Sticking to a Diet: Compliance vs. Adherence

By Sondra Forsyth

You may have noticed that most health care professionals have stopped using the word “compliance” when referring to whether or not people stick with medication regimens or apply sunscreen daily or exercise on a regular basis. The word most often used now is “adherence.” The rationale is that telling patients to comply smacks of issuing a command, whereas asking them to adhere implies that they are partners in their care and can use free will to do what’s best for their health.

Whether or not that bit of semantic reasoning makes anyone feel more inclined to make lifestyle changes, I believe you can use it to your advantage when you’re dieting. Instead of feeling punished because you have to comply with the rules, tell yourself that you are choosing to adhere to a regimen that will pare off pounds and restore your vitality and well-being.

You are in control—and that means being proud of yourself as well as more forgiving; you’re less likely to beat yourself up if you fall off the wagon and have to climb back on.

Why We Overeat and Eat the Wrong Foods

Have you ever wondered why some people—perhaps including you—have a tendency to overeat or eat the wrong foods? Researchers in Germany have discovered the reason for “hedonic hyperphagia,” the scientific term for over- eating for pleasure rather than hunger.

For the study, lab rats were offered three test foods in addition to their standard rat chow pellets: powdered animal chow, a mixture of fat and carbohydrates, and potato chips. The rats ate all three, but they more actively pursued the potato chips. The scientists used magnetic resonance imaging (MRI) and saw that the rats’ brains reacted much more positively to the potato chips than to the other food choices. A long-held belief has been that people and animals want certain foods even when they’re not hungry simply because of the high ratio of fats and carbs. But the rats’ brains lit up much more in response to the potato chips than to the mixture of fats and carbohydrates they were offered. The reward and addiction centers of the brain were most affected, but there were also differences in other centers of the brain.

Obviously, there is something other than the high ratio of fats and carbs that makes potato chips so desirable to rats—and to people. The study’s lead researcher, Tobias Hoch, Ph.D., suggested that the reason some people are able to resist foods like potato chips is that individual taste preferences overrule the reward signal from the food. He also brought up the fact that certain people have more willpower than others. Unfortunately, a lot of us will heed the reward signal and toss willpower out the window. Dr. Hoch believes that if researchers can find the molecular triggers in food that stimulate the reward center, the next step could be developing drugs to block the signal.

Defeat Unhealthy Cravings

Until drugs to block unhealthy cravings are developed, try these strategies to keep yourself from reaching for forbidden sweets or any other food you shouldn’t be eating.

• Distract yourself. If you feel the urge to buy
a candy bar when you see the display by the checkout counter at the supermarket, do something quickly to get your mind off the sweet treats. You could whip out your cell phone and check your email or the weather. You could start a pleasant conversation with the person who’s ringing up your items. You could mentally start trying to count backwards from 100 by sevens, the so-called “serial sevens” test for mental acuity. Any activity that will divert your attention from the candy will help you get past a moment of weakness.

• Chew gum. Choose a brand sweetened with xylitol, which dentists recommend. If you’re in public, don’t forget what your mother probably taught you about chewing with your mouth closed.

• Lower your stress level.If you’re an “emotional eater” who has always tended to use food to ease anxiety, switch to other ways to calm down such as soaking in a warm bath scented with aromatherapy oils or doing some deep breathing by inhaling slowly through your nose and exhaling slowly through your mouth.

• Don’t skip meals, especially not breakfast. Even if you don’t feel hungry in the morning, eat a good breakfast. If you don’t, your blood sugar will drop and you’ll probably experiences cravings for sugar or other forbidden carbohydrates. Eat lunch about 4 hours after breakfast, then have a mid-afternoon snack and an early dinner. But resist the temptation to eat before bedtime or indulge in nighttime noshing!

Deal with Disappointment

A study done at INSEAD Business School found that foot- ball fans pig out on saturated fats and sugars on Mondays following a big game that their favorite team loses. The lead researcher, Yann Cornil, noted, “Although prior studies had shown that sport outcomes influence reckless driving, heart attacks, and even domestic violence, no one had examined how they influence eating.”

The study correlated the outcomes from two years’ worth of NFL games with food consumption by fans in more than two dozen cities. The result? On Mondays, fans in cities with a losing team ate about 16% more saturated fat than normal while fans in cities with a winning team ate about 9% less saturated fat than usual. A particularly close game made the trend even more obvious. And when the study included non–football fans in the mix, the trend held.

The researchers surmised that fans—and even non- fans—feel a threat to their identity when their team loses, and they are more apt to use food as a coping mechanism. By comparison, a winning team seems to boost a person’s self-control.

Write Down What Matters to You

You may have asked yourself, what about the cities with perennially losing football teams? Do the fans there eat themselves silly every Monday, year after year? The researchers came up with a solution that they tested in their study of NFL fans: After a defeat, fans would down what mattered to them in life. They found that this technique, which they called “self-affirmation,” wiped out the effects of losing.

That’s a terrific tip whether your reason for wavering in your commitment to your diet is a losing football team or any other setback in life.
Avoid Diet Sabotage

Of course, I realize that you are not dieting in a vacuum. You may have young children or a spouse, or perhaps elderly parents or roommates, living with you who sabotage your efforts even without realizing it. Even living alone may work against you: A long-term study in Europe showed that people on their own don’t eat as well as people sharing quarters.

Let’s look at how to deal with various life scenarios:

• Parents and Grandparents Helping your children and grandchildren learn to eat more vegetables and fewer foods with sugar and white flour is in their best interest. If you start when they’re little, you’ll have more success. But even if your offspring are now tweens and teens, you can gradually accustom them to healthier eating habits. You don’t have to keep them from eating the occasional treat, including birthday cake and ice cream, but they really don’t need dessert every day. They also don’t need candy on a regular basis, and definitely no soft drinks at all. In other words, your diet doesn’t have
to be in conflict with the way the rest of the family eats even if your menus are stricter than theirs.

• Singles You need to discipline yourself to stock up on healthy foods and to cook at home as much as possible. Especially if you’re older, you may fall prey to poor eating habits. That was the startling conclusion of the European study I mentioned: Older single adults ate 2.3 fewer servings of vegetables per day than other people did.

• Caregivers You may be so focused on your loved one’s welfare that you neglect your own. Don’t let that happen! You need to be strong and healthy
to be an effective caregiver. Make time to sit down and eat nutritious meals.

If need be, ask a family member or friend to spell you now and then so you can eat better and also lower your stress level. Keep in mind that fruits, vegetables, and other nutritious fare are good for your loved one as well.

Here are some tips for coping when you’re not the one doing the cooking:

• Eating at restaurants Consider requesting a gluten-free menu even if you’re not allergic. Also, ask to have your food baked or steamed and to have the chef leave off any sauces. Needless to say, you won’t order dessert.

• Going to parties Master the art of “sober socializing.” Ask for a club soda and don’t make a big deal out of that. Then at the buffet table, head for the nuts, veggies, and allowed fruits and meats. Skip the dips and trays of sweets, and you’ll be fine.

• Eating at corporate functions and conferences If there’s a vegan or vegetarian option, order it ahead of time even if you’re not a vegetarian. That way you won’t end up with a plate of food you shouldn’t be eating. If there’s no vegetarian option, fill up on salad and veggies and don’t eat anything with mysterious sauces and ingredients. And whatever you do, wave the server away when he or she comes by with breads and desserts.

• Being a houseguest This can be tricky but you may need to share your dietary needs with your host. You’re not asking for weird ingredients, after all. You just need to be sure there will be food on hand that you are allowed to consume.
So, now you’re armed with all the strategies you need to adhere to your diet and maintain a healthy weight for all the years to come!

Sondra Forsyth is Co-Editor-in-Chief of ThirdAge.com. Her most recent book is “Candida Cleanse: The 21-Day Diet to Beat Yeast and Feel Your Best.”. This article is an excerpt adapted from the book.