A call to arms in the battle of the bulge

By MARCUS GEE

It's hard to talk about the topic of fitness without sounding insufferably preachy, but here goes nothing. Every Canadian - man, woman and child - should get at least an hour of exercise most days. Schools should make it obligatory. Governments should pour money into encouraging it. Cities should be re-engineered to facilitate it.

Every public servant in a visible role - teacher, cop, nurse - should be required to come to work fit as an example. No more paunchy prime ministers. Being in shape should be as much a requirement for running the country as being bilingual.

Draconian? Unfair to fat people? The beginning of a nanny state? Some will say so. But we are facing a national health crisis. It requires a tough, even radical response, with cities taking the lead.

Recent studies by Statistics Canada and the Heart and Stroke Foundation paint a truly shocking picture. Adult obesity has risen 70 per cent and childhood obesity threefold over the past three decades. The number of people in their 20s and 30s with high blood pressure has nearly doubled in just 15 years. The proportion of teenagers aged 15 to 19 with bulging waistlines has more than tripled. The lead author of the Statscan study, Mark Tremblay, speaks of a "dramatic deterioration in the fitness of the Canadian population."

In historical terms, the transformation of Canadian bodies is happening at blinding speed. The average 45-year-old man is 20 pounds heavier than his counterpart would have been in 1981. The rise of screen-based entertainment, the proliferation of junk foods and the spread of suburbs and car travel have changed the way we live. Close to half of Canadians under 35 are classified as inactive. The vision of the future human in the 2008 animated film Wall-E - where blimp-like people in hovering chairs are tethered to their video screens, almost incapable of walking on their own - no longer looks so farfetched.

The results of our devolution are predictable. From 1994 to 2005, rates of high blood pressure were up by 77 per cent, diabetes 45 per cent and obesity 18 per cent. Knee- and hip-replacement operations doubled over the past decade, partly because of heavier, less active bodies. Studies are linking excess fat to cancers of the breast, colon, gallbladder, pancreas and other organs. The Heart and Stroke Foundation speaks of a "perfect storm" as the effects of an aging society and a fatter population converge, with a crushing cost to the already-overburdened health system.

Governments have to reach for every weapon at hand to combat the crisis. Have schoolchildren start the morning with an hour of physical activity, even if it means a longer school day. Put big health warnings on junk food, just as we do on cigarette packs. Limit or ban advertising for dangerously fatty foods. Subsidize gym memberships and sports clubs. Step up advertising that promotes healthy living. Costly, yes, but recent U.S. studies suggest that every $1 spent fighting heart disease yields $5 in health-care savings. A recent study for the Conference Board of Canada said that an aggressive heart-health strategy could save $76-billion by 2020 in lost income and medical costs.

San Francisco, New York and Seattle already require chain restaurants to put calorie values on their menus. Portland, Ore., plans to spend $613-million on 1,000 kilometres of bike paths over the next 20 years.

Contrary to popular belief, cities are inherently healthier places than towns and villages. A Heart and Stroke study ranks Toronto the third-best region in Ontario (after Waterloo and York) on a scale of health risk factors such as smoking and high blood pressure. Still, fully 57 per cent of Torontonians are classified as physically inactive, the worst record in the province. One in three Toronto children is overweight or obese.

Health may be a provincial responsibility, but cities can play a big part in getting people moving. Under Mayor David Miller, Toronto has dedicated itself to making it easier to commute by bike or on foot. Putting those policies into effect is taking far longer than it should. A fat-fighting city would bring in road tolls, congestion charges and sprawl taxes to encourage better habits.

Yes, there will be push back - from food companies who resent being taxed or stigmatized, from drivers wedded to their cars, from adults who resent the finger-wagging over their personal habits. But tobacco companies and cigarette smokers pushed back, too, when government first started acting against the health calamity caused by smoking. We are at the same stage now with fat, just beginning to recognize the scale of the crisis and still doing far too little to grapple with it.