Factors That Influence Dietary Behavior

Christine Zoumas, MS, RDDirector, Healthy Eating Program

Dept. of Family and Preventive MedicineCancer Prevention and Control Program

healthyeating@ucsd.edu858-822-2237

Top Preventable Causes of Cancer

To eat is a necessity, but to eat intelligently is an

art.La Rochefoucauld, Maxims, 1665

What Influences Food Choices?

Habit Availability Satiety Convenience Economy Trends Social Interaction Social pressure

Advertising Emotional Comfort Values or beliefs (Vegetarian) Region of the country Personal Preference Ethnic Heritage or Tradition Nutritional value

Motivation

Assessment of your motivation is important in the decision to initiate a dietary and physical activity change

How ready do you feel to change your eating patterns and/or lifestyle behaviors?

What kinds of things have you done in the past to change your eating?

What strategies have worked for you in the past?

On a scale from 1-10, how ready are you to make changes in your eating patterns?

www.YaleRuddCenter.org

Setting Goals

A good goal helps you to make a change

Specific

Measurable

Attainable

Realistic

Timely

Setting Goals

Weight goals: BMI and weight goals. • short term • long term goals

Calorie Goals: Calories/day

Nutrient Goals: Grams/day or % of total kcal

Exercise Goals: Minutes/day or Minutes/week

Setting Goals with Body Mass Index

<25 25 to <30 30 to <40 >40

Eat SmarterAnd

Move More

Dietary Change Should…

Meets nutritional needs Slow & steady weight loss Adapted to individuals’ habits and tastes Contains enough kcal to minimize hunger and fatigue Contains common foods Fit into any social situation Improves overall health Includes exercise Includes behavior change

Behavior Strategies

In the current scientific literature, 16 weeks is the minimum for a weight loss, behavior/diet intervention.

The longer the intervention, the more successful the behaviors.

The Dieting and Overeating Cycle

Pressure from Society

Behavior Strategies

• Time Management • Self-Monitoring

• Goal-setting • Benefits and costs

• Social Support • Alternative Behaviors

• Positive self-talk • Environmental control

• Stress Management • Thought-stopping

• Planning • Stimulus control

• Enjoyment • Convenience

• Alternative behaviors • Self-nurturing behaviors

Self-Monitoring

• Self-monitoring helps the individual examine his/her eating, activity and behavior patterns.

• It is a way the patients can truly get to know themselves and monitor their progress.

Alternative Behaviors

• A lot of overeating is linked to the desire to take care of ourselves

• Food is a way of self-nuturing and relieving boredom

• It is helpful to have a list handy of alternatives to overeating and emotional eating

Time Management

Look at Commitments• Fixed Commitments – you cannot control• Mixed Commitments – they probably need to get done,

but you have some control

Look at Time Wasters• Self-generated time-wasters (lack of organization,

procrastination, inability to say no). These are the easiest to control

• External time-wasters (telephone calls, waiting in line). These are more difficult to control.

Schedule time for exercise and healthy eating

Social Support

• People influence our lives, for better or for worse.

• Research shows that people can have a strong influence on health behaviors such as physical activity and eating.

• Studies indicate that social support is one of the most important influences on physical activity, particularly for women.

Examples of Social Support

• Family and Friends

• Co-workers

• Support groups or group activities

• Social Media

• Facebook• MyFitnessPal.com• Loseit.com• Sparkpeople.com• Habitforge.com

Self-talk

• Self-talk is the the conversation we have with ourselves— in our heads.

• Self-talk is very powerful—it affects feelings and actions.

• Positive self-talk is hopeful—it gives confidence and power.

• Positive self-statements can move you toward your exercise and eating goals.

Self-talk

Negative Self-Talk• I’ve only done 15 minutes.

• I’ve just started and I’m tired.

• I don’t have time for this.

• I don’t feel like doing this now

Positive Self-Talk• I’m halfway done.

• I’m getting warmed up.

• I’m proud that I’m squeezing this activity time into my busy day.

• I’ll do this for a short time today and feel good about it.

Self Talk

• He blamed his genes.

• He blamed his parents’ eating habits.

• He blamed the stress he was under.

• He blamed the fast food companies.

• Nothing was his fault or his responsibility

Self Talk

• Maybe my genes aren’t ideal.

• Maybe my parents had bad eating habits.

• Maybe temptations are everywhere.

• But I can, over time, learn a health regime that works for me.

Managing Stress

• Alter the situation, by getting rid of or changing the stressor whenever possible.

 • Avoid the situation: If you know something is going to be

stressful for you, avoid it if you can.  • Adapt to the stressors, by changing the way you think of

them. Challenge your thoughts.

• Be physically active.

Stimulus and Environmental Control

Controlling the environment and food availability so there is more control with food choices and consumption of fewer calories

• Eating at one place in the house

• Limiting “difficult to control” foods in the house

• Choosing restaurants that have lower calorie options

• Eating “unit-based” foods

Benefits vs. Costs

• People tend to DO the things that will pay off in some important way.

• Assessing the pros and cons of a specific behavior can help to make rational decisions when choices or barriers are encountered.

• A benefit is something you hope to gain, while a cost is what you have to give up.

• The goal is to improve the decisional balance (increase the pros and decrease the cons)

Ride or Surf the Urge

• Wait it out!

• Put of eating for 10 to 20 minutes

• Try one or more of these tips:

• Just say “NO!” I know that I am not really hungry

• Replace your thoughts of food with other pleasant images

• Distract yourself with another activity

Working with Lapses

• Lapses provide an opportunity to learn. • The first step in problem-solving is to identify

the problem as soon as possible after it has occurred.

• Next, all the ways of dealing with the problem should be considered, with many potential solutions generated.

Working with Plateaus

Plateaus may be due to biological and/or behavioral • Evaluate and continue healthy behaviors• Monitor food intake• Increase intensity of exercise

Weight Maintenance

• It is estimated that only 20% of people who lose weight actually maintain their weight loss at one year or longer.

• Successful weight loss maintainers eat fewer calories and less fat, do moderate exercise an average of at least one hour/day

Weight Maintenance

Behaviors that are necessary to maintain weight loss are central to the weight loss effort itself

Questions

Healthy Eating Program Website: http://health.ucsd.edu/healthyeating

American Cancer Society: http://www.cancer.org

American Institute of Cancer Research: http://www.aicr.org