Promoting Healthy Lifestyles and Decreasing Childhood Obesity: Increasing Physician Effectiveness Through Advocacy

Many thanks to Dr. McDonough for his excellent suggestions about how physicians can get involved in promoting healthy lifestyles in our communities--and for noting the benefits to ourselves in doing so. Our communities appreciate us when they perceive that we are interested not only in taking care of them when they are sick but in keeping both adults and children healthy and fit. And there is, indeed, a great sense of satisfaction in doing so.

Competing interests:   None declared

Much thanks to Dr. Herbert for reinforcing the need for prevention and for systems change and for noting that this will help our patients feel empowered to improve their health. I believe we should avoid repeating the "nanny state" terminology altogether. There are many ways in which we accept government intervention as part of our lives. Few people would argue that we have a right to drive without licenses, eat food in restaurants that have have not been inspected for safety--or, now, smoke in public places where others are endangered. Enhancing the ability for people to make healthy choices about food and physical activity should gain the same acceptance.

Competing interests:   None declared

Dr. Saxe has written an excellent article on the importance of physician advocacy in promoting fitness and improving nutrition for children and adults. Childhood obesity rates have been increasing for several generations and are the result of many factors. Dr. Saxe noted 70 recommendations by the White House to address childhood obesity and the article by Dr. Thomas Frieden stressing the importance of healthy environments and decisions made in communities. Physicians have many opportunities to become involved in their community, state, nation or world. Rather than being overwhelmed by the enormity of the issue, a physician can pick one project to work on and get accomplished. Physicians can work with their schools to improve menus, to plant school gardens, to promote more physical education and to encourage safe walking or biking to school. Many towns and cities can increase bike paths and encourage utilization of neighborhood parks. Physicians can support the marvelous work done by community organizations such as Boy Scouts, Girl Scouts, 4-H and other youth-oriented community groups. Statewide coalitions exist and national organizations are increasingly becoming involved with promotion of fitness and nutrition. I have worked as a pediatrician in the rural state of North Dakota for over 31 years and have been involved in community efforts to reduce tobacco use and to improve fitness and nutrition. I currently serve on the President's Council on Fitness, Sports and Nutrition with 16 council members including two other physicians. One of the Council's major activities is promotion of the Presidential Active Lifestyle Award (PALA+), a free online fitness log with nutrition goals. Nearly 2 million have completed their PALAs in the past year. First Lady Michelle Obama's Let's Move initiative has resulted in tremendous interest in fitness and nutrition. Organizations such as Boy Scouts of America have included PALA+ in their programming. SCOUTStrong PALA is available for anyone involved in scouting and can be accomplished by youth exercising 60 minutes a day, five days a week for 6 out of 8 weeks while adults need 30 minutes a day, five days a week for 6 out of 8 weeks. A weekly nutrition goal is chosen. Physicians can receive positive feedback for their community efforts and enjoy a sense of satisfaction in helping their community. Find something to work on, if that doesn't work out; find something else to get done. No matter what we are doing, we call all do better. Together, we can make a difference. For more information on the President's Council and PALA+, please go to http://www.fitness.gov/.

Competing interests:   None declared