Culinary Coaching
UNIT 3 |
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The Science of Satiety
Stress Less Good Mental Health and Eating 5-Step Coaching Model Video Review
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GOAL
OBJECTIVES
SOURCES
- Consider the crucial role of diet in mental health
- Explain the relevance of food choices in the regulation of hormones that determine mental health outcome
- Introduce whole food plant-based diet as proven effective remedy for depression
- Encourage students to explore mental health status of patients suffering from eating behaviors resulting to chronic disease.
OBJECTIVES
- To describe the effect of food choices to inflammation and ultimately to mental health
- To understand the role of whole food plant based diet in managing patients with eating behavior problems leading to chronic diseases
- To describe the relationship of mood regulations and diet
SOURCES
- Undo It, Dean Ornish, MD
- Nutrition Facts, Dr. Michael Greger
- Dr. Neal Nedley
- Culinary Medicine, Dr. John La Puma
The Science of Satiety
Satiety is feeling full and fully satisfied after a meal and staying satisfied until your next meal -- without snacking, munching, and mindless eating. It is a small medical word that offers big benefits if you understand how to achieve it. Fortunately, we are learning more and more about how satiety works and ways can have fun reaching it. Satiety is a key component of successful weight loss, but satiety is vital for more than just weight loss. It's vital for preventing common conditions. When you eat high-quality food and feel full and fully satisfied without feeling stuffed, you've eaten fewer of the anti-nutrients that can threaten your health. If you control satiety, you control your salt intake if you have high blood pressure, your sugar and starch intake if you have diabetes or prediabetes, and your food-borne carcinogen and immunity threats if you are at risk of breast or prostate cancer.
Satiety is determined by two things: how fast or slow you eat, and what you eat. First, know your hormones. Your satiety is at the back of the brain in the the hypothalamus. it is controlled by two opposing brain chemicals - cocaine - and amphetamine-regulated transcript (CART) and neuropeptide Y (NPY). CART tells the hypothalamus to increase metabolism, lessen appetite, and increase insulin so that energy can be burned. NYP does the opposite. Leptin, a hormone made by your belly fat, tells your body you've had enough food. Cholecystokinin (CCK), released by your intestines when food with fat is inside, tells the brain you're full. An ghrelin, a hormone your stomach produces when it's empty, makes you hungry.
There are two kinds of Satiety. One is short term, which means you're full after finishing this meal, right now. The other is long term, which means you'll be full four to six hours from now, when you should be hungry again. Most people on diet feel hungry and they hate it. And once hunger sets in you can't help but pick just anything readily available and eat without minding anything. Satiety isn't just about feeling full - it's about true satisfaction, or feeling pleasantly full with genuinely delicious food.
ENGAGE ALL OF YOUR SENSES
When we think of a sensory response to food, we think of taste. But the other senses are used when we eat, too, even when we're not aware of it. The sooner you engage your other senses - smell, feel, sight, and sound - the sooner you can reach satiety.
SMELL
Smell well to eat well. Three-quarters of how well you taste certain foods actually comes from how you smell them. Rhinitis irritates the inside of the nose and causes mucus to form, reducing your ability to sense flavors. Common medications, chemical exposures, lead and silver fumes, and even polyps in the nose can alter your sense of taste. If you cannot smell well, you do not taste your food fully. Smell adds to satisfaction when you slow down to enjoy the aroma of your food. Inhale the aroma of each food before you eat. Don't just gulp a drink or dig into a plate full of food. take the time to notice what scents you can find in your dinner, drink or snack. This will help you taste deliberately, notice color, see what is in your plate, and feel more satisfied. You'll appreciate more. And you'll also slow your rate of eating.
FEEL
Texture is an important part of food appreciation and can speed you up, slow you down, an even count you out. Biting into a mushy tomato or a stale pieces of bread is awful, and you may even spit the food back out. Food manufacturers know this and spend millions trying to create food that have the right "mouthfeel". Mouthfeel for butter should be smooth and round. Mouthfeel for fresh carrots is crunchy, for an orange segment is juicy and bright. None of these are flavors: they are textures.
SIGHT
Food that looks good sends a very strong message to the brain about how good the food is going to taste. People eating in the dark have quite dim eating experience and less appreciation of their food. Take the time to present food beautifully, almost like a present. Simple garnishes, like chopped parsley, sliced almonds, a sprinkle of cheese or sesame seeds, give dishes a visual flair. When we expect food to taste good because of how it looks, it usually does, because the eyes - and not just the stomach - affect satiety. We can feel just as satisfied - remember, pleasantly full, not stuffed - with a small amount of beautiful and delicious-looking food as we can from a bigger amount of less appetizing-looking food.
SOUND
The sound of steak hitting the hot grill and popcorn's sound when it pops both promise flavors that can make your mouth water. Even the snap of topping and tailing fresh green beans has an auditory satisfaction all its own. Enjoy the sound of your food - it can enhance its flavor.
EAT LONG FATS
Eat food that has long chain fatty acids (at least ten carbon molecules) from plant-based sources. When fat in food reaches the small intestine, the CCK hormone is released, which help you feel full in three different ways - through your nerves, stomach, an brain. But only fat molecules at least ten carbons long effectively release CCK. Many foods contain long chain fatty acids: avocado, nuts and seeds are some great choices. Since the food label won't tell you if the fat is ten carbons long, you need to know which foods have them. What type of fat you eat does matter for satiety. Both short-chain solid, saturated fats (fats that are solid at room temperature) - like those in lunch meats and pastries - and trans fats worsen insulin resistance. Both saturated fats cause the hormone NPY to be released from the brain. NPY then accelerates reward eating and causes you to overeat. Eating the wrong fats can actually make you hungrier. In contrast, long-chain unsaturated fats improve insulin sensitivity and help you reach satiety.
Satiety is determined by two things: how fast or slow you eat, and what you eat. First, know your hormones. Your satiety is at the back of the brain in the the hypothalamus. it is controlled by two opposing brain chemicals - cocaine - and amphetamine-regulated transcript (CART) and neuropeptide Y (NPY). CART tells the hypothalamus to increase metabolism, lessen appetite, and increase insulin so that energy can be burned. NYP does the opposite. Leptin, a hormone made by your belly fat, tells your body you've had enough food. Cholecystokinin (CCK), released by your intestines when food with fat is inside, tells the brain you're full. An ghrelin, a hormone your stomach produces when it's empty, makes you hungry.
There are two kinds of Satiety. One is short term, which means you're full after finishing this meal, right now. The other is long term, which means you'll be full four to six hours from now, when you should be hungry again. Most people on diet feel hungry and they hate it. And once hunger sets in you can't help but pick just anything readily available and eat without minding anything. Satiety isn't just about feeling full - it's about true satisfaction, or feeling pleasantly full with genuinely delicious food.
ENGAGE ALL OF YOUR SENSES
When we think of a sensory response to food, we think of taste. But the other senses are used when we eat, too, even when we're not aware of it. The sooner you engage your other senses - smell, feel, sight, and sound - the sooner you can reach satiety.
SMELL
Smell well to eat well. Three-quarters of how well you taste certain foods actually comes from how you smell them. Rhinitis irritates the inside of the nose and causes mucus to form, reducing your ability to sense flavors. Common medications, chemical exposures, lead and silver fumes, and even polyps in the nose can alter your sense of taste. If you cannot smell well, you do not taste your food fully. Smell adds to satisfaction when you slow down to enjoy the aroma of your food. Inhale the aroma of each food before you eat. Don't just gulp a drink or dig into a plate full of food. take the time to notice what scents you can find in your dinner, drink or snack. This will help you taste deliberately, notice color, see what is in your plate, and feel more satisfied. You'll appreciate more. And you'll also slow your rate of eating.
FEEL
Texture is an important part of food appreciation and can speed you up, slow you down, an even count you out. Biting into a mushy tomato or a stale pieces of bread is awful, and you may even spit the food back out. Food manufacturers know this and spend millions trying to create food that have the right "mouthfeel". Mouthfeel for butter should be smooth and round. Mouthfeel for fresh carrots is crunchy, for an orange segment is juicy and bright. None of these are flavors: they are textures.
SIGHT
Food that looks good sends a very strong message to the brain about how good the food is going to taste. People eating in the dark have quite dim eating experience and less appreciation of their food. Take the time to present food beautifully, almost like a present. Simple garnishes, like chopped parsley, sliced almonds, a sprinkle of cheese or sesame seeds, give dishes a visual flair. When we expect food to taste good because of how it looks, it usually does, because the eyes - and not just the stomach - affect satiety. We can feel just as satisfied - remember, pleasantly full, not stuffed - with a small amount of beautiful and delicious-looking food as we can from a bigger amount of less appetizing-looking food.
SOUND
The sound of steak hitting the hot grill and popcorn's sound when it pops both promise flavors that can make your mouth water. Even the snap of topping and tailing fresh green beans has an auditory satisfaction all its own. Enjoy the sound of your food - it can enhance its flavor.
EAT LONG FATS
Eat food that has long chain fatty acids (at least ten carbon molecules) from plant-based sources. When fat in food reaches the small intestine, the CCK hormone is released, which help you feel full in three different ways - through your nerves, stomach, an brain. But only fat molecules at least ten carbons long effectively release CCK. Many foods contain long chain fatty acids: avocado, nuts and seeds are some great choices. Since the food label won't tell you if the fat is ten carbons long, you need to know which foods have them. What type of fat you eat does matter for satiety. Both short-chain solid, saturated fats (fats that are solid at room temperature) - like those in lunch meats and pastries - and trans fats worsen insulin resistance. Both saturated fats cause the hormone NPY to be released from the brain. NPY then accelerates reward eating and causes you to overeat. Eating the wrong fats can actually make you hungrier. In contrast, long-chain unsaturated fats improve insulin sensitivity and help you reach satiety.
Stress Less
One author said "The great thing, then, in all education, is to make our nervous system our ally instead of our enemy." Chronic stress is one of the important mechanisms underlying so many chronic diseases. It has a direct effect on our health mediated through the sympathetic nervous system, and it plays an important role via affecting each of the other mechanisms present in the body.
When it's chronic, stress can increase inflammation in your brain which in turn can lead to or exacerbate depression. And when depressed, your immune system is depressed - for example, people who are HIV positive and depressed have more than double the likelihood of dying from AIDS than those who are not depressed. Chronic stress shortens telomeres, adversely affects how your genes are expressed, and can have a harmful impact on the balance of the trillions of cells in your microbiome. Chronic emotional stress increases oxidative stress as well, and has a negative effects on cellular metabolism and apoptosis, angiogenesis, and stasis. It causes blockages to build up faster in your arteries independent of diet.
So here's one good news: stress comes primarily not just from what happens to us but, more important, how we react to what happens to us. how we react, in turn, is a function of our lifestyle and our beliefs. In short, even when we can't change what's going on in our lives, we have a lot more choice about how we react to it than we might have believed. And just as chronic stress can adversely affect our health via all of the mechanisms described above, managing stress more effectively can beneficially affect our health via all of these same mechanisms - and more quickly than had once been realized. For example, just as chronic stress can suppress your immune function, love, altruism, and compassion can enhance it.
IT'S THE PERCEPTION OF STRESS
Chronic emotional stress shortens our telomeres, the ends of our chromosomes that regulate cellular aging. As our telomeres get shorter, our lives get shorter. Taking care of a child with autism or a parent with Alzheimer's disease can be highly stressful on an ongoing, chronic bases, often for many years. it's hard to change the external stressors when your child or parents needs you for their survival on a daily basis.
In one study, Dr. Dean Ornish and his colleagues studied caregivers of children with autism and found that the more stress the women reported feeling, the shorter were the length of their telomeres. Women with the highest levels of perceived stress had significantly shorter telomeres, corresponding to having telomeres thirteen average "years" shorter! But the researchers found that it wasn't an objective measure of stress that determined its effects on their telomeres. it was how they reacted to the stress. Their perceptions of stress were more important than what was objectively occurring in their lives.
So if you feel stressed, you are stressed. Although these women were in very similar life situations, they had dramatically different outcomes. Those who practiced the elements of the lifestyle medicine program were able to buffer the stress, so it didn't affect their telomeres and health - they became more resilient. In contrast, the others showed a significant shortening of their telomeres and, as such, their lives. This is a very empowering finding - because we can't always change what's happening to us, but we have a lot more control over how we react to it than we might realize. Again, not to blame but to empower. The effects of stress can be debilitating or they can be enhancing. Psychologists often use analogies to talk about finding the right balance of having enough stress but not too much - like a violin string if it's too loose, there's no music; if it's literally too high-strung, it breaks, and there's no music.
For example, a recent study showed that you can change your emotional and biological response to stress just by adjusting your mindset about it. For many people, giving a public lecture is highly stressful. But students who were trained to view stress as enhancing rather than harmful had levels of stress hormone cortisol that were neither too high nor too low. Interestingly, the stress-is-enhancing mindset was associated with reduced activity in high cortisol responders nd increased activity in low cortisol responders to achieve an appropriate or moderate level of arousal.
When you eat well, move more, and love more, then you stress less. Potentially stressful situations just don't bother you as much, giving you more degrees of freedom to react to the same situation in more productive and healing ways.
CHANGE YOUR MIND, CHANGE YOUR BRAIN
Neuroplasticity is the ability of the adult brain to change its structure and function by generating new cells and pathways. When you eat well, move more, stress less, and love more, the part of your brain that controls memory, called hippocampus, cam get measurably bigger in only a few weeks. New research indicates that you can actually rewire your brain to have more positive responses - seeing the proverbial glass a half full instead of half empty. We can all learn to be more positive by practicing doing so. In other words, your higher cognitive function - your thoughts - can directly influence your amygdala, the "animal' part of your brain that houses emotions life fear and anger.
When it's chronic, stress can increase inflammation in your brain which in turn can lead to or exacerbate depression. And when depressed, your immune system is depressed - for example, people who are HIV positive and depressed have more than double the likelihood of dying from AIDS than those who are not depressed. Chronic stress shortens telomeres, adversely affects how your genes are expressed, and can have a harmful impact on the balance of the trillions of cells in your microbiome. Chronic emotional stress increases oxidative stress as well, and has a negative effects on cellular metabolism and apoptosis, angiogenesis, and stasis. It causes blockages to build up faster in your arteries independent of diet.
So here's one good news: stress comes primarily not just from what happens to us but, more important, how we react to what happens to us. how we react, in turn, is a function of our lifestyle and our beliefs. In short, even when we can't change what's going on in our lives, we have a lot more choice about how we react to it than we might have believed. And just as chronic stress can adversely affect our health via all of the mechanisms described above, managing stress more effectively can beneficially affect our health via all of these same mechanisms - and more quickly than had once been realized. For example, just as chronic stress can suppress your immune function, love, altruism, and compassion can enhance it.
IT'S THE PERCEPTION OF STRESS
Chronic emotional stress shortens our telomeres, the ends of our chromosomes that regulate cellular aging. As our telomeres get shorter, our lives get shorter. Taking care of a child with autism or a parent with Alzheimer's disease can be highly stressful on an ongoing, chronic bases, often for many years. it's hard to change the external stressors when your child or parents needs you for their survival on a daily basis.
In one study, Dr. Dean Ornish and his colleagues studied caregivers of children with autism and found that the more stress the women reported feeling, the shorter were the length of their telomeres. Women with the highest levels of perceived stress had significantly shorter telomeres, corresponding to having telomeres thirteen average "years" shorter! But the researchers found that it wasn't an objective measure of stress that determined its effects on their telomeres. it was how they reacted to the stress. Their perceptions of stress were more important than what was objectively occurring in their lives.
So if you feel stressed, you are stressed. Although these women were in very similar life situations, they had dramatically different outcomes. Those who practiced the elements of the lifestyle medicine program were able to buffer the stress, so it didn't affect their telomeres and health - they became more resilient. In contrast, the others showed a significant shortening of their telomeres and, as such, their lives. This is a very empowering finding - because we can't always change what's happening to us, but we have a lot more control over how we react to it than we might realize. Again, not to blame but to empower. The effects of stress can be debilitating or they can be enhancing. Psychologists often use analogies to talk about finding the right balance of having enough stress but not too much - like a violin string if it's too loose, there's no music; if it's literally too high-strung, it breaks, and there's no music.
For example, a recent study showed that you can change your emotional and biological response to stress just by adjusting your mindset about it. For many people, giving a public lecture is highly stressful. But students who were trained to view stress as enhancing rather than harmful had levels of stress hormone cortisol that were neither too high nor too low. Interestingly, the stress-is-enhancing mindset was associated with reduced activity in high cortisol responders nd increased activity in low cortisol responders to achieve an appropriate or moderate level of arousal.
When you eat well, move more, and love more, then you stress less. Potentially stressful situations just don't bother you as much, giving you more degrees of freedom to react to the same situation in more productive and healing ways.
CHANGE YOUR MIND, CHANGE YOUR BRAIN
Neuroplasticity is the ability of the adult brain to change its structure and function by generating new cells and pathways. When you eat well, move more, stress less, and love more, the part of your brain that controls memory, called hippocampus, cam get measurably bigger in only a few weeks. New research indicates that you can actually rewire your brain to have more positive responses - seeing the proverbial glass a half full instead of half empty. We can all learn to be more positive by practicing doing so. In other words, your higher cognitive function - your thoughts - can directly influence your amygdala, the "animal' part of your brain that houses emotions life fear and anger.
Good Mental Health and Eating
Good mental health indicates that positive psychological well-being is associated with reduced risk of physical illness, but which cam first? Are people healthier because they're happy, or are people just happier because they're healthy? Prospective studies that follow individuals over time have found that people starting out happier do indeed end up healthier. An analysis of seventy such studies on mortality concluded that "positive psychological well-being has a favorable effect on survival in both healthy and diseased populations." Those who are happier appear to live longer.
Not so fast though. While positive mental states may be associated with less stress and more resilience to infection, positive well-being might also be accompanied by a HEALTHY LIFESTYLE. In general, people who feel satisfied appear to smoke less, exercise more, and eat healthier. So is being happier just a marker of good health and not a cause of it? To find out, researchers set out to make people sick.
Scientists at Carnegie Mellon University took hundreds of individuals - some happy, some unhappy - and paid them $800 each to be allowed to drip the common cold virus into their noses. Even if someone with a cold sneezes right into your face and the virus gets into your nose, you won't get sick automatically, because your immune system may be able to fight it off. So the study question was: Whose immune system would be better at fighting off a common virus - those in the group initially rated as happy, peppy, and relaxed, or those in the group who were anxious, hostile, and depressed?
About one in three of the negative-emotion individuals failed to successfully fight off the virus and came down with a cold. But only one in five of the happy individuals became sick, even after the researchers took into account such factors as subjects' sleep patterns, exercise habits, and stress levels. In a subsequent study, the researchers even exposed subjects into the influenza virus, a more serious infection. once again, increased positive emotions were associated with decreased verified illness rates. Happier people, it seems, are less likely to get sick.
So mental health does appear to play a part in physical health. That's why it's crucial that the food you eat support both your mind and your body. As you'll see, common foods from leafy green vegetables to your basic garden-variety tomato may positively affect your brain chemistry and help ward off depression. In fact, even simply smelling a common spice may improve your emotional state.
Not so fast though. While positive mental states may be associated with less stress and more resilience to infection, positive well-being might also be accompanied by a HEALTHY LIFESTYLE. In general, people who feel satisfied appear to smoke less, exercise more, and eat healthier. So is being happier just a marker of good health and not a cause of it? To find out, researchers set out to make people sick.
Scientists at Carnegie Mellon University took hundreds of individuals - some happy, some unhappy - and paid them $800 each to be allowed to drip the common cold virus into their noses. Even if someone with a cold sneezes right into your face and the virus gets into your nose, you won't get sick automatically, because your immune system may be able to fight it off. So the study question was: Whose immune system would be better at fighting off a common virus - those in the group initially rated as happy, peppy, and relaxed, or those in the group who were anxious, hostile, and depressed?
About one in three of the negative-emotion individuals failed to successfully fight off the virus and came down with a cold. But only one in five of the happy individuals became sick, even after the researchers took into account such factors as subjects' sleep patterns, exercise habits, and stress levels. In a subsequent study, the researchers even exposed subjects into the influenza virus, a more serious infection. once again, increased positive emotions were associated with decreased verified illness rates. Happier people, it seems, are less likely to get sick.
So mental health does appear to play a part in physical health. That's why it's crucial that the food you eat support both your mind and your body. As you'll see, common foods from leafy green vegetables to your basic garden-variety tomato may positively affect your brain chemistry and help ward off depression. In fact, even simply smelling a common spice may improve your emotional state.
5-Step Coaching Model
We are adopting the Frates 5-step coaching cycle model that was published in the American Journal of Physical Medicine and Rehabilitation in 2011 which is still relevant today. it focuses on the basic of being emphatic, aligning motivation, building confidence, setting SMART goals, and creating a mechanism for accountability. The model features the following five steps, which are designed to help practitioners negotiate and collaborate with their patients:
1. BE EMPATHETIC
Empathy begins and ends the 5-step coaching cycle. Empathy is the fuel that propels the cycle around. It is also the keystone for building a relationship with a patient. It is defined as identification with and understanding of another individual's situation, feelings, and motives." Empathy requires that the practitioner be fully present and engaged with the patient. Among the key features of being empathetic are sharing a caring relationship, being trustworthy, listening and demonstrating attention with reflections, being nonjudgmental, being respectful, being supportive, and being genuinely curious about the patient.
2. ALIGN MOTIVATION
According to self-determination theory, a foundation of behavior change counseling created by Edward Deci, PhD and Richard M. Ryan, PhD, at the University of Rochester, people experience volitional motivation that helps them persevere with their goals when three specific needs are met: they feel a sense of autonomy; they feel competent to achieve the goal; and they feel a sense of relatedness or connection. The work of these two renowned psychologist separates extrinsic (external) motivation from intrinsic (internal) motivation. When patients make changes because they are working toward internal rewards that are important to them, they are more likely to sustain healthy behaviors than when they are working toward external rewards. The key for providers is to be curious about what is important and meaningful to each individual patient.
3. BUILD CONFIDENCE
After cultivating motivation, the next step is to build confidence. One effective way to accomplish this objective is to talk about a patient's strengths and past success. By inquiring about positive experiences and strengths, a physician can find out what is working well. several psychological theories support the concept of building confidence to empower lasting change, including social cognitive theory, positive psychology, and hope theory. Each of these approaches has its own set of unique features that will be explored further in Culinary Coaching 2 module.
Everyone has negative thoughts. They are part of life. Psychologist often refer to them as ANTs (automatic negative thoughts). Most people have an inner critic that lives inside their head. This critic finds fault with just about anything and everything depending on the person. Inserting a positive though plays a crucial role in every situation. Adding positive thoughts to the self-talk mix, as well as recalling occasions when success was achieved, helps people to forge forward in their journey of achieving behavioral change. Even better to address the inner critic. Some people call it the gremlin. it is possible to fire the gremlin and hire a positivity princess or prince who tries to encourage, support, and build you up. Working with patients on being a self-advocate and using self-compassion is helpful when trying to adopt and sustain lifestyle change.
4. SET SMART GOALS
Part of building self-confidence is setting goals that are realistic and achievable. Setting SMART goals namely goals that are specific, measurable, action-oriented, realistic, and time-sensitive. When setting SMART goals, it is important to begin with the end in mind. In other words, it is essential that practitioners determine their end goal first and foremost. it is often helpful to create a vision of the future. What do patients want? What are they striving for? What do they want to be like 10 years, 20 years?
The more specific and creative this vision - including as many senses as possible - the better. Once the vision is set, goal-setting can begin. First choose some long-term goals: one-year, six-month, three-month, and one-month goals. Then, tackle short-term goals. What can patients accomplish in a week? What will they do on a specific day of the week? Starting with the end in mind, the vision and taking the long-term view can then help with short-term planning, as well as goal-setting.
The best way to determine if a goal is realistic is to check on the patient's confidence level about completing the goal. using a scale of 0 to 10 can be helpful. if patients say that they're at a 10 for confidence, then that is a realistic goal. On the other hand, a 10 rating might also suggest the goal is too easy. Inquiring if they want to increase the challenge is appropriate in this instance, as is allowing the patients to set a simple goal and be successful. If an individual picks a 6 out of 10 for a confidence level, then the patient and the practitioner need to reconsider that goal. Asking patients how they could adjust the goal so that it is a little easier for them to achieve will help keep them focused and motivated through the behavior change process. It is important to select goals that are challenging and complex, but not too challenging or complex. If the goals are realistic, then patients can attain them. Success breeds success. Every time a patient achieves a goal, the patient feels a reward. There can be surge of dopamine released in the brain that increases motivation to keep making goals and achieving them. This process is how small changes bring big rewards.
5. SET ACCOUNTABILITY
The last step is setting accountability. While it is critical to set goals, it is just as critical to follow up on them. The practitioner needs to check in with the patient. Alternatively, the practitioner and patient can set up a buddy system in which the patient enlist a spouse, friend, coworker, or relative to be their accountability buddy. This person checks in with the patient on a routine basis - at least once a week.
1. BE EMPATHETIC
Empathy begins and ends the 5-step coaching cycle. Empathy is the fuel that propels the cycle around. It is also the keystone for building a relationship with a patient. It is defined as identification with and understanding of another individual's situation, feelings, and motives." Empathy requires that the practitioner be fully present and engaged with the patient. Among the key features of being empathetic are sharing a caring relationship, being trustworthy, listening and demonstrating attention with reflections, being nonjudgmental, being respectful, being supportive, and being genuinely curious about the patient.
2. ALIGN MOTIVATION
According to self-determination theory, a foundation of behavior change counseling created by Edward Deci, PhD and Richard M. Ryan, PhD, at the University of Rochester, people experience volitional motivation that helps them persevere with their goals when three specific needs are met: they feel a sense of autonomy; they feel competent to achieve the goal; and they feel a sense of relatedness or connection. The work of these two renowned psychologist separates extrinsic (external) motivation from intrinsic (internal) motivation. When patients make changes because they are working toward internal rewards that are important to them, they are more likely to sustain healthy behaviors than when they are working toward external rewards. The key for providers is to be curious about what is important and meaningful to each individual patient.
3. BUILD CONFIDENCE
After cultivating motivation, the next step is to build confidence. One effective way to accomplish this objective is to talk about a patient's strengths and past success. By inquiring about positive experiences and strengths, a physician can find out what is working well. several psychological theories support the concept of building confidence to empower lasting change, including social cognitive theory, positive psychology, and hope theory. Each of these approaches has its own set of unique features that will be explored further in Culinary Coaching 2 module.
Everyone has negative thoughts. They are part of life. Psychologist often refer to them as ANTs (automatic negative thoughts). Most people have an inner critic that lives inside their head. This critic finds fault with just about anything and everything depending on the person. Inserting a positive though plays a crucial role in every situation. Adding positive thoughts to the self-talk mix, as well as recalling occasions when success was achieved, helps people to forge forward in their journey of achieving behavioral change. Even better to address the inner critic. Some people call it the gremlin. it is possible to fire the gremlin and hire a positivity princess or prince who tries to encourage, support, and build you up. Working with patients on being a self-advocate and using self-compassion is helpful when trying to adopt and sustain lifestyle change.
4. SET SMART GOALS
Part of building self-confidence is setting goals that are realistic and achievable. Setting SMART goals namely goals that are specific, measurable, action-oriented, realistic, and time-sensitive. When setting SMART goals, it is important to begin with the end in mind. In other words, it is essential that practitioners determine their end goal first and foremost. it is often helpful to create a vision of the future. What do patients want? What are they striving for? What do they want to be like 10 years, 20 years?
The more specific and creative this vision - including as many senses as possible - the better. Once the vision is set, goal-setting can begin. First choose some long-term goals: one-year, six-month, three-month, and one-month goals. Then, tackle short-term goals. What can patients accomplish in a week? What will they do on a specific day of the week? Starting with the end in mind, the vision and taking the long-term view can then help with short-term planning, as well as goal-setting.
The best way to determine if a goal is realistic is to check on the patient's confidence level about completing the goal. using a scale of 0 to 10 can be helpful. if patients say that they're at a 10 for confidence, then that is a realistic goal. On the other hand, a 10 rating might also suggest the goal is too easy. Inquiring if they want to increase the challenge is appropriate in this instance, as is allowing the patients to set a simple goal and be successful. If an individual picks a 6 out of 10 for a confidence level, then the patient and the practitioner need to reconsider that goal. Asking patients how they could adjust the goal so that it is a little easier for them to achieve will help keep them focused and motivated through the behavior change process. It is important to select goals that are challenging and complex, but not too challenging or complex. If the goals are realistic, then patients can attain them. Success breeds success. Every time a patient achieves a goal, the patient feels a reward. There can be surge of dopamine released in the brain that increases motivation to keep making goals and achieving them. This process is how small changes bring big rewards.
5. SET ACCOUNTABILITY
The last step is setting accountability. While it is critical to set goals, it is just as critical to follow up on them. The practitioner needs to check in with the patient. Alternatively, the practitioner and patient can set up a buddy system in which the patient enlist a spouse, friend, coworker, or relative to be their accountability buddy. This person checks in with the patient on a routine basis - at least once a week.
Video on Demand Review
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PLANT-BASED DIET AND MOOD IMPROVEMENT by: Dr. Michael Greger |
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FOOD TO COUNTER STRESS-INDUCED IMMUNNOSUPPRESSION by: Dr. Michael Greger |
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CURING DEPRESSION WITH FOOD AND LIFESTYLE by: Dr. Neal Nedley |