I have a 7-year-old daughter who has the annoying desire to play with my belongings, which often results in things getting lost or broken.
One approach to getting her to stop this behavior is to follow her around and tell her "no.” If I tell her to stop playing with my clothes, she’ll go play with my makeup. I tell her no, and she'll start to play with my computer. If I keep up with the routine of telling her "no" to everything she tries to do, two things will happen. Our whole day will be filled with negative exchanges, and she'll become increasingly frustrated.
A better parenting approach is to fill her day with positive activities. I could set up an art project on the kitchen table; arrange a play date at the nearby sledding hill. The possibilities are endless.
This approach of reinforcing healthy behavior while ignoring the unhealthy comes from behavioral science and is not just applied to parenting.
Behavioral treatments for depression are also heavily based on this approach. As psychologists, we don't tell people with depression to stop feeling bad, stop laying in bed, stop arguing with your spouse and so on. Instead, we have them think about all the activities in life that make them feel good, and we help them populate their time with those activities.
This has a profound effect on mood.
Historically, researchers have used the “stop it!" approach to diet. They identify the "bad" food they think is responsible for obesity and then set up diets that prohibit people from eating it. The “bad" food used to be fat; now it's sugar. When we focus on restricting people from bad foods, surely they'll do as my daughter does (and what any of us would do): Fill their plates with the next best thing...until they're told not to eat that, either.
In our recent study — published February 16 in the Annals of Internal Medicine — my colleagues and I decided to apply the same behavioral science-informed approach to diet. We found a food type that includes an enormous amount of variety and asked people to fill their plates with this food. The food type we selected was fiber, and we gave participants the goal of 30 grams per day. High-fiber foods include beans, nuts, seeds, fruits, vegetables and grains, which gives people a lot of choices. We chose fiber because no controversy exists whatsoever in the nutrition world about the health benefits of fiber. It isn't one of those food types that research has flip-flopped on every few years. The data are clear about a host of health benefits of eating high fiber, including digestive health, cardiovascular disease risk reduction and cancer prevention.
In the study, we never told our participants what not to eat.
We didn't say sugar was bad or fat was bad, because we wanted to avoid negative exchanges and frustration.
We took the risk they might indulge in those foods anyway. We also never told them to count calories. Our message was clear: Focus entirely on the goal of 30 grams of fiber per day. Spread out the 30 grams across all meals and snacks. Get a wide variety of foods; don't rely on one food, or it may get boring. We gave them long lists of high-fiber foods, prepared tasty recipes for them to sample and gave them volumes of easy recipes to try at home. We compared this approach to the standard American Heart Association diet, which is heavily focused on restriction. It advises people to restrict saturated fat, calories, sugar, sodium and alcohol. It isn't entirely restrictive, though – it also encourages intake of fruits, vegetables and whole grains.
Findings revealed that both groups lost some weight and showed improvements in cardio-metabolic factors, but no statistically significant differences between the groups were observed. The fiber group was not significantly better than the AHA diet, but it was also not significantly worse. A different research design is needed to officially establish that the two diets are exactly the same, but in this study our goal was to see if one was better than the other, and this was not the case. We hope to grow this research by expanding upon the "positive" recommendation and continuing to ignore the negative, restricting advice.
Critics of the study have suggested that diet without exercise is not the way to lose weight. We couldn't agree more, but this study was not designed to be a lifestyle intervention. The purpose was to test a specific question about dietary behavior to inform future lifestyle interventions. We're eager to apply this approach to exercise so we can design a lifestyle intervention that maximizes adherence using behavioral science principles.
Critics have also suggested focusing on one part of diet is too narrow, and people will end up eating more of the unhealthy foods that are not targeted in this diet. At the Obesity Society meeting this past fall, I presented data that showed otherwise. In our high-fiber group, we saw no evidence of increases in intake of any "unhealthy" foods. In fact, we saw statistically significant decreases in saturated fat, sugar, dietary cholesterol, sugary beverages and sodium in our high-fiber condition.
Let's return to the behavioral science. I don't need to tell my daughter all the things I forbid her to do while she's engaging in the positive play experience I set up for her. Why? Because she never plays with my clothes when she's busy gliding down that sledding hill.
