Houston is a hot, humid city that is known for being the 4th largest city in the nation with an economy that relies on oil and gas. It also has the distinction of being one of the fattest cities in the United States based on research of how many restaurants and food establishments are available per square mile compared to recreational parks and other forms of physical activity.

As a registered dietitian in one of the fattest cities in America, I find that sometimes it is difficult to convince people to comply with my recommendations. For example, my suggestion that patients increase physical activity to 20 minutes a day is typically met with resistance. The chief complaint is that it's too hot (which is true) or that it is difficult to take a walk because there is a dearth of parks or they are too crowded. As a result, I am creative with suggestions. I tend to take a walk early in the morning or late in the evening, when the sun is setting, and the weather is a little cooler and more bearable. I always try to go with friends or family to make working out more fun. As few parks as we have, they are loaded with amenities: jogging, biking or hiking trails, tennis courts, baseball or soccer fields, and pools. Although we may have fewer parks per square mile, the parks are always crowded, so Houstonians do work out!

We also live in a city with limited public transportation so we tend to drive everywhere. Walking two blocks to the grocery store is practically considered a crime and parking close is a necessity for those seeking refuge in air conditioning. I tell patients to park further away under a shady tree and reason that the car will not be as hot when returning. Although this has no bearing on our ranking of fattest city, we tend to walk less than other cities that rely on public transportation.

The big issue is that Houston is known for good food and restaurants. Nearly every block has a restaurant, grocery store or coffee shop. Even as a dietitian, I understand why we have such a difficult time avoiding high fat foods in this city. We have too much temptation. Jogging from my home in the morning, the smell of fresh donuts tempts me but I don't give in. Part of the reason is that I don't carry any money with me as I jog past the donut shop. This is just one of many tips I give to my patients to avoid the temptation. As usual, a lot of us don't go grocery shopping on an empty stomach in an effort to only purchase items as we need them. An occasional temptation is okay and with so many cultural options to choose from, we never get bored of food here. Also, most restaurants offer healthy food options that allow us to minimize the amount of high fat and caloric foods eaten.

Overall, as Houstonians, we take pride that our city has so many cultural aspects, including food. Although we don't have many parks throughout the city, we know how to share the ones we do have. Plenty of us run the marathon yearly, so much so that this year, the Houston Marathon is on a lottery system basis. Houstonians have recognized the importance of getting back in shape, and visible changes are on the horizon for many.