Dubbed “An Apostle for Fitness” in her profile in the Wall Street Journal, Carole has been a featured guest on more than sixty radio and television shows, including NBC’s Today show, CBS’s Early Show, MSNBC’s Countdown, and CNN News. Carole has been featured in magazines such as American Fitness, Diet & Exercise Magazine, and Today’s Health & Wellness, as well as in newspapers such as the Honolulu Star-Bulletin, Tampa Tribune, Sacramento Bee, Baltimore Sun and the Los Angeles Times. Carole’s book, From Fat to Fit, was named a finalist in the health and fitness category of the National Best Books 2007 Awards, sponsored by USA Book News.

Besides teaching and consulting, Carole has produced a weekly community television show, The Tipping Point and a reality show, Go Fat to Fit. This, fall Carole will serve as mentor to the national AARP Fat to Fit Community Challenge, a new virtual community devoted to fitness and healthy weight loss.

Carole Carson--

When I began my journey toward fitness, even though I was only 5 feet 2 inches tall, I weighed 183 pounds. You won’t be surprised to learn that, with all that mass, I had a 44-inch waist. (No wonder I had to wear pants with elastic waistbands.) But however troublesome these numbers were to me, no government agent noticed—neither in the state of California, where I live, nor in the federal government in Washington, DC.

Someone should have, though. I had no idea that my waist circumference put me in the 90th percentile for heart disease. As I later learned, studies confirm a strong link between heart disease and a waist of over 40 inches for men and 35 inches for women.

Tim Russert’s premature death dramatically bears out the statistics. Tim’s blood pressure was being managed through medicine, and Tim was exercising daily. Since Tim’s cholesterol was within the normal range, his physician did not feel Tim needed to take prescription drugs to lower it.

Given the absence of heart symptoms and the proactive medical management provided by his cardiologist, Tim should have been fine. Certainly, he wasn’t considered a candidate for bypass surgery. Yet it’s possible that Tim died of a heart attack that might have been prevented had the blockage been diagnosed. The most significant factor in predicting Tim’s heart disease: the size of his waistline.

Even though I would not have fared so well in Japan before I began my fitness makeover, I would have appreciated a wake-up call. Given the link between heart disease and waist circumference, I have more than a passing interest in Japan’s massive social experiment to reduce waistlines. Two months ago, the Japanese legislature created a national program that ambitiously aims to trim the number of overweight citizens during the next four years. The impetus for the program is financial: most of Japan’s citizens receive medical care through their employer or the government. Costs are expanding exponentially, along with their waistlines.

To achieve the collective goal, the government mandated the measurement of waistlines for all citizens between the ages of 40 and 74. Insofar as I can tell from my research, this program is the largest (excuse the pun) anti-obesity campaign ever attempted by a government.

Men’s waistlines cannot exceed 33.5 inches. For women, the limit is 35.4 inches. In establishing the limits, the government officials relied on the advice of the International Diabetes Federation, which recommends the guidelines as a simple way to assess health risks. Even so, the standards seem stringent by American standards, and apparently, there isn’t any wiggle room—either you measure up or you don’t. The objective measurement disables the mechanism of denial: the truth, however unpleasant, must be faced.

The legislation doesn’t end with a mandated measurement of waistlines (although public humiliation would go a long way toward persuading me to become fit). The consequences for individuals who exceed the limit involve nutrition and diet counseling. These people are rechecked, first at three months and again at six months. Those who fail to make progress are steered into further, more elaborate nutrition and exercise educational programs.

Other teeth in the legislation include penalties to companies and local governments who fail to meet the weight-loss goals assigned to employees and residents. For example, the company that manufactures Panasonic products, Matsushita, is required to measure at least 80 percent of all employees and to bring 10 percent of those who exceed the waist measurement into compliance by 2012. Matsushita is enthusiastic about the intervention and has expanded the program to families and retirees.

This massive effort in behavior modification is not without its critics; however, it is an amazing development and a social experiment worth noting. The program also provides a uniquely Japanese solution to the problem of increased medical costs resulting from an aging population with a rising rate of obesity. The relative homogeneous nature of Japanese citizenry, along with cultural support for group effort, lends itself to the design of this program. In comparison, the United States is a multicultural nation with a variety of body types and sizes. Plus, Americans have a proud tradition of supporting individual rights.

The experiment across the sea, however, raises the intriguing question: what will our unique American solution look like? Setting aside medical issues, we may soon find ourselves in the same boat as Japan. We will need to create a collective, public response to an aging and increasingly overweight citizenry—conditions that will inevitably feed swelling medical costs to the point where they will not be sustainable.

In the meantime, I’ve shrunk my waist enough that I can travel to Japan without worrying about being measured when I go through customs. More importantly, my risk of heart disease is normal.

Because the lifestyle changes I made probably saved my life, I’m volunteering to mentor the AARP Fat to Fit Community Challenge, a fitness and weight-loss program beginning this fall. The program will be Internet-based, free and open to AARP members and nonmembers alike and could potentially become global in its reach. Maybe we’ll have some Japanese teams. Wherever you live and whatever your waistline measures, I hope you’ll join a team and become a member of our Fitness Protection Program.

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