Sep. 10, 2007 For lunch, Joy Hesemann loved to dive into a platter of deep-fried, crunchy chicken tenders with a side of ranch dressing. At night, she'd fry up ground beef for Hamburger Helper or another boxed meal for her family's dinner. Later, she'd plop in front of the TV or computer screen and rip into a bag of Oreos or potato chips.
"I knew I was constantly overeating and eating the wrong things, and I wasn't exercising," admitted Hesemann, 27, an administrative assistant from Streamwood, Ill. "I wanted to change, but I needed some motivation."
That came in the form of a new research study at Northwestern University investigating innovative ways to rehabilitate people with lousy health habits. The prerequisites: a chummy relationship with saturated fat but no acquaintance with fruits and vegetables; leisure time spent gazing at a TV or computer screen, along with an "allergy" to exercise.
In other words, a typical American lifestyle.
"That was me," Hesemann said. She signed up.
The study was designed by Bonnie Spring, a professor of preventive medicine at Northwestern's Feinberg School of Medicine, to make change as easy as possible.
Spring knows it's overwhelming for someone with a raft of unhealthy habits to overhaul an entire lifestyle. So she wants them to just change two unhealthy behaviors to see if the others will tag along. Sort of a buy two, get two free sale. Her method is based on the Behavioral Economics Theory used by Nobel Prize winner Daniel Kahneman.
She's also helping these fat-food-loving couch dwellers flip their lifestyles with an arsenal of high-tech tools including a specially programmed Palm Pilot to monitor eating and exercise; virtual visits with a personal coach and an accelerometer which straps around the waist to record the intensity of their movements. (You call that a brisk walk?)
Participants are assigned to eat more veggies and fruits or cut down on saturated fat; and cut back on "screen" time or increase exercise.
"We're trying to figure out which two behavior changes give you the maximum healthy bang for your buck on all unhealthy behaviors that we're trying to modify," Spring said.
"The new behaviors come along for the ride in one of two ways -- a complementary behavior or a substitute behavior," Spring explained. "If watching TV means you also snack when you watch, then eating and snacking are complementary behaviors for you. If I can get you to cut down on your TV, you'll probably automatically cut down on your snacking. I make your life simpler by just asking you to change one. The complementary behavior is a bonus that comes along for the ride."
"A substitute behavior replaces or crowds out another behavior," Spring said. An example would be eating more fruits and vegetables, so you would nibble strawberries instead of being elbow-deep in a bag of Cheetos.
Hesemann's assignment for the four-month study was to slash most saturated fat from her diet and break a sweat for an hour a day. She also got a crash course on healthier eating and strategies to inject more physical activity into her day such as taking the stairs instead of the elevator.
She recorded every bite of food and minute of exercise in the ever-present Palm Pilot, which had software to monitor her daily progress. With each entry, an image of a thermometer with a rising "temperature" showed her intake of saturated fat so far that day (she was allowed 20 grams) and her minutes of exercise.
"It was dreadful to have to write it down," Hesemann said about logging in her food. She learned her favorite fried chicken tenders lunch soared past her fat quota as did her beloved Italian sausages. "I said 'Oh, my god. I'm never eating those again!' I hated seeing that thermometer rise."
At the end of each day she'd download the data into her computer and send it to her personal coach. The coach would zip Hesemann encouraging e-mails ("You're doing a great job!") or friendly reminders to get off the couch ("You need 30 minutes more of activity each day.")
As with all participants, Hesemann's recordings in the Palm Pilot and contact with the personal coach gradually tapered off over the four-month period of the study. This latter period is when it gets interesting for Spring. She's waiting to see who falls off the wagon.
"It's really hard to maintain a new healthier lifestyle," Spring said. "At first it's novel and exciting and then the novelty wears off. You tend to revert back to the old habits. There's kind of an inertia that pulls you back."
Spring is anxious to see which two behavior changes best helped people maintain their healthier habits. But she won't know the results until the study ends in 2008.
In the meantime, Joy Hesemann now races up and down the stairs at work instead of punching elevator buttons and hits the gym three days a week. She bakes skinless chicken for dinner and nibbles strawberries for dessert. She's lost 40 pounds and dropped three dress sizes. She's even eliminated high fat foods from her 6-year-old daughter's meals. Six month after the study, Hesemann's new healthy ways show no sign of abating.
"This program made me more conscious of the foods I'm eating. And the exercise is a blast. I still have my fallbacks, but if I go to McDonald's I'll get the grilled chicken sandwich instead of the comforting, nasty foods. For me this is a new way of life. "
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