Everyone May Have Been Wrong About Health 'Makeovers' All Along

If the "small steps" method has never worked for you, there might be a better way to change your life.
If you want to change your life, making one small change at a time may not be enough, according to new research.
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If you want to change your life, making one small change at a time may not be enough, according to new research.

Conventional wisdom dictates that if you want to make a big life change, you have to start small. Want to lose weight? One good first step might be to drink more water. Want to get fit? Start with a walk around the block.

While these small changes may slowly lead reluctant people down the path of well-being without depleting precious stores of willpower, research out of the University of California, Santa Barbara suggests that this incremental approach to life change may be well-intentioned but completely wrongheaded. If you want to get fit, be more mindful, eat healthier, have better relationships and be a better person, do it all at once.

“Science and society more generally may be significantly underestimating the human capacity to change,” said Michael Mrazek, director of research at UCSB’s Center for Mindfulness and Human Potential. “In some cases, the strategy of only pursuing one small change at a time might actually be counterproductive and frustrating for some people.”

One easy change vs. a whole bunch of them

In traditional science experiments, researchers change just one thing about a person’s life and then observe how it affects them. That's so they can attribute any changes between baseline and post-experiment to that one change without any other interfering influences. These studies enable scientists to suggest things like yoga can improve quality of life, or that a low-carbohydrate diet helps you lose more weight than a low-fat diet. It's just good science.

But just because it's good for an experiment doesn't mean it's the best application for the real world.

“You could do studies where you try to isolate one single component and then you can be very confident that component is causing the benefits, but that sort of reductionist approach inevitably limits your ability to show how much somebody can change,” Mrazek said. “This is about looking at the synergy of bringing all these pieces together."

For example, lifestyle changes like drinking less alcohol and improving sleep quality reinforce each other, resulting in a set of escalating improvements that could motivate someone to keep going, even though making multiple changes at once takes a lot of effort.

How to try Mrazek's 'kitchen sink' approach

Overhauling pretty much everything about yourself sounds unthinkable, and even more undoable. Some people struggle just to get home in time to buy some reasonably healthy take-out and eat dinner in at least the same room as their families -- and that’s an optimistic scenario. So when are they going to find time to exercise, boost their creativity and be a better friend, too?

If Mrazek’s study is any indication, the hard truth is that you’d have to take a break from several personal commitments, a.k.a. REAL LIFE, and dedicate about one-fifth of your day to self-care and self-improvement for six weeks. But the results do seem impressive, and could last for at least as long as the time it took to learn those new habits in the first place.

Mrazek recruited 31 college students to undergo a complete lifestyle overhaul that touched upon nutrition, sleep, compassion, exercise and mindfulness. Every weekday for six weeks, half of them were put through a five-hour regimen: 2.5 hours of yoga and pilates, one hour of mindfulness practice and 1.5 hours of a lecture on wellness topics like nutrition, sleep, exercise, alcohol consumption, gratitude, empathy, compassion and stress management.

They were told to limit their alcohol to no more than one drink a day, eat a whole foods diet and sleep for eight to 10 hours every night. Participants were also instructed to do two high intensity interval training workouts per week, do random acts of kindness every day and keep a food log on weekends. Finally, they also got the opportunity to meet with a counselor to talk about personal issues twice during the study. The program was free for students, and they were paid $10 an hour for the time it took to measure their stats.

The control group, meanwhile, didn't do anything during those six weeks in order to provide comparable baseline measurements. Because of this, Mrazek's trial doesn't offer any direct insight into whether a complete life overhaul is more effective than making small changes, one at a time. However, Mrazek says that he did compare the intervention group participants' improvements in mood and stress to other meta-analyses of studies that focused on mindfulness alone, and found they were 2.5 times greater. This is particularly impressive, because mindfulness interventions are especially good at improving mood and stress.

Yes, overhauling your life really works

At the end of it all, the researchers found that the participants in the intervention group had significantly improved on a bunch of different health measures. Physically, they had improved their muscular and cardiovascular endurance, flexibility and triglyceride levels compared to the control group.

On a cognitive level, the intervention group also improved mental focus, memory and reading comprehension scores. Emotionally, their questionnaire responses showed that they had improved their mood, life satisfaction, self-esteem, self-efficacy and mindfulness. They also had less stress and fewer episodes of “mind-wandering.”

Finally, MRI scans suggested that the interventions had even changed participants' brains. One measurement in particular found that the insula, a part of the brain linked to monitoring experiences and paying attention to priorities, had more connections throughout the rest of the brain and particularly with the somatosensory cortex, the main part of the brain that perceives touch and other bodily sensations.

"What this likely indicates is that while these participants were at rest, they were bringing more attention to the bodily sensations they were having, and were more aware of the present moment, as opposed to being lost in discursive or elaborative thought,” Mrazek hypothesizes.

This graph demonstrates the physical, cognitive and emotional improvements that participants experienced after the six-week program. The dots fall into one of three effect sizes (small, medium or large) compared to the measurements taken at the beginning of the experiment. The dots that are placed above the "Large" area are "Very Large" effects.
This graph demonstrates the physical, cognitive and emotional improvements that participants experienced after the six-week program. The dots fall into one of three effect sizes (small, medium or large) compared to the measurements taken at the beginning of the experiment. The dots that are placed above the "Large" area are "Very Large" effects.

Six weeks after the experiment, these improvements persisted, despite the fact that participants had no contact or follow up between the end of the interventions and the post-six week measurements. The study offers no insight as to whether or not these improvements will persist for longer, so Mrazek is now planning research that would follow participants for up to a year after going through similarly intensive intervention programs.

Could Mrazek's approach work for you?

One unusual aspect of this research is that Mrazek didn’t have a single participant drop out -- something that typically happens in all studies. Mrazek thinks that his research project didn’t suffer the usual attrition rates because the benefits of the new lifestyle were obvious and immediately-felt, he said.

“They rather quickly had a sense of progress,” said Mrazek. “When you actually start making improvements in your life, that can increase your motivation to continue what you’re doing."

Mrazek also believes that the experiment's group accountability aspect played a role in keeping people focused. But if you want to try to makeover your life on your own anyway, Mrazek has one piece of advice: Think of what you’d like to change, and then brainstorm all of the other aspects in your life that you could also improve in order to help support the initial goal.

"If your [new] habit for this month is just to take a multivitamin in the morning, then what are you doing for the other 23 hours and 59 minutes of your day?” he asked. "Every moment counts, and believing you only need to address one thing at a time might lead you to neglect all the other opportunities you have."

Of course, there are a lot of caveats to this research: The sample size was small and a relatively homogeneous group of college students. That makes them fundamentally different from adults with full-time jobs, growing families and other pressures that don’t usually accompany the university experience.

Secondly, the follow up time was only six weeks. As many studies on diet and weight loss interventions show, participants can be motivated do anything for a couple of months. The true test of the a successful weight loss program would be to see how people were doing after one year, and ideally for even longer.

Mrazek’s study was funded by the Institute of Education Sciences, the research arm of the U.S. Department of Education, and the John Templeton Foundation, which supports research on wide-ranging subjects like creativity, evolution and love. It was published in the journal Frontiers in Human Neuroscience.

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