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TV anchors poor diet and sedentary lifestyle
Researchers suggest today’s caregivers should take a hint from current business gurus: Get your patients to think outside of the box. That doesn’t mean it’s time to envision a new para-digm. To the clinician, the advice is literal — your patients need to rip themselves away from the television set.
Harvard researchers have found a correlation between the amount of time men spend watching television and their risk of developing Type 2 diabetes. The investigators suggest men who watch 19 hours of TV per week have double or triple the risk compared to those who are more physically active.
"Of course, television doesn’t cause diabetes," laughs lead researcher Frank Hu, PhD, MD, an epidemiologist at the Harvard School of Public Health in Boston. "But TV watching is indicative of a sedentary lifestyle that is strongly associated with obesity and unhealthy eating patterns."
Sitting on a couch watching television also seems to promote eating high-fat, high-sugar foods and is positively associated with cigarette smoking and a high body mass index, Hu found.
In a study involving 41,811 men between the ages of 40 and 75 and followed for 10 years, Hu found that the more physically active the men were, the lower their risk of developing Type 2 diabetes.
Hu says the average American man spends 29 hours a week watching television, but watching just 19 hours a week (2.71 hours a day) tripled their risk of developing Type 2 diabetes. The more active men became, the less they watched television and lower their risk of developing diabetes.
All this doesn’t mean your patients need to throw the TV out the window and get out and run a marathon every day. There are huge benefits in simply taking a daily walk. "We found that walking in itself was strongly associated with a reduction in risk," he says. The faster the walking pace, the greater the benefits, Hu says. Those who walked at the fastest pace decreased their risk of Type 2 diabetes by 70% over the couch potatoes and by 40% to 50% compared to those who reported walking at a leisurely pace.
Hu says he wasn’t particularly surprised by his results, since previous studies have shown that television watching is associated with obesity, and the leap from obesity to diabetes actually is only a tiny step. Even a small amount of activity, 20 to 30 minutes three times a week will begin to make a difference of 30% to 40%, he says.
Hu and his colleagues say there are important messages to be retrieved from his study. The primary message is that physical activity is essential to preserving good health. "Walking is feasible. It’s low cost, it’s suitable for most everyone, and there is no risk involved except a little of your time, with a very big pay back," he says.
The risk of sitting on the couch watching TV for hours on end, particularly for retired people, is enormous. "Television watching is totally passive. I recommend minimizing time spent watching TV and doing something, anything, no matter how small," Hu says. "Read the newspaper or even simple work at a desk writing letters is more active than television watching."
Hu’s study questions the way people choose to spend their leisure time, says Cathy Mullooly, MS, director of exercise physiology at the Joslin Diabetes Center in Boston. "We all need downtime," she says, "and more and more we find it in front of the TV. It’s a zoned-out tool."
Unfortunately for our health, most Americans no longer have a lifestyle that encourages physical activity, she says. And we have more leisure time than ever. "Most of us rent or own condos, and someone else takes care of lawns and gardens. Even those who own homes frequently pay someone else to do the work, so when we go home, we really don’t have a lot to do anymore, so we plunk down in front of the TV," Mullooly says.
Thirty or 40 years ago, there was not such variety on television, and people had to entertain themselves, Mullooly says. "People don’t know how to entertain themselves anymore. They get bored and TV is instant gratification," she says. In addition, "Going into the year 2000, we don’t often have to do hard physical labor like chopping wood and carrying water anymore."
And we’re paying for it with our health. Many people also are mentally or physically fatigued when they finally get home after a long day’s work that may be sedentary, but stressful, battling traffic in our cars and maybe doing a quick errand or two.
Mullooly recommends health care professionals help their patients establish some new behavior patterns and some of these lifestyle changes:
• Those who typically watch TV for 4 hours a day, cut the time spent in front of the tube to two hours. Make this a gradual weaning process.
• Set some reasonable exercise goals. It’s unlikely that someone who gives up two hours of television a day will spend all the extra time exercising, but perhaps a 30-minute to one-hour exercise period could be added.
• Set up behavior rewards: If people meet the TV goals for the week, they give themselves $5 toward a new CD, or conversely, they earn a certain number of minutes of television for every minute of exercise.
• Push more active goals like walking around the neighborhood after dinner or going to the gym. Even activities that are only slightly physical such as hobbies, crafts, or night classes are better than tuning out by the tube.
"Basically, I recommend that health care professionals help their patients look for anything to get away from the TV," says Mullooly. Failing everything else, she says, if you can’t beat them, join them. Encourage patients to exercise in front of the TV — yoga; tai chi; calisthenics; or resistance training using Lycra bands, light hand weights, cans, and even milk jugs partially filled with water.
Then, there is the inspired story of a parent who was determined to make her children more active. Her story may be true or just urban legend, but the point is well taken: A mother, concerned about the amount of time her children were spending in front of the TV, managed to hook it up to a generator attached to an exercise bike. As long as the kids kept riding the bike, the television would run, but the TV stopped as soon as they stopped peddling.
"Maybe that would be good for a lot of adults, too," laughs Mullooly.
[For more information, contact Frank Hu at (617) 432-0013 and Cathy Mullooly at (617) 732-2563.]