What’s the secret to getting in shape? Here’s what the evidence says

The health benefits of physical activity are endless, and are far too many to go into detail at this point in time. The vast majority of people wish they could do more to get in shape and do more physical activity, though few of us succeed in accomplishing this goal. What is the secret? How can we convince ourselves that this is not just something that we want to do, but to actually do it? Here is a review of a number of strategies to encourage more physical activity in our daily lives, and help us understand what the evidence has taught us on this matter.

A number of studies tested the simple method of putting a sign beside the staircase encouraging people to take the stairs as opposed to the elevator. This sign proved extremely effective, but for a limited amount of time. In some studies the number of people who took the stairs doubled, while other studies also showed marked increases in the use of the stairs. However another study showed that the increase was only effective for a period of 3 months, after which the number of people returned to the base line. Overall this proved to be an effective strategy when people were faced with a binary decision: stairs or elevator.

Another approach was to inform people more specifically about the health risks and benefits of physical activity, more specifically the risks of cardiovascular disease. This was more of a community targeted approach, which sought to educate a large number of people with various methods like pamphlets, media, seminars and more. A five year study in England showed a modest improvement of lifestyle choices, though net cardiovascular disease was unaffected. An additional study conducted in Minnesota also showed improvement that was unimpressive at best. There were a number of problems with these studies, specifically obtaining such generalized data, and drawing accurate conclusions.

Intervention by physicians could be another possible strategy to encourage more physical activity. This could be done by working with a group of physicians to provide concrete recommendations to their patients, and a game plan to carry that out. This was not studied properly in the long term, though short term studies show promising results. Most of the health benefits from physical activity more heavily rely on long term lifestyle choices, so this needs to be taken into consideration when interpreting these results.

There is another interesting approach called ecological momentary interventions. The idea is that a centralized system will send the participants periodic reminders, which can be received through emails or text messages for example. These messages will have anecdotes, words of encouragement, or simple instructions to give momentary reminders about a healthy lifestyle. A study around this this approach showed very promising results for a variety of lifestyle changes, including physical activity, smoking cessation, and others.

Wearable technology has exploded in the last decade, encouraging us to be more active by giving us more accurate measurements and feedback, along with including aspects of social network to that encouragement. In 2010 a study in Pittsburgh concluded that the wearable technology feedback only when combined with a group-support program was sufficient to result in weight loss after 9 months.  A much larger review of the literature pointed at a number of important points which contribute to the success of technological intervention. This included self monitoring, counselor feedback and communication, social support, use of a structured program, and use of an individually tailored program. Short-term results are promising, however long-term feedback with respect to these technologies does not give very definitive results.

Overall we have looked at a number of different strategies, and with this information there are some interesting conclusions to be drawn. Almost all of these interventional strategies have positive effects in the short term. If you can find a way to harness the positive traits over the long run, you have a winning strategy, but this is obviously a major IF.

There are two main themes here that seem to stand out. The first one is people’s tendency to be impulsive, and the second is planning and commitment. The valuable information explaining why physical activity is so beneficial and important seems to fade away in the long term, as do strategies that don’t require too much effort like wearable technology, or social media support. There are a number of little decisions that we have in our lives which can be categorized as ‘the healthy choice’ vs ‘the lazy/convenient choice’. Examples of this are snacks or modes of transportation. If we could push ourselves in the healthy direction at the decision making point in time it could have a pretty big overall impact. The idea of putting a sign at the point of decision is one that I specifically like, and this could be applied to a number of things. For example, put a sign on the fridge reminding you that you decided to snack on vegetables rather than something else less healthy. Then, when you go for a snack, in the heat of the moment you might end up grabbing a carrot to chomp down on rather than the leftover cheesecake.

Planning and commitment was the other theme that jumped out through the research that was done. Personal programs or group programs seemed to have very positive effects for the period of time that the participants were involved. The bottom line that I understand from this, is that if you decide to make a positive lifestyle change, don’t do it alone. It is so much easier to undermine the decisions we make and commit to ourselves rather then the commitments we make to others. Hire a personal trainer periodically (subject to your affordability of course), where he/she assesses the progress you’re making. Join a group that will ask you why you didn’t show up when you are absent. Plan a workout schedule with a friend, in which you depend on one another. As long as you are committed to others and not just yourself, you have a greater chance of success.

Both of these steps, along with a number of other possible steps that you can do to make a positive lifestyle change all require a conscious decision to do it, and proactive steps that need to be taken to seal the deal. Make a commitment to yourself, and jump on the wave of enthusiasm that comes at the beginning to pave the future and make this change long term. Good luck!

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