Research & Education

For Diet & Lifestyle Change, “Accentuate the Positive”

A recent study out of Taiwan indicates that people are more likely to be motivated by positive messages about health and nutrition than negative ones. That is, they respond more to information about promoting and supporting healthy behaviors and positive outcomes than to information about preventing disease and warding off negative outcomes. This suggests that for public health measures and also within private sector healthcare, it might be better for medical professionals to emphasize the beneficial effects of certain practices (“exercise is good for the cardiovascular system”) and focus less on preventing unwanted results (“intermittent fasting may help prevent weight gain”).

The study, “Regulatory focus, nutrition involvement, and nutrition knowledge,” involved 1125 Taiwanese consumers. It found “a positive effect of promotion focus and no significant effect of prevention focus, on nutrition involvement.” According to a press release about the findings, nutrition involvement is defined as the time and effort people “put in to finding out about nutrition and seeking out nutritious food.” The “promotion focus” on nutrition involvement was mediated by income, with higher income consumers being affected more greatly by the promotion focus compared to lower income consumers. The promotion focus also appeared to resonate more strongly with men, but the researchers explained that overall, women typically have higher levels of nutritional involvement compared to men, regardless of promotion or prevention focus.

Adhering to a healthy diet or adopting lifestyle changes is not solely driven by internal motivation or personal interests and goals. Even for the most motivated individuals, obstacles may appear in the form of “social and cultural contexts, perceptions and preferences, and environmental barriers.” (For example, sticking to a low-carb or ketogenic diet might be difficult for an Asian-American whose family regularly consumes rice or noodles. Individuals in economically disadvantaged areas may have the obstacle of living in a “food desert” lacking grocery stores with plentiful fresh foods.)

Individual motivation, whatever its basis, is essential for making lasting changes. As many chronic dieters know only too well, as difficult as it is to lose body fat, keeping it off often proves to be an even bigger challenge. A small study (n=12) of overweight adults who were maintaining a loss of 5% of their body weight since the year before baseline identified five factors that contributed to successful weight loss maintenance: sustained motivation, effective self-regulation, habit formation, plentiful resources and a supportive environment. Participants also reported an identity shift from being a “dieter” to engaging in a new healthy lifestyle.

In a larger study, this one involving 66 overweight or obese adult women participating in a 16-week internet-based behavioral weight loss intervention, autonomous motivation increased initially and remained high for subjects who ultimately achieved a 5% weight loss. Autonomous motivation decreased among those who did not achieve a 5% loss. Autonomous motivation at 4 weeks was a predictor of adherence to self-monitoring and weight loss at 16 weeks. A separate study looking at mediators of weight loss and weight loss maintenance in overweight or obese women found that among other factors, intrinsic motivation to exercise was associated with successful long-term weight loss maintenance.

Autonomous or intrinsic motivation is a recurring theme in research exploring ways to improve health outcomes. In a Danish study looking at associations between health literacy, diet, physical activity and motivation in people with type 2 diabetes, greater autonomous motivation and functional health literacy were associated with following the recommended diet, and autonomous motivation was the strongest factor in adhering to the physical activity recommendations. This won’t be a big surprise to anyone who’s adhered to diet and lifestyle changes over the long term: doctors, nutritionists, health coaches, support groups and even friends and family can provide motivation and encouragement, but ultimately, each individual is responsible for his or her own actions. Motivation isn’t something that can be enforced from the outside, except maybe during military basic training!

Self-motivation is clearly an important part of behavioral change around diet, exercise, and other lifestyle practices. The Taiwanese study introduced at the beginning adds the additional layer that some people may respond better to positive messaging about the benefits of such changes, as opposed to fear-based messages oriented toward preventing unwanted or undesirable outcomes.