Pretty much all cities and towns in the U.S. are car centric. Large amounts of space wasted in the form of parking lots. Houses are mostly built away from grocery stores and shops. Usually there are no decent foot paths to get to them. It’s not just a phenomenon of large cities. It’s pretty much everywhere.

It really depends on the city. A lot of the "urban/rural" statistics are somewhat clouded by the fact that most American cities aren't really walkable outside of a central business district that nobody really lives in, and that its residents probably have to drive out of to get to such basic places as a grocery store.

The correlation looks a lot firmer when you look at overweight rates compared to population density or walkability instead of trying to just coarsely bucket it into "urban/suburban/rural".

Absolutely.

I think people underestimate how much walking or physical activity they’d need to do to counterbalance the calorie surplus they have on a daily basis. You’d literally need to be fast walking for hours and hours a day. Cars don’t help, but walking for an extra 3-4hrs a week isn’t the major factor here. It’s the pound of cheese you had melted on everything, or the 24oz Cola.

> It's really that simple.

Everything you list is simple, but nearly impossible for most people to stick with for life. It's not a matter of education, it's the fact that implementing that plan is physically and emotionally painful and wears most people down inside of a week or two.

As I've gotten older I've come to appreciate pro surfer Laird Hamilton's perspective on making friends with pain. That doesn't mean you should be a masochist, just stop seeing pain as something to always avoid.

http://www.espn.com/espn/story/_/page/bodyreecehamilton/just...