et al., conducted a study on 11,887 children from the ages of 10–15 to test whether or not an increase in a person's activity level would reduce a person's body fat.[7] A test done on girls concluded that an increase in physical activity brought their body mass index (BMI) down .11. The male test resulted in a .33 decrease in their BMI. An increase of inactivity showed an increase in BMI for girls by .02.[7] A way to improve this inactivity would be by changing a child's daily physical regime. Switching an overweight child's daily physical activity could help a child lose weight and get into better physical condition. Rodearmel et al., studied a couple of Latino families who had at least one child between the ages of 7–14.[8] This was done over a 6-month span. There were two groups that the children were put into. The first group was the "America on the Move" group and the other group was the "self monitor only" group. The America on the Move group had to walk an additional 2,000 steps per day from their baseline which was already measured through pedometers and to eliminate 100 kcal/day from their normal diet by replacing dietary sugar with no caloric sweetener. The self monitor group did not have to change their physical activity or their diet. This group only had to record their physical activity with pedometers. Both groups had results showing they had decreased their BMIs with the America on the Move group decreasing their BMI much more significantly.[8]

Reasons for inactivity
Segregated cycling along a Fietspad in Amsterdam, safe by avoiding conflict with traffic.
Nederlands Amsterdam: Cycle route through Rijksmuseum in direction of city

In the West, there is a high prevalence of overweight and obese children and adults. In the US, only 26% of adults engage in vigorous leisure-time activity (which includes a sport) or exercising three or more times per week. In an effort to increase adult involvement and decrease the percentage of adult inactivity, the US Department of Health and Human Services has set a national health objective for 2010 that hopes to "Reduce the prevalence of no leisure time activity from more than 25 percent to 20 percent of US adults" (Berlin, Storti, and Brach 1137). In Australia, the Australian Bureau of Statistics found that in 2011/12 adults spent an average of 33 minutes per day doing physical activity with 60% of the population doing less than 30 minutes and fewer than 20% doing an hour or more per day on average. The survey also showed almost 30% of the adult population reporting more than five hours of sedentary leisure activity each day.[9]

Inactivity can contribute to a range of health related problems including: obesity, heart disease, metabolic syndrome, and other disorders. Researches have shown, "49 percent of heart disease in sedentary patients is due to lack of exercise" (Perkins, Whitehead, Steptoe 725) and the relative risk of metabolic syndrome was, "1.7 (95% CI 0.9–2.8) for lack of exercise, 1.5 (95% CI 1.1–2.1) for a positive family history and 2.0 (95% CI 1.2–3.4) in individuals with none or only an elementary school education versus university graduation" (Lee et al. 48).

Inactivity in young people has been seen to be rising in recent years, and the prevalence of sedentary leisure activities for children is significant. Video games and the internet may play a part in this. It has been found that "26 percent of children and adolescents in the United States spend more than four hours a day watching television, and they have become even more sedentary with access to computers and video games" (Damlo 1434). Along with, "62 percent of children nine to thirteen years of age do not participate in organized physical activities, and 23 percent do not participate in non-organized physical activities outside of school hours" (1434).

There may be many reasons why people may remain inactive. One reason may be due to laziness. Individuals completed a Physical Activity Questionnaire and research showed "Over one third (34 percent) of female and 12 percent of male adolescents had no leisure physical activity during a one-week period. Self-efficacy was found to have the highest correlation to leisure physical activity among all selected determinants, while 'laziness' had the highest correlation among perceived barriers" (Analysis). Along with the questionnaire other research suggested that fitness groups and fitness programs positively altered the exercise behavior of families and youths.

Another reason for physical inactivity is the perception by populations that there is nowhere safe to do so. As cities become more populated, the increased need for housing overtakes the desire for parks, cycle and walk ways therefore increasing the amount of physical inactivity in the population. Ways that can help increase the amount of physical activity is to plan and build the environment in a way that makes the population of the community feel safe to be physically active in the area. This could be done for example by slowing speed limits to safer speeds and providing safe street crossings and also by building infrastructure close to the street and pathways with safe pedestrian and cycle access and safe bike parking.[10] By implementing these simple changes into communities, the residents will have an increased feel in security and therefore increase their daily physical activity.

Initiatives

Given the social and economic costs of low levels of physical activity there have been a number of public policy initiatives to raise the level, particularly focusing on children and adolescents.

Fitness portal

United States government agencies, at both Federal and State levels, have initiated a number of programs which include encouraging workers to bike to work rather than to drive. The Fitness Portal provides a range of tools, examples, and case studies of organization ideas. A few examples given by the Fitness Portal include: using the push mower, going for a walk, taking the stairs instead of an elevator, biking, running errands, visiting friends, cleaning out the garage or the attic, volunteering to become a coach or referee, signing up for a group exercise class, joining a softball league, or parking at the farthest end of the parking lot. For children they suggest: taking a dog for a walk, starting up a kickball game, joining a sports team, going to the park, helping their parents with yard work, playing tag, riding their bike to school, walking to the store, seeing how many jumping jacks they can do, or racing a friend to the end of the block.[11]

Wellness On Wheels

The Wear Valley District Council along with its local Durham Dales Primary Care Trust in England developed an innovative scheme in an effort to combat the high levels of poor health and obesity in the area. They created a mobile gym with electronic fitness monitoring equipment, which is called "WOW" (Wellness on Wheels). This effort was to persuade as many people as possible to enroll in regular workouts as part of a wider campaign in the district. Barry Nelson, a health editor for the Northern Echo, in an interview noted a high level of interest generated. The strategy was to take exercise to people's homes rather than waiting for them to use existing leisure facilities. Children and adults, who otherwise wouldn't have exercised, came out to exercise in the mobile gym. Clearly, from this instance, the availability and nearness of a fitness program in a community positively affected the fitness behavior of the residents. As history explains, twenty-three years ago, Mr. Hackleman was named benefits manager. At this time the county had just three health and fitness programs: blood pressure screenings performed by public health nurses, a tennis tournament and some aerobics classes. However, soon after the roster grew to include at least five preventive health screening programs, eight healthy lifestyle and wellness programs, twelve health improvement and risk reduction programs and five family-life education programs. Finally in 2005, Ms. Gibson documented a total of 3,382 participants in the county's health and fitness programs, or 2,283 individuals, representing 41% of the county's population.

Walking School Bus
Main article: Walking bus
Třebíč-Vnitřní Město, Třebíč District, Vysočina Region, Czechia, Karlovo náměstí
Restaurant U Lišků, originally a country house, U trojského zámku str. 35/9 Troja. At the entrance to the Prague Zoo.

Most research that defends the idea of fitness programs increasing exercise practices among children and adults stems out of San Diego. Heritage Elementary school implemented its first walking school bus. This initiative had students walking to their designated stops, but not waiting for the school bus. Rather, waiting for a train of people on foot to pick them up. This allowed the students to walk to school with their peers. Although it is not directly stated, a major reason children choose to walk is because they fall victim to mob mentality. Perhaps the phrase, "fall victim to mob mentality" has a negative connotation, but that is, in essence, what the children do. Because so many other students were walking, all joined in. In this instance, mob mentality and mass behavior have a positive influence on fitness behavior, and encourage the students to exercise. The opinion of children, teachers and volunteers has been in general very favorable toward the project. Research states, "91.4 percent of participating students stated they liked the initiative very much and 87.4 percent among them prefer to go to school by the Piedibus than by any other means. Teacher and volunteers outlined the social value of the project and the increase in physical activity as positive aspects of the project". The group environment of the walking bus provides comfort in exercising, which in turn leads children to exercise more often. Although not exactly identical to the "Forrest Gump phenomenon", this walking school bus exhibits the same results: "If I can do it, you can do it".

Video games

Several video game companies have developed ways to mix the two spectrums of electronic and exercise. Dance Dance Revolution, perhaps the most well-known exercise game, had players earn points by dancing to a beat. Players earn more points for tapping dance pads on the dancing platform at precise times and in proper sequences, thereby incorporating physical exercise.

In 2006 Nintendo introduced the Wii, a next generation game console the features a motion sensitive controller. Many players have noticed the benefits of increased physical activity due to playing games on the Wii system, but that does not count as serious exercise.

Sedentary Behaviour

According to Biddle (2007) the social influence of technology, such as electronic gaming and screen time are the main causes towards actions of sedentary behaviour, with TV viewing and computer use being the most prevalent benefactors. However, sedentary behaviours, are not simply “opposites” of physical activity, but instead suggests that they "displace time that would otherwise be used for physical activity". (Biddle, 2007)[12]

Children and adolescents, are deemed most at risk for these sedentary behaviours with estimates for youth TV viewing being around "1.8 - 2.8 hours per day". Also Biddle (2007) states that for young people "television took up 40% of the time spent in the five most prevalent sedentary behaviours during the week and 37% at weekends" which stresses the negative impact of these social and technological advances on physical activity and fitness behaviour.[12]

The study Hardy, Dobbins, Booth, Denney, Wilson and Okely (2006) stated that, "there are powerful societal inducements to be inactive and there are increasing concerns of an emerging preference among young people to adopt sedentary lifestyles." Based on Australian adolescents, results were received which indicated that many young people are engaging in sedentary behaviour, with grade 6's spending 34 hours per week, grade 8's with 41 hours and grade 10's with 45 hours. (Hardy et al., 2006)[13]

Another study Zimmit (2010), found a strong, positive association between sedentary behaviours, in particular TV viewing, with obesity and low participation levels. The study stated that in the last 20 years (1990-2010), the prevalence of obesity in Australia has more than doubled. It stresses "public health initiatives targeting the reduction of sedentary pursuits may be necessary to curb the obesity epidemic."[14]

According to the study Martínez-González, Alfredo Martínez, Hu, Gibney, & Kearney, (1999) "Obesity is the most prevalent nutrition-related problem in Western societies, and it is associated with an important burden of suffering in terms of mortality, morbidity and psychological stress". The study stresses that people suffering from obesity place a severe burden on health care systems, and that obesity could become the leading public health problem in the next century.[15]

See also

References
  1. "World Health Organization". World Health Organization. Retrieved 2015-04-16.
  2. Haslam DW, James WP (2005). "Obesity". Lancet. 366 (9492): 1197–209. doi:10.1016/S0140-6736(05)67483-1. PMID 16198769. S2CID 208791491.
  3. Puhl, Heuer, Rebecca M, Chelsea A (June 2010). "Obesity Stigma: Important Considerations for Public Health". American Journal of Public Health. 100 (6): 1019–28. doi:10.2105/AJPH.2009.159491. PMC 2866597. PMID 20075322.
  4. "OBESITY AND OVERWEIGHT" (PDF). World Health Organization. Retrieved 2013-04-13.
  5. Ogden, C.L.; Carroll, M.D.; Curtin, L.R.; McDowell, M.A.; Tabak, C.J.; Flegal, K.M. (2006). "Prevalence of overweight and obesity in the United States, 1999–2004". The Journal of the American Medical Association. 295 (13): 1549–1551. doi:10.1001/jama.295.13.1549. PMID 16595758.
  6. Sweeting, H.; Wright, C.; Minnis, H. (2005). "Psychosocial correlates of adolescent obesity, 'slimming down' and 'becoming obese.'". Journal of Adolescent Health. 37 (5): 409. doi:10.1016/j.jadohealth.2005.01.008. PMID 16227129.
  7. Berkey, C.S., Rockett, H.R., Gillman, M.W., Colditz, G.A. (2003). One year changes in Activity and in Inactivity among 10- to 15-year-old boys and girls: relationship to change in body mass index. Pediatrics, 111(4), 836. Retrieved December 12th from ebscohost database.
  8. Rodearmel, S.J., Wyatt, H.R., Stroebele, N., Smith, S.M., Ogden, L.G., Hill, J.O. (2007). Small changes in dietary sugar and physical activity as an approach to preventing excessive weight gain: the America on the move family study. Pediatrics, 120(4), e869. Retrieved December 12th from ebscohost database.
  9. "Australian Bureau of Statistics". Australian Bureau of Statistics. 2013-07-18. Retrieved 2015-04-16.
  10. Fenton, Mark (December 2005). "Battling America's Epidemic of Physical Inactivity: Building More Walkable, Livable Communities" (PDF). Journal of Nutrition Education and Behaviour. 37 Suppl 2: S115-20. doi:10.1016/S1499-4046(06)60211-X. PMID 16246279. Retrieved 2015-04-16.
  11. http://www.fitness.gov
  12. Biddle (2007). "Sedentary behaviour". American Journal of Preventive Medicine. 33 (6): 502–504. doi:10.1016/j.amepre.2007.08.002. PMID 18022068.
  13. Hardy, Louise L.; Dobbins, Timothy; Booth, Michael L.; Denney-Wilson, Elizabeth; d.Kely, Anthony (2006). "Sedentary behaviours among Australian adolesents". Australian and New Zealand Journal of Public Health. 30 (6): 534–540. doi:10.1111/j.1467-842X.2006.tb00782.x. PMID 17209269. S2CID 25795604.
  14. Zimmit (2010). "Obesity in Australia: People, politics and prevention". Obesity Research. 4: S86. doi:10.1016/j.orcp.2010.09.168.
  15. Martínez-González, M. Á.; Alfredo Martínez, J.; Hu, FB; Gibney, MJ; Kearney, J. (1999). "Physical inactivity, sedentary lifestyle and obesity in the European union". International Journal of Obesity. 23 (11): 1192–1201. doi:10.1038/sj.ijo.0801049. PMID 10578210.

Further reading
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