Stair design in the United States and obesity: The need for a change

Background: Maintenance of healthy body weight is a function of total energy expenditure including household and workplace activity. Light to moderate physical activity has been found to be effective in motivating sedentary and obese individuals, and is at least as effective as structured exercise in lowering weight in some studies. Discussion: Stair use offers a promising intervention for increasing physical activity, because it involves a lifestyle choice that must be made (people must get to their destination), and it requires no personal financial cost. Stairs in United States buildings are frequently hidden from entrances with small signs denoting their location, mainly in connection to fire exits. Using the stairs is usually seen as a way of escaping from fires rather than as a recommended daily activity. To comply with State Fire Marshal regulations, stairs are usually guarded by heavy, spring doors, without air conditioning, and are noncarpeted. In this article, several suggestions to change the architectural design in buildings to be more physical activityfriendly are discussed. Such changes would make stairs attractive, safe, and readily accessible. Local and state authorities may also allow incentives for such designs to compensate for their additional costs. Moreover, standard national building codes that incorporate health concerns should be devised. Conclusion: Stair use at work and in living places has the potential to increase physical activity and decrease obesity. Changing stair design to encourage their use requires a series of interventions both architecturally and legislatively to create physical environments that support active lifestyles.