It’s a habit because it all happens without thinking about it. There’s nothing being done to avoid something. Or even something to enjoy. It’s just a bad habit.

Nonconscious processes direct everything we do. They’re simply the result of everything we’ve always done. We can make changes but we have to plan it all out.

Here’s how to think about redirecting health habits.

To learn more about programs Herd Healthcare offers, our website is:
www.herdhealthcare.com

What Are Habits?

Habits are automatic responses that occur regularly without conscious control. They are acquired initially through frequent repetition in specific situations.

When we first learn a response, we consciously make decisions about what we’re doing, why we’re doing it and how we feel about it. When the situation comes again and we repeat our response, the neural processes get reorganized in our brain. Each time the situation and our response is repeated, the neural connections become more consolidated. Why we’re responding this way soon slips out of our consciousness.

When we’re thinking about what’s happening, we can quickly change our response. We can make conscious decisions that may be different from what happened previously. Also, we can make decisions about what we want in the future. Being able to assemble information and create new responses is a uniquely human talent.

We are able to think about different things at the same time. But about three things at a time is all we can manage. While we’re using all our conscious capacity, our habits take care of immediate details outside our conscious awareness.

Eventually habits may become sufficiently automatic as seeming to occur for no reason at all. We may not even notice what we’re doing. Much less why we’re doing it. When we do notice what we’re doing, we always assume we had a good reason for it.

Our habits don’t always produce the best possible results. Even when we know a better response, we can’t always change our habitual responses. If challenged about it, we defend what we’re doing.

During ordinary daily activities, we’re only consciously directing what’s happening about 10% of the time. Most of the time, habits and other nonconscious processes control our daily experience. Our conscious attention is on other things than just what’s happening around us.

Nobody runs all day entirely on automatic conscious control. However, most conscious decisions bring only immediately expedient adjustments. Minor tinkering all day with occasional major emergency upheaval. Only occasionally do we make major adjustments for possible future benefit.

Habit Formation, Maintenance And Replacement

Formation

Definition and description are extremely important. Exactly what situation should elicit exactly what response must be stated. What to do when, where it will be done and step by step how it should be done.

There are choices to be made. Choose whatever will give the most pleasure and satisfaction. Enjoyment will be the reward for this habitual response. A positive affect is essential! Propose a situation and a response that will make you smile.

Initially, you might get the most satisfaction from successfully completing the desired response. Eventually, the long term benefits will be your reward.

Performance day by day and week by week must be recorded and analyzed. More than just general statements like, “I’ll do the best I can.”

Start with quantitative measurements of baseline skills. How well can you do now what you propose to establish and improve? How does it feel in your body? How does thinking about it make you feel in your mind?

Results from every performance must be recorded, assessed and reported. Prepare text in a computer file or write notes in a daily journal. Take pictures with your camera, photos of where you are and selfies while you’re responding.

Concentrate on what you’re doing with full sense of your routine. Think positively about what you’re doing and attach that sense of accomplishment along with your positive affect associated with the mental image.

Review the text or script and open your photos. Revive the experience stored in your mental image. Reliving this experience adds to the weight and consolidation of memory bits stored in your brain. The virtual copy behaves just like you had done that routine in real time all over again.

Revise your performance as you go along day by day and week by week. If something is not working quite right or you don’t feel really good about what you’re doing, change it. Make it work so you can enjoy doing it every time.

Repetition is essential. As close to daily as possible. Give it your full attention every time.

Eventually, routine responses will become automatic. But that will take several months. In the meantime, keep building your skill, improving your results and increasing your pleasure in successful performance.

Popular belief is that it takes 21 days to establish a new habit. Expert science reveals that it takes months to make habits completely automatic. It’s true that something threatening bodily injury or financial ruin can make a sudden change in your life. But good health habits will build slowly and must be consciously monitored for months or even years.

Quantitative measurements are essential. Actual numbers and photos of performance as you continue are valuable to compare to measurements and photos taken at baseline. This is how to record consistency, assess your skill and demonstrate improvements in performance.

Include quantitative assessments of affect. On scales of 1 to 10, how do you feel before, during and after each repetition of the new routine?

Coaching, mentoring, and sharing your experience. All help build successful routines. A good coach tells you what has worked for others in similar situations. A mentor shows what they’ve done and what you can accomplish. Sharing your experiences with friends and family gives you positive support and feedback about what you’re doing.

Most of all, outreach to others helps to focus on specific objectives and make realistic plans. It helps you pay attention and not get distracted. It also helps you keep going if you get impatient or discouraged.

Maintenance

Pay attention forever. When a habit becomes automatic, it still competes with processes formed during all your previous years of life. If you drift away from a new routine, the old ways will come back into control.

Enjoyment is essential to maintaining good health. Keep noticing what you’re doing and how much you’ve gained. Set up your daily activities so good health practice is important. So you really feel badly when something gets in the way.

Include schedules for relaxation, recreation and entertainment.

Continue quantitative measurements. Keep a pedometer on your hip every day. Add up and note your minutes of exercise every week. Note the miles you walk or run.

Measure your weight at least once every week. Measure your waist circumference at least once every month. What’s your belt length, your pants size, your dress size?

Note the hours of sleep you’re getting every night.

You worked successfully to improve your health. Don’t let it get away.

Replacement

Getting rid of a bad habit is difficult. At some time in your life, that habit provided some benefit. It got established in your brain. Now, it’s almost impossible to “just don’t do it.”

Sometimes, you can change your environment and the situations stimulating the habit you want to replace. But there are some things you just can’t change.

If you’ve been overeating, it’s hard to just eat less. If you’ve been sedentary all day, it’s hard to get moving. If you’ve been sleeping poorly, it’s hard to just tell yourself “go to sleep.”

Establish good habits to replace the old. Establish routines you can do in situations you pretty much have to endure. Most of all find what will give you more pleasure than what you’ve been doing.

If you’ve been overeating, start planning meals and snacks you can learn to enjoy. If you’ve been sedentary, wear a pedometer, take the stairs, walk in from parking farther out. Schedule time every evening to relax before getting ready for bed.

Good And Bad Health Habits

Good Health Habits

Bad Health Habits

Summary

Habits are automatic responses that occur regularly without conscious control. They are acquired initially through frequent repetition in specific situations.

During ordinary daily activities, we’re only consciously directing what’s happening about 10% of the time. Most of the time, habits and other nonconscious processes control our daily experience.

Definition and description are extremely important. Exactly what situation should elicit exactly what response must be stated. What to do when, where it will be done and step by step how it should be done.

Quantitative measurements are essential. Actual numbers and photos of performance as you continue are valuable to compare to measurements and photos taken at baseline.

Enjoyment is essential to maintaining good health. Keep noticing what you’re doing and how much you’ve gained.

Establish good habits to replace the old. Establish routines you can do in situations you pretty much have to endure. Most of all find what will give you more pleasure than what you’ve been doing.

Let us help you redirect health habits to reverse type 2 diabetes.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

All who completely reversed their diabetes reduced their body weight by at least -15%.

Reducing total calories contributes about 80% of success in reversing diabetes while exercise and type of food eaten contribute about 20% of success.

Contact us and learn how to escape failure and achieve success!

What is the record?

A Study of people with Obesity and Diabetes in Scotland and England showed they could reverse diabetes while living at home. Investigators solicited about 1200 people in 49 privates practice clinics and 306 agreed to participate in the DiRECT Study. These were people who said they were willing to reduce calorie intake to 800 Kcal/day.  Half of them were treated intensively and half were given standard self-management education.

Results were remarkable! Almost half of those treated intensively for 12 months achieved remission of their diabetes.

As shown in the figure, half of those who reduced their body weight by -10% reversed their diabetes. Nearly all those who reduced their body weight by -15% had complete remission.

Equally remarkable was that 75% of people invited to participate either refused intensive treatment, reduced body weight less than -5% or actually gained weight. Look at the figure. As you can see, approximately 10% of those originally eligible to participate were actually successful.

A Study of people who were Overweight or Obese and had Diabetes in the U.S. were treated for eight years. Investigators enrolled 5,000 people into the Look AHEAD Study. About half were treated intensively and half were given standard self-management education.

The figure shows the results. After eight years half had reduced their body weight at least -5% and one quarter had reduced their body weight at least -10%. Those who reduced their body weight by -15% had weight reduction sufficient to achieve remission of their diabetes.

Other similar studies have given similar results. In summary:

• 75% of people with diabetes have little change or continue to gain in body weight
• 15% reduce body weight at least -10% for partial reversal but not enough for remission
• 10% reduce body weight at least -15% and retain weight sufficient for remission after 8 years

“The Challenge is not finding what to do, it’s doing it.”

Learning Good Health Skills to Reverse Diabetes:

Think of reversing diabetes like learning a foreign language. We all start out life learning one language or another. We learn more than how to talk to one another. We also learn all our daily activities, our skills, our preferences, our culture, how we feel about everything and how we think. It’s all stored in our brain.

Along the way we learned how to develop new skills. Now our plan is to develop skills that promote good health. Just like learning to play the violin or learning a sport like tennis or soccer. Or learning to play bridge, or poker or chess. We find out what to do and do it every day until we get good at it!

First of all, you need to know how any new skill fits into your ambitions for life. And you must actually like doing it.

The benefits from reversing diabetes are obvious to us. Better health makes us smarter, stronger, healthier and better looking with better sexual function and we sleep better. We avoid distress and disability. We live longer and we save money. Diabetes remission is a very good ambition for life!

Second of all, we must enjoy developing and practicing skills that are essential for reversing diabetes. We can aim our efforts at targets we know we can hit. Then we enjoy progressing day by day, practicing what we realize we can do and getting better at doing it.

Now we need to figure out how long that’s going to take:

The CIA says it takes 1000 hours to become skilled using a foreign language. That would be enough to debate or deliver a lecture in that other language. Training for 1000 hours takes 40 hours a week for six months.

Fortunately, we don’t need that level of skill to reverse diabetes all the way to remission! The Pareto Principle shows us what to do.

The 80/20 Pareto Principle in Reversing Diabetes:

The 80/20 rule states that 80% of results come from 20% of input. An example in medicine is the common assumption that 80% of the costs for healthcare comes from treating 20% of patients.

Did you notice the 80/20 Rule in the first section of this article? Reducing total calories contributes about 80% of success in reversing diabetes while exercise and type of food eaten contribute about 20% of success.

The Pareto Principle also appears in the way we improve as we learn and train ourselves in new skills.

If becoming a World-Class Expert requires 10,000 hours, it takes less time for most skilled performers in chess, music, entertainment and sports to gain recognition in about 2000 hours of training and performing. That’s an example of the 80/20 Rule in real life.

The CIA says it takes 1000 hours to become skilled using a foreign language. That would be enough to debate or deliver a lecture in that other language.

Language educators say that to be less proficient but still able to say something in a foreign language takes 50 to 100 hours of practice speaking, hearing and reading in a new language. That would be enough to call a taxi or find a restroom. Because we increase skill most quickly early in our training, we reach about 60% proficiency in 50 hours and 70% proficiency in 100 hours.

Investing 30 minutes a day would take 3 to 6 months reaching 50 to 100 hours of learning and practicing. That’s about how long it takes to successfully reduce body weight 1 to 2 pounds a week working at it 30 minutes a day.

The first Section in this article reports results of treatment  in the DiRECT Study. Half of those who were successful reached remission in 6 months and the remainder were successful in 12 months. The most intensive treatment occurred in the first 3 months.

Practical experience shows that the during the first 3 months, 20 or 30 hours of skill development are spent learning how to increase physical activity and reduce body weight 1 to 2 lb/week. The remaining 80 hours of effort are invested in actually reducing weight and reaching remission.

Deliberate Practice Makes Perfect

Practical experience also shows that taking a classroom course a couple of hours a week for a year or so doesn’t make anybody able to speak in a foreign language. Zero proficiency. Sort of like our experience teaching Diabetes Self-Management Skills in a classroom.             

There’s an old saying, “Practice makes perfect.” Arthur Rubenstein, a renowned pianist, once was stopped on the street in New York by a tourist who asked him, “Please tell us how we can get to Carnegie Hall?” Rubenstein replied, “Practice, practice, practice!” Then football coach, Vince Lombardi, was quoted as saying, “Practice doesn’t make perfect. Perfect practice makes perfect!”

So the question is, “What is perfect practice?”

Anders Ericsson, a Swedish psychologist at Florida State University, worked this all out for us. According to Ericsson, deliberate practice involves stepping outside your comfort zone and trying activities beyond your current abilities.

While repeating a skill you’ve already mastered might be satisfying, it’s not enough to help you get better. Moreover, simply wanting to improve isn’t enough — people also need well-defined goals and the help of a teacher who makes a plan for achieving them.

Biobehavioral Training

The brain is an enormous network of neurons, connecting fibers and supporting structures. The human brain contains more than 100 billion neurons and each neuron has more than 7000 connections. Storage capacity of our brain is essentially unlimited. About 20% of all neurons are in the cerebral cortex where they can be accessed for short-term memory and conscious cognitive function.

Anything we’ve ever done, learned or imagined and how it affected us is stored in our brain. Since birth, our brain stores information about situations, actions, emotions and immediate outcomes. It also evaluates results, makes judgements and stores rules about actions to take in similar situations. All our experience is coded and stored according to pleasure/pain assessments, social expectations and situationally expedience. Assessments and rules are based on an immediate pleasure/pain metric. As a result, short-term assessments according to internal feelings and external results, command a consistent predictable replication of behavior.

The operating system of our brain manages a whole range of physical, cognitive, emotional and inspirational functions. Situations and actions occurring in the past are most likely to predict our assessments, decisions and actions in the future. Consequently, 95% of our daily life goes on without conscious decisions about what to do, what to think and how we will feel about it.

Along with intrinsic control mechanisms, the human brain has conscious executive control over physical, intellectual and emotional behavior. We can learn and develop new ideas, new skills and new attitudes. Results are stored among neuronal circuits related to similar experience in the past. Frequent repetition makes our behavior more and more automatic and eventually occurs without conscious control.

Did I just hear you say, “I did that and it didn’t work for me.” Or was it “Forget that.  Not for me!“ Don’t be angry or discouraged. You’re just reporting what your memory bank has stored. That’s a rejection report based on years of short-term pleasure/fear analysis.

Any first feeling is like a panel light flashing the output of an operating system onto the front of a computer. How some thought, situation or action is perceived is flashed as how you feel about it.

You still have executive control over that neurocognitive process. As you train in any new skill, you can tell how you’re doing by how it makes you feel. As you get more skilled, you’ll get pleasure knowing the long-term benefits replacing the original rejection signal. Our strategy is to test, revise, assess and retest until it feels good!

An essential concern is how to make implementing new skills automatic. For a long time, intrinsic control mechanisms have to be countered by conscious decisions.

The question is sort of like how do you tell an elephant what to do. The answer is, there has to be something in it for the elephant. Executive control must include good feelings stored in memory.  Satisfaction and pleasure from results favoring long-term outcomes makes new skills and new ideas more competitive with original short-term outcomes. For a long time, if you don’t think about it, the original pattern will take control.

Adopt the attitude that practicing new skills makes every day more worthwhile. You will soon find that some days the only good thing that happened was success towards improving your health.

Getting Started

Test and discover what you can do every day that makes you feel good about your progress. Make action plans and revise your plans according to what happens when you try to carry them out day by day. Keep testing to find what makes you feel good about efforts to improve your health. If you feel good, you’ll keep following your plan and deliberately practice effective thoughts, decisions and actions.

Write down what you’ve done each day and how you feel about it in a Good Health Journal. If you don’t feel good about it, figure out how to fix your plan or your situation. Develop the attitude of really feeling good about what you’re able to accomplish. Never mind what’s left to be done. Above all, avoid thinking you really should have done better!

An essential feature of good health skill development is daily repetition! Note the hours and minutes you spend on each task. Time is required for:

• Information and deliberation,
• Measuring, describing and reporting for Coaching,
• Food diary (My Fitness Pal),
• Physical activity (Pedometer)

• Report something every day. Start with 5 minutes/day, aim for 30.
• Make a conscious deliberate effort to increase your time and effort
• Be pleased and proud of what you’re doing. Most don’t even try!

Don’t Give Up

If it takes a little longer, so be it. We’ll stay with you until you succeed!

Call Us or Contact Us:

James Alan Herd, MD

Call: 713-669-0271
Email: Jaherdmd@herdhealthcare.com
Website: www.herdhealthcare.com

Start a Good Health Journal today:

Every day, do something good for your health and write it down. Start with 5 minutes a day and aim for 30. See what happens in a week, then a month.

If you don’t really like typing on the virtual keyboard of your mobile unit, you can dictate your text and take photos of records. Tap the microphone icon on the screen or in the keyboard display to activate Speech to Text.

Health Behavior is Consistent:

All our behavior is predictably consistent. What we do each day is the same every day. It’s more than just habits like brushing our teeth and combing our hair. More than how we drive to work or go shopping. We are consistent at work, in our social life, what we say to our friends, what we do for entertainment and even how we vote.

Predictably irrational is how psychologist Richard Thaler described behavioral economics.

Dr. Thaler won the 2017 Nobel Prize in Economics. His work shows that assuming people are predictably irrational is the most rational approach to studying their economic behavior. We really do know more than that! Rational or irrational, our consistent health behavior is entirely understandable. Tell me. When was the last time you did something unusual? Why change anything? After all, we made it this far!

Being consistent is something we learn by experience. Subconscious brain activity stores all our previous experience. We come to expect what worked well before will work again and we remember how. Because everybody expects us to be consistent, we do it. Very complex situations don’t bother us because we remember just what to do. Our attitudes and actions are automatic. We don’t even think about it.

When something new appears, we also know what to do. We decide whether we approve of it, whether we need it, whether we can use it, what it will cost us and whether we’ll do something about it. Some times we’ll get right with it, some times we need some persuasion and some times we flatly reject it.

We suppose we’re doing all this by deliberately thinking about it. In fact our subconscious neural networks are filtering this new information and our intentions for new action through memory of our previous experience. You can say what you intend but clearing it for new action requires more than you might expect. You get started by stating what you intend to do and when you’ll do it. Then go on with your activities of normal life and see what happens. If what you intended doesn’t happen, try something less demanding. If nothing works, go back to your source of information and find something more persuasive to get started. When you succeed, keep deliberately trying to accomplish more and more until you find your limit.

Now you’ve got something to work with. Keep trying to do more and more while you build the skill to do it consistently. Do it again, again and again. Eventually you won’t have to think about it. That’s success!

Good Health Plan Description:

Get Started:

√ Keep Good Health Journal to record daily action for good health to be reviewed week by week.
√ Manage with coaching to coordinate planning, measuring, reporting and analysis of good health skills.
√ Manage medications for control of hyperglycemia and hypertension.
√Access and process accurate, up-to-date information about overweight/obesity and diabetes.
√ Manage physical health for blood glucose, blood pressure, body weight, maximum abdominal girth, nutrition and    physical activity.
√ Manage social/professional interactions for eating, drinking, exercise and entertainment.

We’re surrounded by information about what to do. It’s in the newspapers, on TV, it’s talked about amongst family and friends.
For example, your doctor tells you what to eat and drink.

The challenge is where to start. How much is less? How much is more?

Here is where you discover how your stored memory of previous experience affects the results of what you intend to do. As you deliberately plan, train and test your skills in good health, keep a record. That way you’ll know what skills are making progress and which are blocked from progress.

The first task is deliberately recording everything. Start by setting up a Good Health Journal. Make it simple. Use something like Google Keep. On the first day of each new week, write down what you intend to do that week. Then, every day, enter anything you can count, measure or describe related to good health skills.

If you can’t think of anything, or you can’t report something at least 5 days every week, use the time to learn more about getting started. Take as many occasions on as many days as you can to read articles about advantages and benefits of preventing and reversing diabetes.

Self-Managing:

If you are self-managing your Good Health Skills, at the end of every week, review what you intended to do and what got done. For example, here’s what you might have planned and recorded in May 20-26, 2018. The result? Something recorded every day. Success!
If results for the first week were pretty easy, do it again. This time, deliberately plan and explicitly write down something a little more difficult.
If the result was records on fewer than 5 of the 7 days, see if you can figure out what was the problem. Maybe you can fix something. Start with setting an alarm to remind you about recording something every day.

Trial-Run Coaching in Texas (No Charge):

If you live in Texas and wish to start Trial-run Coaching, you can e-mail me at jaherdmd@herdhealthcare.com or call to 713-669-0271. I will reply to each email or call.
If you don’t really like typing on the virtual keyboard of your mobile unit, you can dictate your text and take photos of records. Tap the microphone icon on the screen or in the keyboard display to activate Speech to Text.
At the end of every week, take and share a screenshot of your Good Health Journal or e-mail a copy to me. I will reply with coaching tips.

Telehealth in Texas for Diabetes Prevention and Remission:

MONTH 1:Register in Texas and begin Good Health Coaching: (3rd party Services $110)
 If you live in Texas and decide to register for telehealth coaching, please call/text message me at 713-669-0271 or send an email to jakaherd@gmail.com.

     I will send you a packet of documents by US Postal Service. These documents are Requests for Information that is important for effective coaching. Please fill them out and mail them back to me at PO Box 20669, Houston, TX 77025.

      You also need a food diary account with MyFitnessPal and tests for fasting blood glucose and HbA1c from Request-A- Test.

• MyFitnessPal Premium Account Annual Fee ($50)
• Request-A-Test diabetes screen  ($60)
• Good Health Coaching 1 month (no charge )

Total  $110

We will establish telehealth technology with you for data collection, file transfer and audio/visual communication between Win PC, Android and iOS mobile devices.

 The platform includes hardware and software applications linked within Google and Office 365 ecosystems using secure end-to-end encryption over the internet including WiFi connections. It is completely and strongly HIPAA compliant for audio/visual communication as well as file transfer and data storage.

MONTH 2: Good Health Coaching:  (3rd party Equipment $80  and Refundable Deposit $50 which will be returned when performance criteria are met)

•  Equipment: $80
• Weight Watchers by Conair Body Analysis Glass Bathroom Scale ($30)
• Omron BP 710n 3 Series Blood Pressure Monitor ($30)
• Omron Pedometer HJ 321 (Aerobic Steps and 7-day storage) ($20)
  Total       $80

Refundable Deposit: $50

If you live in Texas and decide to continue coaching beyond the 1st month, you may deposit $50 in an account with DP&R. This money will be refunded at the end of 4 weeks contingent upon:

• One Photo Record of BIA/Body Wt Scale, Digital BP Device and Omron Pedometer, 
• Daily Notes and Records of Measurements in the Good Health Report 5 d/wk and a
• Virtual Coaching Session at least 1 d/wk.

MONTH 3:Managing Blood Glucose: (Refundable Deposit $100 which will be returned when performance criteria are met)

 If you live in Texas and decide to continue coaching beyond the first 2 months, you may deposit $100 in an account with DP&R. This money will be refunded at the end of 4 weeks contingent upon:

• One Photo Record of BIA/Body Wt Scale, Digital BP Device and Omron Pedometer, 
• Daily Notes and Records of Measurements in the Good Health Report 5 d/wk, 
• Full Food Records in MyFitnessPal 3 d/wk and a
• Virtual Coaching Session at least 1 d/wk.

     Objective: Before meals BG 80 to 120 mg/dL and 2hr after meals BG < 180 mg/dL

MONTHS 4 – 10: Managing Diabetes Remission: (Refundable Deposit $100 each month which will be returned when performance criteria are met)

If you live in Texas and decide to continue coaching beyond the first 3 months, you may deposit $100 in an account with DP&R at the beginning of every month. This money will be refunded at the end of 4 weeks contingent upon:

• Photo Records of BIA/Body Wt Scale, Digital BP Device and Omron Pedometer,
• Daily Notes and Records of Measurements in your Good Health Journal 5 d/wk,
• Full Food Records in MyFitnessPal 3 d/wk,
• Virtual Coaching Session at least 1 d/wk and
• Reduced Body Weight -2% in 4 wk.

     Objectives:

Before meals BG 80 to 120 mg/dL and 2hr after meals BG < 180 mg/dL, reduce HbA1c < 6.5%

Reduce BWt -2%/month (-1 to -2 lb/wk) to BWt -15%

Reduce maximum Waist Circumference <40 in for men (<35 in for women)

 Reduce BP< 120/80 mm Hg

Call Us or Contact Us:

James Alan Herd, MD

Call: 713-669-0271
Email: Jaherdmd@herdhealthcare.com
Website: www.herdhealthcare.com

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