Weighty Matter

Sunday, January 21, 2001

Suburbs Ponder Weighty Matter

By Lori Montgomery
Washington Post Staff Writer

After succumbing for 20 years to the drive-through convenience of suburban living, Linda Koulakjian had grown a little plump. So the mother of three donned T-shirt and shorts one sunny day and set out to get some exercise.

But in the cul-de-sacs of suburban Germantown, polite society does not often, well, walk. Koulakjian was powering down a deserted sidewalk about five blocks from home when one neighbor and then another pulled their minivans to the curb, lowered their windows and asked if she needed help.

"They said, 'What's wrong? What are you doing here? Do you need a ride?'‚" Koulakjian recalled. "Frankly, I was embarrassed. I didn't want to walk any more after that."

In some communities on the fringes of America's cities, walking has become as old-fashioned as shoeing horses and crank-starting the car. The suburbs have long been blamed for fostering social isolation and epic traffic jams. Now they stand accused of another sin: By making walking impossible, some say, suburban sprawl is making America fat.

Alarmed by the rapid rise of obesity in recent years, the U.S. Centers for Disease Control and Prevention is trying to develop a research program to test the theory that suburban design plays a significant role in America's spreading paunch. Among the latest projects: a plan to map obesity data so researchers can study the nation's beefiest locales. And an Atlanta project that will outfit 800 people with satellite packs so researchers can study where, when, why and how much they walk.

"We are coming to the conclusion that land use, urban design and the built environment are much larger factors in public health than people have really appreciated," said Dr. Richard J. Jackson, director of the CDC's National Center for Environmental Health.

"When we were kids, most kids walked or biked to school. Now it's 10 percent. How do we deal with the obesity epidemic when our kids don't get even that fundamental level of exercise?"

The CDC is not alone. Over the past few years, a growing number of academics and health researchers has blamed suburban sprawl for contributing to a variety of modern ills, from sharp increases in childhood asthma to a growing adult dependency on anti-stress drugs like Zoloft.

But the nation's skyrocketing obesity rate has drawn the most intense focus. Obesity is spreading so far and so fast in America that alarmed health professionals compare it to an infectious disease epidemic.

Over the past decade, obesity among American adults has increased by nearly 60 percent. Today, the CDC says, one in five American adults is obese, loosely defined as being about 30 percent above the ideal weight for a person's height.

Children, too, are gaining weight at prodigious rates. The CDC estimates that 11 percent of American kids are dramatically overweight, a figure that has nearly doubled over the past two decades.

What makes the fat epidemic so worrisome is that it has no clear cause. For children, researchers have established a direct link between excessive television viewing and extra pounds. But adults are consuming only about 100 calories more per day than they were 20 years ago, surveys show, and their use of leisure time for exercise has remained fairly stable. Yet obesity has gone through the roof.

What changed?

"Our world has just gotten a lot easier to live in," said Dr. Tom Schmid, who directs the Active Community Environment Workgroup within the CDC's Division of Nutrition and Physical Activity. "We sit in cars, we don't walk to the store on the corner, we don't walk to the park."

Not long ago, such moderate forms of exercise were considered irrelevant to good health. But recent studies have shown that as little as 40 minutes of walking per day - even split into 10-minute increments - can provide significant health benefits.

Hence the new focus on suburbia, where large-lot homes, congested roads, megamalls and acres of free parking make a stroll to the store about as practical and attractive as a bike lane on the Capital Beltway.

There are no hard data showing that people who live in places like Burke or Bowie are fatter than their counterparts on the pedestrian-friendly streets of the District or Old Town Alexandria. But at a packed post-holiday Weight Watchers meeting in Gaithersburg, dieters were furious about local barriers to exercise.

One woman, an avid walker, spontaneously decided to walk the 4.5 miles from her house to the meeting, held in a spacious strip-mall conference room one flight down from an Einstein's Bagels shop. It was not a pleasant journey, she said.

"I walked in mud and muck to get here because Midcounty Highway doesn't have sidewalks," said Kathi Carey-Fletcher, 53. "I ended up walking against traffic in the turn lane. It's deplorable."

Linda Koulakjian said she hasn't tried to walk in her town house community since the minivan incident a few years ago. Instead, she lost 20 pounds by sticking to the Weight Watchers diet and walking around the office building where she works as a financial planner.

"Here, you feel stupid walking. People will think you're a homeless person," Koulakjian said. "In addition to the way the houses are laid out, there's an entire feeling about what is acceptable."

Another woman said the easy suburban lifestyle and abundance of food caused everyone in her family to "turn into a giant" when they moved to the Washington area 23 years ago from Iran. Emma Megerditchian has since lost 40 pounds, in part by taking the stairs instead of elevators and running errands on foot.

"Some people think that's a big effort. But in this country, everything has become so easy and convenient," said Megerditchian, 44, a clinical assistant in a doctor's office. "I love this country. Since I was 13, I wanted to come here. But drive-through cleaners? Drive-through post-office? During the day when it's nice, go get some fresh air."

There is scientific evidence to support the notion that people who live in suburban communities such as those around Gaithersburg are less likely to walk or bike than people who live in traditional, prewar communities, where gridlike streets support a mix of homes, stores and businesses.

The suburban model is generally defined by highly segregated land uses: Homes are built on curvy, dead-end streets that feed into high-volume roadways leading to separate retail areas, typically malls fronted by parking. Walking is not only unpleasant, it's often dangerous.

In 1994, a San Francisco study found that residents of traditional communities make 16 percent of their journeys on foot or by bike, compared with 10 percent in suburban communities.

More surprising, an examination of transportation data in Seattle found that a person's activity level can be affected by the year his or her home was built. For example, people living in communities developed before 1947 traveled on foot or by bike more than three times every two days. People living in areas developed after 1977 got out of the car barely once.

The same study found that people in older neighborhoods traveled less than four miles, on average, to reach a park or other recreation area. In the newest communities, people had to drive more than eight miles to find a place to relax.

According to Lawrence D. Frank, a transportation professor at the Georgia Institute of Technology in Atlanta who assembled the Seattle data, some new subdivisions are trying to remedy the problem by providing recreation trails.

"The problem is, people aren't using them because they don't take you somewhere you need to go," Frank said. "The conclusion is that it must be convenient for people to be moderately active."

Frank hopes to explore that theory with his latest study, a $4 million project to begin in March with the CDC that will examine the travel habits of 8,000 households in two Atlanta neighborhoods.

One is a high-density urban area with limited parking and plenty of stores, comparable to Georgetown, Frank said. The other is characterized by single-family homes on small lots  much like Tysons Corner, he said  where "there is potential for people to walk but the design may be wrong."

Most participants will keep a trip diary. But 800 will be outfitted with global-positioning devices "so we'll be able to tell if you cross the road for shade. Or because there are more shops. Or because there's something to avoid, like the sidewalk stops," Frank said.

Ultimately, the goal is to establish a clear link between neighborhood characteristics and obesity. If that link is made, the research could be used to prod policymakers to encourage healthy neighborhood design, much as Maryland and some other states are trying to do through smart-growth initiatives.

In the meantime, the CDC has seen some "tantalizing signs that changing the environment will change behavior," said Dr. William H. Dietz, director of the CDC's Division of Nutrition and Physical Activity.

Last year, in the CDC's Rhodes Building in Atlanta, researchers spruced up stairwells and put up motivational posters stressing the benefits of exercise. By study's end, Dietz said, 14 percent more CDC employees were taking the stairs.