A Healthy Lifestyle, Long May It Last

How often have you struggled with a lack of willpower? As I once again skip my morning run, despite swearing that I would go jogging in the forest every day, I feel my resolve slowly slip away. But changing habits takes time. It’s important to expect setbacks and learn to deal with them, says social and health psychologist Urte Scholz. “It’s a learning process – just like learning a new language.”

The New Year’s resolutions you whisper into your partner’s ear to the sound of fireworks as midnight strikes, champagne in hand, eyes slightly glazed and words softly slurred, sound all too promising. At long last there’ll be less alcohol, fewer sweets, no more pastries for breakfast, no more take-out for dinner, less meat, more exercise, a daily gym routine, enough sleep and, of course, no more cigarettes – never again. You gaze into each other’s eyes as Bésame mucho plays in the background.

January gets off to a good start. The resolutions are still fresh, and stores are replete with options for Veganuary and Dry January, inviting you to spend money on new types of food and drink. Gradually, however, everyday life starts to creep back in. By February, those promising resolutions are long forgotten. Monday rolls round and she’s smoking a cigarette with her after-work beer, while he’s put away two croissants for breakfast after a bad night’s sleep. Then when it starts to get cold outside, it’s hard to resist a comforting meal topped with plenty of cheese and butter. And what about that jog in the forest? Does watching the trees go by from the tram window count? Urte Scholz smiles. You shouldn’t be too strict with yourself, she explains. You won’t get far with dogmatic approaches and strict resolutions. “You need a plan,” says the health psychologist.

We know quite well what makes for a healthy lifestyle: abstaining from smoking, a balanced diet, low alcohol consumption, plenty of physical activity, sufficient sleep and rest are the most important factors. We see these habits recommended not only by medical professionals, but also by lifestyle columns and feeds.

But is our lifestyle really so unhealthy? Does it really matter which bad habits we pick up over the course of our lives? The answer is yes, it does. The Federal Office of Public Health (FOPH) and the World Health Organization (WHO) are in agreement with Urte Scholz here. The most common cause of death worldwide is cardiovascular disease. According to WHO, it is responsible for the deaths of approximately 13.9 million people every year. In Switzerland, cardiovascular disease kills over 20,000 people, which accounts for about a third of annual deaths, followed by respiratory disease, cancer and diabetes. The FOPH lists a lack of exercise as one of the most significant factors that can lead to illness and suffering. It also results in very high healthcare costs that society as a whole must bear.

“In fact, cardiovascular disease, apart from factors such as age, gender and genetics, is very heavily influenced by our lifestyle,” says Urte Scholz. This also applies to acquired type 2 diabetes, which is increasingly being diagnosed in younger, overweight individuals. This demonstrates how efforts to maintain a healthy lifestyle have an impact on our physical health, improved well-being and healthcare costs.

“Unfortunately, we don’t have a health system, we have a sickness system,” says the social and health psychologist. Nowadays, people generally only receive any kind of financial support once they’re already unwell. But treatment is more expensive than prevention. Scholz is convinced that “more prevention and health promotion is needed. This would be more cost-effective”.

The researcher believes one possible approach could be offering individual health advice, targeted coaching provided by health psychologists, as part of standard health insurance benefits. This would help to support those at risk in good time and prevent illness. This kind of individualized support would be more effective than expensive lifestyle campaigns and, above all, cheaper than the costs that arise when people fall ill.

Information campaigns also play a role, but they must be constructive. “Risk communication alone seems to have little effect,” Scholz explains, citing cigarette packaging as an example. People who want to smoke will do so, even when the pack displays shocking images and warnings that smoking causes cancer. Smokers generally know the risks. “That’s why we also need motivating messages with a focus on self-efficacy,” she adds. Changing behavior requires positivity and motivation. Saying “You can do it! Here’s where you get support” and sending a link is more useful than deterrents.

Loved ones can be quite helpful when it comes to finally quitting smoking or getting more exercise. In several studies, Scholz has shown that loving partners, best friends or family members can support each other effectively when it comes to changing unhealthy habits. This could mean sending a text message like, “Remember to get wholemeal bread instead of a croissant... :)” or “I’ve put a non-alcoholic beer in the fridge for you”. Another example is, “Did you use the stairs instead of the elevator today? Check your step counter!” This can support changes in behavior.

Scholz and her team invited overweight couples who both wanted to become more physically active to participate in an intervention study. One member of each couple was randomly designated as the target, while the other was assigned to support them by sending text messages with hints or questions. For example, “Did you do manage to do the workout you had planned today?” The activities were monitored using motion sensors. Indeed, these couples were more physically active than those in the control group, who received no supportive text messages.

Scholz was also interested in what happens when people not only support and motivate their partners in changing their behavior but also actively try to check on and influence it. This can work well – as long as it’s positive, says Scholz. This could mean sending a text saying something like, “It’s great that you only smoked seven cigarettes today instead of ten! Try to get down to five tomorrow” to a partner who’s trying to quit smoking. In fact, couples who kept an eye on their partner’s habits while communicating in a motivational way were more successful. Putting pressure on your partner is less effective. Saying something like, “If you really loved me, you’d stop smoking” can trigger a defiant reaction, says Scholz. It can lead to negative feelings and resistance.

No alcohol, no chocolate, no more smoking – a healthy lifestyle seems to be all about sacrifice and asceticism. Where’s the fun in that? Scholz smiles and shakes her head. That’s not the idea. “The new habits should be positive,” says the psychologist. Doing more exercise should be fun. This means finding the right sport. Maybe jogging doesn’t appeal, but a brisk walk with a friend through the forest does. The focus should be on the advantages and freedoms you gain when you stop smoking or start drinking less, like feeling better in your own body. Urte Scholz also has her vices, she admits: she likes eating sweets. But as long as she only eats a few bites and not the whole bar of chocolate, it’s not a problem. In fact, it even means she enjoys it more.