Making healthier decisions, step by step

Nobody wakes up expecting they'll make unhealthy choices, but the daily grind can compromise our otherwise healthy intentions: fast food instead of a home-cooked meal because we're exhausted; driving instead of walking to the grocery store because it's more convenient. But what if life came with little reminders to make healthy choices? To address that question, researchers from San Diego State University looked at whether a simple sign could encourage airport visitors to take the stairs rather than the escalator.

Even small amounts of activity can have important health benefits, particularly for Americans who sit most of the day, said the study's first author, John Bellettiere, an SDSU alumnus currently working as a postdoctoral scholar at the University of California, San Diego. He is researching ways to boost physical activity at the population-level to help people "sit less and move more."

For 10 non-consecutive days, a team led by SDSU public health researchers Yael BenPorat, Brent Bishop and Melbourne Hovell posted one of five signs at the bottom of a set of stairs and escalators ascending to a sky bridge into San Diego International Airport's Terminal 1. The signs read:

-"Please reserve the escalator for those who need it."

-"Don't lose time, lose weight. Use the Stairs."

-"Don't waste Time, trim your Waistline. Use the Stairs."

-"You'll get more stares if you use the stairs."

-"If you want to feel younger, act younger. Step it up! Use the stairs."

On alternating days, they posted no signs at all. The researchers counted how many people took the stairs versus the escalator on the sign days and no-sign days. They also interviewed people atop the stairs about their health history and physical activity levels.

When one of the signs was present, about twice as many people took the stairs compared to a no-sign day, the researchers reported recently in the Journal of Primary Prevention. The most important finding: The prompts appeared to nudge both people who regularly exercised and those who never exercised, explained study co-author Natasha Bliss, an alumna of the SDSU Graduate School of Public Health and current associate director of development for the university's College of Professional Studies and Fine Arts.

"We saw the effect even when people were carrying luggage, even when they were in a rush," Bellettiere said. "It's the first time this kind of effect has been shown at an airport."

Encouraging even small amounts of exercise is important, Bellettiere added, because of its compounding effect in people's lives: If they take the stairs early in the day, they may make similar healthy choices later in the day. Also, when people see others taking the stairs, they are more likely to do so themselves, creating a ripple effect.

"These nudges are small environmental changes that can really help boost physical activity in the population," Bellettiere said.