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Getting your clients to talk themselves into change, using motivational interviewing techniques

There are a variety of cognitive behavioral therapy techniques to encourage behavior chane especially when it comes to weight loss. One such technique is called motivational interviewing (MI) which is a self management support method. It is a method that has been scientifically shown to increase motivation and commitment for sustained behavior change and adherence to treatment.

Do you have clients who overthink making changes, or always find a way to avoid committing to a goal? Using motivational interviewing techniques in your practice may be helpful in these cases.

This conversational style of communication helps clients to verbalize their thoughts and barriers they might perceive that prevent them from making a change, set their own goals and then verbalize their own commitment plans. This method is rooted in neurolinguistics programming, helping clients to make a switch to positive thinking through eliciting change talk, affirmations, reflective listening and summarizing discussions.

MI has been used in various clinical settings for managing chronic diseases, and recent evidence has demonstrated that it can lead to effective behavior change after just one session. The goal as the practitioner is to refrain from judgement, proved support and nudge clients to create and verbalize their ideal health goals.

Examples of questions to ask include;

“How can I help you get through some of the barriers you are experiencing”

“How would you like to see your life 3 years from now?”

“What will happen if you don’t change?”

“What makes you think that it is time for a change?”

“What is the best thing that will happen if you change?”

MI can be particularly in weight management where several attempts at sticking with a weight loss program is a common occurance. MI can be useful to assess motivation and readiness to change as a reminder for clients on why they are making lifestyle changes as well as affirming that the road ahead may not always be obstacle-free. Your role as a practitioner is then to use right resources and information at the right time for the client.

You may already have your own style of providing counselling to clients, however adopting a new technique which is backed by strong scientific evidence, can move your clients from inaction to action in a shorter period of time with better health outcomes in turn.

When it comes to DNA testing, MI can be a good time to elicit why clients feel they need a test or why they would benefit. This is a great time to manage expectations as the test is part of a long-term intervention, not a quick fix. We hope you’ll give MI a try and see how your clients respond!

 

The GenoVive Team

 

References;

  1. Hhtp://www.nova.edu/gsc/forms/mi_rationale_techniques.pdf
  2. http://www.cellinteractive.com/ucla/physcian_ed/interview_alg.html

6 Ways New Technologies Can Help You Make Healthier Choices

Unfortunately, we currently live in an obesogenic environment where food is available all the time and in copious amounts. We don’t even need to leave the house to get a hold of food! Let alone burning it all off through exercise.

  1. Smart shopping apps: There are plenty of apps created by retailers which make use of big data to help you choose wiser. Whether you have allergies, intolerances or a health goal, these apps can steer you in the right direction and make it easier to choose between products which are not just based on the nice-looking packaging. This can include suitable foods to lose weight, reduce salt intake or just to improve your general health.
  2. Nutrition coaching apps: if you think you are eating healthy but are not quite sure, why not get a little help along the way? By snapping pictures of your meals and getting instant advice from an expert nutrition coach can go a long way in making sure that you personalize your diet according to your preferences and goals. In addition, they can help you with meals and snack ideas to make sure you don’t eat too much of the healthy food.
  3. Cognitive behavioral therapy: It takes a few times before a new habit sticks, therefore you may need a few reminders to make sure you stick to those new years’ resolutions. Whether it’s an image of a fresh fruit reminding you to eat a piece of fruit for you late-afternoon snack, or your phone vibrating to remind you to move around a little. New programs are available that help you to stay motivated and focused.
  4. Health tracking devices: With a new device being launched on a nearly monthly basis, there is certainly no lack of choice. We don’t need them all for sure, but to start off a healthy routine and to measure how active you really are, a tracking device can be indispensable to provide insight. You’d be very surprised how little activity you actually do by just sitting at your desk when the recommendation is to get up to 10,000 steps per day. I dare you to give it a try! Even the use of smart wearable devices are set to increase dramatically, meaning that important data is being collected about you without you needing to think about it or logging it.
  5. Smart cooking appliances: New technologies have allowed the creation of new cookware that can help in reducing the amount of fat that is used in cooking, ensuring that vegetables don’t get overcooked and even tells you when you are overcooking the risotto. If you’re not a comfortable cook and need some guidance, an app can tell you exactly what to do and provide some healthy recipes too!
  6. DNA testing: Looking at which genetic variants you have inherited is without a doubt the latest in using genomic technologies to promote health and tailor interventions. As the science is rapidly evolving, the ability to eat the right foods according to your unique genetic profile has become closer. With insight and knowledge of specific genetic variants and their role within the body, it is possible to tailor your diet to optimize health and reduce weight.

New technologies such as remote controls and cell phones have certainly made our lives easier, but we should not take this for granted. We now have to work harder to ensure we stay active mentally and physically and also use the app to simplify the vast amount of advertising and marketing messages we are exposed to on a daily basis to make the right food choices. Find the technologies that match your need and your health goals and your life may just vastly improve!

 

The GenoVive team

It is impossible to outrun the fork

The Pareto Principle is also applicable to a healthy lifestyle change, regarding nutrition and fitness. The Pareto Principle is the 80/20 rule.

We see this in business. 80% of business comes from 20% of customers. We see it in work days’ productivity. 80% of our work yield comes from 20% of our work time. We see this in almost all aspects of our lives. We must also heed this ratio on our journey to fat loss.

It is not scientifically proven that this is correct, but most scientific studies prove it to be nearly correct.

So, the pros of fitness, I will describe for you. We believe in fitness, because science has proven that number one, it is a mood elevator. Also, it builds muscle, which is extremely important to burning calories. Nutrition alone will not do it. Because we tend to lose our muscle cells, when we tend to reduce our proper macronutrient caloric levels; nor do we augment any new essential muscle cells to burn calories during our fat loss stage and maintenance stage. Thereby, we do not embark on a true healthy lifestyle change. We don’t have to go out and join a gym. We need to buy some good walking tennis shoes and some economical weights from our local sporting goods stores.

If your genetic report shows that you are not a marathon runner and you are more likely to lose fat with resistance training, then we still recommend some walking exercises. Maybe twenty minutes of walking and forty minutes of doing some resistance training with your new weights.

The point that I would like to make in the aforesaid, is that nutrition is our fuel and physical activities are our turbochargers. We need them both. But, let’s not put so much emphasis on physical activities and less on nutrition.

I was walking two weeks ago, with a friend of mine, and he said that he cheated and ate two donuts for breakfast. Chuckling, he told me that he had to walk another hour that day. I don’t believe that we should deprive ourselves of one of our favorite sweets, once a month, or even every two weeks. I didn’t know if it was a plain, glazed or chocolate-filled donuts. I dare to say that he may have had to walk six to seven more hours that day to burn those extra calories.

This is very common thinking about people trying to lose fat and it’s role with physical activity. There are also metabolic issues in play, which I am not even going to touch right now, i.e., insulin levels, etc.

We believe that nutrition comes first, then physical activity, but something almost as important is changing eating behavior and proper sleep.

So, hopefully, the takeaway from this little blog article is that we extricate our mindset that physical activity is most important, but take nutrition and eating behaviors into the fat loss equation toward achieving and maintaining a healthy lifestyle.

In closing, I will say that I am not close in being knowledgeable in kinesiology whatsoever, but we cannot ‘outrun the fork’, nor for that matter, a donut!

 

Hedonistic obesity – the driver of disordered eating behavior?

Our eating behavior is driven by a physiological need to satisfy hunger and provide energy, as well as a neurological desire to consume foods we want or like. These drivers are common to al humankind, however, differences in BMI and the obesity epidemic show that some respond to these needs and desires differently to others.

Many experts agree that we all have a weight ‘set-point’ which is largely determined by our genetics and of which should be kept relatively constant by an ‘energy homeostasis system’ including the hypothalamus, appetite hormones and digestive system to regulate appetite and food intake according to our physical needs (Yu, 2015) The rise of obesity, however, suggests that one is able to override their weight set-point, and researchers are investigating the role of the brain driving eating behavior beyond physical needs and leading to what is being called ‘hedonistic obesity’.

The study of hedonistic obesity looks at the neuronal pathways involved in the reward system of the brain. Through functional MRI (fMRI) scans, images have shown higher activity in the reward regions of the brain in response to food cues among obese individuals, compared to healthy weight controls (Stice, 2008).

Recently emerging is the role of genetics in susceptibility to hedonistic obesity. Commonly known variants such as; FTO and MTHFR, play a significant role in the hypothalamus and can therefore be argued as highly influential to eating behavior. Furthermore, genetic variants for taste receptors and appetite hormones may also play an important role in individuals ‘liking’ and ‘wanting’ food beyond their physical satiety signals (Grimm, 2011)

A recent study on school children used fMRI to measure the response of food stimuli in the reward-related area of the brain – nucleus accumbency (NAcc) and correlated their findings with BMI and the obesity risk polymorphism FTO rs9939609. It was found that those with the risk ‘A’ allele had a larger NAcc volume and also showed higher brain activity in response to being shown a food commercial in a controlled environment. The study concluded that risk of hedonistic obesity may be apparent from a very early age dependent on genetic variants affecting the development and growth of reward-related regions of the brain (Rapuano, 2017).

Also interesting is the correlation between low levels of dopamine and dopamine receptors and obesity. It has been suggested that those affected may display more frequent eating behavior and likely to eat larger portions in order to receive reward signals similar to those with normal dopamine levels (Grimm,2011). Whilst nutritional neuroscience is growing, so is the genetic influence to such, and this is therefore a key area for health professionals to watch. If we can begin to understand the underlying mechanism which dictate eating behavior, then we are much closer to understanding how to tackle hedonistic obesity in susceptible individuals.

As a practitioner, you might want to get further insight on environmental triggers and ask questions such as;

“where do you eat your meals when at home?”

“How do you spend your lunch time?”

“Describe how you would spend family time with your children”

“Do you feel satisfied after finishing your meal?”

Looking into the future, nutritional neuroscience will play a bigger role in the treatment plans as we learn more about the brain and neuronal pathways. By knowing which genotype clients have inherited, this may provide clues as to the best nutritional intervention strategy to employ. We are certainly watching this area closely!

 

The GenoVive Team

 

 

References

Felsted, J. A.-D. (2010). Genetically determined differences in brain response to a primary food

reward. Journal of Neuroscience,30(7): 2428-32.

Grimm, E. R. (2011). Genetics of Eating Behavior: Established and Emerging Concepts. Nutrition

Reviews, 69(1): 52-60.

Rapuano, K.M.-D. (2017). Genetic risk for obesity predicts nucleus accumbens size and

responsivity to real-world food cues. PNAS, 114(1)160-165.

Stice, E.S. (2008). Relation between obesity and blunted striatal response to food is moderated

by TaqIA A1 allele. Science, 322(5900): 449-452.

Stice, E.S. (2008). Relation of reward from food intake and anticipated food intake to obesity; a

functional magnetic resonance imaging study. Journal of Abnormal Psychology, 117(4):

924-935.

Yu, Y.-H. V. (2015). Metabolic vs. hedonic obesity: a conceptual distinction and its clinical

Implications. Obesity Reviews, 16: 234-247.

 

Exercise for mood, health and weight management

Brain-derived neurotrophic factor (BDNF) is a growth factor found abundantly in the brain and is known to play a key role in neuronal cell survival, synaptic plasticity and synaptogenesis (Wrann, 2013). Particularly relevant is its function in the hippocampus which is an area of the brain responsible for learning and development, therefore, studies have looked into the association of cognitive abilities and BDNF plasma or serum levels (Zoladz, 2010).

It has been shown that higher levels of plasma or serum BDNF correlates with good brain function, positive mood and better memory performance which has led to studies looking at how BDNF levels are increased (Gomez-Pinilla, 2013). Of interest is the exercise induced increase of BDNF expression which has been consistently found in rodent studies and now human studies are beginning to replicate findings (Zoladz, 2010).

For example, a year-long study of 120 older adults split into two groups of aerobic exercise and stretching (control group) measured and compared the hippocampal volume, BDNF levels and memory function between the groups. It was found that those in the aerobic group had a 2% increase in hippocampal volume by the end of the study. This was correlated with increased BDNF levels and also better memory performance (Erickson KI, 2011).

Of further interest is the finding of a BDNF polymorphism Val66Met which has been associated with poorer cognitive function and memory (Zoladz, 2010). A study with a relatively impressive sample size of 205 elderly participants looked at the influence of the Met polymorphism on physical activity and memory. As expected, it was found that the Met polymorphism was associated with a significantly decreased performance of episodic memory (Canivet, 2015).

This is relevant to practitioners as we begin to understand more of why exercise is beneficial to the brain and general health. In terms of reducing the risk of cognitive diseases such as; dementia and Alzheimer’s as well as improving mood and well-being for those on a weight-reduction plan, it may be that regular exercise helps to maintain good levels of BDNF expression and therefore improve cognitive performance.

Therefore, exercise is for more than just losing weight or for those wanting to improve their fitness levels, it has benefits that go way further in terms of gene expression and longevity hence practice daily. Brisk walk anyone?

The Genovive team

 

References

Canivet, A. A.-B. (2015). Effects of BDNF polymorphism and physical activity on episodic memory in the elderly: a cross sectional study. European Review of Aging and Physical Activity, 12: 15.

Erickson KI, V. M. (2011). Exercise training increases size of hippocampus and improves memory . Proceedings of the National Academy of Sciences of the United States of America, 108(7):301-3022.

Gomez-Pinilla, F. H. (2013). The Influence of Exercise on Cognitive Abilities. Comprehensive Physiology, 3(1)403-428.

Wrann, C. D.-B. (2013). Exercise Induces Hippocampal BDNF through a PGC-1α/FNDC5 Pathway. Cell Metabolism, 18(5):649-659.

Zoladz, J. A. (2010). THE EFFECT OF PHYSICAL ACTIVITY ON THE BRAIN DERIVED NEUROTROPHIC FACTOR: FROM ANIMAL TO HUMAN STUDIES. JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY, 61(5): 533-541.

 

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