Fit or Fat?

By Christopher Wuensch, CWuensch@ExplorerNews.com

Editor's Note: This is the first installment in a two-part series examining the fitness and eating habits of Northwest and Foothills residents to determine whether they're doing better or worse than others in the battle of the bulge. Next week we will look at how young people handle health and fitness issues.

August 31, 2005 - It's early in the morning, to some still the night, on the top of a very large hill in Pima County. The sun is nowhere to be found. It's still busy waking the residents of the Midwest states. Aside from the infrequent early bird commuter on his or her way to work, these serene streets of the Northwest belong to the crickets. Before the sun can burst through the night with magnificent colors not even found in the Arizona sunset, Janet and Tami have rounded a corner, legs and arms swinging in rhythmic unison, halfway through their five-mile morning routine.

For privacy and safety reasons, their last names and route will be withheld, but the dynamic walking duo might as well be any one of the hundreds of Pima County walkers, joggers and bicyclists found pounding the pavement and trails of the Old Pueblo every morning, all in the name of keeping Pima County fit and in shape.

"It keeps us active and helps us maintain our weight," said Janet, 63. The two are the first to grace this steep Northwest hill this morning, but certainly not the last. Fewer than 10 minutes lapse before the day's first cyclist blurs by. Before long, the calm street resembles a leg of the Tour de France as cyclists strive for the summit of the three-mile-long hill.

So where does Pima County stand in terms of fitness? Are we fat, or are we fit? In literary terms, the only difference is one letter. Physically, the differential can be enormous - literally.

The fit or fat question is one that cannot be answered conclusively. Pima County is among other counties waging a war against an ever-growing obese citizenry. Pima County residents, however, are generally more aware than others of exercise and diet options.

"In terms of opportunities, Pima County has a lot to offer," said Mark Zakrzewski, the assistant director and head of fitness for the University of Arizona's Student Recreation Center. "I think the big percentage of them are not taking advantage of them. There are so many trails; you can play tennis, golf. There are so many options."

Although Zakrzewski spends an estimated 85 to 90 percent of his time exercising in the rec center, he is an avid biker on the many miles of trails around Pima County, whether his route takes him down the Rillito River walk or winding out through the corridors of Gates Pass and Silverbell Road.

But to be fit in Pima County doesn't require one to work out five or six times a week.

Before she knew it, Lauren Giffin had accumulated the extra poundage of a life of little exercise, poor diet and failed fad diets. She found the success she was seeking at Curves for Women, 2040 W. Orange Grove Road, a female-only exercise franchise designed to help people looking to get fit.

"I squatted for the first time in 10 years," said Giffin, "because what's happening is I'm losing the weight but I'm also extending the muscles, because I'm using the muscles now."

In the first two months, she shed 10 inches, and that wasn't with a proper diet. Once she changed her eating habits, the pounds began to melt away.

Giffin will be the first to tell you that her remarkable weight loss hasn't made her thin by today's standards but has changed her life forever. Today, she is considered one of the many success stories of the Curves franchise. She enjoyed the program so much she became an instructor at the Orange Grove location.

Giffin is an inspiration to others. For a large - no pun intended - portion of the population, exercise and proper diet is not a part of the every day lifestyle, and, despite its influx of exercisers, Pima County isn't without its heavy constituents.

According to a study released in August by Trust for America's Health, 20.1 percent of Arizonans are obese, ranking the grand citizens of the Grand Canyon State at 40th most fit in the nation, tied with New Jersey.

Although Pima County topped out as high as ninth fittest, according to the recent Men's Fitness Magazine's annual list of the country's fattest and fittest

cities, the waistbands of many of Pima County's citizens are expanding with those of the rest of the nation - at an alarming rate.

"No one is doing spectacular," said Lisa DeMarie, nutrition coordinator for the Arizona Department of Health Services' Division of Public Health. According to the National Center for

Health Statistics, 64 percent of adults over the age of 20 are overweight and another 30 percent are obese.

Despite the fact that they put less pressure on the sidewalks than most in the United States, Arizonans have cause for alarm.

Although the rate of overweight individuals has stayed steady in Arizona, obesity is on the rise. In 1991, between 10 and 14 percent of Arizona's citizens were obese. Today the number hovers between 20 and 24 percent. Residents of Pima County are slightly lighter than their neighbor to the north, Maricopa County; Pima County's obesity rate is lower at 18.6 percent to 20.4.

With obesity reaching epidemic proportions, death rates from heart disease, diabetes, cancer, cardiovascular disease, arthritis and osteoporosis are on the rise. Annually 400,000 people nationwide die from conditions related to obesity and being overweight.

Chronic conditions such as heart disease (Arizona's and the nation's leading cause of death), high blood pressure, diabetes and cancer claim 1.7 million people a year and are often the most preventable.

Recently the CDC's numbers came under fire from scientists questioning whether the statistics had been deflated. The CDC stated that 112,000 deaths were annually attributed to obesity, a number considerably lower than the previous census of 400,000, suggesting, "too much attention was being paid toward obesity."

The CDC's stance was based on better health care and advances in the medical field that allowed obese people to live longer.

Countering the CDC claim is a new opinion poll released by the Harvard School of Public Health, which stated that three-fourths of the country believe obesity to be a serious risk concern and that few believe scientific data is overstated.

The growing girth of Arizona can be attributed to several factors, but to single out one is impossible.

"I don't think it's any one thing," said DeMarie. "I think it's a combination of things that has gotten us here. It's really lifestyle. Our environment is not conducive to activity anymore. Everyone gets in their cars to go places. Nobody walks or bikes anymore."

The obvious answer is the advent of the technological era. People spend more time in front of televisions, computers and video games and less time involved in physical activity. Nearly every source when interviewed reflects back to days as a child when after-school activities meant playing outside, often until well after the sun went down.

Another major factor in the increased mass of the populous is diet.

"A couple of developments in the last 20 years has shown this upturn," said Dr. Timothy G. Lohman of the University of Arizona's Department of Physiology, "and one is the whole portion size and fast food, super-sizing movement resulting in a lot of us eating more outside the home."

Larger meals fueled by empty calories and vast quantities of soft drinks, combined with the "family on the go" attitude, has made the United States one of, if not the, fattest country in the world.

To reverse this growing trend of expanding torsos, efforts can't come from just one source. Aside from beginning education in schools, adults need an atmosphere at work in which they are granted more time to be active and are given healthier eating choices, Lohman said. It's then that people can learn to correct poor eating habits.

"We're distracted when we eat," said Lohman, who attributed weight gain to less family sit down time and increased meals in front of the television. "We're not aware and so people just are eating a lot more than they are aware of when they report what they're eating. They're reporting less."

To combat this epidemic, the Arizona Department of Health Services Division of Public Health created its Arizona Nutrition and Physical Activity Plan, a detailed diagram focusing on reversing the ravages of obesity.

The plan was created over an eight-month period ending in February with the help of various parties from across the state ranging from school officials, physicians and private businesses. It was funded by a $300,000 grant from the CDC. The plan is a guide for any organization to use to increase health awareness and preventative programs. It's still in its early phases of training a staff and organizing focus groups for each of its six facilities to be located around the state. In Pima County, the program will begin with Casita Maria of the Carondolet Health Network.

"The long-term goal is to have an impact on all chronic diseases by getting people active and eating healthier," said DeMarie, who added that the plan will rely heavily on its pilot programs, which will begin in the schools. The programs will start with the kids but the effort must come from more than just the schools. It must be worked into every phase of life.

"Obviously it needs to come from all directions," said DeMarie, "There's no Band-aid approach to it."

Speaking of Band-aids, the quick fix solution is often construed as the American way. Started in 1983, many forms of gastric bypass surgery have become popular throughout the country. The process often involves stapling portions of the stomach to limit the amount of food and drink that can be consumed before a person feels full. The procedure isn't without it's drawbacks and risks, however, and ultimately it is expensive and is not covered by most health insurance plans. The prospect of leaving the country to have the surgery performed often appears to be an attractive, cost-efficient alternative.

The first hit on a simple Google search of Oro Valley or Marana gastric bypass takes the Web surfer to the site offering discount weight reduction procedures - among others - in Costa Rica. All Bariatric doctors contacted for this story refused to return calls or refused to comment on the subject matter.

"It doesn't necessarily make you fit," said Dr. David Capaccio, an Internist for the Northwest Medical Center, about the option of gastric bypass or other bariatric surgery. "It's a point where something needs to be done or their mortality, their life expectancy, is significantly reduced."

Most patients who qualify for gastric bypass are put through an intense screening process and psychiatric evaluations first and are checked for depression and for whether the option of diet therapy has been fully explored.

Capaccio's advise to those who believe they need to get fit is something as simple as this: Take a brisk walk with a person who will offer emotional and physical support.

Most choose to get healthy the conventional way rather than opt for expensive and dangerous surgery. For many people, like Giffin, getting in the gym isn't the hard part, it's maintaining a consistent regimen that often proves difficult.

"I had every excuse not to," Giffin said. "My back hurts, I couldn't get in and out of the machines, I couldn't lift my feet up to one of the leg press machines. But you learn and you lose weight, and you lose inches, and that's your motivation right there. Every one of these ladies will have a story to tell. I'm just speaking from personal experience."

In the Tucson metropolitan area alone, there are 17 Curves locations and the same number of Jack in Box fast food restaurants. Restaurants of this nature are among the biggest causes of obesity in Pima County and across the nation. In Tucson alone, there are more than 315 fast food restaurants including 26 McDonalds, 29 Subways and 20 Eegees. That equates to two fast food joints for every square mile in Tucson.

The biggest challenge regarding obesity around Pima County and the nation may be informing the public of the dangers of being overweight. According to the Harvard study, 34 percent of those polled believe the epidemic to be extremely serious while another 41 percent find it very serious.

But for every one who finds obesity to be a problem, there are those who feel the opposite: organizations such as the National Association to Advance Fat Acceptance, which promotes being big as being beautiful. The NAAFA, a 36-year-old organization, also helps to eliminate discrimination for overweight people while celebrating largeness. That's evident by its NAAFA Hall of Fame, which lauds corpulent heroes and figures from Winston Churchill, Benjamin Franklin and Buddha to Babe Ruth, John Candy, Santa Claus and Miss Piggy.

For those looking to get fit in the short term, Pima County, despite its overweight and obese population, may be the ideal place to start. Because of its mild to warm winters, Pima County offers exercisers a chance to be outdoors year round, much more than most other cities in the country.

Evidence can be found in the city's bicyclist culture, alone.

According to Matt Zoll, bicycle and pedestrian program manager for Pima County, 13 percent of all Pima County residents ride a bike to work at least once a week. With gas prices threatening to go higher, the number of bikers could increase, Zoll said.

For those who don't bike strictly for commuting purposes, Pima County is full of miles of bike trails, and more are coming.

"The city has added in the past year about 15 to 20 miles of bike lanes in that time period," Zoll said.

Whether it's biking, jogging, running or simply walking, Pima County's trails are a constant haven for its health-minded travelers.

In Oro Valley alone, there are 48.88 miles of bike routes, 7.651 miles of shared use paths, 39.628 miles of multiuse paths and 43.38 miles of existing trails.

"At different times of the day, you have different numbers of people using the trails," said Ainsley Reeder, Oro Valley Parks and Recreation Administrator, about the growing popularity of the Oro Valley trails, "and then the weather makes a big difference."

Others, who aren't blazing the trails and gyms of Pima County the way Zakrzewski is, work out to maintain their weight. John Hogg is the perfect example. After years of working at the Tucson main post office, Hogg has begun working out with personal trainer Ron Holland and SWAT Fitness.

In just a short while working out with Holland, a former military fitness trainer, Hogg said the compliments began to roll in and his shirts even began to fit a bit tighter. Still, Hogg said, working out is simply a means to fighting off the extra pounds.

Local sports icons are getting involved in reshaping Pima County as well.

"My goal is always to make Tucson the most fit, the most healthy city in America," said Richard DeBernardis, founder and proprietor of the Charter Funding El Tour de Tucson bicycle event. "I think we can do it. Are we there now? No, but we're better than most other cities."

DeBernardis cites the city's excellent wellness facilities as one of the main reasons why Tucson can be and is a fit community.

"The way we're looking at these things are as physical challenges, not as disabilities," said DeBernardis.

Physical challenges can range from circumnavigating Pima County in DeBernaridis' 23-year-old, 109-mile bike event, or it can be as simple as a morning walk, such as the one enjoyed twice a week by Janet and Tami.

As their five-mile stretch draws to it's final lap, the sun is now up and a new day is set to begin. With it, Pima County will wake up and continue to shape up and expand all at the same time.