We all want to be healthier in 2017 and beyond. BeWell spoke with Marily Oppezzo, PhD, MS, RD, a registered dietician and post-doctoral fellow at Stanford Prevention Research Center, about how personal food and exercise decisions, technology habits, and other lifestyle choices can make a positive impact on your health this year.

Why don’t we always act in our own best interests?

Many reasons: One is we that we like instant gratification — and things that lead to health are not as instantly gratifying as Moose Tracks ice cream topped with Cinnamon Toast Crunch, or whatever your go-to vice is.

Within an instant, I can communicate with a friend, watch any of thousands of TV shows, or taste something that immediately makes my brain go, “Yes!!” However, the benefits of getting out of breath on a run, choosing some broccoli, getting 30 more minutes of sleep instead of reading about someone you sort of know’s perfect vacation on Facebook are a softer sell.

If only Jeremy Bailenson could come up with a VR-behavior tracker so that when you do healthy or unhealthy behaviors, some virtual hologram of your arteries or you five years from now pops up. Pending that invention, constructing our own environment to set us up for success will  help make these immediate gratification moves just a bit harder to do. (Brian Wansink’s work, referenced in his book, Slim by Design, is great for this!)

Habits are another reason we don’t always act in our own best interests. You automate certain behaviors so that you don’t have to think about them, and they can happen much faster (and speak much louder) than our intentions. The cool thing is, we can use this to our advantage: By making healthy habits, we can theoretically have them be the default drivers, rather than screaming uselessly from the back seat.

What are some bad foods we should always avoid? Or is it “bad” to call some foods bad?

The morality we mix up with health decisions gets into our heads in a weird way. Desserts are “sinful” and salads are “good.” While some decisions are arguably healthier than others, we certainly don’t need to get our character and sense of self involved, a mind game that sets health up as binary, rather than as a spectrum — which can go two dangerous ways. One is all-or-nothing thinking: I had a cookie (which I’ve told myself is bad), so I’m already off the wagon — so I’ll just dive head first into that bin of Soft Batch.

Having this all-or-nothing mindset also limits our consideration of alternatives: If I don’t have time to make it to the gym, it doesn’t “count” in my head, so forget the chance to do a four-minute set of burpees before I get in the shower to feel energized.

And boy, does calling a cookie “bad” suck the fun right out of it. If I told myself I was bad for eating Ben and Jerry’s, I might eat a whole carton very quickly in a dark closet after a depressing day to make myself feel better (and two cartons if it says the words “sugar free”). But if I instead thought, “Boy, this is my favorite ice cream, and I am going to enjoy it!” — and mindfully eat it, relishing the taste rather than pouring guilt all over it, I’ll be happier, more satisfied, and eat less of it. Michaela Kiernan has an amazing weight loss study that actually teaches dessert enjoyment as a skill — an ingredient in the ultimate success at sustaining weight loss.

Classifying health as steeped in good and evil also sets up a health halo trap. Some things are so interchangeable with virtue that they have a halo effect on the rest of the behavior or product. Jodi Prochaska, Lisa Henriksen, and Anna Epperson are looking into this now with cigarette labels that imply health, or products labeled as “organic” or “made with recycled material.” My bet is if you put “gluten free” on there, or interchange the cigarette wrapping with a kale leaf, people would be standing in Black Friday lines to get it.

So you’re saying try to avoid “No”s?

Exactly. Our brain doesn’t have a “No” feature. If I tell myself, “Facebook surfing,” everything related to Facebook surfing gets excited. If I say “NO Facebook surfing,” everything related to Facebook surfing still gets excited. The “No” may even show up later, when after I feel virtuous for biking to work and I say, “Oh boy, I deserve to Facebook surf” because it’s this forbidden fruit. In general, framing behavioral goals in terms of what I want to do sets me up for more success than labeling what I don’t want to do. There are 24 hours to fail with “don’t” — and a moment of yay with “do.”

As we spend more and more of our time on our devices, should we look to social media to help us live a healthier lifestyle?

This is tricky. I think social media can be a great way for people to set up or participate in like-minded groups, offer social support for healthy goals, and give each other tips and motivation to keep on pursuing those goals.

• Jodi Prochaska improved smoking cessation from 20% to 40% with her Tweet2Quit study, a private social media support group where she prompted the members to share tips and support with each other around quit goals. That is a huge effect!

• Abby King’s work emphasizes the important point of building behavior change theory into technology and social media-based interventions to capitalize on their potential and strengths in an evidence-based way.

On the other hand, social media gone wild can be an echo chamber for hearing what I want to hear, and it could be steeped in faulty premises… or it could look like me walking around in a hunched head-down position, spending many thoughts and moments trying to come up with the perfect one-liner caption for a photo on Instagram or taking the umpteenth selfie of myself or my lunch.

See, this is why health isn’t selling — it’s boring! “Everything in moderation” turns out to be so true! But “lose 98 pounds in 5 minutes” or “Kale colon blow detox” sounds so much sexier.

Is walking underrated as a form of exercise?

Yes! It totally is!

• Walking is protective for your joints, a super-sustainable form of exercise, and has a lot of collateral benefits outside of just getting in your physical activity.
• Cognitively, walking can help you be more creative.
• Socially, you may find yourself liking your walking partner more (stay tuned for that research unveiling).
• Emotionally, you can strategically use it as a cheap stress management tool. The benefits of walking in a green environment also have special effects on emotional well-being. (But the good news is, if you don’t have quick access to nature, you can still get the creativity boost even if you’re on a treadmill in a windowless room!)

Should physical activity and nutrition advice take a person’s culture into consideration?

Absolutely. Jodi Prochaska is heading up an awesome multi-risk behavior heart health intervention study in Alaska. She didn’t go in and hand over “eat 7-11 servings of produce” guidelines to people who live where a melon can cost $13 because it had to be flown in, large food stores may be absent, and the weather is harsh most of the year. Instead, with the help of a team native to Alaska, we researched the native diet, which is full of healthy fats from whale, moose, and fatty fish, for the nutrition materials.

• In addition to culture, we need to consider personal circumstance.

When I was doing dietetic consults at the VA hospital, much of my nutrition advice had to be constrained by food kitchens or for people without a stove. I once had a client with only one leg, and my fitness suggestions for him were not “150 minutes a week,” but rather ways to strengthen his body to recalibrate his pelvic stability to promote balance and prevent injury when walking with his prosthetic.

• Maybe the most important consideration that we tend to forget is age.

As Marcia Stefanick has so astutely pointed out, most exercise guidelines are geared for young to middle-aged adults, and most health information is focused on weight loss — which doesn’t take the needs of older adults into consideration. Exercise guidelines recommend “vigorous” exercise, but vigorous for an 80-year old may be moderate for a 30-year-old. Weight as a marker, in general, is quite deceptive — and is especially so in older adults, where weight loss can be associated with muscle loss, which is not a good goal for older adults, and muscle loss may be masked by fat gain (also an unfavorable situation). We often overlook and forget the growing elderly population; instead, we should be focusing our attention on health interventions and health behavior guideline deployments that are tailored just for this population segment. In fact, it is important to weigh the factors of culture, individual circumstance, and motivational readiness when advising any (very young to very old) age segment of the population.

If you could only recommend one small dietary change the Stanford population, what would it be and why?

Hmmm. Tough! Christopher Gardner would probably have the best advice. How about: Find one vegetable you love that is quick and easy for you to prepare and eat — and even defrosting frozen spinach to add to a soup or mixing in pre-packaged riced cauliflower with your Forbes café dish counts! Bring your veggie to work, and add to three lunches next week.

Or, just because it’s nice to have options: Pick something you REALLY love. Decide to uni-task eating it. Take your time, and do nothing else but enjoy how it tastes. Put on a mental guilt-Hazmat suit first, so that no guilt gets in.

… any final thoughts?

One part of health that isn’t always addressed as a goal is altruism: Helping others is bi-directionally nourishing and healthy. Oftentimes, so much energy is focused on setting our own personal fitness, eating, sleep goals. Redirecting a portion of that fervor and dedication toward helping someone else would be a great goal.

January 2017