OBESITY continued...<< 1  2  3  4  endnotes
Roberta J. Park

HEATH AND HYGIENE PUBLICATIONS GROW DURING THE 1920s AND 1930s
SO DO ORGANIZED EFFORTS TO IMPROVE PHYSICAL EDUCATION AND RECREATION

During the 1920s and 1930s the number of health and hygiene textbooks and manuals grew appreciably. Many incorporated information that the emerging nutritional sciences were bringing forth. In Hygiene the Optometrist Ought to Know (1921) Frederick Woll declared that unless one was a blacksmith, laborer, or athlete (all of whom needed more food), breakfast should consist of ripe fruit, an omelet or boiled egg with a chop or small piece of fish, toast or a roll with butter, a cup of coffee or cocoa, or a glass of milk. For diner, soup, fish, roast with two vegetables, salad, bread and butter, and a simple desert. Woll was adverse to smoking during meals and maintained that “the kind of music one must so often listen to nowadays in a restaurant” could impair digestion.⁶² His chapter titled “Exercise Right” opens with the following words: “The Greeks even with their limited knowledge of physiology knew that in order to be strong and healthy, it was necessary to exercise regularly.”⁶³

In The Commonsense of Health (1924) physician Stanley Rinehart observed that inventions like the automobile and telephone had reduced the need to expend muscular effort; hence, “the vast majority of people get too little exercise.” Many men now obtained their exercise by “watching a wrestling match.” Although women who cared for their children’s many needs and did their own housework might have sufficient exercise, others avoided physical work as much as possible and, therefore, grew stouter. The typical response, Rinehart noted, was to “starve” the body not reduce the fat-forming elements of the diet. Unfortunately, people also neglected thinking “seriously of exercise as an antidote.” His chapter on “Exercise” closes with an observation that is all to prevalent today: “Everyone believes in exercise, but it is difficult to put the belief into practice.”⁶⁴

Health manuals that were written for college students during the 1930s usually covered a range of topics. They also were likely to incorporate more up to date information. Two examples are The Foundation of Health, written by Dr. William Sharp (Professor of Bacteriology and Preventive Medicine, University of Texas Medical School), and The Fundamentals of Personal Hygiene, by Walter Krueger (instructor at Grand Rapids College). Krueger gave considerable attention to exercise as well as proper diet, noting the importance of both for health and proper development. Streamline for Health (1935) was written by Philip B. Hawk, whose earlier book Practical Physiological Chemistry would go to fourteen editions by 1965. In it he offered a very readable, yet at the same time informative, account of carbohydrates, vitamins, and other elements, of ways to reduce weight, and of the dangers of dietary fads and quirks. Hawk declared that he had found that he did a better job of carrying out his own duties if he “played tennis moderately three or four times a week.”⁶⁵

As it became increasingly evident that weight control was a public health concern, in 1928 the American Medical Association, in cooperation with other groups, organized what was said to have been the first Adult Weight Conference. Participants included professors of medicine from the Mayo Clinic, Johns Hopkins and other universities, the New York Academy of Medicine, and other agencies. Two papers— “How One Woman Lost Forty Pounds” and “The Overweight Child”—were given by Thomas Denison Wood (Professor of Health Education, Columbia University). A significant contributor to emerging school health programs, Wood would serve as chair of the Committee on the School and the Child for the 1930 White House Conference on Child Health and Protection. He also was a leading figure in the now rapidly growing field of physical education.

Addresses given at the Adult Weight Conference, published as Your Weight and How to Control It (1929), ranged from the comparative values of food groups; to changing food habits; to issues brought forth by the current “craze for reducing.” Although increasing “knowledge of calories and vitamins, of exercise and massage, of electric apparatus and thyroid extracts” was making the control of body weight a highly technical matter, Morris Fishbein (past-president of the American Medical Association) observed, newspapers and magazines continued to be filled with advertisements of all kinds of potentially hazardous nostrums and inappropriate dietary recommendations.⁶⁶

Fishbein was editor of the Journal of the American Medical Association and editor of Hygeia: The Health Magazine, which the AMA had initiated in 1923. From the beginning Hygeia gave extensive attention to play, games, sports, and physical education, publishing numerous articles such as James Edward Rogers’ “The Lost Art of Play,” Helen Smith’s “Natural Gymnastics in the Public Schools,” and Mabel Wood’s “Public Recreation–A Health Source.”⁶⁷ It also published occasional articles dealing with nutrition and obesity. As did most health manuals, these usually included a section that commented upon the importance of proper exercise.⁶⁸ In her August 1924 Hygeia article Wood credited the positive role that properly supervised playgrounds now had in improving children’s health and helping them to become better citizens. The number cities that provided such opportunities had increased from forty-one in 1906 to 6,601 by 1923.⁶⁹ In spite of the Depression, the number would grow to 8, 062 in 1936.⁷⁰

The 1920s and 1930s also witnessed a significant growth of school-based physical education programs. Concerned by the lack of fitness among men conscripted during World War I, in early 1918 United States Commissioner of Education P. P. Claxton had brought representatives from educational, social service, health, and physical education groups to Philadelphia to consider how “an adequate, successful system of physical education may become universal.”⁷¹ The resulting National Physical Education Service, with the support of thirty-five national organizations (and financed by the Playground and Recreation Association of America), would have a major role in fostering the establishment of state laws requiring physical education and the employment of state directors of public school physical education. By 1938 thirty-six states had enacted laws making physical education a required part of the curriculum; twenty-three also had appointed state directors.

LOSING WHAT WE WORKED SO HARD TO GAIN!

In an article published in the Journal of the American Medical Association in 1938, physician Horace Gray stated that a 1929 study had found that 2.6 percent of high school aged boys were overweight. Another study of young delinquents, conducted in 1931, had found the number to be 2.3 percent.⁷² According to the United States Department of Health and Human Services, in 2002 more than ten percent of pre-school aged children were overweight.⁷³ A 2003 JAMA article reported that whereas in 1960 fewer than 1 in 4 adults in the United States had been classified as overweight the number now was 2 out of 3.⁷⁴ In May 2008 the American Academy of Child and Adolescent Psychiatry maintained that between sixteen and thirty-three percent of American children and adolescents are obese.⁷⁵

Many things have happened since 1960 that contribute to today’s “Obesity Epidemic.” These include, but are not limited to: spending too much time on the internet and watching television; the rapid expansion of the fast food industry; and the increased consumption of carbonated soft drinks. The question of possible links between obesity and ADHD (Attention Deficit Hyperactivity Disorder) is under investigation⁷⁶; and far too little is known about the effects of medications now taken by children as well as adults.

The decline of quality programs of physical education---and also of community-based recreation programs---beginning in the 1970s certainly has been a major factor. According to the CDC’s Guidelines for School Health Programs to Promote Physical Activity, the percentage of high school students who attended daily physical education classes dropped from 42 percent in 1991 to 33 percent in 2005. (Twelfth graders accounted for only 22.0 percent of the participants.) Only 27.8 percent of high school girls and 43.8 percent of high school boys engaged in sixty minutes of physical activity a day.⁷⁷ The same report, which can be accessed through the CDC’s Healthy Youth website,⁷⁸ states that the percentage of overweight children ages six to eleven rose from 6.1 percent in 1974 to 15.1 percent in 1999. For those ages twelve to nineteen the increase was from 6.5 percent in 1976 to 14.8 percent in 2000.⁷⁹ These data give added strength to the assertion that the decade of the 1970s was a period of decisive - and devastating - changes.

The fact that large numbers of children and youth now fail to engage in anything approaching adequate amounts of physical activity is very troubling for it is during childhood and adolescence that proper habits regarding exercise are most likely to be developed. It has been twelve years since the 1996 Report of the Surgeon General of the United States declared: ‘Scientists and doctors have known for years that substantial benefits can be gained from regular physical activity.”⁸⁰ However, we constantly fail to put “knowledge into practice.” The authors of an article published recently in the Journal of Physical Activity and Health noted that 70 percent of “all measurement or surveillance studies of PA [physical activity]” conducted during the last four decades had been published since 1996. They then observed: “Even in most areas with sound research, we lag behind in translating science into practice.”⁸¹ The problem exists elsewhere. In 2000 the International Journal of Sports Medicine reported that in spite of extensive clinical evidence supporting the importance of pediatric exercise, young people in Europe rarely engaged in “the accepted minimal norm for physical activity in terms of duration, intensity, and frequency.”⁸² The “obesity epidemic” also has made inroads in China⁸³ and elsewhere.

How did we allow this to happen to our field; and why has our professional organization—the American Alliance for Health, Physical Education, Recreation, and Dance—not spoken out more forcefully against such things? The American College of Sports Medicine recently established an “Exercise is Medicine” initiative; and in early March 2008 (jointly with the AMA) held a news conference in Washington, DC to initiate a congressional bill aimed at establishing “The Physical Activity Guidelines for Americans” Act. Why was not AAHPERD one of the twenty-five organizations listed as supporting these efforts?

Our predecessors, those women and men who built such school and community-based programs during the six decades of the twentieth century would be dismayed to see what has happened since the 1970s. It is time for use to rebuild, in twenty-first century fashion, what once existed. It is time for us to declare to the general public, by deed not just by word, the importance of our profession!

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