Making heart-healthy decisions: are you on autopilot?

by Carolyn Thomas

With rare exception (like the woman I witnessed at the Minneapolis airport pouring Coca-Cola into her child’s baby bottle), most thinking adults already know perfectly well what’s good and bad for our bodies. Yet we continue to smoke, eat too much (of the wrong foods) and exercise too little.  A recent study suggests that instead of swamping us with health reminders to eat better and exercise more, public health initiatives should actually try targeting the knee-jerk behaviours that are making us fatter and sicker.*

This study, published in the journal Science, found that part of the problem is that current public health initiatives are still focused on educating us about what decisions we should and shouldn’t be making to improve health outcomes – as if we are actively contemplating the pros and cons of making each decision.  Trouble is, most of us are not. 

Dr. Theresa Marteau, lead author of the study and director of the Behaviour and Health Research unit at Cambridge University in the U.K., told The Globe and Mail:

“We now know that much of our behaviour is not driven by deliberation upon the consequences of our actions but rather is automatic, shaped by our environments, often without awareness.”

She and her co-authors note that subtle changes in the environment, which require little or no conscious engagement, may nudge people to make healthier choices.

For example:

• when elevator doors are programmed to close slowly, more people take the stairs

• cafeteria customers are more likely to choose fruits and vegetables when salad bars are easier to reach

• drinkers tend to consume less alcohol when it is served in tall, narrow glasses instead of short, wide-bottomed tumblers

Here’s a personal example of this: while on the train to the San Francisco airport last month, I met a woman lugging a large floor sign onboard that read:

“Taking The Stairs Helps You Get Fit!” 

When I asked her about this sign, she revealed that she was working on a research study to see how many train commuters could be motivated to take the stairs instead of the escalator if a simple sign was stationed at the bottom of each.  I asked her:  ‘How’s it going so far?’ and her quick response was: “Almost everybody is taking the stairs!”

Charles Duhigg’s excellent book The Power of Habit: Why We Do What We Do in Life and Business cited a 2006 Duke University study that found that more than 40 percent of the actions people performed each day weren’t actual decisions, but habits.

And both good and bad habits can apparently be modified by changing the environment supporting those habits, as reported by NPR:

Surprising research results on military veterans of the Vietnam war, for example, suggested that the number of soldiers who continued their heroin addiction once they returned to the U.S. was shockingly low. The number of people who actually relapsed to heroin use in the first year back home was about 5 percent. In other words, 95 percent of the people who were addicted to heroin in Vietnam did not become re-addicted when they returned to the United States.

Meanwhile, the U.K. researchers recommended:

 “Much of the global burden of disease is associated with behaviours – overeating, smoking, excessive alcohol consumption, and physical inactivity – that people recognize as health-harming and yet continue to engage in, even when undesired consequences emerge.

“To date, interventions aimed at changing such behaviours have largely encouraged people just to reflect on their behaviours. These approaches are often ineffectual, which is in keeping with the observation that much human behaviour is automatic, cued by environmental stimuli, resulting in actions that are largely unaccompanied by any conscious reflection.

“We propose that interventions targeting these automatic bases of behaviors may be more effective.”

* Theresa M. Marteau, Gareth J. Hollands and Paul C. Fletcher. “Changing Human Behavior to Prevent Disease: The Importance of Targeting Automatic Processes”. Science 21 September 2012:  Vol. 337 no. 6101 pp. 1492-1495 DOI: 10.1126/science.1226918

See also:

• Mindless eating: 8 reasons women eat when we’re not even hungry
• How to stare down that plate of chocolate chip cookies
• Do you suffer from ‘kitchen illiteracy’?
• Why you’ll listen to me – but not to your doctor
• Six steps to stop emotional eating
• Why don’t patients listen to doctors’ heart-healthy advice?

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Q:  Any ideas on how we can snap out of autopilot habits?

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