Oct. 7, 2010 -- The Bible is not customarily listed among the great fitness manifestos of our time, but preaching exercise as a form of praise and prayer may be the key to motivating the elderly to stay fit.
In hopes of increasing overall activity levels among 62 elderly black women in a Los Angeles community, researchers leveraged the high religiosity of this demographic in designing a faith-based exercise program. Over the course of eight weeks, subjects attended 45-minute weekly exercise sessions in tandem with 45 minute exercise education lessons incorporating positive reinforcement, Scripture readings, and group prayer.
Four months after the effort finished, researchers measured the women's blood pressure and activity level, measured by steps taken per week. Those receiving the faith-based interventions increased their activity level by 78 percent. Women who were given only the exercise sessions (and lessons with no religious component), increased activity by only 19 percent.
The elderly African Americans in the Los Angeles community studied suffer from a lot of health problems and are particularly difficult to motivate to exercise, says Dr. O. Kenrik Duru, lead author on the study and a doctor at the UCLA Medical Center.
"We were trying to use the strength in the community to help them. Over 90 percent of older African-American adults report praying nearly every day. We thought that if we could leverage the church in exercise interventions, this might be more effective and sustainable," he says.
Though significant weight loss was not noted in the women, those in the intervention group walked an estimated 4 to 5 miles more per week than they had before, and had a drop in resting blood pressure.
My Sister's Keeper – Social, Spiritual Exercise Support
Duru's project, called "Sisters in Motion," was a bit of a "kitchen sink approach," he says. It combined motivational tools known to work -- such as social support and group contests -- with religious themes. Participants were drawn from a Catholic, an African Methodist Episcopalian, and a Seventh Day Adventist church.
"The model of the program was, 'With God's help we can achieve what our minds can conceive.' To improve social support for participants, we emphasize the theme of 'You are your sisters' keeper,' that as a fellow Christian you have a responsibility to help them stay healthy."
This theme was brought out during a discussion of a passage from Ecclesiastes: "Two are better than one….for if either of them falls, the one will lift up his companion. If two lie down together they keep warm, but how can one be warm alone?"
The "socialization, belonging…[and] being included and surrounded by positive energy" provided by this kind of sisterhood is one of the reasons this faith-based approach is effective, says Eileen McKeon Pesek, director of Pastoral Care and Education at Beth Israel Medical Center in New York.
"Working towards a goal with other people makes it fun and less burdensome," she says. The message to participants: "It matters to us that you are…taking care of the previous gift of life God has given to us."
Using social networks to boost motivation and adherence to a diet or exercise program is a time-tested tool among fitness experts, but by tying it to religion, Duru's program connected the new desired activity (physical exercise) to an already-valued activity (scripture-reading and prayer), says Timothy Birdsall, vice president of Integrative Medicine at the Cancer Treatment Centers of America.
Practicing What You Preach
This isn't the first time that researchers have tried to use faith to motivate churchgoers to be healthy, though programs of this nature are still few and far between.
In a similar effort, researchers at the Medical College of Georgia tested a faith-based weight loss program called "Fit for Body and Soul" last year at a church in Augusta, Ga.
In Augusta, church leaders helped to develop scripture-based "sermons" on weight loss, increased physical activity, and behavioral change. Among overweight and obese black members of the community, they found that the 12-week church-based program resulted in a 5 percent loss of body weight for nearly half of the participants -- a considerable effect that would have positive health consequences.
Body and Soul Changes
While Duru reports that women enjoyed the faith-based Sisters in Motion program, the increased activity didn't translate into weight loss, leading some experts to wonder whether the change in behavior would be enough to lead to health benefits.
"While the differences between the two groups in terms of steps walked per week were statistically significant, the additional level of exercise…is probably not sufficient by itself to generate health benefits such as reduction in blood pressure and weight loss," says Birdsall. A gradual approach to increasing exercise would be ideal for this elderly population, he adds, so if this kind of program could build up to the recommended 60 to 90 minutes of activity per day, that might show stronger benefit and change in disease risk.
Others said those extra miles would produce benefits to cardiovascular health and overall well-being, even if they didn't translate into pounds lost.
"Adding the equivalent of three miles would [be enough to] enhance weight loss, reduce cardiovascular risk, and improve overall well-being," says Dr. Tim Daaleman, the Vice Chair and Associate Professor of Family Medicine at University of North Carolina, Chapel Hill.
Michael Dupper, assistant professor of Health, Exercise Science and Leisure Management at the University of Mississippi, says this extra distance would also benefit blood flow, flexibility, and digestion; improve balance; and increase basal metabolic rate among the older women.
Even if the increase in activity wasn't terribly large, "the implementation of an exercise regimen, in itself, represents a significant change in mindset for this particular population," says Dr. Jay Milstein, professor of pediatrics and a member of the Clinical Pastoral Education Advisory Committee at the University of California, Davis Medical Center.
"If this were possible because of the addition of the spiritual element, it would be reasonable to think that this could potentially have other important health benefits because of the enthusiasm that may have been generated."
Duru says he hopes the study, which will be published in the Journal of the American Geriatrics Society Thursday, will bring funding for future research on this faith-based approach.