I am writing this article from Geneva, Switzerland, where I have been working for almost four weeks. While I have not grown homesick yet, I stop and think of the home, the United States, almost every day. These periods of daydreaming are usually triggered by something I would notice that is drastically different from what I am used to in the U.S.
For example, one of the first things I noticed about Geneva was the number of people I saw walking and riding bicycles to work and school in the morning. This includes everyone from teenagers to interns at the international organizations to senior staff members at the World Health Organization (WHO). I was further surprised to see people on bicycles in full business attire ( including suit jackets and ties) riding up the unforgiving hill to where the international organizations are located. I also saw a father taking his young son to school on the back of his bicycle. Of course, I noticed all of this as I rode past everyone on the bus to work. Even my fifty-something year old supervisor at WHO walks to work when the weather is nice. Mind you this at minimum a 45-minute walk from her home. It was then that I began to realize how truly American I am. Last year, I lived in Philadelphia directly across the bridge from my hospital in Camden, N.J. where I did my third-year clerkships. I took the 6-minute train ride from 8th & Market to Broadway just about every morning. Not once did I ever consider riding a bike to work (which would have probably taken about 20 minutes), let alone walking. Perhaps the fact that I have not ridden a bike since the 7th or 8th grade may have had something to do with it.
In the U.S. we have become completely dependent on our vehicles. We have a tendency to drive everywhere, even if our destination is only 15 minutes away. In addition, the average American’s idea of exercise involves purchasing a gym membership followed by a few days of scheduled workouts each week. The problem with relying on this notion of exercise is that when we are stressed and/or pressed for time, such as meeting an approaching deadline, studying for an upcoming exam, or rushing home from work to prepare dinner for the children, exercise is often the first thing to get cut in order to make more time for everything else. However, when exercise is incorporated into our daily routine such as walking or biking to work/school, like our European friends, it is the start of an overall healthier lifestyle, not to mention going beyond the 150 minutes of moderate exercise per week recommended by the American Heart Association. It also carries the potential for a huge snowball effect, making you want to walk/bike a little further each day.
If exercise becomes part of our regular day and not only our “gym days”, then it also forces us to be more conscious of what we are eating and drinking. Somehow the term diet has come to refer to something one does temporarily to lose weight, as opposed to referring to our daily nutritional intake. Perhaps it is a result of the commercialization of the word due to the success popular weight-loss books. However, eliminating something because we are ON a “diet” is not the same as eliminating it FROM our diet as the former suggests that it is only short-term. Thinking of our diet as what we intake on a regular basis is the first step to improving said diet. Eating smaller portion sizes, less fast foods and junk foods, and more fruits & vegetables are basic steps that everyone can take to better their dietary intake, but again, only if these become part of our daily routine.
As medical students, we have become eyewitnesses to the health implications of being overweight and obese. If we ever hope to defeat obesity, the approach must be a multi-dimensional one. It must include efforts from healthcare professionals, government, and individuals alike. The problem is too large for either group to take on alone. There must be more teamwork among healthcare professionals in order to make one large, concerted effort from everyone involved in patient care. We must also call on our elected officials to invest in healthy lifestyles from all levels of government. From drafting policies at the federal level that will make fresh, healthy foods affordable and accessible to everyone, down to maintaining playgrounds & organized sports/activities for youths and constructing bike lanes to keep bike riders safe at the state local levels. Lastly, but most importantly, each American must make the choice to make an overall change from the “diet and exercise when it is convenient” mentality to making it a part of their everyday routines. Similarly to when one is climbing a mountain, it is usually that extra effort that gets you over the top.
Bonne nuit SNMA. I have to wake up a little earlier tomorrow for my long walk to work in the morning.
Yonatan Yohannes, MS-IV
2013 M.D. Candidate, Robert Wood Johnson Medical School
Intern, Patient Safety Programme, World Health Organization
Filed Under: Global Health
About the Author: firstname.lastname@example.org