Well: Less Active at Work, Americans Have Gotten Bigger

Getty Images/SuperStockA worker operates a press at the New Orleans Times-Picayune, typical of the physical activity that was common in many workplaces in earlier decades.

Looking beyond poor eating habits and a couch-potato lifestyle, a group of researchers has found a new culprit in the obesity epidemic: the American workplace.

A sweeping review of shifts in the labor force since 1960 suggests that a sizable portion of the national weight gain can be explained by declining physical activity during the workday. Jobs requiring moderate physical activity, which accounted for 50 percent of the labor market in 1960, have plummeted to just 20 percent.

The remaining 80 percent of jobs, the researchers report, are sedentary or require only light activity. The shift translates to an average decline of about 120 to 140 calories a day in physical activity, closely matching the nation’s steady weight gain over the past five decades, according to the report, published Wednesday in the journal PLoS One.

Today, an estimated one in three Americans are obese. Researchers caution that workplace physical activity most likely accounts for only one piece of the obesity puzzle, and that diet, lifestyle and genetics all play an important role.

But the new emphasis on declining workplace activity also represents a major shift in thinking, and it suggests that health care professionals and others on the front lines against obesity, who for years have focused primarily on eating habits and physical activity at home and during leisure time, have missed a key contributor to America’s weight problem. The findings also put pressure on employers to step up workplace heath initiatives and pay more attention to physical activity at work.

“If we’re going to try to get to the root of what’s causing the obesity epidemic, work-related physical activity needs to be in the discussion,” said Dr. Timothy S. Church, a noted exercise researcher at the Pennington Biomedical Research Center in Baton Rouge, La., and the study’s lead author. “There are a lot of people who say it’s all about food. But the work environment has changed so much we have to rethink how we’re going to attack this problem.”

The report shows that in 1960, one out of two Americans had a job that was physically active. Now it is estimated that only one in five Americans achieves a relatively high level of physical activity at work. Dr. Church notes that because the research doesn’t factor in technological changes, like increasing reliance on the Internet and e-mail, many people in service and desk jobs that have always involved only light activity are now moving less than ever, meaning the findings probably understate how much physical activity has been lost during work hours.

While it has long been known that Americans are more sedentary at work compared with the farming and manufacturing workers of 50 years ago, the new study is believed to be the first in which anyone has estimated how much daily caloric expenditure has been lost in the workplace.

“It’s a light bulb, ‘aha’ moment,” said Barbara E. Ainsworth, the president-elect of the American College of Sports Medicine and an exercise researcher at Arizona State University. “I think occupational activity is part of that missing puzzle that is so difficult to measure, and is probably contributing to the inactivity and creeping obesity that we’re seeing over time.”

For years, the role that physical activity has played in the obesity problem has been uncertain. Numerous studies suggest there has been little change in the average amount of leisure-time physical activity, posing a conundrum for researchers trying to explain the country’s steady weight gain. As a result, much of the focus has been on the rise of fast-food and soft drink consumption.

Other studies have suggested that changing commuting habits, declining reliance on public transportation and even increased time in front of the television have played a role in the fattening of America. But none of those issues can fully explain the complex changes in nationwide weight-gain patterns.

Some earlier research has hinted at the fact that workplace physical activity is associated with weight and health. One seminal set of studies of London bus drivers and conductors showed that the sedentary bus drivers had higher rates of heart disease than the ticket-takers, who moved around during the workday.

Dr. Church said that during a talk on the country’s obesity patterns, he was struck by the fact that Mississippi and Wisconsin both have high rates of obesity, despite having little in common in terms of demographics, education or even weather. It occurred to him that both states have waning agricultural economies, prompting him to begin exploring the link between changes in the labor force and declines in workplace physical activity.

He quickly discovered that a decline in farming jobs alone could not explain increasing obesity around the country, and began exploring job shifts over several decades. Using computer models, Dr. Church and colleagues assigned metabolic equivalent values to various job categories and then calculated changes in caloric expenditure at work from 1960 to 2008.

“You see the manufacturing jobs plummet and realize that’s a lot of physical activity,” said Dr. Church. “It’s very obvious that the jobs that required a lot of physical activity have gone away.”

Ross C. Brownson, an epidemiologist at Washington University in St. Louis, said that both health professionals and the public needed to broaden the traditional definition of physical activity as something that occurs during planned exercise, like running or working out at the gym.

“We need to think about physical activity as a more robust concept than just recreational physical activity,” said Dr. Brownson, whose 2005 report on declining physical activity in the workplace is cited in the PLoS One report. “In many ways we’ve engineered physical activity out of our lives, so we’ve got to find ways to put it back into our lives, like taking walks during breaks or having opportunities for activity that are more routine to our daily lives, not just going to the health club.”

Researchers said it is unlikely that the lost physical activity can ever be fully restored to the workplace, but employers do have the power to increase the physical activity of their employees by offering subsidized gym memberships or incentives to use public transit. Some companies have set up standing workstations, and marketers now offer treadmill-style desks. Employers can also redesign offices to encourage walking, by placing printers away from desks and encouraging face-to-face communication, rather than e-mail.

“The activity we get at work has to be intentional,” said Dr. Ainsworth. “When people think of obesity they always think of food first, and that’s one side of it, but it’s high time to look at the amount of time we spend inactive at work.”

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The TV Watch: Television Diva Gives Thanks and Signs Off

The surprise was that at long last there weren’t any more surprises. Oprah Winfrey took her final bow on Wednesday by holding back. “There will be no makeovers, no surprises — really, no surprises,” she told her studio audience. “You will not be getting a car or a tree. This last hour is really about me saying thank you.”

"The Oprah Winfrey Show," a daytime television fixture for 25 years, ended on Wednesday.

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An electronics store on Union Square in Manhattan tuned into the finale of “The Oprah Winfrey Show” on Wednesday. The show ended a 25-year run.

And Ms. Winfrey did exactly that in a valedictory monologue that was something between a graduation address and a Sunday homily, praising God and her fans for her success and exhorting viewers to “connect, embrace, liberate, love somebody, just one person and then spread that to two and as many as you can.”

And the lack of ceremony, the absence of celebrities, goody bags or confetti, was less a letdown than a relief after the star-studded, two-part Oprah-fest on Monday and Tuesday at the United Center in Chicago, a Pharaonic tribute that capped what was already a season-long elegy to the star of the “The Oprah Winfrey Show.” Ms. Winfrey called the tribute a “love intervention on steroids.” And come to think of it, there hadn’t been such an over-the-top display of self-celebration since 2005, when Ms. Winfrey released a six-disc DVD collection of her greatest moments, timed to the 20th anniversary of her syndicated show — unless it was her 50th birthday celebration in 2004, which featured 2,000 roses, a 400-pound cake and testimonials from the likes of John Travolta and Nelson Mandela.

Ms. Winfrey’s last show was a lot more like the first nationally syndicated episode of “The Oprah Winfrey Show” in 1986, when the young woman who overcame an abusive, deprived childhood was only beginning to be known but had already developed a messianic streak. Ms. Winfrey showed a clip of that maiden appearance, in which she explained, “This show always allows people, hopefully, to understand the power they have to change their own lives.”

For her final farewell Ms. Winfrey chose to separate the two contradictory strands — spiritual guide and show-business diva — that are the alchemy of her success. Inconsistencies are the core of her improbable, inimitable career. There is no one like her partly because she is never less than two opposite things at once, Hollywood royalty and star-struck commoner, entertainer and confessor, profit seeker and prophet. Ms. Winfrey was a tycoon and also a tastemaker whose endorsement made the fortunes of housewives, authors, singers and even presidential candidates. She built schools, rescued abused children and hawked beauty treatments, sometimes all in the same show. Ms. Winfrey could move from high literature to lowly undergarments in a heartbeat; she is the woman who introduced “Anna Karenina” and Spanx to the masses.

The best way to measure her stature in the world isn’t by her rank on the Fortune 500 list or the number of accolades from celebrities like Tom Hanks, Tom Cruise and Maria Shriver. (Ms. Shriver gave audiences an extra frisson by seeming to allude to the deceptions of her estranged husband, Arnold Schwarzenegger, while praising Ms. Winfrey. “You have shown love, support, wisdom and most of all,” Ms. Shriver told her, pausing to add, “the truth.”)

Ms. Winfrey’s role isn’t calculable even through the obeisance paid by world leaders or the heartfelt tributes from the ordinary people whom she has inspired over the past 25 years.

It’s easier to look around and try to determine who in popular culture is poised to take her place, and the answer is no one. Her most popular protégés, like Dr. Oz and Dr. Phil, may take over some of her share-and-heal duties. Competitors like Ellen DeGeneres and perhaps newcomers like Anderson Cooper and Katie Couric could inherit some of her celebrity interviews. But nobody can copy her unique gift for mixing philanthropy and self-interest. Whether giving a car to each member of a studio audiences or sending scores of needy students to college, Ms. Winfrey made doing good seem like fun; carrying out good deeds didn’t preclude living the good life.

That could be because Ms. Winfrey blends the mystical and the practical better than anyone else in show business. Last week, in an episode devoted to her three most memorable guests, she said that one of them, Mattie J. T. Stepanek, a child poet with muscular dystrophy who later died, persuaded her to continue until 2011 instead of ending after the 20th anniversary. Ms. Winfrey said she considered Mattie a prophet, so that when he told her he had a feeling she should continue her show until the 25th season, she instantly complied. She did not add that it was also the moment her contract with CBS, which owns the syndication rights to her show, expires.

Ms. Winfrey closed with these words: “I won’t say goodbye. I’ll just say ‘until we meet again.’ To God be the glory.”

And she has spent her last days — and her entire 25th season — not so much bidding farewell as coaxing viewers to follow her to her next project, the cable network she created in her own image, OWN.

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Patriot Act Battle Could Hinder Investigators

Two sections of the Patriot Act, the law Congress passed shortly after the terrorist attacks of Sept. 11, 2001, and a section from a related intelligence law are set to expire Thursday night unless lawmakers vote to extend them. Majorities in both chambers are apparently willing to approve extending them for four years.

But Senator Rand Paul of Kentucky, a libertarian-leaning Republican elected last year, is blocking a hurry-up vote to do so. He wants the Senate majority leader, Harry Reid, Democrat of Nevada, to first allow a vote on several proposed amendments, including a measure that would exempt gun records from being searched under the Patriot Act.

Mr. Paul and Mr. Reid blamed each other for the standoff. If the Senate cannot speed up its usual process for debating bills, the chamber will not be able vote until Friday morning. The House would then still need to approve the bill before it could be sent to President Obama, who is visiting Europe, to be signed into law.

Mr. Reid said Wednesday night that he was working on an agreement that would allow some amendments to be considered Thursday before proceeding to the final vote.

If there is a lapse, a senior administration official said, the F.B.I. would be able to continue using orders it had already obtained, but it would not be able to apply for new ones if further tips and leads came in about a possible terrorist operation. The official, who spoke on the condition of anonymity, reacted with alarm to that prospect, saying no one could predict what the consequences of a temporary lapse might be.

“This is unprecedented,” the official said. “We don’t believe the risk is worth it.”

The three sections that may lapse allow investigators to get “roving wiretap” court orders allowing them to follow terrorism suspects who switch phone numbers or providers; to get orders allowing them to seize “any tangible things” relevant to a security investigation, like a business’s customer records; and to get national-security wiretap orders to monitor noncitizen suspects who are not believed to be connected to any foreign power.

The standoff led to a harsh exchange Wednesday. Mr. Reid accused Mr. Paul of putting the country at risk with “political grandstanding.” Mr. Paul accused Mr. Reid of breaking a promise to allow a full debate over the Patriot Act, which he portrayed as a threat to constitutional rights.

“We don’t want our records to be sifted through by a government without judicial review,” Mr. Paul said. “They don’t want to vote on this because they know the American people agree with us.”

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Suspect in Shooting of Giffords Ruled Unfit for Trial

The ruling by Judge Larry A. Burns of Federal District Court suspends the court proceedings against Mr. Loughner while the suspect, who experts said has schizophrenia, undergoes treatment at a federal psychiatric facility in Springfield, Mo.

Before the judge’s decision, Mr. Loughner disrupted the hearing with an outburst that prompted deputy marshals to carry him from the room. He will return to court on Sept. 21, when the judge will review again whether Mr. Loughner understands the 49 charges against him and can assist in his defense.

It remains possible, legal experts said, that Mr. Loughner will never be found competent, and could remain in a psychiatric facility indefinitely, but prosecutors said they hoped the trial would resume. “Our goal has always been and always will be to go to trial,” said Dennis K. Burke, a United States attorney, speaking to reporters outside the courthouse.

Mr. Loughner, 22, looked haggard when he walked into court in shackles. Shaved bald and standing erect during his first court appearance in January, he now has long sideburns and unkempt hair and walks stooped over. He rocked back and forth in his chair during the proceedings, buried his face in his hands midway through and interrupted the judge with an outburst.

“Thank you for the freak show,” he appeared to say. “She died right in front of me. You’re treasonous.”

Other witnesses heard him say, “Thank you for the free shot,” and court officials were reviewing the recording to confirm.

A lawyer close to the case said that Mr. Loughner continued to believe he killed Ms. Giffords and that he has clashed with his lawyer, Judy Clarke, who told him the congresswoman survived a bullet wound to the head.

Expecting that he might act out, security personnel were positioned within two feet of Mr. Loughner and quickly spirited him out of the room. He was escorted back moments later and told the judge he would prefer to watch on a television screen in an adjoining holding cell.

Judge Burns’s ruling that Mr. Loughner was incompetent followed the recommendations of two experts, Christina Pietz, a psychologist who works for the Bureau of Prisons and was appointed by the prosecution, and Dr. Matthew Carroll, a psychiatrist in private practice in San Diego appointed by the judge.

Dr. Pietz conducted 12 interviews with Mr. Loughner over nine hours. She found that his thoughts were random and disorganized and that he suffered delusions and offered nonsensical answers to her questions. She diagnosed schizophrenia.

Similarly, Dr. Carroll found after five interviews over seven hours that Mr. Loughner experienced delusions, bizarre thoughts and hallucinations and appeared to suffer from paranoid schizophrenia, the judge said. Dr. Carroll considered whether Mr. Loughner was faking a mental illness but reported that he showed no signs of that, the judge said.

Judge Burns said he reviewed the hours of videotaped interviews and agreed with the experts’ conclusions. “At the present time, Mr. Loughner does not have a rational understanding of these proceedings,” Judge Burns said, ordering him treated for up to four months.

Paul G. Cassell, a criminal justice expert at the S. J. Quinney College of Law at the University of Utah, said psychiatric evaluations would continue to determine whether Mr. Loughner’s condition has improved. If the experts believe that Mr. Loughner can be rendered competent through psychiatric treatment, then he can be forced to take medications, said Mr. Cassell, a former federal judge.

Forcing medication raises troubling issues for society, said Cynthia Hujar Orr, a lawyer in San Antonio who is a past president of the National Association of Criminal Defense Lawyers. “Is it ethical and proper to help someone regain competence just to go after them for a death penalty offense or a murder offense?” she asked.

John Schwartz contributed reporting from New York.

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