After the bike lanes, the calorie counts and failed attempt to ban jumbo soft drinks, New York Mayor Michael Bloomberg's latest health initiative seems relatively low-key. He just wants people to consider taking the stairs more often.
"I'm not here to tell you how to live," he told reporters at a news conference announcing the proposals.
That didn't stop the predictable backlash from his critics – that it smacked of "nanny-statism" and (according to Fox News) "Gestapo tactics." But among these criticisms was a more serious claim that deserves a rebuttal: that it's pointless.
"Taking the stairs, as a habit in the course of your day-to-day life, will make you more fit in the same way that stopping to pick pennies up off the ground will make you more rich," the website Gawker proclaimed, arguing that Bloomberg's proposals won't eradicate obesity.
Well … yeah. Schlepping up the stairs won't make your gut magically disappear any more than clicking that link about "one simple trick to get rid of belly fat." Obesity is stubborn, complex and multifactorial. But as obesity researchers have been arguing for the past decade, there is plenty of evidence that small changes in diet and lifestyle – the fitness equivalent of pennies – can add up to significant health benefits.
The main focus of Bloomberg's proposals is to make stairways more inviting and accessible, for example, by tweaking building codes to allow the use of "auto-shut" doors that stay open unless a fire alarm is triggered, and putting up signs to encourage stair use.
These sorts of cues do work. In one study published earlier this year, 49 per cent more Singapore subway riders chose the stairs over the escalators when signs such as "I want to climb the stairs to fitness" were posted over a four-week period. We have good intentions, but we're creatures of habit and need reminders to try out new behaviours.
More important, there's also evidence that such changes result in measurable health improvements. A study at the University Hospital of Geneva in Switzerland took a battery of health measurements from 77 employees before and after a 12-week campaign in which posters and floor stickers encouraged stair use.
The results, published in the European Journal of Cardiovascular Prevention & Rehabilitation, showed that the workers had increased the number of flights ascended and descended from 4.5 a day to 20.6 a day, and as a result had increased their aerobic fitness by 9.2 per cent. They also lost weight and significantly improved blood pressure and cholesterol scores.
In an interesting postscript, the hospital's central staircase was unexpectedly closed for renovations after the completion of the study, forcing workers to seek out a less convenient staircase – and as a result, staircase use dropped back to 10 flights a day after three months.
"It underlines the importance of architectural design and convenient placement of stairwells to help people make healthy choices," lead author Dr. Philippe Meyer noted after the results were published – precisely the factors Bloomberg is trying to influence.
Of course, convenience can also be a selling point for stairs – a point that doctors at Saskatoon's Royal University Hospital made in a lighthearted study published in the Canadian Medical Association Journal in 2011. For 56 trips ranging from one to six storeys, the stairs took an average of 13.1 seconds per floor (without "rushing") while the two sets of elevators took 37.5 and 35.6 seconds per floor, including the time spent waiting.
That adds up to a savings of about 15 minutes a day – enough to make an impression on time-pressed health-care workers at the hospital since the study's conclusion, notes senior author Dr. Thomas Wilson: "I can't say there's a traffic jam on the stairwells, but I definitely meet more people there."
Still, the health benefits of taking the stairs are undeniably modest – which may, in fact, be their biggest advantage. In the latest issue of Obesity Facts: The European Journal of Obesity, University of Colorado obesity expert Dr. James Hill and his colleagues lay out the arguments that a "small changes" approach to obesity is much more sustainable for most people than crash diets and killer exercise regimens. After all, they point out, the difference between stable weight and steady gain is as little as 100 calories a day.
The upshot is that the approach taken by Toronto Mayor Rob Ford in his attempt to lose 50 pounds last year – "running a lot, lifting weights and eating like a rabbit" – is less likely to produce long-term success than Bloomberg's seemingly more modest initiatives.
That's not to say that a few flights of stairs is all you need to stay fit – far from it. But any change that you can live with for the rest of your life, no matter how small, is more powerful than one that turns out to be as fleeting as a politician's promise.
Alex Hutchinson blogs about exercise research at sweatscience.runnersworld.com.