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LETTER |
Correspondence: Requests for reprints should be sent to Bruce S. Rabin, MD, PhD, Healthy Lifestyle Program, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA 15213 (e-mail: rabinbs{at}upmc.edu).
The April editorial of McLeroy et al.1 emphasizes the importance of proper development and implementation of modalities that will be accepted by adult residents of communities for the enhancement of the quality of health and therefore life. The editorial clearly indicates the importance of developing acceptable approaches to allow individuals to comfortably and permanently "change." However, implicit in this approach is an acknowledgment of failure to prevent participation in lifestyle practices that need to be changed.
The experience of the University of Pittsburgh Healthy Lifestyle Program has been that few adults will participate in wellness programs and those who do are not representative of the total socioeconomic spectrum. Thus, rather than the need for programs to help individuals change existing behaviors that do not contribute to an optimization of health, we would better serve the coming generations by finding ways to make acceptance of health-enhancing behaviors the standard from the earliest stages of life. Only then will we produce future generations that are both mentally and physically healthier than our current generation.
Such programs must begin with pregnant women to reduce the impact of high levels of maternal stress on the physical and mental development of the fetus.2–4 Effective education of children is needed—they should be taught that the quality of their lives will be enhanced if they keep physically active, are not overweight, and do not smoke or drink alcohol to excess. Parents, schools, and community role models must teach children that they can minimize their risk of living with chronic pain and illness as they age by adopting a health-enhancing lifestyle. Children must understand that attention paid to the quality of their mental and physical health will be rewarded with a high quality of and enjoyment of life.5–7
In addition to directing large financial and personnel resources to existing programs for changing the behavior of adults, we could better serve future generations by directing more attention to enhancing the desire of the next generations to be mentally and physically healthy. Healthy aging begins with the fetus, not the adult.
References
1. McLeroy KR, Norton BL, Kegler MC, Burdine JN, Sumaya CV. Community-based interventions. Am J Public Health.2003;93:529–533.
2. Barbazanges A, Piazza PV, Le Moal M, Maccari S. Maternal glucocorticoid secretion mediates long-term effects of prenatal stress. J Neurosci.1996;16:3943–3949.
3. Wadhwa PD, Sandman CA, Garirte TJ. The neurobiology of stress in human pregnancy: implications for prematurity and development of the fetal central nervous system. Prog Brain Res.2001;133:131–142.[Medline]
4. Coe CL, Lubach GR. Critical periods of special health relevance for psychoneuroimmunology. Brain Behav Immun.2003;17:3–12.[Medline]
5. Strawbridge WJ, Shema SJ, Balfour JL, Higby HR, Kaplan GA. Antecedents of frailty over three decades in an older adult cohort. J Gerontol B Psychol Sci Soc Sci.1998;53:S9–S16.[Abstract]
6. Guralnik JM, Kaplan GA. Predictors of healthy aging: prospective evidence from the Alameda County study. Am J Public Health.1989;79:703–708.
7. Niaura R, Todaro JF, Stroud L, Spiro A III, Ward KD, Weiss S. Hostility, the metabolic syndrome, and incident coronary heart disease. Health Psychol.2002;21:588–593.[ISI][Medline]
This article has been cited by other articles:
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  L. Terre Behavioral Medicine Review: Promoting Healthy Lifestyles in Pediatric Populations American Journal of Lifestyle Medicine, February 1, 2008; 2(1): 37 - 39. [Abstract] [PDF]
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