"Obesity is a critical public health problem in our country that causes millions of Americans to suffer unnecessary health problems and to die prematurely," said Tommy Thompson, Secretary of the U.S. Dept. of Health and Human Services (HHS).

"With this new policy, Medicare will be able to review scientific evidence in order to determine which interventions improve health outcomes for seniors and disabled Americans who are obese."

While exactly which treatments for obesity Medicare will agree to cover has not been finalized yet, analysts expect lifestyle-change approaches such as diet and exercise programs to be included, along with more radical interventions such as gastric bypass surgery.

Vitamins, minerals and other nutritional supplements are the keys to a healthier lifestyle for a growing number of consumers, and this is another area where there are plenty of attractive new business opportunities available to aspiring entrepreneurs interested in profiting from that trend.

REGULAR USERS

"We have evidence that people are taking up to 16 supplements a day, although on average most people were taking two to three supplements," said Jessie Satia-Abouta, lead author of the study and an assistant professor of nutrition at the University of North Carolina at Chapel Hill.

The researchers found that 75% of participants in the study regularly took a vitamin or mineral supplement. More than half were taking a multivitamin, and the most popular single supplements were vitamins E and C, calcium, folate and selenium.

Those most likely to use supplements tended to be older, female, highly educated, Caucasian and with a normal body mass index, the study concluded. "Education correlates with income, and supplements are not necessarily cheap," said Satia-Abouta. "These people probably have more money, and they know more about trends."

A survey conducted by Roper Starch Worldwide on behalf of the Consumer Healthcare Products Association (CHPA) found that Americans rely on nutritional supplements to maintain good health. The survey showed that the majority of consumers-57%-were either actively taking dietary supplements or researching information about them.

One area where analysts see strong opportunities emerging is weight management.

Increased usage of and interest in dietary supplements is just one manifestation of a broader trend that sees many consumers relying more on themselves than on conventional health care providers when they feel under the weather, according to the CHPA.

Reflecting an emerging trend toward self-reliance, a growing number of people say they are increasingly comfortable managing their own health care needs. According to the findings of the Roper Starch survey, 59% of Americans say they are more likely to treat their own health conditions now than they were a year ago.

In addition, 73% would rather treat themselves at home than see a doctor, and 62% say they would like to do more of this in the future. An overwhelming majority of those polled-96%-say they are generally confident about the health care decisions they make for themselves.

"Self-reliance is a dominant theme of American lifestyles this millennium, especially in health care," said Michael Maves, M.D., president of the CHPA. "While there is no substitute for a physician, Americans are taking control of minor medical problems with safe, reliable over-the-counter medications and dietary supplements."

Nutritional supplements are a $20 billion-a-year business, with growth projected to continue at an annual rate of about 4.2% for at least the next five years, according to research conducted by Nutrition Business Journal. The fastest growth is expected to take place in the specialty supplements and sports nutrition segments, 9.5% a year and 6.1% a year, respectively.

THE FITNESS FACTOR

Dietary supplements are the key to a healthier lifestyle for many men and women.

"There are not enough clubs to serve the growing market of aging baby boomers," said a recent research report from Deutsche Bank. "Building more clubs will be a necessity to meet the growing demand."

According to the IHRSA's "Guide to the Health Club Industry for Lenders & Investors," there is good reason to believe the industry will be buoyant through at least 2012.

"In the past 10 years, health club membership in the U.S. has grown by an average compound annual growth rate of 4.6%," the IHRSA guide states. "If health club membership continues to grow over the next 10 years at its current compound annual growth rate of 4.6%, then U.S. health club membership will reach 51.4 million, up from 32.8 million."

This robust environment is also reflected in the outlook for employment in the fitness industry, according to the U.S. Bureau of Labor Statistics (BLS).

"Overall employment of recreation and fitness workers is expected to grow faster than the average for all occupations through 2012, as an increasing number of people spend more time and money on recreation, fitness and leisure services and as more businesses recognize the benefits of recreation and fitness programs and other services such as wellness programs," states a BLS report.

Self-reliance is a dominant theme of American health care in the 21st century.

"These are dangerous trends," the report states," and we need to turn them around quickly, for the health of our citizens and our country." Poor health behaviors are the second leading cause of death, behind smoking, among U.S. citizens, the report found.

While the fitness industry may appear to be focused on youth, in reality it is driven by older consumers-primarily aging baby boomers who want to look and feel younger than they are.

"Over the past 15 years, the defining characteristic of industry change has been the growth in the population of older health club members," said a spokesman for IHRSA. "In 2003 there were 6.8 million members over the age of 55, representing an absolute increase of 343% over 1987."

With baby boomers hitting upper age brackets in growing numbers, that trend will only intensify. As has been the case with virtually all aspects of life touched by the baby boomers, they are bringing their own unique spin to the fitness industry.

SOMETHING DIFFERENT

"There is every indication that women's interest in health and fitness is beginning to transcend all generational barriers, and that women's participation in health clubs will become, if anything, even more pronounced in the future than it is today," said the IHRSA spokesman.

"Wellness" is the term sometimes used to describe the healthy lifestyle being embraced by a growing number of consumers. Optimal wellness revolves around a healthy balance of four fundamentals: physical activity, proper nutrition, managing stress and good preventive health care.

According to "Tracking the Fitness Movement," a report prepared by American Sports Data, Inc., people who keep fit have a firm commitment to living life to the fullest. A major trend identified in that study is growth in mind/body/spirit forms of physical activity.

"Gentler forms of exercise, such as yoga, water exercise, tai chi and Pilates, have been growing in popularity," the report states. Some of the most explosive growth can be found among practitioners of Pilates. Participation in the body conditioning system, developed by Joseph and Clara Pilates in the early 20th century, is estimated to have increased by more than 250% since 2000.

The fitness industry is an area of wellness rife with new business opportunities.

ACE's No. 2 trend for 2005 was the growing tendency to blend popular mind/body programs such as yoga and Pilates with more traditional forms of exercise. Other major trends for 2005 identified by ACE included shorter duration workouts and increased demand for nutritional counseling and wellness coaching.