A thrilling new initiative of the National Indian Health Board (NIHB), "GO the EXTRA MILE with NIHB" greatly expands the reach of the National Physical Activity Plan (NPAP).

NIHB Executive Director, Stacey Bohlen, described GO the EXTRA MILE in a recent letter to tribal representatives.

"The GO the EXTRA MILE initiative is a result of the NIHB signing the CEO pledge, which is part of a national campaign to encourage Executive Directors to commit to supporting and fostering a physically-active workplace. NIHB's GO the EXTRA MILE initiative achieves these goals by creating a workplace that supports physical activity for every member of its staff. Through the GO the EXTRA MILE with NIHB initiative, we will provide 30 staff minutes during the workday to walk one mile each day for a year. We will aggregate these miles and 'virtually' walk to each of the 12 Indian Health Service Areas, either to an Area Indian Health Board or to a Tribal Partner in Areas that do not have a Board."

The letter also invites the tribal representatives to sign the CEO Pledge - originally developed for the NPAP and now championed by the National Coalition for Promoting Physical Activity (NCPPA) - and take advantage of the GO the Extra Mile website, which will include a toolkit, electronic mapping, and access to information from the Association of American Indian Physicians.

The need for the initiative is urgent. According to NIHB, the age-adjusted incidence of Type 2 diabetes is higher among Amercian Indians and Alaska Natives (AI/AN) than all other US racial and ethnic groups. Furthermore, the adult obesity rate among the AI/AN population is 39%, while the inactivity rate is over 50%.

IHRSA applauds NIHB for elevating the importance of physical activity and creating such an innovative initiative to dovetail with the CEO Pledge. We are hopeful that the leadership of NIHB and others will inspire novel outreach efforts across the country and deep into every segment of the population. Clearly, our national approach to addressing the sedentary criss must be judged, in great part, by its effectiveness in reaching the communities most impacted.

Above: NCPPA Executive Team takes CEO Pledge

About the CEO Pledge

The CEO Pledge is an evidence-based national campaign promoted by NCPPA to encourage every CEO in the United States to recognize physical activity as an important driver of employee health and business performance. Studies of employee wellness programs consistently find that executive leadership is critical to employee engagement. If employees believe that creating a culture of physical activity is an executive priority, employees are more likely to be physically active.

The National Physical Activity Plan (NPAP) will have reached success when the vast majority of Americans regularly meet or surpass the Physical Activity Guidelines. The NPAP has over 250 evidence-based recommendations for changes in the policies and systems that guide the environments in which we live, work, learn, play, and commute. It's a roadmap that, if followed, will lead to a more physically active nation. It's the "if followed" part, however, that poses the greatest challenge. But fortunately, evidence is beginning to emerge that the NPAP is being followed.

There's no question that policy changes at the national/federal level (e.g. enacting the FIT Kids Act, requiring school accountability for the quality and quantity of physical education and physical activity programs) can impact policies and programs at the local level. Through its relationship with the National Coalition for Promoting Physical Activity (NCPPA), the NPAP is working to create change at the national level. However, NPAP's success will also come as the result of state and local efforts, through which the NPAP is used as a roadmap for states and municipalities.

In the last year, two examples have emerged for how the NPAP has been used to develop state and local level physical activity plans.

Last year, the state of West Virginia and the city of San Antonio, Texas released their state and city physical activity plans, respectively. In both cases the NPAP's eight societal sectors provided the framework for each plan's content. The strategies and tactics from the NPAP's sectors were either copied directly, if applicable, or modified to meet the state and local needs. Or, in cases where the specific needs of the state or municipality were not directly addressed, new strategies or tactics were included. In addition, the process employed by the NPAP to develop and launch the national plan was adopted to develop the state and local plans.

It may be decades before the proverbial fruits of our labor are realized, where incidence and prevalence of non-communicable disease are substantially decreased because most Americans are sufficiently physically active. However, important progress is being made at the state and local level, and development of state and local physical activity plans is an example of that progress.

Do you have examples of progress being made in your town, city, or state?

Obesity rates continue to rise across the United States. In fact, the Centers for Disease Control and Prevention (CDC) currently estimates that more than 35% of American adults are obese, and about 17% of children and adolescents are obese.

Numerous health risks are linked to obesity. They comprise some of the most common preventable causes of death, including coronary heart disease, type II diabetes mellitus, and strokes. In 2008, medical costs associated with obesity were estimated at $147 billion. Efforts to decrease obesity among adults and children are crucial from a public health standpoint.

Current Physical Activity Guidelines recommend 150 minutes (or about 30 minutes, five times a week) of moderate to vigorous physical activity per week. Specifically for weight loss purposes, many experts recommend longer durations of exercise - up to 60 minutes per day.

Are these longer periods of exercise necessary for optimal weight loss? Does the extra time increase fat loss? Or is there a compensation effect whereby the body adjusts to the additional exercise?

In a paper published recently in the American Journal of Physiology, studied this question using samples of overweight, sedentary men. The authors compared a group which performed 30 minutes of daily aerobic exercise for 13 weeks to one which performed 60 minutes per day.

The authors compared the groups based on body fat loss, as well negative accumulated energy balance, which they calculated from the changes in body composition.

Participants who performed 30 minutes of aerobic exercise per day experienced the same amount of body fat loss compared to those who performed 60 minutes per day. Surprisingly, the overweight men who exercised 30 minutes per day had a much greater than predicted negative energy balance. There was no additional benefit obtained by doing 60 minutes of exercise per day.

The authors concluded that while one group of overweight men performed twice the amount of daily aerobic exercise, the decrease in body weight and body fat was no greater than the group that performed half as much.

This study provides good news to overweight individuals who want to start an exercise regimen to lose weight and body fat. Since many of these people do not regularly exercise, starting with 30 minutes per day might be more appealing. They might be more likely to stick to the shorter programs.

When it comes to obesity and weight loss, any exercise seems better than none at all. While we need much more research to find ideal nutritional changes and specific exercise recommendations, Americans of all ages can at least start with moderate amounts of exercise each day.

What do you think about this study and its findings? Will it make you more likely to try to perform physical activity each day?