The Surgeon General on the State of the Nation 2006

By Barbara Day, M.S., R.D., C.N.

I recently attend the 53 rd Annual Meeting of the American College of Sports Medicine in Denver . One of the highlights of the meeting was hearing the Surgeon General, Vice Admiral Richard Carmona, M.D., M.P.H., F.A.C.S. discuss The State of the Nation: Celebration of the 10-Year Anniversary of the U.S. Surgeon General Report on Physical Activity and Health. Dr. Carmona, homeless at 6, high school drop-out, Vietnam veteran, police officer, EMS, nurse, trauma surgeon, and father, discussed the report on physical activity and health and how the impact has effected our current health situation. According to Dr. Carmona, with 16 percent of our dollars being spent on disease with the numbers climbing there is still much work that needs to be done. Dr. Carmona stated that in the past, Americans “have accepted care as the standard for disease but the simplest remedy is all about health, wellness, and fitness ….changing eating behaviors and activity behaviors.” Dr. Carmona said that question is who pays this disease burden since the cost is continually climbing. Dr. Carmona reinterated that increasing activity levels in Americans is a monumental task. He said government officials are concerned with this upward spiral of obesity and inactivity. In fact they are wondering where will all the essential first responders like the police officers, firefighters, military come from to fill all the spots. These professions require a certain level of fitness.

The three areas that Dr. Carmona emphasized were Prevention, Preparedness, and Health Disparities. Behavior change is the key for all three components but delivering an effective message is essential. Translation of the message is different for each population but the result should be the same …make America healthier. Dr. Carmona likened his job as Surgeon General to that of a cemetery caretaker, “A lot of people below me – but not a lot of people listening.”

According to Dr. Carmona, the current situation seems to be that everyone wants to play the blame game and blame the current health situation on somebody else. However, Dr. Carmona suggests that breaking the inactivity cycle is critical and learning good health habits are essential starting at home first and extending to the schools and churches. His vision is that all American are active for at least 1 hour a day.

Dr. Carmona said that many Americans have felt the federal government has let them down by taking physical education out of the school and replacing the time with more academics. He said that since he's been Surgeon General – that's the number one topic that many parents want him to address but he clearly explained that this decision was not made at the federal level but was made at the local level. He suggested that if parents wanted PE to be offered in the schools they needed to be proactive at the local level. Dr. Carmona insisted that when PE was taken out of the schools locally – no one could have ever imagined the impact this one change would have on the overall health of Americans. According to Dr. Carmona, there is conclusive evidence that “children who are active everyday are better students and score better academically.” Ofcourse he advocates adding some form of fitness back into the school day. It makes good sense for the physical welfare of our youth, plus the evidence indicates that the students will learn better.

But, as a parent, I think parents should take the burden of the guilt for inactivity and poor food choices. After all, the parent should be in control of the food that comes into the house, where the family eats out, and what the children are doing in their recreation time.

Dr. Carmona said that when he gives talks across the country that many of the media wants him to discuss bioterrism and the country's preparedness to deal with that situation or the bird flu but he feels like “Obesity is the Terror within — quality of life goes down and the burden on society and family goes up.” Americans should be more concerned about obesity and the improvement of their personal health.

My son, Geoff, who is a second year internal medicine resident at Vandy, reports that when he even mentions the word exercise to the majority of his patients – they completely turn the him off. It's frustrating for him and many other health professionals as well who are trying to encourage patients to take care of their health. Many of us health professionals seem to be butting our heads against the wall on how we can get people to take control of their own health and make better food choices and be more active. I suggested that to Geoff that he replace the word exercise with the word activity and suggest each patient purchase a pedometer requesting that each patient take at least 10,000 steps per day moving up to at least 12,000 steps per day.

Even though the research is quite clear — daily exercise helps to prevent all the major diseases that kill Americans: heart disease, diabetes, stroke, cancer, obesity, etc., the majority of Americans don't exercise and won't exercise unless some major medical issue creates a wake-up call for them.

Barbara Day, M.S., R.D., C.N., is a nutritionist with a masters degree in clinical nutrition who is also registered dietitian and has over 30 years of experience in promoting healthy active lifestyles to consumers. Barbara Day, M.S., R.D., C.N., is the publisher and nutrition editor of Kentuckiana HealthFitness and Kentuckiana Healthy Woman and a runner, cyclist, hiker and mother/grandmother.