The newest health and fitness business in town has no barbells, wheat grass shakes, or stethoscopes. Headquartered principally in cyberspace, at least for now, Princeton Living Well is a web-based community outreach start-up with a not-so-modest goal to create a nationwide network of companies that will deflate the country’s obesity epidemic.
The new company is a partnership between veteran ad man Tom Sullivan of Princeton Partners and Rick Weiss, a computer expert who has created a business, Witherspoon Street-based Viocare, by being a whiz at corralling National Institutes of Health grants to develop health-related technology tools. The joint venture has a beta website (www.princetonlivingwell.com), a $500,000 NIH grant, some angel funding, and a business plan that calls for $10 million in venture capital funding within three years. Its goal is the creation of a 40-person company, American Living Well, with its own building, CEO, and executive staff — separate from Viocare and Princeton Partners.
But aren’t there already lots and lots of diet and exercise websites? Really good ones? The Daily Plate (www.thedailyplate.com) comes to mind. It is a free site that allows users to easily record and track their eating and exercise, participate in active chat rooms, and instantly see graphs and pie charts of their cholesterol, carbohydrate, fat, and protein consumption on a daily, weekly, or monthly basis. Sparkpeople (www.sparkpeople.com) and Fitday (www.fitday.com), interactive websites loaded with features, are also free, and have won high marks from Internet reviewers.
The Princeton Living Well website, in comparison, is a bit skimpy. Though not ready for full release, which is slated for the fall, it does already have a community calendar that aggregates nuts and bolts information on area fitness events, health screenings, and nutrition classes. It also contains a blog, which at this point is an entertaining account of Weiss’ running and biking adventures around town, featuring rainy bike rides on the canal towpath and guilty visits to the Bent Spoon. There are a few health tips on the website, and some breaking health news, most of it on sober subjects like heart attack risk factors or childhood obesity.
Some features of the website are free. Others will require a yearly membership fee of $20.
Sullivan shrugs off comparisons to other diet and fitness websites. He and Weiss are out to create far more than a website, he says. They are attempting nothing less than a lifestyle revolution. And they know it can be done because they have a recent — and very potent — point of reference.
“Look at tobacco,” says Sullivan. “Ten years ago you could smoke at work. Then no smoking became corporate policy. The change in the attitude of business turned smoking inside out.” Legislation was proposed, and swiftly passed. In a short time the smoker became a largely undateable, unemployable, uninsurable pariah. Even those willing to risk social ostracism by continuing to smoke found themselves unable to light up at desks, in restaurants, on planes or trains, and then in bars. Even New Jersey’s casinos went largely smoke-free in April, and there have been calls for smoking bans in private cars, at least when children are along for the ride. Tired of working around all of these barriers — and of hearing tearful pleas from their loved ones — hundreds of thousands of smokers kicked the habit.
The same thing could happen around eating and exercise, says Sullivan. “We could change the whole environment.” Restaurants, for example, could be recruited as partners. They might offer a daily low-calorie, low-fat dinner special, provide more nutritional information, and perhaps even reduce portion sizes, and advertise the benefits of doing so. Diners might become more aware of what they are eating, and might be encouraged to make changes at home. Employers, already sick over rising health insurance costs, might offer incentives for increasing fitness — including, Sullivan hopes, subsidized membership in Princeton Living Well.
Change at a person-by-person rate might not create a more fit community, says Sullivan, but change in a community’s practices and attitudes could well be the impetus needed to reduce waistlines and obesity-related diseases.
The inspiration for Princeton Living Well, in fact, came from a community program — Lighten Up Princeton, a initiative of the Princeton Health Department headed up by Francesca Calderone-Steichen. Weiss read a newspaper ad for an organizing meeting, was impressed by what he heard, and worked pro bono with his senior website designer to create a website. The outreach had only a little funding, including $3,000 from Bristol-Myers Squibb, and was slated to last for about four months, but was popular enough to double that time over a period of two years. Elements of the program included a public health nurse who answered questions and conducted screenings at Wild Oats for a few hours on Saturday mornings, and a partnership with the Alchemist & Barrister restaurant, which put together a weekly prix fixe healthy dinner.
“The idea for Princeton Living Well came directly from Lighten Up Princeton,” says Weiss. He explains that programs like Lighten Up Princeton that rely on government funding “are ultimately not sustainable.” They are generally designed for the short term, because it is impossible to keep money flowing to them. In his application for an NIH grant for Princeton Living Well, Weiss emphasized that a big plus for this program would be a business plan that would allow it to carry on indefinitely.
Smart marketing will be a key component in keeping Princeton Living Well going in a space that is already becoming crowded as the public, satisfied that smoking in public is under control, is turning its collective attention to erradicating creeping weight gain. Sullivan is convinced that he is the man to get a good buzz going for the new company. A 1980 graduate of Trenton State, he joined Princeton Partners in 1989, and is credited with expanding its employee roster fivefold, to more than 50 people. He bought out his former partner, Cathy Mathis, in 2001. He is now CEO of the firm, which has clients in a broad spectrum of industries, but which has a specialty in healthcare marketing, and a fondness for interactive, web-based campaigns.
But he and Weiss both say that Princeton Living Well needs to be much more than a website.
“The website is a minor part of Princeton Living Well,” says Weiss, who holds a bachelor’s degree in engineering and math from Carnegie Mellon, also Class of 1980, and a master’s degree in electrical engineering and computer science from Princeton University. He founded Viocare in 1993, and, with a staff that has grown to eight, has reeled in NIH grants for a family of nutritional analysis tools that are being used by top research institutions, including Rockefeller University, Emory, Yale New Haven Hospital, and the Mayo Clinic. (Displaying people skills that contradict the popular stereotype of the computer programmer as a preoccupied loner, he makes a special call to ask that Randy Harmon, director of New Jersey’s small business development centers, be given credit for helping him to obtain the grants that power Viocare. “His help was really significant,” he says.)
Weiss is the technology guy in the Princeton Living Well partnership, but he believes that to succeed the new company needs newsletters delivered by mailmen and significant partnerships with local bricks and mortar businesses and non-profits.
“A big part — a very large component — of Princeton Living Well is marketing local programs,” he says. “Our philosophy is that we don’t believe in a total tech-driven wellness solution. We believe it entails working with the local healthcare system. Our suggestions will be customized to the community. We want people to connect with services in the community.”
Despite a tower of diet books, ubiquitous Weight Watchers meetings, and the creation of the low-fat cookie, Americans keep packing on the pounds. Weiss strongly believes that systemic change at the community level is the answer.
“I don’t believe in diets,” he says. “I believe in changes. Find some things to change, things people are willing to do. If you add a fruit, you make a big change. If McDonalds would change lettuce to spinach in its sandwiches, it would have a huge impact on society. If you can shift restaurants just slightly, you can have big change.”
The partners see this change happening first in Princeton and surrounding towns, and then spreading to other cities — 1,000 of them by 2013. They are already working on lining up franchisees, which they would prefer to be healthcare organizations, chambers of commerce, or other non-profits. These potential partners, the owners of a future Cleveland Living Well, San Diego Living Well, or D.C. Living Well, for example, would pay a licensing fee and would split advertising revenue with Princeton Living Well. In each location the “Your City” Living Well would be tailored to include area advertisers and healthcare and fitness providers. The co-founders would step back from day-to-day management, but would retain an ownership interest.
Closer to home, Sullivan and Weiss are busy working on their prototype, Princeton Living Well, which won’t officially launch until the fall. The pair have known each other for “five or six years,” says Sullivan. “We’ve always liked one another,” he adds. “He’s an innovative entrepreneur. He’s put in 13 years of R & D work. He’s devoted his life to nutritional research. At Princeton Partners we do a lot of wellness marketing. We both have a strong social impact focus. It’s a perfect dovetail to bring his tools to a local marketing effort.”
They are banking on forging partnerships with healthcare providers at all levels — one-person dietitian practices through regional medical centers. They also aim to recruit restaurants and other businesses. These partners can participate in a number of ways. They can advertise, get help in posting interactive, easily-updatable mini-websites on Living Well Princeton, or offer rewards to the website’s members. Weiss and Sullivan will pitch their concept, and look for partners and advertisers, at a presentation to businesses and non-profit organizations on Thursday, June 28, at 8 a.m. at the Theological Seminary. David Katz, co-founder and director of the Yale Prevention Research Center, prolific author on the subject of weight loss and nutrition, and medical contributor for ABC News, will speak. The meeting is only for organizations. The partners have sent 1,000 invitations to businesses and non-profits in Princeton and in 12 nearby towns, and are sending 12 logo-wearing “ambassadors” around between now and next Tuesday to fan interest. To reserve a place, call Carol Feiveson at 609-497-4600, ext. 11.
The partners say that connecting with area resources is one thing that sets Princeton Living Well apart from other diet and fitness websites. The support that comes from face-to-face social networking opportunities is another thing that the website can offer. While other diet and fitness websites feature 24/7 chatter about how to broil fish, prepare for a first marathon, or curb midnight refrigerator raids, Weiss sees Princeton Living Well creating links between area residents who would like a walking or working out partner.
Rewards are the other important point of differentiation for the website. When pressed on why potential members, already being offered low-hanging fruit in a veritable Garden of Eden of slick, free diet websites, would spend $20 to join Princeton Living Well, Weiss talks about its rewards system. While the specifics are not yet set, he is hoping that area businesses will offer things like free meals, running shoes, or a can of tennis balls to website members who rack up enough points through, perhaps, replacing chips with cherries as a mid-day snack, working up to one hour of brisk walking three times a week, or choosing the healthy entree of the day at an area restaurant.
“You have to give people a motivation system,” Weiss says. The rewards are part of this, and, he says, can be thought of like the addictive points American Express doles out to its card members, some of whom have been known to finance the down payment on their homes just to rack up more points. Likewise there are more than a few air travelers who spend their spare time figuring out which flights offer an especially high number of points — and then get onboard solely to add to their totals.
Another example, Weiss points out, are the little cardboard punch cards that plump up many a Princetonian’s wallet. Offering a free coffee, sandwich, or scoop of sorbet after the purchase of 10 items, they are so popular that even those who could easily afford to buy the business handing them out will keep track of the cards, and proffer them with each purchase.
Many popular diet and exercise websites offer online tracking tools as a motivation to get fit. Daily Plate members, for example, can enter what they ate last weekend, see the number of calories they consumed, and compare the total with previous weekends. For an extra fee, $29 a year, they get a graphic that shows them on a bike inching ever closer to a weight loss goal.
Weiss says he is in favor of tracking, but sees it, in its current form, as a hardship, and believes that most people simply won’t keep at it over time. His website will have a couple of more complex tools, which he has developed through NIH grants, and will cost users about $29 for one-time use.
Vioscreen, the first tool slated to appear, is already being used by researchers and clinicians. The 30-minute diet assessment yields a “very detailed” report on food intake, but provides no advice on how to create a more healthy diet. “The next step could be a referral to a dietitian,” says Weiss, who sees a Vioscreen as a valuable tool to take along on a doctor’s visit. A second tool, further away from introduction, would be more interactive, suggesting behaviors to change, maybe just one at a time, and encouraging users to check back after a few weeks. Most people who carry extra pounds would love to shed them, but, says Weiss, hurdles stand in their way. Perhaps they can’t find time to exercise or they find themselves eating fast food as they dash between business appointments. This tool would suggest ways to overcome the hurdles and would track progress in doing so. It will also would cost website visitors about $29.
Down the road, says Weiss, “we’ll be using hand-held mobile tools” to track eating and exercise. He doesn’t think that most people are willing to log onto a computer to record every snack and trip to the gym, but does see promise in capturing this data on a portable device — ideally a cell phone. He is working on a program that will do just that, but says that “it’s still in the research mode.”
Sullivan and Weiss are both healthy eaters who exercise and remain fit. Sullivan, the father of four children, ages 22 to 30, says that, for him, fitness has “changed through the years.” He now concentrates on flexibility, lifting light weights and swimming. He and his wife, Jan Sullivan, a nurse who was director of the Robert Wood Johnson Hamilton Maternity and Child Health Center until she joined Princeton Partners in 2001, have gone on three-mile walks on a regular basis for some 20 years. As for meals, Sullivan says, “Jan is an outstanding cook. We’ve always had meals together five to six nights a week. Our diet has been phenomenal.”
Weiss is an enthusiastic biker. He met his wife, Susan Gertner-Weiss, a teacher, on a bike ride with Princeton Freewheelers, a cycling group with whom he rode 6,000 miles a year before the demands of work and family — the couple have a daughter — caused him to cut back to something more like 2,000 miles a year. While exercise, fueled by healthy eating, is central to Weiss’ life, he is not the son of cheetahs. In fact, his life could be a textbook case in the never-ending nature-versus-nurture debate that surrounds obesity and weight loss — and, in fact, every aspect of what a person is and how he functions.
Take personality, for example. Weiss grew up in Cleveland, a notoriously gray, damp city. His parents were both Holocaust survivors. “My dad was in Auschwitz,” he says. “My mother lived under false papers. Most of my parents’ immediate family perished.” With a childhood shadowed by the heartbreaking enormity of the Holocaust, and lived in one of the least sunny parts of the country, it would not be too much of a stretch to expect Weiss to grow up to be pessimistic or at least a little glum.
But no, environment did not win out. Weiss could hardly be more sunny, even-tempered, and off-handedly optimistic. His memories of his childhood are all positive. He doesn’t have one bad thing to say about Cleveland. He attacks business challenges expecting to win, and doesn’t appear to be the least bit upset when he doesn’t. Nature has clearly won out, and it’s not hard to trace it to its source. Weiss’ father opened a jewelry store after settling in this country. Did he find his new life stressful? “Oh no,” says Weiss. “He loved his work. He enjoyed his customers. He was well-regarded.”
Nature apparently also won out in molding Weiss’ fit physique. Nowhere is the genes-versus-environment debate more emotionally charged than in weight gain. Popular culture tends to regard fat people as victims of their own sloth and lack of self control, while the unfortunates who shop at Lane Bryant often counter that they don’t eat any more than their size two neighbors.
Weiss’ life indicates that at least some of these plus-size shoppers could be at least partly correct. If environment is everything, Weiss’ upbringing should have doomed him to a lifetime of elastic-waisted pants.
“My parents were Hungarian,” he says. “I ate an Eastern European diet growing up. It was one of the worst diets you could imagine. It was high in meat and potatoes and high in fat.” He recalls a before-dinner treat that his mother, now 85, frequently served. She removed the skin from chickens before making chicken soup, and then skimmed the fat from the soup. That fat was then used to fry the chicken skin, which she liberally salted before serving. She also made “wonderful desserts,” recalls her son, citing a six-layer chocolate cake that was only one-inch high.
Neither of Weiss’ parents were physically active, and yet, despite their diet, neither was overweight. His father, did, however, suffer his first heart attack at “age 65 or 70,” Weiss recalls. He survived that attack, but began to suffer from congestive heart failure in his mid-80s. He lived to age 91.
Weiss, fried chicken skin notwithstanding, has never been overweight either, despite the fact that he says he sometimes supplemented his meals at home with three Big Macs when he was a teen-ager. “I was always physically active,” he says. But it would take an awful lot of driveway hoops, his favorite childhood activity, to offset the calories from his diet had his inherited metabolism not been set on high.
Katz, the co-founder of the Yale Prevention Research Center, puts Weiss’ high-fat childhood environment and high-metabolism into perspective. An advisor to Princeton Living Well, he is the author of eight books — both popular and scholarly — on nutrition and weight loss. They include “The Flavor Point Diet,” “The Way to Eat: A Six-Step Path to Lifelong Weight Loss,” “Nutrition in Clinical Practice,” and “Clinical Epidemiology & Evidence-Based Medicine.” Katz has also written a number of interesting articles on issues surrounding weight loss, which are available at no cost at his website, www.davidkatzmd.com.
Read through just a few of Katz’s articles and it’s evident that he has abundant sympathy for all of the folks who cannot — no way, no how — eat chicken-fried chicken skin with a Big Mac chaser without bursting out of their gym shorts. In an article published last April he writes a commentary on a recent report in “Science” about the discovery of a gene for obesity. He does not find the news earth shattering. He had suspected it all along.
“Many times over the years,” he writes, “I have had patients tell me, often on the brink of tears, that they tend to gain weight even though they eat the same amount, and exercise the same amount, as someone who stays thin. They tell this tale as if seeking confirmation, and redemption.
“I have always been able to provide it, because I know that susceptibility to weight gain varies considerably. Our bodies use calories three ways: physical activity, the generation of heat, and basal metabolism. Only the first is under our control, and accounts for just 15 percent or so of total daily energy expenditure. The remaining 85 percent is under genetic control, something we have long known even without identifying the specific genes involved.”
Acknowledging this fact, Katz is still more than willing to sign on with Princeton Living Well, a company based on the belief that a change in environment can reduce weight gain and improve fitness. In his view, environment does matter, and can be manipulated to reduce weight gain.
“There is some value, of course, in studying the genetic underpinnings of our varied vulnerability to weight gain,” he writes in the April 15 article. “But there is danger, too, in the potential for distraction, in thinking that what we find through a microscope will better illuminate the causes of obesity than what we see by looking around a typical shopping mall.
“Our weight regulating genes are, by and large, what they should be; a modern environment of fast food, vending machines, and video games is not. For now, our individual efforts at weight gain require us to confront the challenges of that environment and overcome them. That a majority of our population is overweight reveals how daunting that challenge is, and how urgently we need adjustments to the modern environment that make eating well and being active easier for all of us.”
That is exactly the tack that Princeton Living Well is taking. The start-up is betting, says Sullivan, that the tipping point for resistance to mass societal weight gain is drawing near, just as the tipping point for the tolerance of smoking occurred a decade ago.
There are signs that he just may be right.
Honey Brook Organic Farm in Pennington has just sent around a press release saying that it, and all of the other organic cooperative farms ringing Princeton, are seeing record numbers of new members this spring. These members pay several hundred dollars, and generally go substantially out of their way, to pick up bags full of fresh vegetables every week, to pick their own fruit, and to figure out how to incorporate all of that produce into their meals. Also, Lenox Drive based law firm Stark & Stark has enlisted AmeriHealth’s population health and wellness department to coordinate a health and fitness program for its employees. There have been screenings, stress reduction lectures, massages, and a walking contest — complete with prizes.
Just as the three-martini lunch of the 1950s, enjoyed through a haze of smoke, gave way to the Perrier and salad (dressing on the side, please) mid-day meal of the 1990s, so too may winning website rewards for healthful eating and exercise supplant drive-through burger and fry dinners in the coming decade. Fast food restaurants and donut chains may suffer, and any number of fitness purveyors may prosper. If healthy eating and working out pick up anything like the momentum that propelled a nation to shun its smokers, there is bound to be lots of competition in the community fitness business. Will Princeton Living Well’s model stand out? It’s backers are banking on it.
Meanwhile, Weiss, even-tempered scientist that he is, looks at the new company and its website as an evolving experiment. “I think we’ll learn where people need us to be,” he says. “We’ll focus on those needs. We’re creating an architecture to adapt.”
Princeton Living Well, 145 Witherspoon Street, Princeton 08542. Rick Weiss, Tom Sullivan, co-founders. 609-497-4600. E-mail: firstname.lastname@example.org. Home page: www.princetonlivingwell.com.