PAC 230 Module 5 Weight, Eating and Exercise Example

Changing the Sunday Table Together: Weight, Eating and Exercise as a Family Matter

Student Name

Psychology and Addiction Studies Program, Aspen University

PAC 230: Families and Health Psychology

Instructor Name

Month Day, Year

Changing the Sunday Table Together: Weight, Eating and Exercise as a Family Matter

Walt Dawson, seventy-four, is finishing twelve weeks of cardiac rehabilitation after a heart attack. Three mornings a week he has walked on a treadmill under supervision, and for the first time in his life he exercises regularly. He is proud of it, and worried: when the program ends, he says, he has nowhere to go and no one to make him. His daughter Carla has prediabetes. His grandson Mike walks as part of his recovery. His great-granddaughter Brianna, sixteen, quit her high school soccer team this year and spends most evenings on her phone. Every Sunday the family gathers for dinner at Carla's house: pot roast, mashed potatoes, rolls and two desserts. This paper applies research on weight, eating and exercise to the Dawsons as a family. They are composites, like the clinic that serves them, Maumee Valley Family Health; the research is real.

The Cost of Inactivity

Lee et al. (2012) estimated the burden of disease attributable to physical inactivity worldwide. They calculated that inactivity causes about six percent of the burden of coronary heart disease, seven percent of type 2 diabetes and ten percent each of breast and colon cancers, and about nine percent of premature mortality, more than five million deaths a year. They estimated that eliminating inactivity would raise world life expectancy by close to a year. The figures place physical inactivity alongside smoking as a major cause of preventable disease.

For the Dawsons, inactivity runs through several diagnoses at once: Walt's heart disease, Carla's prediabetes and the family's shared habits.

How Much Activity Helps

Arem et al. (2015) pooled data from six large cohort studies including more than six hundred thousand adults and examined how leisure-time physical activity related to mortality over follow-up of more than a decade. Compared with people who reported no leisure-time activity, those who did some activity but less than the recommended minimum had about a twenty percent lower risk of death. Those who met the minimum had about a thirty percent lower risk. The benefit continued to grow with more activity, up to about three to five times the minimum, where it leveled off at roughly a forty percent lower risk, and very high amounts showed no added harm.

The most important finding for the Dawsons is the shape of the curve. The largest gain comes from moving from nothing to something. For Walt, maintaining even part of his rehabilitation walking matters more than meeting any ideal target.

Weight and Social Networks

Christakis and Fowler (2007) studied more than twelve thousand people in the Framingham Heart Study, followed over three decades, whose friendships and family ties had been recorded. They found that obesity clustered in the network and that a person's chance of becoming obese increased substantially if a friend became obese, and to a lesser degree if an adult sibling or spouse did. Geographic neighbors had no such effect, suggesting that social closeness rather than shared environment drove the pattern. The authors proposed that people's sense of what is a normal body size, and their eating and activity habits, may spread through social ties. They noted that healthy changes could spread the same way.

The finding supports treating the family as the unit of change. If the Dawsons change together, each member's change supports the others.

The Family's Patterns

Food, Meaning and Change

Sunday dinner is more than a meal for the Dawsons. Carla learned the pot roast from her mother, who died three years ago, and serving it each week is part of how the family remembers her. A plan that told Carla to stop making it would fail, and it would also ask her to give up something that matters more than any nutrient. Health psychology research on eating consistently finds that food carries identity, memory and love, and that lasting change works with those meanings rather than against them. The plan therefore keeps the roast and the gathering and changes what surrounds them: more vegetables, smaller portions of the heaviest dishes and a single dessert that the family takes turns choosing.

A Family Plan

The plan changes shared routines rather than asking one person to change alone. First, Sunday dinner stays, because it holds the family together, but its content changes: a roast with more vegetables and a salad, one dessert instead of two and a family walk around the neighborhood before the meal. Mike, who already walks, will lead it. Second, Walt will continue walking three mornings a week after rehabilitation, at the local mall or the park depending on weather, with Carla joining him on her days off and the cardiac rehab staff giving him a written home program. Third, for Brianna, the plan avoids any talk about her weight. Instead, her family will ask what activity she might enjoy, and Mike has offered to take her to the climbing gym where a friend from his recovery group works. Fourth, Carla's packed lunches and reduced sodas, part of her prediabetes plan, will be shared with Mike, who will try replacing his energy drinks.

Measuring Progress

The family will keep a simple shared calendar on the refrigerator marking walks. Walt's cardiologist will follow his fitness, and Carla's A1C will be rechecked in three months. Success will be measured by activity kept up after rehabilitation and by whether the Sunday walk becomes a habit, not by anyone's weight on a scale.

Conclusion

The Dawsons' health problems share roots in inactivity and eating patterns that the family holds in common. Lee and colleagues show how much disease inactivity causes, Arem and colleagues show that the first steps bring the largest benefit and Christakis and Fowler show that weight and the habits behind it spread through close ties. A plan that changes the Sunday table and adds a family walk lets the Dawsons spread health instead.

References

Arem, H., Moore, S. C., Patel, A., Hartge, P., Berrington de Gonzalez, A., Visvanathan, K., Campbell, P. T., Freedman, M., Weiderpass, E., Adami, H. O., Linet, M. S., Lee, I.-M., & Matthews, C. E. (2015). Leisure time physical activity and mortality: A detailed pooled analysis of the dose-response relationship. JAMA Internal Medicine, 175(6), 959-967. https://doi.org/10.1001/jamainternmed.2015.0533

Christakis, N. A., & Fowler, J. H. (2007). The spread of obesity in a large social network over 32 years. New England Journal of Medicine, 357(4), 370-379. https://doi.org/10.1056/NEJMsa066082

Lee, I.-M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., & Katzmarzyk, P. T. (2012). Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. The Lancet, 380(9838), 219-229. https://doi.org/10.1016/S0140-6736(12)61031-9