Warning Labels for Inactivity: A New Trend in Health Education?

Health and Healthcare CategoryThis is an era where lawsuits are filed for the absence of warnings — the McDonald’s lawsuit of 1994 (81-year-old woman awarded 2.9 million dollars for being scalded by a beverage that she ordered) and of 2003 (the plaintiff complaint stated that eating at McDonald’s contributed to his obesity; was dismissed and later modified to state that the fast food giant did not disclose it’s ingredient list).

Can we expect a lawsuit against professionals in the healthcare field for not aggressively educating the community about the consequences of prolonged inactivity?

The answer may well be in the affirmative. Who would ultimately be responsible for these consequences? The individual? The manufacturers of products that encourage a sedentary lifestyle? Or is it the healthcare workers who could have potentially educated the community through health promotion programs? In order to preemptively address this issue, I propose the following to spread awareness about the importance of incorporating moderate physical activity daily.

McDonaldsResearch certainly confirms that inactivity leads to obesity, and can advance to other diseases — diabetes, high cholesterol, cardiovascular diseases, stroke. A story covered by the Canadian Broadcast network in 2002 suggested that only 10% of 1700 high school students surveyed were participating in adequate levels of physical activity, and 40% of students were either obese or at high risk of being obese. Various hurdles to students joining gym class were cited — such as conflicts with academics and overbooked gym teachers. Some suggestions to encourage activity in students in and outside of school:

  • Posting catchy slogans posted around the school campus (e.g. “Run! Run! Run… so obesity doesn’t catch up with you”).
  • Introducing non-traditional class formats where science and math classes are held outdoors and involve learning through activity.
  • Setting assignments in social studies or civics that involve research into the ill-effects of inactivity, so students come to a realization on their own; and then providing resources and options for increasing activity.

Another interesting avenue that can be explored to get this message across is video games. An article by Dr. Lorraine Lanningham-Foster suggested that adding activity to video games maybe one way of fighting adolescent obesity. There are already games such as Dance Mania and the Wii games that demand some exertion by players. Some suggestions that I have to incorporate warnings into the more traditional video games:

  • Flashing a warning at the start of the game — about the ill effects of prolonged engagement in the game (for games that involve remaining seated in front of the screen)
  • Having the main video game character pop up between stages and say “Wow! I sure got my dose of running/jumping/walking today! Did you get yours?”
  • Usually, gamers are able to set features of central characters to mirror their own personality, and so might relate to a message from their alter ego.
  • Having a mandatory “running” or “stretching” routine in between stages of the game.

Apart from these more specific ideas, the following are a few generic suggestions that target a wider audience innovatively:

  • In cities with public transport – having labels on the inside of buses — “Take me to one stop earlier than your original stop – gain some steps, lose some pounds.”
  • Signs at the bottom of the stairs encouraging people to use them, and signs on the elevator recommending the stairs instead.
  • Internet service providers flashing a “Surfing for too long” warning or “Get up and stretch out” suggestion if they detect that a user has been actively using the Internet for prolonged time periods.
  • Cafes and Bistros in city downtowns offering “frequent walker” rewards.

These are ideas from just one brain storming session, and I hope this sows the seeds of thought in the minds of people that can make a difference.


Lanningham-Foster, L., Jensen, T.B., Foster, R.C., Redmond, A.B., Walker, B.A., Heinz, D., Levine, J.A. (2006). Energy Expenditure of Sedentary Screen Time Compared With Active Screen Time for Children. PEDIATRICS, 118(6), e1831-e1835. DOI: 10.1542/peds.2006-1087

Li, T.Y. (2006). Obesity as Compared With Physical Activity in Predicting Risk of Coronary Heart Disease in Women. Circulation, 113(4), 499-506. DOI: 10.1161/CIRCULATIONAHA.105.574087

Tremblay, M.S., Willms, J.D. (2003). Is the Canadian childhood obesity epidemic related to physical inactivity?. International Journal of Obesity, 27(9), 1100-1105. DOI: 10.1038/sj.ijo.0802376

Nirupama Shankar, PT, MHS

Nirupama Shankar, PT, MHS, is a physical therapist by profession, and has over 7 years of clinical experience in the field of neurological rehabilitation. She has treated individuals with stroke, traumatic brain injury, spinal cord injury, Parkinson's disease, multiple sclerosis, and amputations. She has also completed training modules and community education projects in Michigan and North Carolina.
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