Nutrition nutrition coaching

Nutrition and Behavior Change: Strategies for Helping Clients

Christopher & Kara Mohr 0

It has often been said that nutrition is 90% of the game and training just 10%.  The truth is, nutrition and training are equally important for various reasons, and it's not just a 50/50 game because there are many other equally important habits or rituals paramount to the long term health of clients.

Sleep, socialization, types of training, behavior change, mobility, mental health, and, yes, nutrition are vital aspects of overall health.  Truth be told, what may be most important is how to make any of those better for you practices permanent habits. 

This article will function as a cheat sheet on how to help clients create new nutrition habits through behavior change and how to talk about nutrition with your clients.

How to Create New Nutrition Habits

Adopting new habits and breaking old ones can be a challenge. Too often, when we're trying to work with someone, we try to instill our goals on them - eat this, don't eat that, or do this, don't do that.

But just like every training client isn't immediately put under a barbell to do a set of squats, not everyone who walks into the gym will have the same outcome goals or strategies to get them there when it comes to nutrition. 

When we think about the habits most of us have, many are well-established.  Every day you make automatic choices that require little consideration or thought.  You simply do them. And the same is true of your clients.  

It's great when these habits work for us and help us to live the lives we desire, from the simple choices of remembering to shower and brush our teeth, to the more complex ones of making the time to study and stay current on continuing education. 

But what about the habits that don't align with what we want to achieve?  What about the client who really wants to lose weight and is consistently training to make that happen but can't stop late-night snacking on chips?  Or the athlete who says they are committed to improving performance but keeps grabbing drinks with friends several nights a week? 

Reminding clients (and if we're honest, even ourselves) how these choices impact our ability to reach our goals, isn't sufficient.  Many times we already know these things are working against us. Instead, we have to learn how to unwire the habit and rewire a new one to create changes that support our goals, and that can last. Changing a pattern takes conscious and repeated effort.

The interesting thing about our brains is that they like to be efficient. Your brain wants to move any action you repeatedly do into a habit because it requires less effort to process and perform the behavior - meaning we do them over and over again. That's great when habits work for us - not so good when they work against us.  You see, when a habit is formed, the brain stops participating fully in the decision making - instead, it turns it over to our subconscious.

What Does The Subconscious Brain Have to do with nutrition habits?

Our subconscious can run the show for as much as 95% of the choices we make each day (1). This unconscious part of the brain, also referred to as the automatic, fast brain, or system one, helps us preserve mental effort for critical thinking and problem solving for the more critical decisions.

The fast brain is the one that steps in and quickly decides what to do based on experience or emotion or impulsivity.  It's the one that when you feel a surge of stress at the end of a long day, declares, "I. Need. A. Drink!"

The Logical Side of the Conscious Brain 

The conscious part of the brain, also referred to as the slow brain or system two, is much more rational and logical. This part of the brain considers the pros and cons of the situation, the potential long-term consequences, and connects those choices to long-term goals. The slow brain is the one that can plan for how you might handle that stressful situation where you want to turn to a drink and what you might choose instead.

So which one "wins"?  

It depends on what system you're using at the moment the decision is made. There's not a "winner" or "loser" per se, but there are ways to move toward a more conscious awareness of the choices we make and why we make them, and how to make it less likely that our fast brain will rule the roost.

Ultimately, though - you and your clients are in the driver seat, and that is all based on the habits we build and how we build them.  The brain is capable of vast change after all, through neuroplasticity and active behavior change when we put our minds to it.

Process of Habit Formation: The Habit loop

Let's consider what the normal process of habit formation looks like. Typically, patterns are formed over time as we begin to perform a new series of behaviors over and over again. 

In The Power of Habit, Charles Duhigg described research from MIT that discovered three elements that can be consistently found in any habit that we have – cue, routine, and reward (2)

More recently, in Atomic Habits, author James Clear expanded on this concept to include one additional element, CRAVING (3).

It is this description of the habit loop that we'd like to use to define how we form habits.  Of course, to expand on this understanding, both books are excellent additions to your toolbox to allow you to serve your clients better.  For now, here's the abbreviated version.

Behaviors are shaped over time using the following formula. 

The 4 Steps of Habit Formation

CUE -------> CRAVING ------> RESPONSE ------> REWARD ------> Repeat this process

As you see here, it's this normal pattern by which habits are ultimately created.  Let's talk through this a bit more to bring it to life.

Step 1: Cue 

A cue is anything that brings about a craving.  Cues can include a time of day, a person, feeling or mood, a smell, or even a specific environment.   For example, you wake up in the morning, and that triggers a cascade of habits that you may not even think about. 

Maybe you wake up, go to the bathroom, make a cup of coffee, brush your teeth, get dressed, etc.  Your cue?  Time of day or for most people, the alarm clock told them it's time to wake up.

Step 2: Craving

Sticking with our time example above and waking up, the craving – or in other words – the motivation behind the habit is what moves someone into action.  You aren't motivated necessarily to brush your teeth, but rather the feeling you have from a clean mouth.  Or you may not crave coffee, but rather the feeling it provides to you.  Cravings differ for each person.  For some, they may crave to feel awake; for others, they may crave the feeling of "attacking the day."  In general, cravings occur because we want to change our internal state, so what that looks like for your clients may differ.  

Step 3: Response

Next, we have a response.  The response is the actual habit you perform (brush your teeth, drink the coffee, etc. if we're sticking with our time example).  Think about what your usual response is to your cue in the morning and what craving you fill.  And also consider how many responses are possible.  Some may choose to wake and go to the bathroom.

Others may get up and head to the kitchen to start the coffee before going to the bathroom.  Others may wake and lie in bed for a bit, scrolling through texts and social media.  If we're talking about 100 people, there could be 100 different responses to the same cue based on experience, preferences, environment, etc. 

Step 4: Reward

Finally, we have a reward.  On one level, the reward is that the craving is gone. We wanted to change our internal state, and we successfully achieved that. Pretty interesting isn't it? 

We like satisfying the discontent our brain creates.  On the other hand, the brain is hard-wired to notice rewards from our behavior - so we're also paying close attention to what other rewards the response has created.  If the reward also has other benefits – the coffee was delicious, we can now kiss our spouse with our fresh breath, etc.… it's more likely we'll repeat this cycle over and over.  

Applying Habit Formation with Nutrition

Let's say a client comes to you and has laid out some of her health goals.  As you talk through a typical day, she tells you that she struggles with the mid-afternoon slump like so many.  She typically works through her lunch, spends the next couple hours on conference calls or in meetings, then 3 PM hits, and she completely tanks.  Her energy.  Her mood.  And it's taken out on everyone or anything in "her way."  

Let's play this out using the cue, craving, response, and reward to apply this to the everyday situation.

Mary might start with a bad emotion - that she doesn't like how she feels in her body. This is her cue, which may have been what brought her to you in the first place. 

That cue then leads to a craving, which, in this case, is her internal desire to change because she simply wants to feel better. 

The desire to change in this case would lead her to you, the trainer, as a response or maybe making some changes within her nutrition plan.  But then the challenge here is with what she desires, and that is losing weight, which is outcome-driven. Unfortunately, the outcome of weight loss is detached from the immediate choice of the behavior.  For example, meeting friends (again) on a Tuesday night for happy hour isn't connected to the outcome of reaching a specific bodyweight six months down the road. 

With her ultimate reward being the scale, encouraging her along the way could be a challenge. If instead, the discussion is around those small, daily wins - educating her through those daily choices will go a long way.  How can she reward herself by focusing on process outcomes such as working out or eating healthier foods By rewarding herself for the specific choices she can do along the way that will allow her to reach her outcome goal, she can stay connected throughout the process. It's the power of those tiny habits and wins that will truly propel her towards long term success.

The Power of Tiny Habits

Many times when clients come to us for help, they are looking to achieve a goal. "I want to be stronger." "I want to be a better athlete." "I want to be thinner." They come in focused on the outcome they want to attain.  Again, this goes back to the discussion around an outcome goal but doesn't necessarily consider the necessary steps to achieve that long term win.

The other piece of knowing who your client desires to become and what responses they'd want to choose is that you can help them move in the smallest direction.  When we select tiny habits that move toward who we want to become while still staying in alignment with our current self-image, we're much more likely to stick with the change because it doesn't feel so drastic.  Switching from fast food to grilled chicken and broccoli may not be possible for someone who identifies themselves as a veggie hater or a fried chicken fanatic. 

Someone who dislikes exercise may not be on board with a program that requires them to do five workouts a week.  But maybe they can agree to swap their regular stir fry base of rice with stir-fried veggies and aim for just two workouts a week.

When you know what they think is possible and you help them identify small shifts that they can make in that direction, we can help them move toward the new identity or goal they want to achieve. Small changes don't trigger discomfort, fear, or other feelings of "I can't do this" and therefore lead to greater adherence and success. 

But that all comes back to the formation of habits.  Remember, cue, craving, response, and reward.  When you frame client discussions around these, it can help them achieve what they want to achieve, which ultimately helps you in building long term relationships. 

Real Life Nutrition Examples: How to Build a Plate applying the Power of Tiny Habits

We've now touched on the creation of habits and the power of tiny habits. Let's now look at some specific examples using nutrition and the ways clients can build their plates to meet their needs or sense of identity.

First, when we think about a plate, it's important to stress that nutrition is not black and white. Clients want it to be, and it would be so easy for us to simply give people those nutrition rules - eat this, don't eat that.  But there's much more to nutrition than what to eat or not eat. 

What if you're out with co-workers or friends at a social event or it's a big holiday and you're surrounded by traditional foods and alcohol, making it a challenge to stick with the plan to reach the primary goal?

That said, let's simply share what a smart plate could look like.  This example allows for some flexibility in its approach - it's not low carb, low fat, vegan, gluten-free, or anything else - it's a way to balance your plate and will meet the needs of most clients and also allow for personalization since no one diet is universal.

How about merely discussing the importance of balancing a plate to your clients? What does that mean?  Think about it in terms of handfuls - two handfuls of produce per meal, one handful of protein and one handful of quality, fiber-rich grains. That's it. 

You can draw this for them, draw lines on a paper plate - whatever it is that makes it most comfortable to teach, but at the end of the day, making simple shifts like this helps emphasize the tiny habits message.

Using the Habit Loop to Create New, Positive Habits

We've covered a lot so far - the habit loop, fast and slow brain, and tiny habits.  Now we're going to focus on how we can use the habit loop to consciously create positive habits using an example. 

We'll assume a client wants to start a training program with you and hopes to work out first thing in the morning three days a week.  Let's walk through the habit loop to see how we can make it more likely she consciously chooses this behavior and repeats it until it's habitual. 

Habit Looping - The Cue

For the cue - the key is to make it something that occurs consistently. Now in this example, she is choosing to work out first thing in the morning (which actually makes it easy), because not many things are likely to get between her cue of waking up and her response of going to the gym to train.

An easy strategy to cue yourself to do a new behavior is to create a  "When I, Then I" statement and pair the new behavior with something you already do.    When I do x, then I do y.  Or in this case, it might look like: When I wake up, then I workout.  Have your clients think about how they can tie the new behavior to something they already do.  

Habit Looping - The Craving

For the craving, you've got to get a bit more creative because you have to think of what will make your client crave something she is currently not doing.  One way to do this is to have her combine a Want to Do an activity with a Need to Do one.  In this case, her workouts are a Need to Do behavior. 

To crave the exercise, she would combine her training sessions with you with another activity she wants to do.  Maybe that is spending time with a friend. So in this example, to crave her morning workouts, she signs up for group training with her friend, which makes her look forward to it even more. 

Habit looping - The Response

Now, let's talk about the response.  This becomes important because your client needs to make sure the response is something she's likely to do.  For this, have them think of 0 as equal to no chance she'll do the behavior and 10 as equal to 100% certainty she makes it happen. 

You want her to choose a response that she is 90% certain she can make happen.  So, in this case, 9 times out of 10, she will make it to the training session.   She feels confident she can - especially since it's the first thing before her day begins (cue) and because her friend will meet her there (craving), and so you agree to 3 days a week.  If she is only at a 7 though, in terms of confidence, you'd look at what would make the number higher. 

Does she need to go to fewer training sessions per week?  Do the training sessions need to be shorter?  Keep working to make sure it is a choice she feels confident she can achieve.

Reward Considerations for the client

And then we get to the sweet reward.  How can your client reward herself for her new behavior?  What immediate response can she include in her routine that will make it feel like a win?  For years when we ran a fitness Bootcamp first thing in the morning, we had women who would go to the coffee shop afterward to reward themselves for making it to camp. 

Have your client consider what she can use as a reward for her efforts to make it more likely to stick with it. Immediate is best, but as long as she finds it rewarding, and it doesn't compete with the outcome she desires, anything can work. 

By consciously thinking through the cue, craving, response, and reward, your client can create support for her new behavior and increase the likelihood that she will form a new habit loop and ultimately a habit.  The next time you or your clients have a habit you'd like to work toward, consider how you can use those four elements to make it stick.  

Applying these Principles for Positive Nutrition Habits

picture-of-healthy-food

Let's now apply this to a nutrition behavior, as it's often helpful to walk through different scenarios to apply this to your own situation better. How about encouraging your client to drink more water, for example. Simply telling a client to drink more water isn't too effective on its own, so a strategy like what I'll describe may help. Using the framework discussed around building habits, let's see how we can shape this.

Of course, there are lots of times of day you can drink more water. But since it would be easiest to spread out intake throughout the day, one cue you could encourage here would be to have a glass of water immediately after waking up. So when I wake up, then I drink a glass of water.

Yes, it can be that simple. The craving then can be the feeling of drinking a glass of water before anything else. That feeling of wetting your mouth first thing in the morning. Or the sense of how that feels in your body when you first drink it.  The response then is deciding how much to drink. 

Positive Habits in action

If the goal is to drink half their body weight in ounces each day, for example, well, then starting with an 8 oz glass might be sufficient.  Finally, the reward might be as simple as checking off on the calendar that the client drank water or mark it off in a nutrition log or tracker.  So these can be pretty simple. It depends on what the client would benefit from, and this can be decided together.

While this may seem rather straightforward, when stacked together with other positive habits, you can see how "magic" can start to happen.  What if your client stacks together that simple habit of drinking 8 oz of water each morning with a 5 or 10 minute morning walk.  When they get back from their walk, then they enjoy a piece of fruit and take their vitamins. 

Next thing we know, more and more positive habits are in place and take permanent residence leading to desired outcomes. Now keep in mind, all those habits wouldn't take place or shouldn't be suggested overnight; the beauty of tiny habits is that they happen over time and get stacked on top of each other once previous behaviors have been established.  

As we know, though, it's not just about building positive habits on top of positive habits. We also have to consider breaking (or replacing) old habits just the same.

Using the Habit Loop to Break Old Habits

We make 1000's of decisions day in and day out.  And for most people who are making the same type of decisions in the same kind of environment, these decisions are ultimately being handled from our fast brain.  They're automatic, based on years of learned patterns and may ultimately conflict with our goals.  So what do we do if we have habits that we believe are problematic that have a negative impact and are keeping us, or our clients, stuck? 

Let's take a look at how we can use the four elements of the habit loop to unlearn a negative habit. Beginning with the cue, in an ideal environment, you'd just remove it.  But cues are complex - and include the time of day, people, mood, environment, and other behaviors.

You can't always eliminate them, but you may be able to avoid them or alter them, so they are within your control. Say, for example, your client complains that he always overeats in the evening. One of the reasons for overeating is snacking as soon as he walks in the door after work. If the cue is when I get home, then I grab a snack from the fridge, choosing to come in through a different entrance to avoid landing in the kitchen may be beneficial.  Or he could decide to head to the bedroom and change clothes instead while he thinks about what he wants to make for dinner. 

What is Urge Surfing?

Urge surfing is a technique that compares a craving to a wave. At the height of the wave (the crest) comes the most difficult part of the craving to resist. But this high point of the craving is only temporary - as the wave eventually subsides (all that comes up must eventually come down). With the enough time and patience, you can surf on the manageable craving and wait for the next to rise.

When it comes to craving - this is the part that usually makes people give in to the old habits over and over again.  They feel a craving to raid the pantry or fridge, and that craving grows and grows.  It's as if once your client recognizes he wants to eat something, his brain will increase the urgency and the intensity of that craving.  To change the craving (and this is something that works with repeated use and practice over time), you can teach your client to use Urge Surfing.

On average, it takes about 15-20 minutes before cravings will go away.  Depending on the habit, this could differ, but the key is to remember that left on its own, the craving will eventually go away.

The first time your client tries to resist the urge and surf the wave, it'll feel pretty intense, because the brain is used to giving in to the urge, but eventually with repeated practice and saying no, it gets easier. 

strategies for successfully urge surfing

Strategies for riding out the urge include waiting that 15-20 minutes before deciding if you still want to give in.  But you can also take advantage of distraction (finding something else to do, going for a walk, etc.) and can also substitute a healthy option in its place.  Instead of raiding the fridge and pantry for the high calorie and salty snacks, your client could opt for a piece of fruit instead.

Then to target the response, your client could increase the distance between himself and the high-calorie snacks.  Maybe he only keeps healthy options in the house, so even when he does raid the pantry, it doesn't do much damage.  Or perhaps he moves the tempting snacks to a far-removed cabinet instead. And lastly, to target the reward aspect, your client could find someone to help hold him accountable.  Maybe that's you, and he texts you to let you know when he navigates that habit loop successfully, or perhaps it's his spouse/partner or kids.  

Sharing "give up" goals makes it that much more likely those old habits will be given up or replaced.

Summary

It's not just about the snacks, the breakfast, lunch, or dinner.  It's not even just about the workout or daily movement breakfast.  Sure, all of these add up, and one of our jobs as trainers is to help clients sort through their daily health behaviors. 

The key to any long-term success - whether that is around nutrition, exercise, or, well, anything - is building slowly over time. Progress over perfection.

Consider this with your clients and even apply it to your behaviors.  Changing habits may feel challenging, but with the right awareness and support, we can craft the behaviors to help our clients and us, achieve goals and become who we'd like to be.  

When we think about the habits most of us have, many are well-established.  Every day you make choices that you don't have to consider or think about.  You simply do them. And the same is true of your clients. 

This well-designed system is a positive, because if we had to think about every daily thing, every single minute - well, heck, we'd be mentally and physically exhausted. The more positive habits we can automate and help our clients do the same, the better off all of us will be.

References

  1. Wyer JR., RS (1997). The Automaticity of everyday life. Hillsdale, NJ: Lawrence Erlbaum Associates.
  2. The Power of Habit by Charles Duhigg
  3. Atomic Habits by James Clear

Tags: Nutrition Tags: nutrition coaching

The Author

Christopher & Kara Mohr

Christopher Mohr, PhD, RD is an internationally recognized nutrition expert and is the Co-Owner of Mohr, Results, Inc. He is on the Men’s Health Magazine Advisory Board, was the consulting Sports Nutritionist for the Cincinnati Bengals and has worked with select WWE wrestlers to help them with their nutrition programs. His expertise has offered him the opportunity to speak at the White House, the CIA and to audiences in over 10 countries and almost all 50 states. Dr. Mohr often appears on TV as a nutritional guest expert, including an appearance with Chef Emeril Lagasse, CBS’s ‘The Talk’ and another on the Montel Williams Show. He worked alongside LL Cool J as the nutrition consultant and expert for the NY Times Bestseller, “LL Cool J’s Platinum Workout” and collaborated with Fitness Celebrity Denise Austin & Mario Lopez, to write the nutrition sections for their books. Kara Mohr, PhD is an internationally recognized dynamic keynote speaker who is known for her expertise and experience in the areas of behavior change, exercise and mindset. Previously named one of the Top Weight Loss Doctors in the country by Prevention Magazine, Kara has worked with thousands of individuals to help them discover how to get healthier and become the best versions of themselves. Kara is co-owner of Mohr Results, Inc., a well-being company that helps people & organizations create healthy, thriving cultures that drive performance. She lectures nationally and internationally and is a regularly sought after expert source by national publications including the New York Times, Fitness, Women’s Health and more.