[Senate Hearing 108-42]
[From the U.S. Government Publishing Office]
S. Hrg. 108-42
FITNESS AND NUTRITION:
THE PRESCRIPTION FOR HEALTHY AGING
=======================================================================
HEARING
before the
SPECIAL COMMITTEE ON AGING
UNITED STATES SENATE
ONE HUNDRED EIGHTH CONGRESS
FIRST SESSION
__________
WASHINGTON, DC
__________
MARCH 11, 2003
__________
Serial No. 108-6
Printed for the use of the Special Committee on Aging
U. S. GOVERNMENT PRINTING OFFICE
87-354 WASHINGTON : 2003
____________________________________________________________________________
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SPECIAL COMMITTEE ON AGING
LARRY CRAIG, Idaho, Chairman
RICHARD SHELBY, Alabama JOHN B. BREAUX, Louisiana, Ranking
SUSAN COLLINS, Maine Member
MIKE ENZI, Wyoming HARRY REID, Nevada
GORDON SMITH, Oregon HERB KOHL, Wisconsin
JAMES M. TALENT, Missouri JAMES M. JEFFORDS, Vermont
PETER G. FITZGERALD, Illinois RUSSELL D. FEINGOLD, Wisconsin
ORRIN G. HATCH, Utah RON WYDEN, Oregon
ELIZABETH DOLE, North Carolina BLANCHE L. LINCOLN, Arkansas
TED STEVENS, Pennsylvania EVAN BAYH, Indiana
RICK SANTORUM, Pennsylvania THOMAS R. CARPER, Delaware
DEBBIE STABENOW, Michigan
Lupe Wissel, Staff Director
Michelle Easton, Ranking Member Staff Director
(ii)
C O N T E N T S
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Page
Opening Statement of Senator Larry E. Craig...................... 1
Statement of Senator John Breaux................................. 18
Statement of Senator Thomas Carper............................... 20
Panel I
Judith A. Salerno, M.D., Deputy Director, National Institute on
Aging, Bethesda, MD............................................ 2
Alfred Maguire, National Senior Games Association, Twin Falls, ID 10
Sam Ulano, Jazz Musician and Author, New York, NY................ 14
Panel II
Linda Netterville, President, Meals on Wheels Association of
America, Lee's Summit, MO...................................... 25
Jane V. White, Professor, Department of Family Medicine and
Graduate School of Medicine, University of Tennessee-Knoxville,
Knoxville, TN.................................................. 35
Lynn C. Swann, Chairman, President's Council on Physical Fitness
and Sports, Sewickley, PA...................................... 43
(iii)
FITNESS AND NUTRITION: THE PRESCRIPTION FOR HEALTHY AGING
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TUESDAY, MARCH 11, 2003
U.S. Senate,
Special Committee on Aging,
Washington, DC.
The committee convened, pursuant to notice, at 10 a.m., in
room SD-628, Dirksen Senate Office Building, Hon. Larry Craig
(chairman of the committee) presiding.
Present: Senators Craig, Stevens, Breaux, Talent, and
Carper.
OPENING STATEMENT OF SENATOR LARRY E. CRAIG, CHAIRMAN
The Chairman. If we could have your attention, thank you
very much. The U.S. Senate Special Committee on Aging will be
convened. We want to thank all of you for coming this morning.
Today's hearing will explore the importance of fitness and
nutrition for older Americans. We are holding this hearing to
highlight the need for all Americans over the age of 50 to be
active, to focus on a nutritional diet, and to take advantage
of a routine nutrition screening. Most importantly, all of
these activities can be started at any age.
This is a timely hearing because March marks the Meals on
Wheels Association's March for Meals campaign. This is a
national initiative carried out by local senior meals programs
throughout the month of March. I have had the opportunity to
travel with the Meals on Wheels program in my State and have
not only seen the value of the food delivered, but the
tremendous value of the outreach and the contact that goes on
between the deliverer and the senior.
I would like to welcome the members of the Meals on Wheels
Association who are here today. How many of you are with that
association and are in the audience?
Thank you. Thank you for your work and thank you for being
here.
Many people think that physical decline is an inevitable
consequence of aging. Today, we have assembled a panel of
witnesses who will speak to the contrary. We will hear from
witnesses who will talk about how becoming active at any age
can actually help extend our lives and improve the quality of
life. Today's witnesses will demonstrate that fact by living
very active lifestyles well into their 70's and 80's.
We also have nutrition experts who will discuss how simple
eating habits and nutritional screening can help us live
healthier lives and may also help reduce overall health care
costs to this country.
As Chairman of the Senate Special Committee on Aging, I
welcome the opportunity to encourage all seniors to take better
care of themselves. Our testimony will show that it is possible
to live healthier, and have active lifestyles at any age.
I will have to tell you a little story. I was filming a
clip yesterday that will go on our website about the committee.
The staff had written in my talking points that my father was
in his 80's and played golf every day. My father is in his
80's. He is 85. He doesn't play golf. We had to correct the
script. He works 8 to 5 every day and hasn't missed work in his
life except for a cold. He is fit and trim at 85 and can't
understand why everybody is just sitting around. So I chuckled
a bit, but it is a true statement and story and I think that it
witnesses for me, at least, the active lifestyle that my
parents have led well into their 80's because they eat well and
they have remained very active and physically fit.
We had planned our first witness to be Lynn Swann, who, as
we know, was a famous Pittsburgh Steeler player, an ABC Sports
broadcaster. He will be here. He is en route. Weather has held
him out, so he will be here as one of our later panels.
So we will feature a different panel at the first of our
program, and that panel today is made up of Dr. Judith Salerno,
Deputy Director of the National Institute on Aging; Alfred
Maguire, a 77-year-old swimmer from Twin Falls, ID, with a
remarkable story to tell you about, who competes in the Idaho
Senior Games; and Sam Ulano, 82-years old, a jazz musician and
author and still very active.
In our third panel, we will have Linda Netterville,
President of the Meals on Wheels for America, and Dr. Jane
White, Professor of Family Medicine at the University of
Tennessee-Knoxville.
So we welcome all of you once again, and Doctor, why don't
we start with your testimony this morning. Please pull the
microphone as close as you can and have it comfortable and that
way we can hear you all well. Again, welcome.
STATEMENT OF JUDITH A. SALERNO, M.D., DEPUTY DIRECTOR, NATIONAL
INSTITUTE ON AGING, BETHESDA, MD
Dr. Salerno. Thank you. Thank you, Senator Craig, for
inviting me to appear before you today to discuss fitness for
people over 50, an issue of importance to us all. I am Judy
Salerno, Deputy Director of the National Institute on Aging. I
am delighted to be here this morning to tell you about our
commitment to promoting exercise and healthy lifestyles across
the lifespan.
One year ago, I took up running and ran my first race, a
half marathon, to honor the memory of my father, who had died
of a stroke due to high blood pressure. I also ran the race to
celebrate my 50th birthday. I had the good fortune to find a
coach, running partner, and role model named Dixon Hemphill,
who at 78 remains fit and active. I felt like Rocky Balboa when
I crossed the finish line with my family and my coach cheering
on the sidelines.
The fact is, exercise and lifestyle changes are long-
distance goals which everyone over 50 can achieve. It is a
matter of making a commitment. Exercise helps maintain healthy
bones and joints. It also helps control weight and improves our
mood and sense of well-being. It can strengthen all of our
muscles, especially the very important one, the heart.
NIA research continues to demonstrate the phenomenal
benefits of physical activity. I would like to give you a few
examples.
Compared to their sedentary counterparts, older exercisers
are not only more likely to live to an advanced age, but are
more likely than non-exercisers to remain independent right up
to the end of their life.
A recent study showed that exercise and diet are effective
in reducing the risk of Type II diabetes in high-risk older
individuals by over 70 percent. This is important, since over
seven million older Americans have diabetes, a serious and
costly illness.
Moderate exercise has been demonstrated to be an effective
way to reduce stress, high blood pressure, and improve sleep
among older women caring for family members with Alzheimer's
disease. We have also found that older exercisers are able to
fall asleep quickly, sleep for longer periods, and have better
sleep quality after moderate exercise.
Finally, exercise in conjunction with other common sense
interventions was able to reduce falls in older people by 44
percent. The intervention strategies cut health care costs for
each of these high-risk individuals by $3,700, thus potentially
saving millions of dollars in health care costs.
Several years ago, NIA launched an exercise campaign to
promote physical activity for the over-50 crowd. The message is
simple. Through regular exercise, older adults can stay healthy
and maintain independence. Our campaign addresses the four
necessary types of exercise in a book called Exercise: The
Guide from the National Institute on Aging, and in a companion
video based on the book.
First, endurance exercises, like walking rapidly, raise the
heart rate and get the heart, lungs, and circulatory system
working optimally.
Strength exercises, such as leg lifts and arm raises, build
muscles. Just a small increase muscle mass can reduce frailty,
even in 90-year-olds.
Balance exercises that build leg muscles can prevent falls,
a major cause of broken hips and other injuries that often lead
to significant disability.
Flexibility or stretching exercises keep the whole body
limber and improve range of motion.
The NIA's exercise guide tells people over 50 how to begin
a safe, effective exercise program. All the recommended
exercises are based on evidence from research. To date, the NIA
has distributed over half-a-million copies of the free guide,
which is available in both Spanish and English. A free copy can
be obtained by contacting the NIA Information Center through
our website or by calling 1-800-222-2225.
The bottom line is that exercise and good genes may
ultimately be the wellspring of healthy older age. Even the
oldest and frailest among us can improve health and
independence by making physical activity a part of our everyday
lives. The message for older Americans is clear. You are never
too old and it is never too late to be fit for life.
I would like to now share with you our television public
service announcement which has been airing throughout the
country which promotes exercises.
[A videotape was shown.]
It really makes you want to get up and move.
The Chairman. Is that Sam's music? [Laughter.]
Dr. Salerno. Our next one will be.
The Chairman. All right.
Dr. Salerno. Thank you very much, Senator.
The Chairman. Judy, thank you very much for your testimony.
I will find this book fascinating. I think it has the simple
kinds of directions and guides that are understandable, usable,
and appreciated.
[The prepared statement of Dr. Salerno follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
The Chairman. I dare not call the gentleman who has just
entered one of our senior Senators, although he is----
[Laughter.]
Senator Ted Stevens of Alaska, who lives a very active
lifestyle. Ted, do you have any opening comment before we
continue with our witnesses?
Senator Stevens. No. I just told a group, though, this is
one committee I am a natural member of. [Laughter.]
The Chairman. Well, that he is, and a very active one at
that.
Alfred, we will turn to you, Alfred Maguire of Twin Falls,
ID, who has a remarkable story to tell us about aging and
exercise.
STATEMENT OF ALFRED MAGUIRE, NATIONAL SENIOR GAMES ASSOCIATION,
TWIN FALLS, ID
Mr. Maguire. Senator Craig, panel members, distinguished
visitors, ladies and gentlemen, I wish to thank you for the
invitation to speak to you today. I am Al Maguire, a senior
swimming athlete from Twin Falls, ID, who has participated in
five National Senior Games, numerous State Senior Games, and
many California Regional Games.
I have a book written by a nutritionist, Dr. Michael
Colgan, who relates that our bodies have muscles which are, in
essence, the machines which move us anatomically. Protein is
the food that builds these muscles around our limbs, but our
muscle machines can't work without fuel. Carbohydrates are that
fuel. The bigger the muscle is, the more the available fuel
capacity.
There is another kind of food called fat. There are good
fats and bad fats. An athlete needs only the essential fatty
acids. Saturated fats should be eliminated from your diet.
Make a clear distinction between nutrients that are
building materials and nutrients that are fuel. Proteins,
vitamins, minerals, and essential fats are predominately
building materials. They are used long-term to grow a better
body. All carbohydrates are predominately fuel and are critical
for any particular performance to succeed.
Then comes exercise, you know, that which moves those
muscle machines, that moves those lubricated limbs, that keeps
all those neurotransmitters electrically and biochemically
connected, and that facilitates the removal of waste toxins and
the input of good nutrition for maintenance and continuance of
energy.
During one of the National Senior Games, I became impressed
with some of the 90-year-old senior athletes who were still
doing whatever they could to be active. There was even a 98-
year-old blind athlete who swam long distances.
In the Twin Falls area, there are over 800 people 60 to 94
years of age within the city and in isolated locations who
exercise three times a week for an hour by walking, resistance
training, stretching, and who have in a 10-week period achieved
dramatic results when put through the Fullerton, CA, Senior
Fitness Test. These participants were tested for balance, lower
body strength, upper body strength, flexibility, and
cardiovascular endurance. The College of Southern Idaho and the
city of Twin Falls provides these events which have great
social interactivity under the personal care of the event's
pioneer, Jan Mittleider.
Now, according to William Evans, who wrote ``Bio Markers,''
seniors who remain independent and are able to care for
themselves at home just 1 month longer save the government
millions. It would seem reasonable to conclude that prevention,
therefore, is less costly than disability treatment.
Fortunately for me, the existence of the Idaho State Senior
Games and its sponsors, along with the National Senior Games
Association, the NSGA, have helped me with the availability of
accessible competition. I do remember back in 1948 when the
World Olympics were activated again after World War II that it
was very difficult for myself as an individual to even try out
in any preliminaries. In 1993, because there was Senior Game
help, when I began my first Senior Game competition,
opportunity was made very accessible and I was helped to
overcome my fears and to continue with hope and courage.
The National Senior Game Association now, fortunately, has
made available quantities of opportunities for all of the
10,000 men and women so that they may select any one of 18
different sport venues in which they are able to exercise,
train, and finally compete according to their own age group,
with peers who travel from all the 50 States of the U.S., from
archery to volleyball. I now personally thank them.
I also thank you, Senator Craig, for giving me this
opportunity to give my modest testimony. Thank you. I invite
all committee members to attend the National Senior Games in
Hampton Roads, VA, May 26 through June 9, and I do now also
encourage all the committee members to get involved and support
the National Senior Game Association, the NSGA, including the
State Senior Games in Idaho. I would like to thank the Idaho
Senior Games and the Special Committee on Aging for providing
the transportation so that I might be with you today. Thank
you.
The Chairman. Well, I will thank you very much. Your
testimony is marvelous and your presence here is living
testimony. I see, looking at your resume, 43 gold medals, three
national ribbons. That is an outstanding record.
Congratulations.
Mr. Maguire. Thank you.
[The prepared statement of Mr. Maguire follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
The Chairman. Now, the committee turns to Sam Ulano. Sam, I
am looking at your resume and I find out that for 56 years, you
have been a music professional, instructor, educator, author,
and I see those drumsticks there. I assume that means you are a
drummer of the first order.
STATEMENT OF SAM ULANO, JAZZ MUSICIAN AND AUTHOR, NEW YORK, NY
Mr. Ulano. I have been a drummer for 70 years, Senator, and
I want to thank you for inviting me here to this interesting--
--
The Chairman. Well, start pounding on the table. We are
anxious to hear you. Thank you.
Mr. Ulano. I brought this along to demonstrate a very
interesting idea about staying in condition. I have been
drumming with metal drumsticks for many years, which was
considered a no-no by most of the people in the drum community
for many, many years. They were saying you are going to get
muscle bound, and there is no such thing as being muscle bound.
What they are really saying is that you overtrain and you tire
your muscles out and they have given it that name called muscle
bound.
But I have been practicing since I was 13 and I have found
that by staying in shape [playing drumsticks and humming]--so
these sticks, by the way, were made by my twin brother in 1946,
but Louis Belson, the very famous drummer who was married to
Pearl Bailey for many years, was the originator of inventing or
creating the metal sticks. So the principle is that when you go
to the lighter drumstick, your hands don't get faster, but they
got stronger.
So in 1960, I weighed 320 pounds. I think that was pretty
heavy, I would say.
The Chairman. How tall are you?
Mr. Ulano. I am five-foot-seven.
The Chairman. I would say you were pretty heavy.
[Laughter.]
Mr. Ulano. I wore a size 54 jacket and a 52 waist belt, and
a student of mine brought me over to a gentleman who was Mr.
America in 1936, had a little gymnasium near where I teach
drums, by the name of Sigmond Klein, and Sigmond Klein said
something that was very interesting. He said ``Boy, you are a
mess.'' I said, ``Well, what are we going to do about it?'' He
says, ``What are we going to do about it?'' he says, ``What are
you going to do about it?'' He says, ``I don't have to worry
about it.'' He was in incredible condition.
He said, ``How long did it take you to get out of shape?''
I said, ``About 25 years, after I got out of the Army.'' I was
in the Army band, the 98th Division. We wound up in Hawaii and
then ended up in Japan and came home. He said, ``Well, it took
you 25 years to get out of shape, it's going to take you 25
years to get back in shape.'' You know what? He was right.
But his principle was weights, using light weights, 5-
pound, 10-pound, 20-pound weights, and doing a short routine of
exercise every morning and at night before you go to bed,
roughly 10 minutes a day, not this business about doing 2, 3
hours. A lot of the reason people go to the gym--I am not
knocking gyms, by the way--they like to be seen getting macho
and maybe they are going to go on a beach. I am not going to go
on a beach. I am going to be 83 on August 12 of this year.
So what I am trying to say is that we have got to find a
system. I tell all my students--I do some drum instruction--I
say, ``What do you do in the beginning of the day?'' ``Well, I
make coffee and then I''--I said, ``Well, I have a system.'' I
get up, go to the bathroom, take a shower, put on some clothes,
and then the day starts, and that is the system that happens
Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday,
Monday, Tuesday, Wednesday. The whole year goes that way, and I
have been doing that kind of a routine using light weights
which I keep on my bed right next to me.
When I wake up in the morning, I do my stretching exercise
and I work on three parts of my body, my legs, my midriff, and
my shoulders. Your arms are attached to your body. Your legs
are attached to your body. You can't make your feet stronger.
If you make your hips and your thighs stronger, everything down
the line on to your feet are going to get stronger. On my arms,
in order to play my instrument, I have to have strength in the
shoulder [playing drumsticks and humming]. I still practice 3,
4, 5 hours a day. It is like an athlete, if you don't stay in
condition.
So what I say to most people when we talk about this thing,
you have got to do two things. One is find a system of
lightweight exercise, not once every other day but 5 minutes a
day, maybe in the mid-afternoon a day. Some people say, ``I
don't have time to do it.'' Keep a set of weights under your
desk. Your boss won't see you doing that. You pick them up
while he is turning around, you do some exercise with them, put
the weights back. Or you bring them into your bathroom and you
have them there and you do some squats.
I work on keeping my legs strong, because without your
legs, you are nobody. Think about it. You can't go shopping,
you can't go dancing, you can't play football. I don't care if
you are young, old, or I don't think there is anything as
getting old. I am going to be 83 and I don't consider myself
old.
The other part is learning how to eat. I love to eat a lot
of things, but I have learned how to eat a pizza once a month,
have a steak maybe once a month, eat some bread maybe once
every 2, 3, 4 days, cut down on some of my excessive dairy
food, and I wound up weighing 168 pounds.
So I think the theory works. The resistance of putting the
weights against your arms and your shoulders and your legs will
make you stronger and people who--I live, by the way, in the
senior citizen building and nobody does any exercise. They are
lucky if they walk into the cafeteria to have breakfast.
So that is what I have got to say about this and I think it
is important that we find a system, how to stay in condition.
And the condition that I use is with light weights. They are
very inexpensive. I have got 5-pound, 10-pound, 15-pound
weights, and I just went and got a set of 20-pound after 43
years of doing this conditioning. I want to thank you for
inviting me here to say my little piece about this. I think it
is very important.
The Chairman. Sam, thank you. That is outstanding
testimony, and as I say, ``You are living proof, to come from
300 pounds down to your current weight, and your health
condition by all appearances is excellent, and I congratulate
you for that.'' As I said to Al, I say to you, your testimony
is living testimony that you can age well and----
Mr. Ulano. Do you remember Packard Auto, Senator? I didn't
mean to interrupt you. They used to have this slogan, Packard
cars. ``Ask a man who owns one and he will tell you.'' That was
their slogan and it is a very true slogan.
The Chairman. All right.
Mr. Ulano. If you want to find out how to do this, you have
got to find somebody who can teach you how to do it.
The Chairman. Well, that is true.
Mr. Ulano. You go and pick up a 100-pound weight and you
didn't stay in condition, you are going to bang your back out.
You are out of condition.
The Chairman. Sam, thank you.
[The prepared statement of Mr. Ulano follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
The Chairman. We have been joined by the ranking member of
the committee, John Breaux. John, do you have any comments or
questions?
STATEMENT OF SENATOR JOHN BREAUX
Senator Breaux. Just briefly to thank you, Mr. Chairman,
for calling this hearing today. It is very, very clear that
exercise among all Americans is really the key to a healthy
society. Five percent of all of our Medicare beneficiaries
consume about 50 percent of the total amount of money spent in
the Medicare program. It is being spent by 5 percent of our
citizens.
I think, clearly, exercise and proper nutrition are the
major ingredients in preventative medicine which will allow
people to live not only longer lives, but certainly better
lives, and I am very glad that we are using this hearing to
emphasize the importance of rational and balanced exercise as
part of our regular health programs in this country.
Thank you, Mr. Chairman.
The Chairman. John, thank you very much.
Let me turn to our colleague from Missouri, Jim Talent.
Senator Talent, do you have any opening comments?
Senator Talent. I think I will reserve, Mr. Chairman, for
the next panel.
The Chairman. Well, thank you.
Doctor, in your testimony, you mentioned that family
caregivers are at a risk of increased rates of depression,
serious illness, and mortality. Are you aware of any outreach
efforts for family caregivers to provide some type of respite?
Dr. Salerno. Well, NIA is a research organization and we
don't provide direct care. We make a considerable effort to
provide information with particular emphasis through our
Alzheimer's disease education and research and referral centers
to family caregivers. We have a caregiver kit which provides a
lot of resources and also gives information on exercise,
because exercise has been demonstrated to improve the health
and well-being of caregivers. We have lots of connections to
other organizations through our website, lots of links which
help caregivers get the support they need in their local
communities. We get thousands of calls each month to our
hotline, and mostly from family caregivers.
The Chairman. Al, you became active again at, what, age 60?
Mr. Maguire. Sixty-four.
The Chairman. With that experience, the obvious experience
you have had now into your 70's, can you offer any suggestions
of how we better inform seniors of the health benefits of
becoming active, physically active, I guess is the question?
Mr. Maguire. One of the things that I discovered was that
every 7 years, the body changes. Almost every molecule in the
body just revolves around and it is brand new. In about 1991--
when I was 64 years of age, I determined that this body that
you see before you right now is going to be a new body and it
has taken me some time to do it, but it was a slow process. I
had to learn how to eat correctly and to sleep correctly and to
exercise moderately to get everything going.
One of the things that you mentioned now was how to get
other people to do it, and that is that if you have
accessibility, if they are able to get out amongst themselves,
to get out amongst a group and walk. As an example, in Twin
Falls, we have 200 people that walk around a gym three times a
week, Monday, Wednesday, and Friday, and during that time, they
exercise and do all sorts of things. Since they are doing it
together, they enjoy it, and by the time 10 weeks goes by, they
have increased their--everything about their body.
The Chairman. In other words, involving yourself in a group
or getting somebody involved in an active group.
Mr. Maguire. Right. Right.
The Chairman. Is a greater motivator.
Mr. Maguire. Right, and the more that you do that, the more
the body feels great. In fact, as you are feeling better, your
body says, ``Gee, I like this and I want to do more.''
Since I am speaking right now, I want to say hello to
Senator Breaux. I did hear you in 1993 at the Senior Games and
I was very impressed with your thoughts.
The Chairman. Thank you, Al.
Sam, you are 82. You have obviously continued to teach
music. You play in your band. You have stayed active. You live
in a senior community or a senior environment where there is
inactiveness. How do you stay motivated to be active?
Mr. Ulano. Well, that is a good question. I am a big
believer that we have to learn how to motivate ourselves,
Senator. If you don't do that yourself, you could be told all
day long how to stay in shape, you can go and watch people do
it, but somewhere inside yourself, you have got to say, ``Hey,
I am a mess.'' I am getting older and I had better find some
way that I can get my legs stronger because eventually I won't
be able to go out dancing and I won't be able to play with my
grandchildren and I will wind up in a wheelchair if I don't
find some way to put some resistance against these muscles.
I found a very inexpensive way to do it, and I was taught
that by Sigmond Klein. He was a very dear friend of mine. He
says, go out and buy a 5-pound set of weights, 10-pound, 20-
pound, and they are very inexpensive. I keep them under my bed.
I have a set in my practice studio. I will come in and I will
do maybe ten lifts, I will do ten stretching. I do a bicycle
ride by laying flat on my back. I do 20 squats. I go to the
men's room. I grab hold of the sink and do another 10, 15. So I
am always constantly putting a resistance against the muscles.
So now when I want to play my instrument, I can get up at
any time of the night. I was up this morning at 3:30 to get
ready to come here from New York and I did about 20 minutes of
what I call drum exercise, lifted the weights for about another
5 minutes. I didn't have to do an hour. I didn't have to do 2
hours. People think you have to do a lot of it.
You can do it right in your home. It is nice if you can do
it with groups, but a lot of us don't have the time to go with
a group. We have a day job. We have got maybe children or
grandchildren or family or whatever. We have other things that
have to be done. So you have them in your apartment. I hold on
to my door and I kick my legs for about 50 counts, making my
knees and my thighs and my hips and I stay strong, and it can
be done. So I think we have to motivate ourselves with
moderation.
The Chairman. That is well spoken. Thank you.
Mr. Ulano. Yes.
The Chairman. We have been joined by another one of our
colleagues, Senator Tom Carper. Do you have an opening comment?
STATEMENT OF SENATOR THOMAS CARPER
Senator Carper. I am really tempted to just jump in,
because I am a guy who believes in fitness. I work out almost
every day. I ran five miles this morning about 5:30 in
Delaware. On Sunday, I was visiting my mom----
The Chairman. You ran from Delaware to here?
Senator Carper. I could have. [Laughter.]
The Chairman. It is faster than the Metroliner, yes.
Senator Carper. Last night, it would have been. [Laughter.]
I am getting ready to run my 21st Caesar Rodney half
marathon this Sunday for 13.1 miles. I am one of those people
who believes that we run or we exercise daily and it not only
is good for our body, it is good for our mind. People used to
talk about runner's high, and there is really something that
happens physiologically in our brains when we exercise
rigorously and it helps us in so many different ways. You are
all an inspiration. We welcome you coming here today, setting a
good example.
I just wonder, Mr. Ulano, what your neighbors thought at
3:30 this morning when you started your drum exercise.
[Laughter.]
Mr. Ulano. I have a question. Can I ask a question?
The Chairman. Can you ask a question?
Mr. Ulano. Can I ask a question?
The Chairman. Sure.
Mr. Ulano. I saw an article in the local newspaper in New
York that some doctor said that if the mind is kept active, you
stand less of a chance of getting Alzheimer's, so I am
wondering, is there any kind of a survey they have done on
that, some kind of way that they came to that conclusion?
The Chairman. I have heard that said on numerous occasions
and there is research being done now. I don't know of a survey
per se that indicates that, but I understand, Sam, there is
considerable research now that the more active you keep the
mind, the less likely the onset of Alzheimer's.
Senator Carper. Can I take a quick shot at that?
The Chairman. Yes.
Senator Stevens. There is a book, Sam, written by David
Mahoney, ``How to Live to Be 100.'' He was a resident of your
city. You ought to get David Mahoney's book. He is part of the
group of the Decade of the Brain, and there is a lot of
information about what you asked. It is available.
Mr. Ulano. I have a sister, Ida, who was 95 3 weeks ago. We
went to her 95th birthday party. She just finished writing her
memoirs, typed it all out, and it is amazing what she does. She
goes shopping, cleans her own apartment. She says, ``Don't
bother me. Leave me alone. I do my own thing.'' Ninety-five
years old.
The Chairman. Senator Carper.
Senator Carper. This is subtitled, ``The First Part''? Is
this just the first part of her memoirs? Has she got some more
to go?
You asked a question about Alzheimer's. There was an
interesting study done in Europe, fairly large scale, about a
year ago. The results were released about a year ago, and the
study was not on Alzheimer's but it was on depression. They
took a large group of people, divided them into three
categories. A third of the folks exercised strenuously
regularly about 30 minutes a day, I think 5 days a week. The
second group took a medicine that is designed to control
depression. The third group was given a placebo, sugar pill, or
something like that.
Then after an extended period of time, they measured and
kept track of whose depression was reduced the most. The people
who took the placebo, no. The people who took the medicine for
depression, no. The people who exercised regularly had the most
improvement on their depression.
The Chairman. Thank you. Any further questions of this
panel? Yes, Senator Breaux?
Senator Breaux. Just briefly. Mr. Maguire, I am sorry I
missed your testimony, but I am very pleased to see that you
reference your participation, I think as a swimmer, in the
National Senior Games.
Mr. Maguire. Correct.
Senator Breaux. I have attended the Games in Orlando and
Baton Rouge, and I hope to go to the Games this May in
Virginia. I think the Games are an incredible opportunity for
the Nation to witness the activity of seniors participating in
competitive sports. I think they are absolutely wonderful. I
just wish we could entice some of the major corporations in the
country to participate as sponsors since the Games struggle
financially.
I met with AARP just this past week and they are getting
ready to engage in a massive new effort to try and get seniors
to be more active through exercise. There is no better example
of seniors doing that than their participating in the National
Senior Games. If there is anyone out there who is interested in
seniors and selling products to seniors and encouraging
seniors' exercise programs, the National Senior Games, I think,
is a wonderful venue to get that message out.
I realize, everybody cannot run the 100-meter dash, but
maybe they can walk the 100 meters, and they can't throw a 16-
pound shot put but they can throw a baseball. But they are
active, they are competing with people in their own age
category and I just think it is a wonderful signal to other
seniors.
We talk about our youngsters sitting in front of
televisions and computers and not getting off their you know
what. Well, it is also important for seniors to get out of the
recliner and to do whatever they can, because it is going to
mean a lot to them and their children and their grandchildren
as they get older, and the National Senior Games is incredibly
important as an inspirational message to seniors and to all
Americans to participate in exercise. So I just congratulate
you for being here and telling us that story.
Ms. Salerno, on the question of the importance of exercise,
I mean, this is real. This is real in terms of health care
spending, quality of life, the last 6 months of a person's
life. People who have chronic diseases in this country like
diabetes, I mean, all of that is brought on to a greater extent
because of lack of exercise, being overweight, living a sedate
lifestyle as opposed to an active lifestyle is all very, very
important.
I think it is also important to tell seniors that if you
have never done anything in your life in terms of exercise, you
can't just jump into this when you are 80 years old and all of
a sudden I am going to start working out five times a week or
running with Senator Carper five miles a day every day. I mean,
they have to take this upon themselves gradually and not try to
do it all at one time and I think that is very, very important,
as well.
I can't think of anything else I would like to say about
it. I don't have any questions. I agree with what you are
saying. This is important from a health standpoint. This is
just as important as anything else we recommend Americans to do
in terms of managing their health care. Managing your health
care is much more than taking prescription drugs. It is much
more than a yearly checkup at your doctor. I mean, you go to
the doctor once a year and they tell you what you should have
been doing for the previous year, whereas a regular exercise
program saves money and it makes the lifestyle of our seniors
much better as well as much longer. So I thank all of you for
what you are doing.
Mr. Maguire. Could I add one little thing? One of the
things that I mentioned before, Senator Breaux, you came in was
that there are 18 opportunities for seniors to be involved, 18
different types of things, from volleyball, anything that you
can think of. In fact, in 1993, when I was in Baton Rouge,
there was a man who was in his middle-90's and he was so happy
because he threw horseshoes or something like that and he was
beaming all over.
I also would like to add something that was sort of
mentioned in here, was by exercising, you actually get rid of
the toxins in your body, all sorts of toxins which can cause
all sorts of disabilities, and it also then increases things so
that you can also continue on and get new nutrients in.
Senator Breaux. I remember meeting one of the gentlemen in
Baton Rouge who was in his upper 90's who won the javelin
throwing context who was from the State of Hawaii and he was
just a remarkable athlete. I would just mention, I probably
shouldn't, but both in the Orlando Games and the Baton Rouge
Senior Games, Ted, I challenged the winner of the Senior tennis
event to play because I thought it would be a lot of fun and
also to bring about more attention to the program, and I can
report that both in Orlando and in Louisiana at the Senior
Games, I lost both times to the person who had won the tennis
event. [Laughter.]
But it just shows you how competitive they can be, but
also, I mean, just being with your colleagues in your same age
division doing this, it is just a wonderful social outlet that
is very, very important, as well. So thank you.
The Chairman. John, thank you for those questions and that
testimony.
Senator Stevens. Mr. Chairman.
The Chairman. Yes, Senator Stevens?
Senator Stevens. Sam, you give me a copy of your book and I
will mail you a copy of David's book, OK?
The Chairman. Did you hear that, Sam? Senator Stevens would
like a copy of your book and then he will mail you a copy of
David's book.
Mr. Ulano. Here it is.
The Chairman. Here it comes. You have got to sign it,
though.
Mr. Ulano. I will sign it.
The Chairman. Senator Talent.
Senator Talent. I didn't have an opening statement, but I
did have a question I wanted to ask. Maybe I ought to direct
this at Ms. Salerno. My father just passed away last November
at 91 years of age and one thing I learned as Dad grew older
was it was harder and harder to make him do anything he didn't
want to do, and we can't make seniors exercise and probably
wouldn't want our government to try actually to do that.
But what I do think works is if we send the message from
all different directions to them, and a key, it seems to me, is
through the various programs that seniors are already
participating in. Now, there is this huge network. Some of
these are public and some of them are private out there. We are
going to have testimony on the next panel from the lady who is
the President of the Meals on Wheels Association. There are
senior centers, day care centers, and the whole spectrum of
independent living centers, retirement centers, et cetera.
I am wondering, is there some way that we could encourage
all those groups to send a message for a concentrated period of
time about the importance of exercise? Do you see what I am
getting at, so that the seniors around the country are hearing
this from a lot of different places for several weeks at a
time.
I remember when I was in the legislature and we first
started passing the mandatory seat belt laws, I always thought
that the publicity attendant to the passage of the law helped
as much as the law did, in convincing people. Do you have any
suggestions along those lines?
Dr. Salerno. Yes. I think that you are absolutely right. It
has to be a multi-pronged approach. That is why we are on
radio, we are on TV. We are trying to get our exercise
materials into public libraries. We are distributing to 250
community health centers around the country so that the message
gets out there.
But also, I think that it is important to have an exercise
buddy, and that really makes a difference for most people,
because some mornings I know I get up and I really don't feel
like putting on my running clothes and getting out there and
doing a few miles. But when I get my son to go with me, who is
sitting behind me, he motivates me. We motivate each other. So
it is that kind of thing that I think is very important, and
there is a natural group in senior centers, through all kinds
of networks, assisted living facilities, where people can do
that.
We are also interested in having our materials be part of
the program that we can provide as a public service to groups
such as those who run activities in senior facilities.
Senator Talent. Thank you, Mr. Chairman.
The Chairman. Thank you. We thank all of the panelists.
Judy, I saw that young man wave back there. You brought
some of your family with you?
Dr. Salerno. Yes, my three children.
The Chairman. Why don't you introduce them.
Dr. Salerno. Lauren Guberman, Alyssa Guberman, and Michael
Guberman, and please don't tell their teachers they are here.
[Laughter.]
The Chairman. No, quite the opposite. They should go back
and tell their teachers that they attended a Congressional
hearing today.
Dr. Salerno. Absolutely.
The Chairman. They can get credit for it.
Dr. Salerno. Absolutely.
Senator Talent. Judy, this is on C-SPAN. I am afraid it is
a little bit too late. [Laughter.]
The Chairman. Prior to you coming in, Senator Talent, Judy
did talk about this document and also showed a public service
announcement encouraging access to this, so that is a part of
the outreach that the Institute is undertaking.
Thank you very much, all of you. We appreciate you being
here. Thank you.
The Chairman. Let us turn to our second panel. We would
excuse you. Thank you. We trust that Mr. Swann is still en
route. Do we have any report on Lynn yet?
We have two in our next panel, and I think that Senator
Talent had already mentioned one of them, so I will allow the
Senator to introduce that panelist when we get them seated.
As I mentioned, March marks the Meals on Wheels
Association's ``March for Meals'' campaign, and so this next
panel in part will be discussing nutrition and certainly Meals
on Wheels. Senator, would you introduce our first panelist,
please?
Senator Talent. That would be a privilege, Mr. Chairman. We
are honored in Missouri to have living in Lee's Summit, MO, the
President of the Board of Directors of the Meals on Wheels
Association. She is Linda Netterville. That is the oldest and
largest national association representing senior meal programs.
Linda serves not only in that capacity, but as the Nutrition
Program Manager with the Johnson County Nutrition Program in
Olathe, KS.
She has enjoyed a number of professional appointments
through her career. She really has a long and distinguished
career in helping seniors, Mr. Chairman. I am not going to
mention them all, but among them are the National USDA
Commodity Food Distribution Advisory Council and she has been
on the National Elder Care Institute on Nutrition, the Advisory
Committee. Above and beyond all that, she is a graduate of the
University of Missouri, and so I thank you for the opportunity
to introduce her today, Mr. Chairman. Thank you for being with
us, Linda.
Ms. Netterville. Thank you, Senator.
The Chairman. Well, Linda, we thank you very much for being
with us.
Our second panelist will be Jane White, Professor,
Department of Family Medicine, Graduate School of Medicine,
University of Tennessee-Knoxville, in Knoxville, TN, so we
welcome this panel. Thank you very much, Doctor.
Linda, if you would start, please.
STATEMENT OF LINDA NETTERVILLE, PRESIDENT, MEALS ON WHEELS
ASSOCIATION OF AMERICA, LEE'S SUMMIT, MO
Ms. Netterville. Thank you. Chairman Craig, Senator Breaux,
and members of the committee, I am Linda Netterville, President
of the Meals On Wheels Association of America for whom I am
testifying today.
The Meals On Wheels Association of America, or MOWAA, as we
call our organization, represents senior meal programs from
every State. Our members provide nutrition services to older
Americans to improve their dietary intakes, nutrition and
health education; links to informal and formal community
support; and opportunities for active living. I am joined here
in the audience by the Board of Directors of MOWAA. We, on
behalf of MOWAA member programs from across the country, thank
you for holding this hearing and giving us the opportunity to
testify.
Before I begin to address the issue of the role of
nutrition in healthy aging, I want to briefly note a couple of
important milestones. Later this month, we will commemorate the
31st anniversary of the inclusion of senior meal programs in
the Older Americans Act, a Congressional action that has
literally changed the lives for the better of millions of
Americans over the years. To date, over six billion meals have
been served through the Act and senior meal programs are adding
to that total every day.
As part of their commemoration of this, senior meal
programs in communities throughout the country will be
participating in MOWAA's ``March For Meals'' campaign, as you
mentioned. ``March For Meals'' is a national initiative carried
out individually by local senior meal programs throughout the
month of March. The campaign is designed to raise public
awareness about our senior programs and the need for meals, to
raise funds to enable the provision of services locally to meet
those needs, and then most important, to recruit volunteers to
assist in the delivery of services so that no senior goes
hungry.
I know that this is quite familiar to you, Senator Craig
and Senator Breaux, as Chairmen of the Honorary Congressional
Advisory Committee and as Senators who helped kick this off
last year here in Washington at a press conference with race
car drivers A.J. and Larry Foyt. But some of your colleagues,
particularly those new to the Senate, might not be aware of
your leadership and involvement in the Meals on Wheels behalf.
So remembering that anniversary, we want to thank you again
publicly and encourage your colleagues to get involved, as
well.
``March For Meals'' is just another way that MOWAA is
helping individual meal programs enhance public-private
partnerships that are essential to their past and current
success, as well as to the future growth of the senior meal
program.
Senior meal programs, some over 4,000 across America, are
as diverse as the communities in which they operate and the
seniors that they serve. They are urban and suburban and rural.
They furnish congregate meals in places like senior centers and
community centers. Others provide home-delivered meals, and
still others provide both the congregate and the home-delivered
meals. Some programs are small serving 30 meals a day, while
others serve as many as 3,000 meals a day.
But all programs share one commitment, and that commitment
is the regular provision of healthy, nutritious meals to
America's seniors who need them. By doing so, all of these
programs are important partners, ``senior partners'' as we call
them with President Bush and Lynn Swann in their efforts to
promote a healthier lifestyle in the Healthier U.S. Initiative:
The Healthier U.S. Initiative identifies four components, first
of all, being physically active every day; eating a nutritious
diet; getting preventive screening; and making healthy choices
and avoiding risky behaviors.
It will not surprise you when I tell you that MOWAA would
like to reverse that order and put a nutritious diet first.
That is precisely what our programs endeavor to do to put
healthy nutrition first in the lives of seniors. There is no
question that scientific evidence supports the relationship
between good nutrition, health, and functionality among our
older adults.
The majority of our MOWAA member organizations provide
nutrition services under the Older Americans Act. Under the
Act, meals served must provide one-third of the recommended
dietary allowances, or the RDA, established by the Food and
Nutrition Board of the National Academy of Sciences National
Research Council. The meal must also follow the dietary
guidelines for Americans, which encourage healthy eating habits
and physical activity as a part of life.
Although one-third of the RDA is the minimum requirement
for our meals, most of our meals contain 40 to 50 percent of
the daily nutrients needed by older adults. In addition, the
meals provide more than half of many recipients' total meal
intake for the day. So our outcome is two-fold. By providing a
nutritious meal, we address both malnutrition and hunger.
Our programs also encourage physical activity. Congregate
programs provide important opportunities to engage in community
life. They offer--in addition to the meal--a variety of other
programs, including exercise. Home-delivered meal programs make
it possible for many home-bound older adults to continue to
live in their homes and thereby maintain some level of physical
activity. I am referring to just moving from room to room,
interacting with their pets, eight gardening, watering plants,
caring for their home, and remaining active in their community.
I believe that all panelists would agree to me that every
movement counts.
Meal programs also direct seniors to other key
recommendations of the Healthier U.S. Initiative, namely the
preventative screening and making healthy choices. Meals are
not the only thing provided by senior meal programs. Programs
conduct a nutrition screening at the intake. A simple
``determine your nutritional health'' checklist identifies
warning signs of poor nutritional health and assigns
appropriate nutrition interventions. Nutrition programs also
provide nutrition education, which stresses the importance of
nutrition and health. It equips older adults with the knowledge
they need to make healthy food choices on their own.
For some older adults, general nutrition education may not
be enough, and for then, many programs employ a dietitian to
provide individual nutrition counseling to translate a person's
nutritional needs into better personalized food choices. These
healthy choices can have a measurable effect on health status.
I would also like to elaborate on just two benefits from
the home-delivered meal program. Home-delivered meal programs
address two distinct populations: the frail in need of long-
term support and also those in need of short-term intervention.
The first group I believe most generally comes to mind when
we talk about home-delivered meals, because the Older Americans
Act targets its limited services to those in greatest economic
and greatest social need with an emphasis on low-income
population. This long-term needs group is the one that is most
likely to be served by our programs, and that is the way it
should be.
But the other group, those with short-term needs, merit
attention, as well. The last national survey, conducted almost
a decade ago, found that 41 percent of all home-delivered meal
programs have waiting lists. The median time on these waiting
lists is 1 month, with some programs having wait times as long
as 3 months. As a result, particularly in some areas, those in
need of short-term intervention may go unserved. The group may
be comprised of individuals who are recently hospital
discharged, for example, or recovering from an acute illness,
or have a short-term mobility impairment, say from a broken
bone. Without access to community-based services, they may have
to be institutionalized further or return home to fend for
themselves. Regrettably, that can result in deterioration of
nutrition and health status and, in turn, can result in re-
hospitalization.
MOWAA believes that this is an unnecessary cost in both
human and financial terms. Our programs can feed an individual
for a year for the approximate cost of a one-day Medicare
hospital stay. Whether or not the worst-case scenario occurs,
the lack of service does not contribute positively to our
shared goal of promoting healthy aging.
The Chairman. Linda, if we could have you start wrapping up
now, please.
Ms. Netterville. OK.
The Chairman. Your full statement will be a part of the
record.
Ms. Netterville. OK. Actually, we are almost done.
The Chairman. All right.
Ms. Netterville. We come before you to show how important
nutrition is to the nation's elderly and to our seniors, and
the fact that you have convened these witnesses here today
demonstrates once again your concern and support of America's
seniors. We thank you for focusing on these important issues.
Senior nutrition programs are a lifeline for millions of
Americans.
Thank you very much. This concludes my oral testimony and
the written testimony is submitted.
The Chairman. Linda, thank you very much for that very
valuable testimony on the importance of senior nutrition.
[The prepared statement of Ms. Netterville follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
The Chairman. Now, I am turning to Dr. White. I would be
remiss for two reasons if I did not mention not only is she a
tenured professor at the Department of Family Medicine at the
University of Tennessee, but as Jane knows, I am married to a
dietitian. Dr. White is the recent Past President of the
American Dietetic Association and currently serves on ADA's
Foundation Board of Directors. So, Jane, welcome before the
committee.
STATEMENT OF JANE V. WHITE, PROFESSOR, DEPARTMENT OF FAMILY
MEDICINE AND GRADUATE SCHOOL OF MEDICINE, UNIVERSITY OF
TENNESSEE-KNOXVILLE, KNOXVILLE, TN
Ms. White. Thank you so much, Chairman Craig, Senator
Breaux, and distinguished committee members. I appreciate the
opportunity to discuss nutrition and its relationship to
healthy aging.
America is getting older. More than 35 million Americans
will turn 65 during the next 30 years. Older Americans are
increasingly seeking lifestyle improvements to maintain health.
Eight out of ten older Americans have one chronic disease, and
half of them have two or more. Eighty-eight percent of Medicare
spending is for beneficiaries with three or more chronic
conditions.
I am a professor of family medicine at the University of
Tennessee in Knoxville and a registered dietitian. I am
technical advisor to the Nutrition Screening Initiative, or
NSI, a health care coalition led by the American Dietetic
Association and the American Academy of Family Physicians. NSI
promotes routine nutrition care for older adults to prevent and
manage chronic disease. Mr. Chairman, NSI was founded because
the efficacy of nutrition intervention is one of the best-kept
secrets in town.
Chronic disease affects people of all ages. I expect many
otherwise healthy members of the Senate and many of your
constituents at home have a condition, a diet-related condition
that they are working to manage, such as high cholesterol or
high blood pressure. Hypertension affects one out of three
people aged 70 years and older, while roughly one in ten have
diabetes and one in four has coronary heart disease.
Nine out of ten people with a chronic disease have a
condition that could be improved with nutrition intervention.
Through my work with older adults and physicians, I have seen
the critical role nutrition plays in maintaining the health of
adults as they age. I have submitted a patient case study
attached to my testimony.
Nutrition intervention is supported by substantial
scientific evidence. The Institute of Medicine reported that
there are proven nutrition strategies for managing
cardiovascular disease, diabetes, and renal failure. These
measures are cost-effective, leading to a reduced number of
hospitalizations, reduced length of hospital stay, and fewer
physician office visits.
Medical nutrition therapy, or MNT, offers economic
advantage to individuals as well as to the nation's health care
industry and to our economy in general. Chronic disease costs
our country $300 billion annually, one-third of the U.S. health
care expenditures. Ninety-nine percent of all Medicare spending
is being used to treat chronic illness. Prescription drug costs
are rising and patient drug use is skyrocketing. The number of
older adults taking eight or more drugs per day has increased
50 percent in the last 3 years.
The American Diabetes Association reported recently that
costs associated with diabetes have doubled in the last 5
years. The annual cost per patient with diabetes is more than
$13,000, compared to $2,500 for individuals without this
disease. Changes in diet and regular exercise can reduce the
risk of developing diabetes in older people by up to 71
percent.
Further, nutrition strategies offer a cost-effective
treatment alternative to prescription drug therapy. For
example, it is estimated that nutrition intervention could save
anywhere from $52 to $168 million for older adults with high
blood pressure and $132 to $330 million for those with
diabetes.
However, physicians seldom discuss nutrition with patients.
Doctors say they lack the time, knowledge, and tools to provide
this information. At the same time, 85 percent of older
patients want nutrition information from their physicians, but
only 36 percent report that their doctor emphasizes nutrition
during office visits.
The clear need for practical tools for both physicians and
consumers led NSI to develop the ``Physician's Nutrition Guide
to Chronic Disease Management for Older Adults.'' This brief
synopsis includes specific nutrition information on eight
chronic diseases. The patient education materials include
nutrition tips on each disease that can be tailored for the
individual in the physician's office, with referral to a
registered dietitian mentioned for complex cases.
We want to underscore the need for updates to Medicare that
keep pace with the current state of knowledge and best
practices, including nutrition care. Older Americans want to be
as healthy and independent as possible. Nutrition and fitness
within individual limits can contribute to successful aging,
but more can and must be done to make basic nutrition services
available to every older American.
I urge you to support programs that provide nutrition
services for older adults, to enable nutrition research through
adequate funding, and to support graduate medical education in
nutrition for residents and fellows in the primary care
specialties.
Senator Craig, the public wants this. Our nation needs it.
The economics of health care mandate it. Nutrition is essential
to healthy aging.
Thank you for allowing me to be here today, and I would be
pleased to answer any questions you might have.
The Chairman. Well, Jane, thank you very much for that
valuable testimony. That, as you know, is an area we have
worked collectively on as it relates to Medicare and Medicare
reimbursement, to allow nutritional experts to be reimbursed
for obviously the advice and the programs they develop instead
of having it screened through a primary care provider, or at
least to be able to be billed directly for those services and
that information.
[The prepared statement of Ms. White follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
The Chairman. Linda, in your testimony, you mentioned that
the senior meals program conducts nutritional screening. Can
you elaborate on how this program works and what you do with
the outcome of the information?
Ms. Netterville. As part of the requirements through the
Older Americans Act and through the national NAPAS requiring,
we use the determine check list, which is about ten questions
which are simple questions and gives us some kind of an idea of
what appropriate nutrition interventions might be appropriate
for those individuals. Depending on the staff and skills at
each of the nutrition programs, it depends on how far we go
with that information and what we do with that information.
It does help an individual and nutrition education
materials that are appropriate that are provided that go along
with that screening that we do, so an individual knows how many
fruits and vegetables they should eat and so on.
The Chairman. So screening includes also, obviously, the
advice that follows then?
Ms. Netterville. Right. That is a big part of it.
The Chairman. Is there then the opportunity to follow up to
see if down the road some weeks or months that advice is still
being taken?
Ms. Netterville. There is the opportunity every time we
reassess. At an annual reassessment of any of our individuals,
we follow that same procedure and do a screening so we can see
changes in health care, in healthy status. It is part of our
outcomes that we document.
The Chairman. Thank you.
Jane, you referred to the disease management hearing that I
chaired last September. In general, can you elaborate on how
the private insurance companies currently integrate nutrition
care into disease management programs?
Ms. White. Certainly. It is extremely variable from State
to State. Many of the programs follow national Medicare and
Medicaid guidelines, and so reinforcing the need for nutrition
services and paying for services through these programs would
help to ensure that the private insurers follow suit and
provide appropriate nutrition services for patients.
In Tennessee, with TennCare, TennCare does provide chronic
disease management services and nutrition counseling for
patients with specific chronic diseases. This has been a big
boon to the older population in Tennessee.
The Chairman. What would a state-of-the-art nutrition care
program look like for the Medicare program?
Ms. White. I think the state-of-the-art program would have
to incorporate routine nutrition screening and assessment with
the caveat that appropriate intervention be provided, and this
intervention might include referral to social services and
programs such as Meals on Wheels congregate feeding sites, et
cetera. It would be a review of prescription drugs, because,
you know, many drugs, such as the ACE inhibitors and beta
blockers and diuretics are very dependent on a low-sodium
intake for efficacy. So, again, advice related to diet and
exercise in terms of chronic disease management.
So I think it is two components, nutrition assessment and
then appropriate nutrition intervention, and, of course,
reimbursement for services provided.
The Chairman. Thank you. Senator Breaux.
Senator Breaux. Thank you, Mr. Chairman. I thank both of
our witnesses. It is clear that diet and exercise together play
an incredibly important role in the aging process and
guaranteeing that people live, again, not just longer lives,
but better lives and less costly in terms of the medical care
they need, particularly in their last months of life. Also,
obviously, it brings about a quality of life that is a big
improvement, so they both go together. If you have a great
exercise program and horrible nutrition, you are not going to
get the job done. If you have great nutrition and no exercise,
you are not going to get the job done. So the two are very
directly interrelated and very necessary.
The Meals on Wheels program provides so much in terms of
meals and nutritional programs to help seniors. It is a
wonderful program. I have delivered them on numerous occasions
and you see the joy they bring. It is also a point of social
contact for many of the people and a connection with the
outside world that many of them might not have. It is hard to
believe that may be the only person that visits that senior
sometimes is the person delivering the Meals on Wheels. So in
addition to delivering the nutritional food, they also deliver
friendship and a contact with that senior which is incredibly
important.
I get, Ms. White, from your testimony that you would
support that the Medicare program has as one of its
reimbursable things that are covered, what, nutrition?
Ms. White. Yes. Medicare covers currently treatment for
diabetes and renal disease, but we really need to expand
coverage certainly to include the cardiovascular diseases and
other diseases where there is a clear indication that nutrition
care and nutrition intervention work improve quality of life,
and lower health care costs.
Senator Breaux. Would you know whether private health plans
in the country that are not for Medicare individuals have that
type of provision?
Ms. White. It is very variable from State to State. Some of
the private plans do cover nutrition intervention. Some of the
State programs cover nutrition intervention. But it is not
universal across our health care system and we really need to
institute these services for all Americans.
Senator Breaux. Does Medicaid cover it, do you know? Some
States maybe and some States not?
Ms. White. Some States. Maybe TennCare does, but other
States not. So again, we need to institute early intervention
for the Medicaid population, and continued intervention for our
seniors because we know that nutrition and physical fitness
implemented at any age improve health.
Senator Breaux. Do you have any kind of a ballpark estimate
of how much including this type of service under Medicare would
cost?
Ms. White. I don't have the specific figures, but it was
included in the Institute of Medicine report on the benefits of
nutrition care for older Americans. Again, it would depend on
how often the services are prescribed, because for chronic
disease management, we really don't diagnose disease. It is up
to the referring primary care provider to diagnose a problem
and refer. So again, it would depend on how many of our
physician colleagues were involved in screening and assessment,
and then how many of our older Americans recognize that this
benefit is available and choose to avail themselves of the
services.
But certainly in the long run, as I mentioned with the
figures on hypertension and diabetes, we have similar cost
saving estimates for the dislipidemias, osteoporosis. The funds
that you would expend to provide nutrition services would be
more than covered by the cost savings in medications, in
hospital admissions, readmissions, length of stay, and so
forth.
Senator Breaux. Well, unfortunately, the way we score
things in Washington, we don't consider the positive effects.
We only consider the expenditures of how much it costs. I think
that is patently unrealistic. I mean, obviously, if you have
better preventative care, you are going to reduce the cost in
the long term, but the only thing we look at is the up-front
costs, which is one of the problems.
I think that we have a Medicare program that today spends
more money than we take in, and just as I said, ``Unless we
reform the program, I am going to strongly resist adding things
to a program which is already financially in very serious
trouble, and with the 77 million baby-boomers getting ready to
come eligible for the Medicare benefits, we cannot add benefits
without reforming the system and bringing it into the 21st
century.''
The micromanagement of health care in this country for
seniors is unlike any other health program that I have been
able to find anywhere in this country and we really have to
reform it as well as allow for new and innovative ideas. We
shouldn't have to come to Congress and ask that this type of
process be covered. It should be covered because it is the
right thing to do in the private world.
So I thank you for your suggestions and for the good work
that Meals on Wheels does. Congratulations and continue the
good work.
The Chairman. To both of you, thank you very much. I agree
with John. Our difficulty without reforming is to add more to
an already overburdened cost in a system that does provide
critical care access or care access that is so critical. But at
the same time, we are also recognizing now in the heightened
awareness of nutrition and exercise, and I think there is a
heightened awareness that we shouldn't allow the doctors, or if
you will, the primary care practitioner to be the sole screener
of that service and I think that is a concern that we all have.
I thank this panel. I thank both of you very much for being
here today.
The Chairman. I understand our first/last panelist has
arrived. Would you please come forward? Lynn Swann, let me
thank you for being here today, and most importantly, let me
thank you for being the Chairman of the President's Council on
Physical Fitness and Sports.
I must tell you that probably everyone in this audience
knows about you and your marvelous athletic career and record,
now being in the Hall of Fame, of course, being that marvelous
wide receiver for the Pittsburgh Steelers. I have a former son-
in-law--you know how that can happen on occasion.
Mr. Swann. Yes, I do, sir.
The Chairman. Who is from Pittsburgh who would give his eye
teeth to be in the audience today and to meet you. He is also a
father of a marvelous grandchild, so he is still a very close
personal friend of mine and will always be. He is a delightful
gentleman.
But as an Idahoan, I never grew up with pro ball and I
never realized how addictive it is until I came to Washington,
and then I really didn't realize how addictive it was until I
had in my family a Pittsburgh Steeler fan. It is obsessive in
that crowd. [Laughter.]
But probably it is because of the marvelous game that you
played and obviously the record you delivered and the support
you built with your fans throughout the years, so we thank you
so much for being here.
But now we thank you for heading up the President's Council
on Physical Fitness and Sports. Senator Breaux and I have
mentioned, our growing concern about the absence of physical
activity in our population and now we have what some would term
an epidemic of obesity in our society that is of great concern
and brings on the kinds of chronic illnesses that continue to
cost this society a great deal of money and cost the individual
a great deal of life, and so, clearly, physical fitness is
important.
We thank you for being here. Please proceed with your
testimony.
STATEMENT OF LYNN C. SWANN, CHAIRMAN, PRESIDENT'S COUNCIL ON
PHYSICAL FITNESS AND SPORTS, SEWICKLEY, PA
Mr. Swann. Senator Craig, thank you very much, Senator
Breaux. Thank you for holding this hearing.
Indeed, Senator Craig, there are some obsessions worth
having, and for all those Pittsburgh Steeler fans, I understand
how they feel about their obsessions.
The Chairman. You have got it.
Mr. Swann. But certainly an obsession of mine is also being
fit and maintaining a great quality of life.
You have the statement that we prepared obviously for this
day and I don't want to go over that word for word. But
certainly, we have to set better examples for young people in
America and our elderly in terms of what we expect and what
they can do.
The President of the United States believes in this and he
is physically fit. The Secretary of Health and Human Services,
Tommy Thompson, has lost 15 pounds since he took that office in
an effort to walk the walk and not just talk the talk, and we
all have to do----
The Chairman. It has nothing to do with the stress of the
job? [Laughter.]
Mr. Swann. Well, his level of physical fitness probably
allows him to deal with that stress in a better way.
We have to look at our aging population, and sometimes we
have to ask a question before we get to the answer in terms of
being able to help them and the question is, Why are our
elderly people in such a poor state of physical health? For
many reasons, one of which is because for many of our older
citizens, they never have worked out. It was not a part of
their lifestyle.
We have shown that a healthier lifestyle is far more
important than we used to think of it. It is not just a matter
of running around and trying to look good in a bathing suit in
the summertime. It is not a matter of trying to fit into that
tuxedo you bought 10 or 15 years ago for a special event. It
means a higher quality of life.
Our senior citizens can have a higher quality of life even
if they have never worked out before, and so they can start
now. It is never too late to start working out and you can
derive the benefits.
There are more than, I think the number is about 300,000
hip injuries to senior citizens a year, and unfortunately for
our senior citizens who are in poor health, that one injury can
also lead to death. A lot of us like to think that weight loss
is an important thing, is a positive sign. But when the elderly
start to lose weight rapidly and for no apparent reason, it is
a very poor sign that they may never recover.
If an older person is more physically fit, their bone
density is going to be stronger. Their muscles are going to be
stronger. Their reactions are going to be stronger. So in an
inadvertent fall, a hand can go down that prevents that fall
from being a broken hip and prevents that particular injury
that could lead to their death, to mortality.
So we can start our elderly on programs that give them
great benefits today, but I think it is equally important that
while we attack that front, we also attack a larger front in
terms of our children and our adults. The President's Council
on Physical Fitness and Sports has an adult lifestyle program
that we have enacted this year that is different than the
Challenge program for the children that we have had for many,
many decades and we are trying to encourage adults and families
and senior citizens to work out to derive all the health
benefits of good, balanced physical fitness.
We are not asking people to become professional athletes. I
am not asking that everybody go out and try to run the marathon
or become a triathlete or become a part of the extreme sports
that we have in our society today, but that we do a little bit
of something. Thirty minutes a day, moderate exercise, can
derive all the benefits for our senior citizens. We have over
60 million people who don't really work out at all, don't do
anything. Ten minutes a day of moderate exercise, they can
derive those benefits.
What is the cost of that? Senator Breaux, you had mentioned
beforehand that the expectation of putting a lot of money up
front is not warranted. You can't expect to have those kinds of
outlays of cash. But we are spending over $250 billion a year--
$250 billion--on obesity-related diseases that are preventable.
Diabetes are preventable. Where will we spend that $250 billion
if we didn't have to spend it there, and wouldn't we need to
get that $250 billion back into other parts of our economy, to
other areas? We need people just to be more active.
We are instituting sometime this year, late spring, early
summer, a new President's Challenge website that will be able
to track citizens for the rest of their lives, to give them
information they need to be healthier and to stay fit--young
kids, adults, senior citizens. It will track them and give them
the kind of information they need to maintain or to gain an
active physical lifestyle so they can derive those benefits,
and that cost is minimal.
We just need to get people to be active and to start doing
something, and there are many ways we can get that going, but
the key here is to take that one step, and then the next step
and the next step.
So I am sure, Senator Breaux and Senator Craig, with your
help and your emphasis on this problem, we as a nation will
continue to move forward and get stronger. Thank you.
The Chairman. Lynn, thank you very much for your testimony
and your commitment and your involvement.
[The prepared statement of Mr. Swann follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
The Chairman. In what ways is the President's Council
promoting the President's Challenge? You mentioned the website.
Beyond that, is there an incorporated effort?
Mr. Swann. There are several partnerships that we have with
various companies in corporate America to get people in the
workplace to continue to work out and derive those benefits. We
have programs in place with the YMCA to engage people to
continue to work out and tracking them. We certainly want to
get them all signed up on our website, but to motivate them. I
think it is important to motivate, to incent, and to encourage
people to work out in a variety of ways.
The President's Council is about 20 members strong and we
have been out speaking to groups, large groups across this
country. We will continue to do that and continue to seek
forums to express the President's position on a healthier us,
that is, 30 minutes of exercise every day, 5 days a week. It is
a balanced diet, getting the proper testing to see what our
state and physical condition really is and make sure we are
medically OK, and to avoid risky behavior, things like if you
don't smoke, don't start, and if you do, don't smoke around
children, wear your seat belt, wear a bicycle helmet, those
kinds of things.
The Chairman. In addition to holding this hearing, what can
the Special Committee on Aging do to help you and the
President's Council on Physical Fitness and Sports promote
physical fitness for seniors, because you said something in
your opening comments that really is a reality to me in talking
with older Americans about exercising and they will say,
``Well, I never have.'' Why should I start? I never did play
any sports. I never have done anything of that nature. I think
there is quite a bit of truth to that. When you talk about
these 60 million out there who are not, part of it is because
they never have.
Mr. Swann. Correct. It is very much like that student that
was in your school probably, that guy, that girl that never had
to really open the book very long and they just kind of got it.
The Chairman. Oh, I really resented them.
Mr. Swann. Oh, didn't you? You resented them. They were so
bright and so smart, they just got it like that, As and Bs just
up and down the report card. [Laughter.]
But as soon as they went to college, they found themselves
in a bit of trouble. It didn't come that easy and they couldn't
compete. Why? Because they didn't have the tools. They didn't
know how to study. When the other bright minds came to that
university, they were bright and they had the tools. They did
know how to study and so they competed better. Many of those
bright kids got lost and didn't have the results they were
looking for.
There is also that guy and that girl you grew up with, they
could eat anything in the world and they never gained an ounce
and they looked great in their clothes, and they ate the
desserts, they ate the pies, they ate everything they wanted
to, never gained a pound. Then all of a sudden, 35 and 40 hit
and the belly started getting out there. There was one guy, if
you asked him for $5, he could reach into his wallet this way
because it just grew that big out the other end. They never had
the tools to start working out. They never understood it.
We can give senior citizens those tools. As a matter of
fact, later this week, we are meeting with the American
Association of Retired Persons to talk about a plan to get more
senior citizens activated and working out, light weights,
moderate exercise to derive the benefits. They can increase
their muscle mass at age 60 and they can gain more flexibility.
They can increase the density of their bones so they are not
quite as frail. They can derive all the benefits of moderate
exercise.
Again, we are not talking about anything substantial. It
could be 10 minutes here, 10 minutes there, another 10 minutes
vacuuming, gardening, walking their grandchildren, walking the
dog, exercising with other senior citizens, and that is enough
to derive the benefits.
The Chairman. My last question to you, Lynn, would be--and
this is going to put you on the spot, but I suspect you can
handle it well. You have been an athlete all your life. How
often do you exercise?
Mr. Swann. I exercise about 5 to 7 days a week.
The Chairman. What is your routine?
Mr. Swann. Just last weekend, I celebrated my 51st
birthday, and I get up at about 5 in the morning because that
is my routine. I will do anywhere from 45 minutes to an hour of
cardio, treadmill, bicycle, elliptical machine. I will do a
minimum of 300 sit-ups a day, and then 3 or 4 days a week, I
will lift weights for about an hour.
The Chairman. You can stop. [Laughter.]
Mr. Swann. But it is important, sir. Certainly, I am not
asking people to do what I do, but I am asking America to be a
little more fit. I am asking all the organizations who need to
have America be more fit because their dollars and cents can be
spent elsewhere. The American Diabetes Association, the
American Heart Association, all of these organizations are
doing great work and research to find cures and prevent
diseases and to prevent death.
One of the things we need all of us to do is be more
proactive. If they get their constituents to lose weight, if
they promote a healthier lifestyle and moderate exercise, and
it costs nothing to do that, then they take people off the
rolls of diabetics and obese people with other diseases and we
get some of that money back looking for a cure.
So we need everybody from all parts of our society to
encourage people to work out and derive those benefits. If we
get that, if we become much more proactive on the preventative
side, then that $250 billion a year we spend can go to other
areas where we certainly need that money.
The Chairman. Lynn, thank you. You are a wonderful example
and it is very obvious why the President has selected you to
Chair the Council.
Let me turn to my colleague, Senator Breaux. John?
Senator Breaux. Thank you very much, Mr. Swann, Lynn. Thank
you for your participation and your involvement.
I will just ask, if I followed your suggestion, would I be
able to play like Michael Jordan? [Laughter.]
Who is a real example, I mean, among others, but an example
of what you can do later in life at the very top of an athletic
profession. It is just absolutely amazing.
I do think, sincerely, that what you are doing is very
important, because you are such a recognizable person in the
athletic world. To take this position on behalf of the
administration and be able to use your fame and position to
encourage others to do the same thing is very, very important.
You are giving something back.
Although I hate to admit this, there were some in my
office, and I would say that it was some of the females in my
office that thought that Lynn Swann was a female. [Laughter.]
They have been banished for a long time. [Laughter.]
The Chairman. You should bring them down and introduce
them.
Senator Breaux. I think they would like to meet him.
[Laughter.]
Mr. Swann. Senator Breaux, I hate to tell you this, but my
mother was hoping I would be a girl, too. [Laughter.]
Senator Breaux. I thank you just for that involvement,
because your being where you are is really giving back to this
country and it is just wonderful to see you doing this.
Maybe everybody in America needs to do more in this area,
but two populations where it causes the greatest degree of
problems is with the young and the elderly. I mean, we have so
many of our young people who are tied to the television and
tied to the Internet and who don't do what I think we did
growing up. We didn't really have access to television like
that and certainly didn't have the Internet, so we had sports.
Boys and girls both were out doing things. It seems like it is
a huge problem now.
Then there is an attitudinal problem, I think, among our
elderly. My father was an outstanding athlete when he was
young, but when he hit a certain age, people in his generation
said, ``That is it, I can't do anything anymore, and they just
retired to the lounge chair and to the television.''
Those are two distinct challenges. How do we get to the
young people to tell them to get off their backsides and get
out and do something, and how do we encourage the somewhat
elderly in our society that they, too, need to still be doing
this because of what it means not only to themselves, but also
to their children and their grandchildren who are going to have
to participate in helping to take care of them? I mean, how do
we do that?
That is the real challenge, and I think the President's
Council on Physical Fitness hopefully can come up with some
ways to target that. Certainly, your being a spokesman will
help. Do you have any thoughts about how we get to those two
distinct groups, the young people and the elderly?
Mr. Swann. Certainly through our school systems. We mail
out, we provide for the school systems the information on the
President's Challenge, a program by where they can earn points
and awards through the Presidential Fitness Program. Any
teacher can put this program in place. They don't have to be a
physical fitness teacher or a physical education teacher to
enact this program and plan. So we mail out information and
make it available to children, to schools all over America. Our
corporate partners make it available to many more children, to
the Boys and Girls Clubs, through Big Brothers and Big Sisters
of America, and through the YMCAs, YWCAs, so that the kids can
have access to these programs.
We continue to try and reach adults in other sections of
our society to reach adults and senior citizens to make these
programs available to them.
Senator Breaux. But aren't we finding, for whatever reason,
that more and more schools now are not requiring physical
education as part of their curriculum? It seems like the first
thing they drop is PE, physical education, because it is sort
of assumed it is sort of an extra, when now we know today it is
much more a part of an educational process. It is just as
important to teach people to exercise and save their lives as
it is how to add in a math class. One is not more important, I
think they are pretty much even. But aren't we finding that
more and more schools are not even requiring physical education
any more?
Mr. Swann. That has been the case for quite some time. Now
about 10 years ago, the Chairman of the President's Council on
Physical Fitness and Sports was a gentleman by the name of
Arnold Schwarzenegger.
Senator Breaux. I remember the name.
Mr. Swann. Arnold spent a great deal of time in his tenure
trying to reach out to Governors of all 50 States. As a matter
of fact, my research tells me he visited every Governor at that
time to encourage them to have physical education as a mandated
portion of their educational system. At the time, there was
only one State, the State of Illinois, that mandated physical
education as a part of their educational program.
Senator Breaux. How many do you think today?
Mr. Swann. Today, Illinois is still the only State that
mandates physical education.
Senator Breaux. Unbelievable.
Mr. Swann. It is the only one. The State of California has
failed a physical education test for its young people recently.
Senator Breaux. I think that you have highlighted in this
something that--I mean, if our schools who educate our children
do not recognize that physical education is an important part
of the learning process, then we have a challenge that is
almost insurmountable.
Mr. Swann. It is a challenge, not insurmountable, I
believe, Senator Breaux. I believe if we just kind of dig our
heels in, we can fight that trend toward obesity.
Senator Breaux. Well, insurmountable is too tough a word.
Nothing is insurmountable. But, I mean, I tell you, to have to
do it without the schools' participation is an unnecessary
challenge that we shouldn't have to face. Schools should
recognize that physical education is part of the learning
process and a very important part of it.
Mr. Swann. We certainly need that balance, and we need to
reach our children to get them more active. But part of that, I
also believe, is because we have been so extraordinary
successful as a nation, our technology. We look at our
workforce. We don't necessarily need as physical a workforce as
we had 10 years ago, or as we had 20 years ago. We have a
society that has grown up with a great deal of convenience. I
mean, you don't even have to turn the handle to open the can.
You just press the button.
Senator Breaux. But that is part of the problem. Not to be
argumentative, but we have become such a high-tech society that
things that used to require a degree of physical activity and
qualification to operate a particular piece of machinery or to
perform a function is no longer necessary. You can sit behind a
desk and push a button, or you can get on a computer and get
the job done. So there is a lot less physical activity involved
in what we used to have. You used to have to be in better shape
in order to perform certain work tasks.
So I would argue that that is an indication that physical
exercise not connected to your work activities is even more
important. We are going to have a bunch of high-tech people who
are as smart as hell but are obese and fat and sick with
diabetes and it is going to cost us, as the lady said, $250
billion a year. They are going to be really smart, but they are
going to be so fat and obese and sick that they create a
problem for society that outweighs the ability to be a high-
tech society.
Mr. Swann. In my effort to reach Washington, DC, this
morning, my plane was delayed a bit and I ended up landing in
Baltimore. I was facilitated in getting here by Representative
English and Tim Murphy, and Tim, I have known for many, many
years in Pennsylvania, and we were having this conversation and
we were discussing physical fitness and how you get the time to
exercise in a busy schedule, the busy schedule of a
Congressman, of a Senator, of any individual, and we came to
one of several conclusions.
One is that it has to be a priority, and as a priority, we
have to schedule it. I would prefer to sleep in. I would prefer
not to get up at 4:30 or 5 in the morning. But as my day
unfolds, I know that I may not get the opportunity to get that
workout in, and I will be sitting in my office and I will be
reading material getting ready for the next broadcast or the
next project. I will be on the Internet. I will be on the
computer. I will be one of those people sitting there, not
moving around. So I get up at 5 in the morning to schedule that
activity.
Senator Breaux. Well, I don't----
Mr. Swann. If it is important to us, we need to figure out
how to schedule it.
Senator Breaux. I don't know how to do that, Mr. Chairman.
I mean, I don't like to mandate to States what they should do.
I would be last to mandate what the curriculum should be in
schools. But we as a nation have an invested financial interest
in this. When they are not teaching young people how to be part
of an organized exercise program, it is costing all of society
a huge amount of money. The fact that the schools have moved
away from this is something that--they did it in many cases
because they don't have the money, so they figure they cut the
least important program in the curriculum and it has always
been physical education, which I think is a huge mistake.
I don't want to belabor it, but I asked also about seniors.
Do you have any thoughts about how do we get people who think
it is time to retire to the rocking chair to also do more than
just rock away their lives?
Mr. Swann. I think if we can engage our senior citizens. I
think certainly the conversations we are going to have with the
AARP this week are going to give us some help in enlightening
us in terms of how we can approach that. But I do believe we
need to engage them.
As a matter of fact, I just met recently a doctor from the
University of Pittsburgh who was headed down to Miami for a
conference and her mother had passed away several years ago.
Her father was at home in Massachusetts and he had never lived
anywhere other than Massachusetts, and she convinced him to
move to Pittsburgh with she and her new husband. He came there
and he lives in an area called Squirrel Hill and he spends his
time at the community center with other senior citizens and it
has opened up an entirely new world for him, the exercise
programs with other senior citizens. He is taking Tai Chi, and,
as a matter of fact, tried to pull a couple of moves on his
daughter so he could take her down if it was necessary.
[Laughter.]
It is not just the physical benefits that seniors get when
they engage in these programs, but it is also a psychological
benefit. They feel better. Their attitude is better. They have
an air of confidence.
So I think if we can engage them, show them through a
variety of means that the quality of their life is going to
improve, that they will be able to see that little bright light
in the eyes of their grandchildren for many more years if they
take a little bit of time, it is well worth it and we can make
that effort.
Senator Breaux. See if you could help, I mean, use the
office that you are in, that you head, to really see what we
can do to maybe help promote the National Senior Games
Association. I mean, it has struggled. It has sort of been the
stepchild of athletic endeavors in this country and I think
that it is the only thing that really encourages seniors to be
involved on a national level in something that emphasizes
physical fitness. I have tried, and I would love to join with
you and others to try and find out what we can do to encourage
that as an endeavor that continues. They have had really tough
problems in getting people to recognize this as a commercial
entity.
I mean, if I was an advertiser, I would say, look, you are
talking about a group of people who are some of the largest
purchasers in this country that are seniors, and to try and
find ways to get the private sector involved. It shouldn't be
the government doing it, but we should be involved in that. So
I look forward maybe if you have any thoughts on that.
Again, congratulations. I know you couldn't land here
because of the snow storm and you went to Baltimore, and the
worst thing possible, you had to hitch a ride with two
politicians. [Laughter.]
Thank you for being here.
Mr. Swann. It was not the worst thing. I actually enjoyed
the ride. But I certainly look forward to working with you,
Senator Breaux. It would be an honor and a pleasure to work
with you on the Senior Games, to encourage and to motivate our
senior citizens to be more active and give them the goals. We
do need to give everyone goals to reach for and to motivate
them and it would be a pleasure personally and through the
office to be able to help you with that project.
The Chairman. Lynn, thank you very much for your time and
your struggle in getting here today to be with us. We thought
it was very important that we make an effort to highlight
senior nutrition and senior physical fitness by example and
certainly by building a record for our colleagues and for a
broader public awareness.
The evidence is there. It is just irrefutable that a
healthy lifestyle, certainly exercise and reasonable nutrition
extend lifestyle. Senator Breaux and I had hearings here
yesterday, and when we look at the demographics of aging today,
even under current demographics, simply because we are making
people healthier longer, it is a task at hand that requires us
to reform institutions of government, and I would like to make
them even healthier.
But to see folks living well into their 90's, being
physically fit and mentally active is absolutely wonderful, not
only for themselves, but for their families. You have played
and are playing a role in that kind of information education
and we thank you very much for it and thank you for coming to
the committee.
Mr. Swann. Senator, thank you very much.
The Chairman. The committee will stand adjourned.
[Whereupon, at 11:43 a.m., the committee was adjourned.]
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