Louisiana Has the Most Sedentary Lifestyle

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It also factored in a spike in employment that came from the rebuilding efforts following Hurricane Katrina in 2005.

This sedentary lifestyle—combined with the effects of Louisiana's famous cuisine—has its consequences. The lack of physical activity "correlates with our obesity rates," says Christy Reeves, director of community relations at Blue Cross and Blue Shield of Louisiana. The obesity rate in Louisiana is 31.2 percent, the fifth-highest rate in the country, according to a recent report by Trust for America's Health. In 2009, the state ranked eighth with an obesity rate of 28.9 percent. Louisiana spends about $1.4 billion dollars annually on obesity-attributed medical expenses, reports the state Office of Public Health. "I think in general people here recognize it's an issue," says Reeves.

Television and Obesity

Louisiana is not unique: Americans spend more time sitting around than ever, and the number of overweight and obese people continues to rise. Even in the state with the lowest obesity rate, Colorado, nearly one in every five to six people is obese.

One major contributor is television. According to a recent report by Nielsen, Americans now spend more time in front of TVs than ever, with the average viewer watching two more hours of TV per month in the first quarter this year than in the same period in 2009. On a weekly basis, the typical American watches more than 35 hours of TV and spends nearly four hours on the Internet. People over age 65 watched the most television (about 49 hours weekly), and those aged 35 to 49 spend the most time online (nearly six and one-half hours per week), according to Nielsen data.

Growing offerings for online video and mobile video also contribute to this trend. For example, Nielsen says events such as the Super Bowl and March Madness drive online viewership. Nielsen reports the mobile video audience grew 51.2 percent year-on-year in the first quarter.

Promoting Bicycling

The challenges to getting people up and moving are complex. Outside the big cities is a dearth of public transportation, bike paths, and sidewalks, says Berry Trascher, Louisiana advocacy director of the American Heart Assn., "and there are so many poor and underserved and undereducated people who don't understand how to eat healthy." On top of that, she says, "everything is centered around food in Louisiana." Trascher, a lobbyist, and others hope to change this.

Adding physical activity positively affects physical health, as well as mental health, emotional well-being, and social functioning, according to a study of sedentary women by Pennington Biomedical Research Center.

One outlier is Mark Martin, a Baton Rouge resident, who has built a lifestyle around his bicycle. Despite the heat and people's odd reactions, he says, he has not owned a car for about 20 years. "Originally it was economics: I had just gotten out of grad school and couldn't afford [a car]," says the 56-year-old photo archivist at Louisiana State University. "I started riding more and realized how much fun it is, and the health benefits are certainly there."

Martin is working to make the city more accessible to bikers and walkers through a nonprofit, Baton Rouge Advocates for Safe Streets, which he started in 2006. The group organizes rides and advocates policies that ensure the right of way for nonmotorists. "People can't use things that aren't there," he says. "You can't walk and bike if there is no built environment for that."

Awareness programs are also growing. Blue Cross and Blue Shield of Louisiana started a free, online fitness program in 2007 called Louisiana 2 Step, which allows users to track (and hopefully change) what they eat and how much they exercise. Says Reeves: "We have a lot of outreach in schools and churches."

Still, widespread lifestyle changes take time and require alterations not only in mindset but also available services and facilities. "In the medical community, we are well aware of the situation," says Pennington's Katzmarzyk, but "there is a lag time between what we understand in science and what we put in place in the population."

Click here to find out which are America's Laziest States.

Wong is a lifestyle and real estate reporter for Bloomberg Businessweek.

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