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Most people know what they need to do to be healthier, but they may not know precisely how to do it. There is no shortage of information on different diets and exercise programs, yet people are often confused about what will work best for them. Additionally, there can be internal and external barriers to making healthy changes. External obstacles to healthy eating might include a lack of time to prepare nutritious meals, living a high-stress lifestyle, and hearing mixed messages about the best diet to follow. Internally, a person might experience anxiety, worry, or pessimism, which could make it difficult to follow through on making intended changes.

A study of 356 patients with high cholesterol explored why people don’t follow dietary guidelines given to them by their doctors. Researchers found that 34.7% of study participants thought their diet habits were already suitable, 33% did not want to feel deprived, 27.8% thought it would be difficult to eat a separate diet from their family, and 22.2% were taking cholesterol-lowering medications and did not think dietary changes would be necessary.

There are many ways that we can facilitate behavior change when it comes to diet and lifestyle. Personalized nutrition is one avenue to increase motivation for change. It is also worth considering how factors such as stress, gut microbiome, and inflammation impact decision-making. Finally, harnessing the power of guided imagery and life purpose can support the formation of positive health habits.

Personalized Nutrition

Personalized nutrition takes a person’s genetics, physiology, and diet into account. While the research is mixed on the effectiveness of personalized nutrition for reducing chronic disease risk, there is some evidence that personalized nutrition recommendations are more helpful than general guidance in facilitating the implementation of dietary changes.

A study looking at how genetic information influences dietary intake found that adults with a particular polymorphism of the ACE gene significantly reduced their sodium intake compared to controls. A separate study found that participants who received genetic information were more likely to maintain weight loss (73%) after 300 days compared to controls (32%). The group receiving genetic information also experienced a reduction in fasting glucose. The Food4Me study discovered that participants who received personalized nutrition advice had a higher Mediterranean Diet score at six months compared to controls. Those who received additional information about their genetics experienced the most significant change in diet scores by the end of the intervention. Participants in the personalized nutrition groups also consumed less red meat, saturated fat, and salt while increasing their dietary intake of folate.

Young women were assessed for polymorphisms of the FADS1 gene, which is involved in the conversion of alpha-linolenic acid (ALA) into eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). While the control group and those who received their genetic information both significantly increased their dietary intake of EPA and DHA, those in the genetic group found dietary recommendations to be more useful and found cost to be less of a barrier to consuming these omega-3 fatty acids. They also had an increased awareness of omega-3 terminology.

When giving personalized nutrition advice, it is also important to consider how a person’s psychology influences their ability to receive the information. People have different needs and motivations for change. For example, some people have more intrinsic motivation for healthy eating that supports their dietary choices, while others may need to address their perceived barriers to change. Diving deeper into personal motivation can be an additional piece to the puzzle of personalized nutrition.

Physiological Influences

It is also worth considering how factors such as stress, the microbiome, inflammation, and nutrition impact the decision-making process. One study found that participants who experienced mental or physical stress had altered taste perception. After completing mental tasks, participants felt tense and fatigued with a shorter duration of sweet, sour, and bitter tastes. After rowing on an ergometer, they also had fatigue and tension but noted an increase in vigor. In the case of physical exertion, only the duration of sour taste decreased. Changes in taste perception may impact a person’s affinity for certain foods as they are striving to make dietary changes.

Inflammation can impact the brain and, subsequently, behavior. Chronic neuroinflammation affects synaptic plasticity, or the ability for the space between neurons to change. An animal study looking at the connection between inflammatory pain and behavior found that pain increased anxiety, activated the stress response, and influenced gene expression in the amygdala, the part of the brain that is involved in emotional regulation. Inflammation has been found to be predictive of impulsivity, as well as an inability to delay gratification. When it comes to diet and exercise, it is essential to delay gratification since the results of healthy eating and exercise may not be visible right away. It may be more satisfying in the moment to eat a donut rather than broccoli, but a diet rich in vegetables is much more supportive of health in the long run.

The microbiome plays a role in the inflammatory response through its influence on the gut-brain axis. Diet plays an influential role in modulating the gut microbiome and quelling inflammation. Healthy medical students who received omega-3 fatty acid supplementation experienced a reduction in anxiety and inflammation induced by lipopolysaccharides, or endotoxins produced by gram-negative bacteria in the gut. Omega-3 fatty acids can be found in cold-water fish, which are an important component of the Mediterranean diet. This dietary pattern is rich in colorful fruits, vegetables, nuts, seeds, and olive oil with decreased saturated fat and added sugars. It has been found to positively affect the gut microbiome and reduce metabolic endotoxemia, or an increased level of lipopolysaccharides (LPS). LPS activate the immune system which creates chronic, systemic inflammation. While high-fat diets (particularly those rich in saturated fat) may decrease microbial diversity and increase intestinal hyperpermeability, fiber-rich foods and polyphenols nourish beneficial gut bacteria and support the integrity of the intestinal lining.

Tryptophan is another component of the diet that influences the gut-brain axis. Tryptophan is an amino acid that serves as a precursor for serotonin, the neurotransmitter involved in functions such as emotional regulation and sleep. Tryptophan metabolites influence parts of the brain involved in learning and memory. Dietary sources of tryptophan include turkey, oats, nuts, seeds, and dairy products.

The Power of Purpose & Imagery

Life purpose can be a strong driver of behavioral change. People can find their purpose through health and well-being, personal relationships, spirituality, and more. Having a life purpose in older adulthood has been found to increase life satisfaction, as well as decrease the risk of cognitive decline. In young adults, having a purpose in life has been associated with preventative health care, greater well-being, and more time spent volunteering.

Guided imagery is a tool used to promote behavioral change. A study looking at the use of guided imagery in obese Latino adolescents at risk for type 2 diabetes and cardiovascular disease found that guided imagery significantly reduced sedentary behavior by approximately 38% and increased physical activity by approximately 29%. It also decreased cortisol levels, which is significant since stress can cause us to reach for high-calorie comfort foods. The guided imagery sessions included different topics centered around relaxation, as well as having participants imagine themselves engaging in healthy habits such as eating well and exercising.

A separate study used guided imagery to help women reduce their cravings for high-calorie foods. Two groups received information on guided imagery exercises, with one group setting smart phone reminders to do the protocol while the other group did not set reminders. Participants were instructed to imagine throwing high-calorie food away while they adopted negative body language (slumped posture). Next, they imagined eating delicious, healthy food while having positive body language (standing tall). The women who set phone reminders reported performing the imagery exercises more often, which was important as exercise frequency was associated with an improvement in cravings. Both of the guided imagery groups reduced subjective dietary intake compared to the control group.

Closing Thoughts

• Personalized nutrition, which considers a person’s genetics and unique physiology, may facilitate greater habit change compared to general dietary guidelines. Working with a qualified nutrition professional is an excellent way to learn more about which foods work best for you.
• Neuroinflammation can negatively influence behavior, making it more difficult to choose healthy habits. Address inflammation by supporting the gut microbiome. Incorporate various colorful plant foods in the diet to increase intake of polyphenols and fiber.
• Tools such as guided imagery may be helpful in promoting behavioral change. Spend some quiet time imagining yourself engaging in healthy behaviors. Setting phone reminders could be a great way to ensure consistency with guided imagery exercises.

If you plan to incorporate more colorful, plant-based, and/or whole foods into your daily eating or have food allergies or questions about which foods can best support your health, talk to your doctor, nutritionist, dietician, or another member of your healthcare team for personal options based on your individual circumstances. There are certain medications that may interact with plant-based foods.