Join this Dance of Opportunity
“It’s messy being human; but not a total mess.”
So said Margaret Moore (aka “Coach Meg”) MBA, and CEO of Wellcoaches last Saturday afternoon as she explored the power and mechanisms of coaching at the first IDEA World Nutrition & Behavior Change Summit, a one-day conference within the larger 2016 IDEA World Convention in Los Angeles (July 13-17).
Personally, I think her comment was generous. It seems to me that as a nation of humans, fallible though we are, that we’ve made a red hot mess of matters pertaining to health, personal accountability and planet sustainability. But before I spiral too far down that wormhole, I will also tell you that there are some really smart people who care a lot about moving us toward collaborative transformation. They brought their evidence to this Summit; they spread their creative energy; and they shared their good ideas for how we can shift our thinking and our actions.
This day of learning was certainly unparalleled in our industry. I came home to San Diego on Sunday feeling heartened about what I had learned and joyous for the flashes of enlightenment I had seen as I looked around at the faces in the room, filled to its 500-person capacity throughout the day. As the information further settled into my brain, it transmitted into my being and lightened my heart to bring me closer to the optimist I was before I began covering health and nutrition news so many years ago.
A String of Pearls
Yale University’s David Katz, MD, MPH, likened his role as master of ceremonies to being the “string threading together the pearls” offered by each of the eight thoughtful experts presenting. The Summit explored the many challenges we and our clients face as time-crunched, disengaged and stressed-out people who are trying to navigate the nutrition strategy du jour and “move through the jungle without a flashlight,” to lift a phrase from David Eisenberg, MD, presenter and adjunct associate professor of nutrition at the Harvard T. H. Chan School of Public Health.
Well, let there be light! IDEA planned this day expressly to kindle the conversation among physicians, dietary and fitness professionals, coaches and mindfulness leaders. The result was both enriching and exhilarating.
Here is a summary of observations made by this stellar faculty.
Willpower vs. Skillpower
Stacy Nelson, EdD, a senior consultant and master trainer at VitalSmarts, rejects the notion of willpower and suggests instead that we teach ourselves and our clients to develop “skillpower” by being both the scientist and the subject. Willpower, he says, is an unsustainable trap that we simply don’t have the reserves for. He suggested that we guide clients to study both their bad and good habits and tease out the reasons for them. We also must promote more self-awareness so we can “turn bad days into good data.”
Finally, said Nelson, “Bad habits are always a team sport. There are always accomplices.” Figure out who your aiders and abettors are; run toward the former and steer clear of the latter.
Lifestyle Is the Best Medicine
Katz, who also is the president of the American College of Lifestyle Medicine, neatly summarized each talk, buttressing the layers into the big picture architecture of the day. He also kicked off a series of four, 20-minute talks on the morning program that focused on the power of food and the importance of convergence and collaboration—looking less to what we disagree on and more of what we do agree on.
The top three actual causes of death in the US—tobacco use, dietary pattern and lack of physical activity—account for 80% of premature deaths and chronic disease burden. And they are all preventable through lifestyle change. Katz assigns each a partner: tobacco = fingers; diet = forks; and lack of physical activity = feet. “I think we can all agree that we’re not confused about fingers—smoking is bad; not smoking is much better,” he said. “I don’t think we’re particularly confused about feet, either. Using them is good. But when it comes to forks, out there in the real world there is enormous confusion, because people come along every day to tell us there’s a new way to eat for health now, and inevitably throw everybody who came before them under the bus.”
What we can acknowledge from a longstanding and vast body of literature is that if we optimize diet and lifestyle practices we could pretty reliably eliminate 80% of premature death and chronic disease around us, and help the planet out in the bargain, he explained. “We could add years to life and life to years. All that tells us is that lifestyle is the best medicine. We are all purveyors of this.”
Finally, he encouraged the assembly to “think beyond the limits of our own skin” and consider what we’re doing to the planet with our food choices and what that portends for the future.
Normalizing What’s Normal Again
Yoni Freedhoff, MD, an assistant professor of family medicine at the University of Ottawa, is unwaveringly critical of how we’ve allowed the “normalization of an abnormal food environment.” Over the course of decades, he observed, society has normalized the use of junk food to reward, pacify and entertain us (especially children), at every turn. He showed slide after slide to demonstrate the endemic and insidious practice of fundraising in schools and for sports teams using candy and other junk food. “We need cultural change. Today's talks are about swimming lessons. I'm a swim coach and so are all of you.” The quest for perfection is fatally flawed, he said. “We are so far away from healthful living that it has to start in small increments.”
Freedhoff gave a longer talk in the afternoon regarding why most diets fail miserably (they demand unreasonable sacrifice that is not sustainable in the long term). “Listen, if you can't happily eat less, you’re not going to eat less. If you can't happily exercise more, you're not going to do more,” he said.
The U.S. Protein Obsession
Christopher Gardner, PhD, professor of medicine at Stanford University and the director of Stanford Prevention Research Center’s Nutrition Studies Group, focused his comments on Americans’ obsession with dietary protein and demonstrated the disconnect between the amount we need and the amount we get. He suggested practical ways to move people toward a more plant-based approach. Rather than focusing on nutrients, he says, we should be focusing on foods—both animal and plant sources of protein. He also clarified the misunderstanding about the amount and quality of protein in plant foods (bottom line: they are a rich source of dietary protein and they convey numerous additional health benefits).
For promoting optimal individual, societal and environmental health, we can and should be eating less animal-based, protein-rich foods, better quality animal-based foods and more plant-based foods, he said. “Americans are justifiably confused about how much protein they need and from what sources to get it. In general, they get a lot and with some qualifiers, a lot more than they need. There is tremendous room for a substantial shift from animal to plant protein.”
The Mind Matters!
Margaret Moore (aka “Coach Meg”), MBA and CEO of Wellcoaches, spoke on the power of and the mechanisms of coaching. She paralleled her exploration of a new psychological model she developed called the “Mindful Self,” to the Pixar film called Inside Out, the story of a young girl and her disparate cast of emotions as they maneuver for the spotlight inside the child’s head. We all have an inner family of siblings in us that can directly oppose each other, gang up on each other and render us ambivalent, Moore described.
“Often more of you is not on board than the parts of you that are on board, and that’s why you get stuck.” We need to corral these with our Mindful Self, which will help to recognize the players at work and navigate the sometimes dysfunctional tribe inside each of us, she said. “It’s not that people resist change, it’s that they resist being changed.”
The Teaching Kitchen Intervention
David Eisenberg, MD, founding co-director of the “Healthy Kitchens, Healthy Lives” educational conference co-sponsored by the Harvard Chan School and The Culinary Institute of America, opened with a question and his vision: Might learning how to cook impact weight and health? and “In my imaginary future, chefs, physicians, other health professions and coaches collaborate to address obesity.”Transforming public health and society through cooking actually doesn’t seem to be that far off. Eisenberg described a study (currently under review for publication) that he conducted to understand the potential outcomes a teaching kitchen environment could have. Teaching kitchens are virtual spaces where one could come to learn nutrition facts, shopping and cooking skills, instruction in exercise and movement, mindfulness and behavior change through coaching interventions.
“In my mind this is a life immersion class,” he said. “The scientist in me is willing to bet the farm that if we could build these real and virtual teaching kitchens, and over time invite people to participate in studies, that those who had access to teaching kitchen programs would do better in terms of changing their behavior, improving their clinical outcomes, reducing their costs and improving the quality of life.”
Eisenberg capped his talk by saying there are three pillars to consider in this construct: the cooking/nutrition piece; the movement/exercise piece; and the mind piece. “That’s the future. It’s not unimaginable that 25 years from now just like we have physical fitness facilities everywhere, that we will have teaching kitchens aligned with them. And so I ask you all to just contemplate that.”
Connecting How and Why to What
Holly Wyatt, MD, associate professor of medicine at University of Colorado Anschutz Medical Campus concedes that almost all of us know WHAT to do for better health. The challenge is bridging the gap between the WHAT, and connecting it to the WHY and the HOW-to-do-it pieces. That’s where coaching for lifestyle transformation can help clients to dial the right combination on their personal behavior locks. Aligning behavioral change with a client’s purpose, passion and values is the pivotal tumbler in the “big why” of the lock.
Wyatt also is clearly a proponent of using the power of the mind to transform the body: “We should be doing just as much mental work as we do physical work if we want to see change,” she said. “The first three or four questions in a client interview we ask should focus on mindset. If you change someone's mindset you will see the true transformation.”
Practice Takes Practice!
John Berardi, PhD, founder of Precision Nutrition, shared the PN “formula” that he says has helped 45,000 clients to follow with a remarkable 70% compliance rate (Eisenberg had mentioned earlier that most diets have an 80%–90% recidivism rate).
Berardi described how his team puts clients front and center in the coaching process; implements a cohesive, practice-based curriculum tailored to body and health transformation; and uses technology to manage client data and support them in a virtual environment. In addition, though clients and coaches never meet in person, Berardi’s team integrates support and accountability.
“Goal achievement only happens reliably when you do two things, he said: 1. break the goal into skills; and 2. practice those skills daily.” He advises putting anchor practices or habits first and then layering on concrete practices. For example, instead of asking a client to give up alcohol completely, try asking him to “try it for two weeks as an experiment.” This way, the client doesn’t feel like he’s being asked to give something up forever.
The Opportunity is Now
Natalie Digate Muth, MD, MPH, RDN, pediatrician and obesity medicine physician and health coach, urged attendees to get familiar with the Affordable Care Act and to understand the opportunities that are opening for them to work with physicians and other healthcare providers.
She explained how American healthcare is transforming, investing more in prevention and high-value behavior change interventions. “Primary care doctors increasingly recognize the value of physical activity and behavior change interventions, and want to connect patients with community resources,” said Muth, who also is the senior advisor for healthcare solutions at the American Council on Exercise. Unlike any other time, health and fitness professionals skilled in delivering effective physical activity and behavior change interventions are in the position to change more lives, and their business, she pointed out.
As she wound up her talk, Muth quoted from H. Jackson Brown, Jr.’s Life’s Little Instruction Book saying that “Opportunity dances with those already on the dance floor.” She repeated her top three takeaways with conviction a few times: 1. Learn behavior change strategy; 2. know the evidence; and 3. get on the dance floor!
If you’re not out there already, it’s time to get your dancing shoes on and go for it. The opportunity is now, and people need nutrition and behavior change coaching more than ever.
What are you waiting for?