A Winnable BattleLittle Steps = Big Successes

Selling health to the publicHochbaum, 1976

“[…] the most challenging, most difficult problem is not how to sell

the public on health-supportive practices […]. It is to persuade and

help them to stick with new practices, to keep these up

conscientiously and consistently for the rest of their lives.”

Healthy lifestyle: One small change at a time

a “lifestyle change” can be dauntingstart where you are! make clear and (somewhat) realistic

picture of where you are nowmake changes that love you backassess, reassess and re-reassess

Small changes

Food Intake

Eating more for less

Energy DensityFeeling full = VOLUME of food Enaergy Density is the number of

calories per volume of foodFood high in water content (and low in

fat) make you feel more full and curbs overeating. Fill your plate with veggies; there is

less room for everything else (magic!)Examples?

Energy Density and Volume

700 g320 g

475 kcal11% protein58%

carbohydrate31% fat

0 1 2 3 4 5 6 7 8

LettuceVegetable soup

Skim milkApple

Black beansWhite fish

YogurtVeg. lasagna

Roast chickenWhite bread

PretzelsCheddar cheese

BaconButter

Salad dressingPotato chips

Energy Density (kcal/g)

SWEETENED BEVERAGES!

Stop drinking your calories…

Starbucks Mocha Frappuccino (Grande) 400 calories 102 minutes of

bicycling 51 minutes of

basketball

Starbucks Mocha Frappuccino, Light (Grande)

130 calories 33 minutes of

bicycling 17 minutes of

basketball

Small changes

Energy expenditure

Moving more without knowing it

lifestyle physical activities

It’s difficult to add exercise to busy schedules.

Find ways to integrate more physical activity into your existing routine.

Mowing the lawn, vacuuming, cleaning the windows, walking to work or to the store

lifestyle Activities

doesn’t have to be continuous Psssst… 10 min + 10 min + 10 min =

30!easy to build into lifestyleno equipment neededno gym membershipno special clothes

lifestyle activities

A dog owner: Walk the dog for 15 minutes in the

morning. Walk to work, church, etc(15 min) Walk the dog for 30 minutes after

dinner.

lifestyle activities

8:00 - 15 minute brisk walk.

10:00 - Take the stairs instead of elevators.

12:00 - Take a 30 minute brisk walk during lunch.

3:00 - Walk to meet your friends instead of calling or emailing them.

Small changes

Determinants of health

Health Determinants

The type of WORK we do jobs, careers, caregiving

Where we LIVE our homes, neighborhoods, and

commuteOur RELATIONSHIPS

family, friends, colleagues

Type of Work we do….

Lifestyle…

Food environment…

Neighborhood…

Small changes

Make it happen

How???

Assess, assess, reassess people who record their eating and

activities lose 25-50% more weight. self-monitoring: most important tool to

change behavior increases awareness gives feedback on change (or non-

change…) helps planning for the rest of the day

8:00 banana (medium)

2 whole wheat toasts

coffee (black)

10:30 Apple

12:00 2 c lettuce w/ grilled chicken

diet coke +

low fat yogurt

4:00 pretzels + grape (alone)

7:00 w/ family

ham (slices)

peas (1/2 cup)

2 c lettuce + dressing (2 ts)

9:00 peanut butter toasts (2

toasts + 2 tbs pb)

Assess, assess, reassess

Measure the amount of oil you use to cook.

Record the number of walks you take. Count the portions of vegetables you

are eating in a week (this week!)How many foods that have >20g of fat

are you eating this week?

Small changes: be concrete

Decrease the time you spent sitting by 30 minutes.

Walk an additional 1000 steps tomorrow.Try one new vegetable this week.Replace frozen cappuccinos with ice tea

once this week.Try one new exercise class this week.

Small changes: changes that love you back shape your environment to increase your

control over the choices you make If you don’t want to eat chips, don’t get

chips! fattening food that you eat but don’t really

like? vegetable that you like but don’t REALLY

eat? activity you enjoy doing and can easily

incorporate in your schedule?

Small changes: start at home

use measuring cupsuse smaller plates, bowls, cups and

glassesuse portion-controlled foodsincrease the variety of healthier

foodsif your not a chef… stop being a chef

for everybody!

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Small Changes: big Benefits

improving one health behavior has multiple benefits changes that are decreasing your risk

of diabetes will also improve stress and coping

Small gains in many of the areas = exponential effects