44. Prevention of Chronic Disease by Means of Diet and Lifestyle Changes

One successful example of increasing activity is Agita Sao Paulo, a multilevel physical activity initiative designed for the 34 million citizens of Brazil's Sao Paulo state (Matsudo and others 2002). The program was launched in 1996 to increase the public's knowledge of the benefits of exercise and expand participation in physical fitness activities by encouraging people to do 30 minutes of moderate activity at least five times a week. As elsewhere, program designers perceived a lack of time as the major factor preventing daily exercise. They chose three settings as places to promote activity: home (gardening, chores, avoidance of television watching); transportation (walking, taking the stairs); and leisure time (dancing). Agitol, a prescription for exercise, was developed for physicians to dispense. Its message is displayed on electricity bills and stickers, and it is touted by radio stations and other media outlets.

After four years, 55.7 percent of those surveyed had heard about Agita, 37 percent knew its purpose, and those who knew of the program's purpose were more likely to be active. Agita appears to have played a role in increasing activity in the region (Matsudo and others 2002). It is closely linked to a national program to promote healthy diets and active lifestyles by nutritional content labeling, promotion of healthy diets in schools, communication of guidelines for healthy eating, and encouragement of innovative community-based initiatives (Coitinho, Monteiro, and Popkin 2002).