According to a new national health statistics report out today analyzing five key health behaviors among U.S. adults — sufficient sleep, smoking, drinking, obesity, and physical activity — there are several bright spots. For instance, the survey found that fewer young people (18-24) are smoking and the number of adults who report they’re completely aerobically inactive showed ‘notable’ declines in recent years, from 39.7% inactive between 2005-2007 to 33.9% in the years 2008-2010.

O.K., now the bad news: Heavy drinking has increased, except among the senior set over 75, smoking prevalence remains virtually unchanged (beyond the youngsters) and obesity is up.

My first reaction is: Huh? Is anyone out there listening to Michelle Obama and all those other Get-Out-There-And-Move and Cut-The-Sugar advocates?

But then I talked to Dr. Eddie Phillips, director of the Institute of Lifestyle Medicine and an assistant professor of Physical Medicine and Rehabilitation at Harvard Medical School, who insisted on highlighting the positive.

A little background: Dr. Phillips’ focus is on physical activity, the link between health and exercise and on educating physicians about how to more seamlessly incorporate physical activity into the practice of medicine.

His takeaway from the CDC report is this: “People are starting to move.”

What’s truly promising, he says, is that the ‘notable decline’ in aerobically inactive adults comes on the heels of a global campaign to have doctors assess physical activity as a vital sign and then “prescribe” exercise as they would any other medication. This suggests that both practitioners and patients are starting to get the message.

Dr. Phillips adds that his overall gestalt on the topic is that “this is not an all or nothing” prospect: “It’s not like you’re ‘healthy’ or you’re ‘not healthy.’ “If you make small changes, it makes an impact.”

So, for instance, he says, even if you don’t meet the federal guidelines for physical activity — 150 minutes per week of moderate-intensity physical activity, like brisk walking — it still helps to do something. “Seventy-five minutes is OK,” Phillips says. “Anything you do short of sitting on the couch is beneficial.”

Dr. Phillips even has something upbeat to say on the CDC finding that obesity is up, noting that, while he’s not an obesity expert, studies have found that being physically active is somewhat protective against the medical conditions associated with obesity. “So if we have a lot of heavy people walking briskly, we may be ahead of the game,” he says.

On an individual level, Dr. Phillips adds: “The challenge is not about getting the information out: people know they’re supposed to be moving and eating less junk food. This is a translational issue; it’s about encouraging them to make modest, sustainable changes.” On the overall statistics, he says: “This is a report card, so while there are some bad marks, there are also places where, as students, there’s hope.”

Here are more of the bottom line numbers, from the CDC report:

•About 6 in 10 (64.9%) U.S. adults were current drinkers in 2008–2010; about 1 in 5 adults (20.9%) were lifetime abstainers.

•About one in five adults (20.2%) were current smokers and over one-half of adults (58.6%) had never smoked cigarettes. Less than one-half of current smokers (45.8%) attempted to quit smoking in the past year.

•Nearly one-half (46.1%) of adults met the federal guidelines for aerobic physical activity, about one-quarter (23.0%) of adults met the federal guidelines for muscle strengthening physical activity, and about one in five adults (19.4%) met both guidelines.

•About 6 in 10 adults (62.1%) were overweight or obese (BMI ≥ 25), with about 4 in 10 (36.1%) adults being of healthy weight (18.5 ≤ BMI < 25).

•About 7 in 10 adults (69.7%) met the Healthy People 2020 objective for sufficient sleep.

The report is massive and you could spend the day wading through it, comparing men and women, racial groups and income levels. (For instance: “Adults who had family incomes four times the poverty level or more (57.8%) were nearly twice as likely as adults with family incomes below the poverty level (32.4%) to have met the 2008 guidelines for aerobic physical activity through leisure­ time activity.”)

Here are some notable changes since the government last conducted the survey:

•Since the last report, the percentage of adults who had five or more drinks in 1 day at least once in the past year increased from 20.5% (2005–2007) to 23.6% (2008–2010)— with increases in every age group except adults aged 75 and over.

•Adult smoking prevalence remained unchanged between 2005–2007 (20.4%) and 2008–2010 (20.2%) although declines were seen among adults in the youngest age group (aged 18–24) from 23.5% (2005–2007) to 21.2% (2008–2010)

•With the introduction of new national physical activity objectives since the last report, direct comparisons of the percentage of adults meeting most physical activity goals are not possible; however, the goal of reducing the percentage of adults who are physically inactive in terms of aerobic activity remains comparable. The percentage of adults who were completely aerobically inactive had remained at 38%–40% between 1997 and 2004. However, in subsequent years the percentage of adults who were aerobically inactive showed a notable decline from 39.7% (2005–2007) to 33.9% (2008–2010). This decline coincides with the release of the 2008 federal guidelines for physical activity and major public health initiatives to promote physical activity.

•Yet despite declines in physical inactivity, the percentage of adults who were obese increased from 25.4% to 27.4% during this time period; the percentage of adults who were overweight but not obese, on the other hand, remained stable at about 35%.

•For ages 25 and over, the percentage of adults who got insufficient sleep remained essentially unchanged between 2005–2007 and 2008–2010.

Girls need to move for so many reasons, among them, mental clarity, physical fitness and confidence, and simply to learn that their own bodies can bring them immense joy. Now, add another benefit to the list: it keeps them out of trouble.

Researchers from Columbia University in New York report that teenage girls from inner-city neighborhoods who exercised regularly were less likely to carry a gun and engage in violent behavior and activities.

Here are some of the findings, from the Columbia news release:

–Females who exercised more than 10 days in the last month had decreased odds of being in a gang.
–Those who did more than 20 sit-ups in the past four weeks had decreased odds of carrying a weapon or being in a gang.
–Females reporting running more than 20 minutes the last time they ran had decreased odds of carrying a weapon.
–Those who participated in team sports in the past year had decreased odds of carrying a weapon, being in a fight or being in a gang.
–In males, none of the measures of exercise was associated with a decrease in violence-related behaviors, which could be because a larger proportion of males than females did not answer all of the survey questions…

The survey included questions on how often students exercised, how many sit-ups they did and the time of their longest run in the past four weeks as well as whether they played on an organized sports team in the past year.

Students also were asked if they had carried a weapon in the past 30 days or if they were in a physical fight or in a gang in the past year.

Nearly three-quarters of the respondents were Latino, and 19 percent were black. Fifty-six percent were female.

The findings — based on analyzing data from a 2008 survey completed by 1,312 students at four inner-city high schools in New York — were to be presented this week at the Pediatric Academic Societies annual meeting in Washington, DC.

Readers, do you have any experience with teenage girls and exercise and how they may have been influenced by daily activity? Please let us know.

A number of efforts are currently underway to try to reverse this trend by focusing directly on the physical health of the mentally ill.

The latest study in this arena, published in The New England Journal of Medicine today, found that a so-called “behavioral weight-loss intervention” including weight-management counseling and group exercise “significantly” reduced weight “in overweight and obese adults with serious mental illness” (including those with major depression, schizophrenia and bi-polar disorder).

The mean weight loss, after 18 months, was 7 pounds, researchers from Johns Hopkins report. Not so much, you may think. But researchers note: “This extent of weight loss, albeit modest, has been shown to have beneficial effects, such as a reduced risk of cardiovascular disease among persons with an initially elevated risk.” Also noteworthy is that people in this study, called ACHIEVE, lost weight gradually over time.

“Participants in the intervention group in ACHIEVE continued to lose weight after 6 months and did not regain weight, even with a reduced frequency of weight-management contact sessions and with rehabilitation staff assuming responsibility for some exercise classes. One possible explanation is that persons with serious mental illness take longer than those without serious mental illness to engage in an intervention and make requisite behavioral changes.

Maybe we can all learn something from this slow, steady, no-magic-bullet approach.

It’s one of those studies that infuses a little science into what we already know but is reassuring nonetheless.

From the news release:

Exercise may play a key role in helping children cope with stressful situations, according to a recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

When they are exposed to everyday stressors, the study found sedentary children had surges of cortisol – a hormone linked to stress. The most active children had little or no increase in their cortisol levels in similar situations.

“The findings suggest physical activity plays a role in mental health by buffering children from the effects of daily stressors, such as public speaking,” said the study’s lead author, Silja Martikainen, MA, of the University of Helsinki, Finland.

The cross-sectional study monitored physical activity and cortisol levels in a birth cohort of eight-year-old children. The 252 participants wore accelerometer devices on their wrists to measure physical activity. Saliva samples were taken to measure cortisol levels. To measure reactions to stress, children were assigned arithmetic and story-telling tasks. The study is the first to find a link between physical activity and stress hormone responses in children.

The children were divided into three groups – most active, intermediate and least active. The most active children’s cortisol levels were the least reactive to stressful situations. The most active children exercised more vigorously and for longer periods of time than their counterparts.

“Clearly, there is a link between mental and physical well-being, but the nature of the connection is not well understood,” Martikainen said. “These results suggest exercise promotes mental health by regulating the stress hormone response to stressors.”

Hoping to extend the reach of her three-year-old Let’s Move! campaign, Michelle Obama today made a pitch for kids to be more active at school. The First Lady’s new initiative, Let’s Move Active Schools, is partnering with 9 organizations — including one based at Tufts — to help combat childhood obesity by instituting a range of creative, accessible programs for kids to get more exercise through fun, school-based activities.

The Huffington Post covered Ms. Obama’s announcement this morning: “With each passing year, schools feel like it’s just getting harder to find the time, the money and the will to help our kids be active. But just because it’s hard doesn’t mean we should stop trying,” the first lady said in her prepared remarks. “It means we should try harder. It means that all of us – not just educators, but businesses and nonprofits and ordinary citizens – we all need to dig deeper and start getting even more creative.”

Christina D. Economos, PhD, is Associate Professor at the Friedman School of Nutrition Science and Policy at Tufts University, and a leading researcher in the field of childhood obesity prevention. She’s also Vice-Chair and Director of ChildObesity180, a nonprofit based at Tufts that is working with the First Lady and supports a variety of strategies to help kids become healthier through improved nutrition and physical activity.

Piggy-backing on Ms. Obama’s news, ChildObesity180′s program, the Active Schools Acceleration Project (ASAP), made its own announcement today: the group will award grants totaling $1 million to 1,000 schools to launch one of three award-winning physical activity programs. Each of the three plans — one started by a bunch of moms in Natick, another called the 100-Mile Club and a third that supports short bursts of activity in urban classrooms — are fun for kids, accessible and have shown both physical and behavioral benefits, like better concentration in class, Economos said.

The $1 million in grants will support schools in adopting one of these programs, Economos said, including tools and resources like in-person training and assistance from professional groups.

Here’s a bit more on the three exercise prograns:

–The BOKS initiative, started by the Natick moms, is a before-school plan designed to prepare children’s bodies and brains for the day. It features a range of moderate to vigorous activities — games, strengthening exercises, cardio work and stretching — and ends with a cool-down and nutrition tips (like how many cubes of sugar in a juice box).

–The 100 Mile Club, started in California, challenges elementary school kids to run, jog, or walk 100 miles over the course of the school year. “They can accumulate the miles through school classes or outside school and it fosters great comraderie. It’s a club, so you feel like you’re part of something and there’s a big celebration at the end of the year,” Economos said.

–CHALK/Just Move is a classroom-based activity program for small spaces and “challenging environments” like schools in New York City, Economos said. Students are encouraged to get up and do short bursts of activity throughout the day, either during class or in between. (Just last month, a new study found that this type of short-burst activity is particularly effective for students.) The program began in New York City and Economos said that teachers who have used it report after just 10 minutes of exercise, “kids sit back down and they’re ready to learn.” She added: “This is delivering a dose in a consistent way; the trick is you have to do it throughout the day.”

Of course, some teachers push back, she said, “and it’s understandable — all these things interfere with the core curriculum. It’s a question of introducing it and seeing what the results are. Most of the time it’s positive — it’s that toe in the water, a principal has to take that initiative.”

Any school can apply for the Acceleration Grants,” from February 28 through April 22. Funding for the grants comes from the health insurer Cigna’s foundation and Kaiser Permanente.

The current situation in many schools is bleak when it comes to physical activity. “The Physical Activity Guidelines for Americans, issued by the federal government in 2008, recommend that children and adolescents be active for at least 60 minutes per day. But in 2003-2004 only 42 percent of children ages 6 to 11 met that standard and fewer than 8 percent of adolescents did,” according to one recent study.

What’s your school doing to get your kids moving? Or isn’t it? Do you have your own ideas on how to fix this? Let us know.

A few weeks ago, on an otherwise uneventful Sunday afternoon, I got an urgent call on my cell phone from my daughter-in-law, Robin, a vigorous 42-year-old. She was calling from her health club, barely “10 minutes into a decent run” on the treadmill

Suddenly, she told me, she had gotten a “hole” in her vision in her right eye, and zig-zaggy lines like lightening when she closed her eye, a predictable sign, she knew from past experience, that a migraine headache was about to start.

An exercise-induced migraine was not a total surprise for Robin, who has had about a dozen such episodes over the years. “It does make me scared to exercise for a few days,” she told me later. “But then I just get on with my life. I only get four or five migraines a year, so it’s not as scary for me as for some people.”

For years, exercise has been believed to be a significant “trigger” for migraines, along with other triggers, or premonitory symptoms, such as food cravings, being very tired, mood changes, increased urges to urinate, muscle aches, stuffy noses – all part of what Dr. Carolyn Bernstein, a neurologist and migraine specialist at Beth Israel Deaconess Medical Center calls the “build up of what’s changing in the brain before migraine pain gets going.”

But in a recent study in the journal Neurology, researchers explored the exercise-migraine link in a novel way.

They gathered 27 people, good sports and brave souls all, who reported getting migraines with aura that were triggered by bright or flickering light or strenuous exercise. (Migraine auras are typically visual symptoms like Robin had, but can also be other sensory problems or even difficulty speaking.)

The researchers, from the University of Copenhagen, then deliberately exposed the 27 volunteers in the lab to light stimulation, strenuous exercise or both. For the exercise stimulus, patients either went for an intense run or used an exercise bike for an hour, reaching 80 percent of their maximum heart rate. They were also exposed to bright light for 30 to 40 minutes, then were monitored for three hours afterwards and told to report any symptoms of migraine or migraine with aura.

Surprisingly, hardly anyone did. Only three patients reported an attack of migraine with aura after being exposed to light or exercise; three others reported a migraine without aura. Nobody got a migraine with exposure solely to light.

The fact that these triggers for migraine were not as powerful as long believed has left researchers scratching their heads.

Perhaps, suggested two headache specialists in an editorial accompanying the research, the triggers that people believe are harbingers of migraines are not so much triggers that lead to migraines as symptoms of a migraine already in progress.

“Are patients driven to exercise as a premonitory symptom and could their migraines be the cause, not the consequence?” they wondered. “Is the association with light simply reporting photophobia during the premonitory phase?”

Good questions, of course. But here’s an even more important one: What is a migraine patient – most of whom are young women like Robin – to do? Exercise? Not exercise? Avoid other supposed triggers as well?

“It’s a delicate balancing act,” the study’s lead author, Jes Olesen, said in an email. “People with migraines are often told to avoid triggers, including exercise, but exercise is a valuable health activity, and it doesn’t make sense to tell people with migraines to avoid all exercise.”

The solution, in other words, becomes a juggling act. If pounding up and down while running on the pavement or a treadmill brings on migraines, said Bernstein, perhaps exercising on a stationary bike or elliptical machine might help, though Robin has gotten migraines on elliptical machines, too.

If ramping up your heart rate triggers migraines, “you might walk for a while but not increase your cardiac rate.” If getting hot and sweaty brings on an attack, staying cool by swimming might be the solution.

Be vigilant, Bernstein said, and keep a diary of when migraines occur, noting exactly what was going on prior to the attack, including stress level, sleep loss, mood changes, exercise patterns and so on.

But don’t let migraines become an excuse not to exercise. “The idea is to understand how exercise affects your migraines, but don’t think it’s a license to say, ‘Okay, I won’t exercise.’ ”

Robin agrees: “If I think I’m close to getting a migraine,” she said, “I won’t exercise. But otherwise, I do.”

Judy Foreman, a health reporter in Boston, just completed a book about chronic pain: “A Nation in Pain: Healing Our Biggest Health Problem