How to Create a Lasting Behavior Change

by Brooklin White MS Candidate, Dietetic Intern Lifestyle

“The only constant in life is change” - Heraclitus

Understanding Behavior Change

Behavior change is one of the most challenging things a person can do. As we age, we become comfortable in our lifestyle patterns and are often hesitant to make changes that disrupt that pattern. We hate to feel uncomfortable and therefore retreat back to bad habits. As unattainable as behavior change may seem, it is always possible when approached in the right manner.

One of the most widely applied behavior change models is the transtheoretical model (TTM) which is composed of 5 stages: precontemplation, contemplation, preparation, action and maintenance (1). The stages of change build upon one another and are designed for individuals to progress through one step at a time. Individuals are often able to get through to the action phase, but are not able to maintain their lifestyle behaviors due to restrictions, unrealistic goals and short timelines. Our registered dietitian nutritionists at the Amos Institute are dedicated to helping our clients create lasting lifestyle changes that are not only achievable but also enjoyable. Consider applying some of the following ideas for lasting behavior change:

Start small and create realistic goals:

Unrealistic goals rarely equate to long term success. It is crucial to establish an end goal with a registered dietitian and then create small steps that help you attain this larger goal. For example, if your end goal is to have better cognition after 6 months while following the Bredesen Protocol, one of our dietitians will help you navigate through your lifestyle patterns to determine which changes need to be made and what small steps are required to obtain those larger goals. Long term success with small goals translates into reaching your end goal.

Set your priorities and schedule them in:

Before you begin your lifestyle change, make sure to write down why this lifestyle change is important to you. Is it because you want to feel strong and cognitively healthy as you progress into older ages? Or because you want to climb Mount Kilimanjaro at age 65? Either way, writing down your ‘why’ and keeping it posted in a place you will see every day (bathroom mirror/bedside table etc.) will help you set your priorities each day. After you’ve determined your end goal and have set your priorities, schedule in when you will incorporate these changes. For example, if you have a goal to exercise 5 times per week, write it in your schedule for the days and times that work best for you. Having it written into your calendar will help you hold yourself accountable.

Drop the “going on a diet” mentality:

The diet mentality is extremely restrictive and has been shown to be unsuccessful when it comes to lasting lifestyle changes (2). Although people are continuing to seek ‘dieting’ as the ultimate weight loss solution, the prevalence of obesity in America has hit an all-time high of 42% (3). Learning how to adopt healthier food habits slowly without inducing food restrictions will allow you to make lasting behavior changes. After all, if your goal is life long optimal cognition, your brain healthy nutrition plan is something you will follow for life.

Incorporate friends and family on your health journey:

Having a supportive network is critical for maintaining behavior change. If you are working toward a more healthful lifestyle with a friend or family member, the odds are you will be able to maintain that lifestyle going forward. This is why the Office Hours offered by the Amos Institute is such an important part of cognitive recovery. The sense of community experienced from Office Hours allows individuals the reassurance that we are not alone on this journey to cognitive health. By asking questions, sharing stories, and hearing the success and challenges of others, we are better able to support lasting behavior changes.

Learn to recognize satiety cues and avoid emotional eating:

There is a difference between hunger and appetite. Hunger is a physiological signal from the body such as a grumbling stomach or low energy. This indicates the body needs food. Appetite on the other hand is psychological, are you feeling stressed, sad or bored and thus craving certain foods? This is an important time to recognize if your body actually needs food. Here are a few things you can replace food with when likely not hungry:

  • Make a cup of coffee or tea: Reaching for a sip of tea or coffee instead of a snack helps keep our hands busy and fills the void of emotional eating.
  • Drink a glass of water: Often when we think we are hungry we are actually thirsty. Keep a reusable water bottle with you at all times and try drinking water before opting for a snack. Recent data suggests there is a significant association between inadequate hydration and obesity (4). A meta-analysis of 33 studies also found that dehydration corresponding to more than a 2% reduction in body mass was associated with significant impairments on attention, executive function and motor coordination (5).
  • Try a short 10- minute meditation: Clearing the mind can help us reset our emotions and allow us to make better decisions regarding food. There are a variety of apps that provide guided meditations (Headspace, Calm etc.). Before giving into a craving that would deviate from your nutrition plan, try a mini-meditation to help you stay on track.
  • Exercise: Exercise is not only beneficial for increasing blood flow, increasing brain vascularization and curbing your appetite. Evidence is suggesting that it also increases left dorsolateral prefrontal cortex activity, which plays an active role in regulating dietary self-regulatory abilities and is thus associated with healthier decision making (6).

Don’t restrict your favorite foods:

The goal is to make this behavior change as enjoyable as possible, which means don’t take out your favorite foods – just modify them to make them compliant with your nutrition plan. Speak with your dietitian about appropriate swaps you can make in order to recreate your favorite dishes into those that will support your cognitive health. If and when you do choose to indulge, do so mindfully and in moderation.

Plan ahead of time:

Everyone falls into a rut or lacks motivation to cook for themselves. It’s important to have a game plan before these emotions kick in. A great option is to keep healthy snacks and meal options on hand that are quick to make. You can also prepare healthy meals before a busy week that keep well and are easy to reheat. Keeping a few of these options on hand is a great way to opt for a quick healthy meal, instead of resigning to order take-out.

Conclusion

It’s important to remember that behavior change takes time and that setbacks are inevitable. However, if we have a game plan before those setbacks happen, it makes it that much easier to get back on track. Diet changes are difficult to incorporate at first, but once new habits have been established, our clients find that they feel, think and look healthier which prevents them from regressing back to old habits. Our dietitians at the Amos Institute are dedicated to understanding your specific needs and helping you establish healthy habits without restricting you from your favorite foods. If you approach your behavior change one step at a time with a detailed game plan and support from your closest network, you will have the most success at creating new habits and living happier and healthier lives.

It takes time to change but it can be done, and you can absolutely do it!


References:

(1)Holli, B., & Beto, J. (2018).Nutrition Counseling and Education Skills: A Guide for Professionals(7th ed.). LWW.

(2)Stroebe, W., van Koningsbruggen, G. M., Papies, E. K., & Aarts, H. (20121210). Why most dieters fail but some succeed: A goal conflict model of eating behavior.Psychological Review,120(1), 110.https://doi.org/10.1037/a0030849

(3)The World Health Organization. (2020, February 27).Obesity is a common, serious, and costly disease. Centers for Disease Control and Prevention.https://www.cdc.gov/obesity/data/adult.html

(4)Chang, T., Ravi, N., Plegue, M. A., Sonneville, K. R., & Davis, M. M. (2016). Inadequate Hydration, BMI, and Obesity Among US Adults: NHANES 2009–2012.The Annals of Family Medicine,14(4), 320–324.https://doi.org/10.1370/afm.1951

(5)Wittbrodt, M. T., & Millard-Stafford, M. (2018). Dehydration Impairs Cognitive Performance: A Meta-analysis.Medicine and Science in Sports and Exercise,50(11), 2360–2368.https://doi.org/10.1249/MSS.0000000000001682

(6)Hare, T. A., Camerer, C. F., & Rangel, A. (2009). Self-Control in Decision-Making Involves Modulation of the vmPFC Valuation System.Science,324(5927), 646–648.https://doi.org/10.1126/science.1168450