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E-Mailing Your Way to Healthier Habits
Date:5/20/2009

People move more and eat better when messaged to do so, study finds

WEDNESDAY, May 20 (HealthDay News) -- E-mail messages suggesting small ways to eat more healthfully or boost physical activity can significantly improve health habits, a new study has found.

Participants in a worksite e-mail program walked more, ate more fruits and vegetables and consumed less saturated fats and trans fats than workers who didn't receive the e-mails, according to a report in the June issue of the American Journal of Preventive Medicine.

People whose dietary habits and physical activity levels were below recommended levels at the start of the study realized the greatest improvements, the researchers reported.

"What this study really tells us is that this particular program is effective," said the lead investigator, Barbara Sternfeld, a senior research scientist with the Kaiser Permanente research division in Oakland, Calif. "It gets the behavior change that we're looking for."

What's more, the program appeared to have a lasting effect. "Our data show, at least four months later, the behaviors were still sticking," Sternfeld noted.

Susan Finn, president and chief executive of the American Council for Fitness & Nutrition in Washington, D.C., said she's not surprised that the e-mail program succeeded, "especially in a workplace setting where people have easy access to a computer plus the support of colleagues."

Research has shown that "people who have a support system in place are better able to maintain the behaviors that keep them working toward or maintaining a healthy weight," Finn said.

An estimated 33 percent of U.S. adults are overweight, 34 percent are obese, and 6 percent are extremely obese, according to the latest data from the U.S. National Center for Health Statistics.

Despite a glut of information on the benefits of a healthy diet and regular exercise, fewer than half of the population are getting the minimum amount of recommended physical activity, fewer than 25 percent eat five or more fruits and vegetables a day, and about 60 percent consume too much saturated fat, the study authors noted.

In response, scientists are testing models of what they call "behavior change theory" aimed at motivating people to adopt healthy habits and stick with their lifestyle modifications. The e-mail program tested in the study is one such approach.

For the study, Kaiser partnered with NutritionQuest Inc., which developed the e-mail program, known as ALIVE! (A Lifestyle Intervention Via E-mail).

Participants in the study, 787 Kaiser employees, completed an electronic diet and physical activity assessment at the beginning. All respondents got instant feedback on how their health habits stacked up against national guidelines.

Of the group, 351 were randomly assigned to receive weekly e-mails and mid-week reminders with "small step goals" tailored to meet people's individual lifestyles and health goals. Participants were asked to work on one of three paths: increasing physical activity, increasing fruit and vegetable intake or decreasing fat and sugar consumption.

A mom on the physical activity path who didn't work out much and had children at home might have received an e-mail suggesting that she go to the playground with her kids two days that week and walk around the playground. A worker on the fruit and vegetable path who ate out frequently might have been asked to add vegetables to pizza and other carry-out dishes that week.

E-mail recipients and control-group members were surveyed again at the end of the four-month test period and again four months later.

After 16 weeks, the group that had gotten the e-mails showed significant improvements across all three paths. The most impressive gains were among those who, at the start, were not meeting recommended dietary and physical activity levels. Their participation in moderate physical activity, for example, increased by nearly an hour a week, compared with those who hadn't been e-mailed, and time spent on sedentary activities, such as watching TV, dropped by two hours a week.

Sternfeld said that she believes the e-mail program was successful because it was convenient for people and easy to follow. "People realized that, 'Oh, I can do this. I can actually do this particular behavior,' " she said.

Finn noted that "making small changes, letting them stick and then stepping it up as needed is the best way to modify eating behavior over the long run."

If your workplace doesn't offer health advice via e-mail, look around.

"All the major weight-loss programs have e-mail support -- which consumers must pay for, of course," Finn said. "Companies like Campbells and Kraft Foods, however, have free weight-loss tools on their Web sites and offer some interaction, such as message boards."

More information

The U.S. Centers for Disease Control and Prevention has more on improving health habits.



SOURCES: Barbara Sternfeld, Ph.D., senior research scientist, Division of Research, Kaiser Permanente, Oakland, Calif.; Susan Finn, Ph.D., R.D., president and CEO, American Council for Fitness & Nutrition, Washington, D.C.; Kaiser Permanente, May 19, 2009, news release; National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Atlanta; January 2009, Journal of Medical Internet Research; June 2009, American Journal of Preventive Medicine


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