Medical Compass: Keeping New Year’s health resolutions
By David Dunaief
Happy 2024! If you’ve watched any media in the past week, you’ve probably been inundated by ads for weight loss plans, apps and other tools intended to help us achieve our New Year’s resolutions. Many of these are oriented around helping us increase the “stickiness factor” of our new habits.
Setting a goal that is simple and singular helps. We often overdo it by focusing on an array of resolutions, like eating better, exercising, developing better sleep habits, and managing stress better. While these are all admirable, their complexity diminishes your chances of success. Instead, pick one to focus on, and make the desired impact part of your goal, for example: improve health by losing weight and reversing disease.
Changing habits is always hard. There are some things that you can do to make it easier, though.
Your environment is very important. According to David Katz, M.D., Director, Yale-Griffin Prevention Research Center, it is not as much about willpower as it is about your environment. Willpower, Dr. Katz notes, is analogous to holding your breath underwater; it is only effective for a short time. Instead, he suggests laying the groundwork by altering your environment to make it conducive to attaining your goals. Recognizing your obstacles and making plans to avoid or overcome them reduces stress and strain on your willpower.
According to a study, people with the most self-control utilize the least amount of willpower, because they take a proactive role in minimizing temptation (1). If your intention is to eat better, start by changing the environment in your kitchen to one that prompts healthy food choices.
Support is another critical element. It can come from within, but it is best when reinforced by family members, friends and coworkers. In my practice, I find that patients who are most successful with lifestyle changes are those whose household members are encouraging or, even better, when they participate in at least some portion of the intervention, such as eating the same meals.
How long does it take to form a new habit?
When does a change become a new habit, or automaticity? The rule of thumb used to be it takes approximately three weeks of daily practice. However, the results of a study at the University of London showed that the time to form a habit, such as exercising, ranged from 18 days to 254 days (2). The good news is that, though there was a wide variance, the average time to reach this automaticity was 66 days, or about two months.
How do you choose a diet that will help you achieve your goals?
US News and World Report ranks diets annually and sorts them by objective, such as weight loss, healthy eating, diabetes diets, heart-healthy diets, etc. (3). Three of the diets highlighted include the Mediterranean diet, the DASH (Dietary Approach to Stop Hypertension) diet, and the Flexitarian diet, ranked one through three, respectively. These were also the top three for healthy eating, for diabetes, and for heart health, although their rankings among the top three shift in some cases.
What do all the top diets have in common? They focus on nutrient-dense foods. In fact, the lifestyle modifications I recommend are based on a combination of the top diets and the evidence-based medicine that supports them.
For instance, in a randomized cross-over trial, which means patients, after a prescribed time, can switch to the more effective group, showed that the DASH diet is not just for patients with high blood pressure. The DASH diet was more efficacious than the control diet in terms of diabetes, decreasing hemoglobin A1C 1.7 percent and 0.2 percent, respectively; weight loss, with patients losing 5 kg/11 lbs. vs. 2 kg/4.4 lbs. It also achieved better results with HDL (“good”) cholesterol, LDL (“bad”) cholesterol and blood pressure (4).
Interestingly, patients still lost weight, although caloric intake and the percentages of fats, protein and carbohydrates were the same between the DASH and control diets. However, the DASH diet used different sources of macronutrients. The DASH diet also contained food with higher amounts of fiber, calcium and potassium and lower sodium than the control diet.
Therefore, diets high in nutrient-dense foods may be an effective way to lose weight while also treating and preventing disease.
I will share one more tip: take it day by day, rather than obsessing over the larger picture. I have found many patients make better headway by choosing to change one meal at a time — like starting with what they choose to eat for breakfast or for snacks each day. Once this is a habit, they shift their focus to another meal.
Best to you for optimal health in 2024!
References:
(1) J Pers Soc Psychol. 2012;102: 22-31. (2) European Journal of Social Psychology, 40: 998–1009. (3) www.usnews.com/best-diet. (4) Diabetes Care. 2011;34: 55-57.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.
