Earlier this week I wrote a post about raising heart healthy children. The data summarized in that post may be the most important data I discuss all year when you consider that heart disease kills more of us than anything else. Thing is, I’m not surprised many of you haven’t read it. I expected it.
It’s just so flipping hard to read, or have any interest, or take advice about health when the advice or data requires us to make big changes. Or when the advice (regardless if we trust it or not) seems intuitive and self-evident. Things like eating less, restricting salt, or exercising more don’t sound so new. Those are things we already know we should do, but we often just can’t find a way to implement change in our totally overwhelming and busy lives. Big changes regarding how much we exercise, what we eat, and how we model behavior for our children seem daunting, overwhelming, and somewhat paternalistic. I also think it’s uninspiring to read about preventing heart disease in our kids because it feels so far off (thinking of our child dying of a heart attack or stroke doesn’t really compute) and really, we often can’t see heart disease. Heart disease walks around us silently.
That’s where we physicians fail, I think. There is convincing data about preventative health care that urges us to help get our patients to change behaviors that cause them suffering and ultimately threaten their life. But we fail to convince our patients to make changes because we simply don’t make it relevant enough. Or easy enough. Or we’re not convincing because we don’t demonstrate that we follow our own advice. Many docs are constantly trying to figure out what works best. See this tweet from Dr Pourmassina, an internal medicine physician in Seattle.
I think about ways to improve our translation of research for our patients all the time. And I think telling stories really helps. But I didn’t begin that post about heart disease with a story. Although there are many.
Last weekend for example, I set out to exercise every single day (without fail) for 30 days. I haven’t had time to prioritize exercise (let’s be honest: since F was born) over the last 5 years. And in my quest for 1 month of change, already I’ve failed. I made it only 3 days. And not for a lack of motivation; I love to run.
But yesterday I was gone from home for over 15 hours and it simply left no time for self-care. When I got home around 10pm, I couldn’t muster up the energy to step out into the cold air for a run. My loss, really. Now I have to re-start my 30 day challenge feeling a bit defeated.
I think we’re all very similar as we raise our children; we want to do this right (eating right, exercising, parenting perfectly), and often we are highly motivated (we care more about our children than anything else). It’s just the time crunch. Or the cost of implementing change. So many demands, so many things to change.
Back in September, I had the fortune to hear BJ Fogg present at Stanford about his model for behavior change. As I understood him, activating a change of behavior demands a trigger and a balance between the ease or ability of a new behavior and the motivation we carry to implement the change. He plots ease of an activity against motivation. Habits, he described, are things that stick around in our life every day because either they are super easy (tying your shoes or brushing your teeth or feeding your dog) or the motivation is fairly easy to come by (hunger cues us to eat every day, for example). He urges us to make new, desired behaviors simply easier. If we do, they will be more likely to happen. And so while I think more about talking with families in my clinic about preventing heart disease, I wonder, what has worked in your life to change your bad habits? How do you find time to exercise, make healthy meals, prepare healthy snacks, and prioritize an hour a day of outdoor play for your kids? What have you done to make these things easier?
Please share. I have my ideas but we need your ideas more.