After speaking with Dr. Steven Blair, I became very interested in the research done in the LIFE study, and was thrilled to speak with Abby King, a Stanford University professor of Health Research and colleague of Dr. Blair.  In addition to teaching, King also serves as the director of the Healthy Aging Studies in which the major goal is prevention.  Researchers who focus on aging know that the older segment of our population is the most diverse and heterogeneous, so there is never any “one size fits all” solution to health issues.  However, since functional impairment can begin as early as your forties or fifties, King’s preventative research is designed to make sure people “run out of life before they run out of health.”  In particular, Abby King is concerned with designing interventions that take into account the interaction between an individual and his or her social and physical environment.  In terms of promoting healthy exercise behaviors, context is the important factor, not just an individual’s motives alone.

According to King, there are several reasons for inactivity among older adults aside from lack of motivation.  One such reason is the lack of knowledge many adults have about how much and what kinds of exercise to do.  Figuring out what works for an individual person is a necessary part of beginning an exercise regimen.  Additionally, many people have misconceptions about what is or isn’t good for them that can prevent them from exercising.  Furthermore, loved ones close to older adults may encourage them to remain sedentary, “take it easy,” or lower their activity level, which discourages exercise.   Amidst all these discouraging factors, how does one begin an exercise regimen?

One of the most important factor in predicting the success of a behavior change is self-efficacy, King says.  Over the course of the last few weeks, I’ve been hearing quite a bit about what self-efficacy entails, so my next question for Abby King was: How do we change someone’s self-efficacy?  She answered with a series of steps employed in exercise intervention programs.

1. Make sure the individual does not harbor any misconceptions about exercise.
2. Empower the individual to harness his or her own self-regulatory skills.  In order for exercise to become an enduring habit, the individual needs to know that he or she has the ability and resources to do it.
3. Seek out  positive role models in the social environment in order to inspire and encourage the individual.
4. Set goals.  The one important thing to remember with goal-setting is that these goals need to be short-term and realistic.  For example, many people who start exercising with the goal of losing weight may be disappointed because exercise alone is not typically enough to prompt weight loss.  Exercise goals need to be specifically related to exercise.
5. Track the progress via logging (in a diary, with a step counter, etc.)

These steps sounded great to me, but how would someone access this information outside of a laboratory setting?  Although many commercial exercise programs don’t harness and teach these skills, the NIH has an excellent exercise and physical activity guide that King recommends—it is available online here: http://www.nia.nih.gov/NR/rdonlyres/E2A819E3-8BAA-46AA-89E8-321B527D8A2B/0/Exercise_and_Physical_ActivityYour_Everyday_Guide_from_The_NIA.pdf.  Additionally, King says that many YMCAs adapt their exercise programs in order to cater to individuals with physical ailments, so your local Y would be a great resource as well.  Abby King is continuing to work on research that promotes successful aging, and if you’re interested in what she does, the LIFE study is currently recruiting participants (see the attached e-flyer for contact information).

Stay healthy,

Nikki

In most of my blog posts, I’ve included a section on lack of motivation among the general public to exercise and take care of themselves.  However, recently, I spoke with someone who had a different perspective, claiming that lack of motivation isn’t the real issue at all; his name is Dr. Steven Blair.  Dr. Blair is currently a professor in the Department of Exercise Health of the University of South Carolina and has received various awards for his research.  Before delving into the topic of motivation, Dr. Blair told me a bit about the current study on which he’s working.  This epidemiological research, called the LIFE (Lifestyle Interventions and Independence for Elders) study, follows a cohort of 80,000 people whose ages range from 18 to 100.

Regardless of the large sample size, the research on this group has been incredibly thorough and papers are published quite frequently detailing some of the findings.  One particularly important finding came from the pilot of this study in which age decline was studied in individuals aged 70 to 90.  After separating the participants into two groups, one subjected to a moderate physical activity intervention and the other to a health education intervention, researchers collected data for more than a year.  They found that the group subjected to exercise improved their mobility, which supported their hypothesis that exercise can be used as a preventative measure to frailty.

Another study that Blair conducted evaluated cardio-respiratory performance on mortality.  Exercise, the researchers discovered, is more important than obesity and fat distribution, or, as Blair put it, “Fitness is more important than fatness.”  This means that, regardless of weight, exercise is one of the most important factors in preserving your physical functioning.  I found this point fascinating, and I had to ask Dr. Blair what his opinion was on motivating people to become more fit.  According to Blair, we don’t lack motivation so much as we lack the cognitive behavioral skills necessary to change our behavior.  Because our environment doesn’t encourage us to exercise (poor public transportation, easy accessibility of information online), we need to figure out how to exercise in a way that works for each of us individually.  However, without the knowledge of how to self-monitor via goal-setting, problem-solving, and seeking support when we need it, exercising becomes much more difficult.

My conversation with Dr. Blair was quite eye-opening, and for my next post, I’ll be speaking with a colleague of his with whom he worked on the LIFE pilot study.  For more information on Dr. Blair, you can visit his profile on the University of South Carolina website at http://www.sph.sc.edu/facultystaffpages/facstaffdetails.php?ID=333.  Additionally, Dr. Blair was kind enough to send me several papers on studies he has done.  If you’re interested in reading any of those, please send me an email (nyates@stanford.edu).

Stay healthy,

Nikki