Can getting away from the TV and computer help improve your eating habits? That’s what a new study published in the Archives of Internal Medicine suggests.
The study led by Dr. Bonnie Spring, professor of preventive medicine at Northwestern University’s Feinberg School of Medicine, indicates that modifying one bad habit can have a ripple-effect on other bad habits – that is, less time being a couch potato means less time eating potato-chips on that couch.
For their research, Dr. Spring and her colleagues selected 204 adults (156 women and 48 men aged 21 to 60) who reported all of the following unhealthy behaviors: high intake of saturated fat; low intake of fruits or vegetables; low physical activity and more than 90 minutes a day spent engaging in sedentary leisure activities.
She then placed them into one of four treatment groups where they had to:
1) Increase fruit and vegetable intake and increase time in moderate/vigorous physical activity
2) Increase fruit and vegetable intake and reduce time in sedentary leisure activities
3) Decrease fat intake and increase time in moderate/vigorous physical activity
4) Decrease fat intake and decrease time in sedentary leisure activities
The participants were given personal digital assistants, which they used to record and report their behavior over a two-week baseline phase and a three-week treatment period. The data was transmitted to a coach, available via telephone or email on an as-needed basis, and those who met treatment goals were offered a $175 incentive.
After the treatment period, participants were no longer required to maintain the behavioral changes; however, they were offered compensation of $30 to $80 per month to continue transmitting behavioral data 3 days per month for 6 months.
Compared with the other treatments, increasing fruit and vegetable consumption and decreasing sedentary leisure activities elicited the greatest healthy lifestyle change. It also had the unintended result of improving saturated-fat intake, making it the first study to find an association between reduced sedentary time and decreased fat intake.
While there was a decline in improved behaviors after the treatment period, follow-up data showed an overall improvement in target behaviors. Average fruit/vegetable consumption increased from 1.2 servings per day pre-study to 5.5 during treatment and 2.9 afterwards. Average sedentary leisure time saw a decrease from 219.2 minutes before the study, 89.3 minutes during, and 125.7 minutes during follow-up.
The follow-up results were a surprise to Dr. Spring, who expected a return to bad habits as soon as they saw an end to the financial incentives.
Instead, “we found people can make very large changes in a very short amount of time and maintain them pretty darn well,” she said. “It’s a lot more feasible than we thought.”
The Bottom Line
It’s encouraging to hear that making a simple change in two unhealthy habits can have a positive effect on other unhealthy habits.
Indeed, 86% of the study participants reported that the seemingly easiest adjustment to make – eating more fruits and vegetables – gave them the feeling that they would be capable of any of the changes outlined in the four treatment programs.
Interestingly, the third treatment option – decreasing fat intake and increasing physical activity – was the least effective in maximizing health behavior changes. This is important because this approach is most commonly used in traditional dieting.
The takeaway here might be that the carrot is more effective than the stick. People may feel that increasing fruit and vegetable intake and reducing sedentary time is easier (the carrot) than decreasing fat intake and increasing exercise (the stick).
We also shouldn’t neglect the fact that the new behaviors had to be tracked and transmitted remotely to a coach – adding an additional level of support and accountability, which has been proven effective for weight loss.
With most Americans exhibiting multiple unhealthy behaviors, figuring out how adopting one or two healthy behaviors can have a halo effect is a winning strategy.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.