That’s a question that’s preoccupied me since I graduated from naturopathic college and set up my own practice, at the tender age of 23. Young and naive as I was, I thought that all I needed to do was explain to my clients that their habits of living were causing their health problems, tell them what they needed to do in order to get well again, and they would waltz merrily out the door, implement all my suggestions forthwith, and be healed from whatever ailed them.
It didn’t take long for that illusion to come crashing down. I quickly discovered that change is hard for most people, most of the time. Even if a client fully understood my explanation of why she was sick; accepted the rationale behind the treatment plan; believed that it would work for her; and really, truly, genuinely wanted to implement said treatment plan; that didn’t automatically translate into her doing it.
The frustration of knowing that I could help people only if I learned how to help them change their habits drove me to undertake further qualifications in counselling and EFT, as well as a heck of a lot of self-directed study of best practices in behaviour change, all of which dramatically increased my success rate with clients.
It seems I’m not the only one who’s been obsessed with learning how to help people drop their bad health habits and implement good ones. Dr Hans Diehl has devoted his professional career to studying the dynamics of health behaviour change, and developing and refining programs to facilitate the adoption of simple healthy lifestyle practices that make dramatic differences to people’s well-being, and even their life expectancy.
He opened his presentation at the 2015 International Plant-Based Nutrition Healthcare Conference with some slides documenting the changes in death rates from several conditions in the Finnish province of North Karelia, after a comprehensive government-sponsored initiative to change the health practices of this population.
By way of background, in the late 1960s and early 1970s North Karelia’s rate of cardiovascular death was so shockingly high, that this largely rural, socioeconomically disadvantaged region had been dubbed ‘The Valley of the Beautiful Widows’. So many men in the prime of their lives were being laid waste by heart attacks, strokes and other cardiovascular causes of death, that the locals launched a petition to get help.
In response, The North Karelia Project was launched in 1972. Government health and human services departments, local GPs and nurses, community organisations, schools, NGO’s, local media, supermarkets, the food and agriculture industries were all recruited, and innovative media campaigns were developed in order to achieve widespread change in the population’s health-related behaviours, in particular smoking, intake of vegetables, and consumption of animal fats.
The following slides from Dr Diehl’s presentation illustrate the dramatic results of this intervention:
Results like that really grabbed Hans Diehl’s attention. After working at the Pritikin Longevity Center, UCLA and the National Institutes of Health, in 1988 he founded the Lifestyle Medicine Institute at Loma Linda University in southern California (just down the freeway from the conference venue, in fact!) and launched CHIP – the Complete Health Improvement Program. CHIP is a community-based lifestyle intervention program that incorporates the most effective strategies that Diehl learned in his studies of human behaviour change, in order to help people adopt and maintain better health habits and appropriate lifestyle modifications.
You can read all about CHIP here, including the studies that Diehl and his co-workers have published on its effectiveness at lowering disease risk factors such as blood cholesterol, hypertension, blood sugar levels and excess weight.
My big take-home from his presentation, however, was that change is easier when people do it in groups. Diehl noted that the groups that come together to undertake CHIP provide each other with mutual reinforcement and support; a ‘hive brain’ which generates novel solutions to implementation problems; and a ‘cheer squad’ to help members celebrate their successes and get back on track after they’ve fallen off the wagon.
Having run group cooking classes and programs to help people overcome emotional eating for many years, I’m well aware of the power of groups to facilitate lasting positive change. I’ve been tossing around the idea of running group programs on nutrition for over a year now, and Dr Diehl’s presentation was the kick in the rear that I needed to stop thinking about it and start doing it.
I’m pleased to announce that Empowered Eating, my 1-day nutrition intensive and online self-paced course; and EmpowerEd, a comprehensive health education program with a strong focus on building community among health-minded people, are now up and running.
P.S. The most disturbing part of Dr Diehl’s presentation was when he recounted his experiences with a group of final-year medical students at Loma Linda University. In the last weeks of their training, before they graduated and were unleashed on the public, the students have the opportunity to spend some time at the Lifestyle Medicine Institute that Diehl founded, learning from the man himself about how to help their future patients to help themselves.
Diehl asked the class if anyone had heard of Dr Dean Ornish, whose pioneering work on reversing cardiovascular disease and containing prostate cancer I discussed in a previous post. Two students raised their hands.
“Is he the dean of the medical faculty here?”
one tentatively asked. No, wrong ‘Dean’!
The other confidently asserted,
“He’s the leader of a religious cult that claims that people can heal themselves by changing their diets.”
Poor Dr Diehl! Can you imagine his chagrin at hearing this ignorance and hostility at the whole idea of lifestyle medicine, expressed by a medical student at a university founded by a Christian denomination – Seventh Day Adventists – which has emphasised the importance of a plant-based diet for physical and spiritual health from its inception? And the fact that no one else in the class had heard of Ornish, after 3 years of pre-med studies and a further 5 years of medical school, is nothing short of criminal. Is it any wonder that most doctors know less than their patients about nutrition?
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