Much of diabetes self-management involves building new healthy habits. Diabetic Living magazine dietitian and diabetes educator, Dr Kate Marsh, discusses some of the research around building habits and how you can use this to support you in managing your diabetes and improving your overall health and wellbeing.
What are habits?
Habits are routine behaviours or actions that we perform each day, often unconsciously. They develop through repetition and become part of our everyday life, accounting for a large proportion of our daily behaviours. Habits can be either positive or negative and can affect various aspects of our life, including our health. In fact, habits drive many of our daily health-related behaviours.
Health-related habits
These are behaviours and routines that you take part in regularly and which can affect your physical and mental wellbeing.
Examples of healthy habits include:
- Eating a healthy diet
- Exercising regularly
- Getting adequate good quality sleep
- Managing stress levels
- Having regular health checks
Examples of negative health-related habits include:
- Emotional eating
- Excessive screen time
- Drinking too much alcohol to manage stress levels
- Smoking
- Being physically inactive
Building healthy habits
In an article titled ‘Making health habitual: the psychology of ‘habit-formation’ and general practice’, researchers from the Health Behaviour Research Centre at the University College of London suggest the following steps for building a new healthy habit:
- Decide on a goal that you would like to achieve for your health.
- Choose a simple action that will get you towards your goal, which you can do on a daily basis.
- Plan when and where you will do your chosen action. Be consistent: choose a time and place that you encounter every day of the week.
- Every time you encounter that time and place, do the action.
The researchers say that the action will get easier with time, and within 10 weeks you should find you are doing it automatically without even having to think about it.
For example, if your goal is to eat more vegetables, you might decide that with every dinner meal (when) at home (where) you will fill half of your plate with vegetables (action). Or if you have a goal of being more active, you might decide that you will walk for 15 minutes (action) around the local park (where) after breakfast each morning (when).
The four laws of behaviour change
In his bestselling book, Atomic Habits, author James Clear discusses a framework for creating good habits and breaking bad ones based on the four laws of behaviour change. To create a new habit, he says, you need to make it obvious, attractive, easy and satisfying. To break a bad habit, on the other hand, you need to make it invisible, unattractive, difficult, and unsatisfying.
Let’s look at this in practice
If you are aiming to build a habit of eating fruit in place of other snack foods, you could:
- Keep a bowl of fresh fruit on the kitchen bench or store fruit at eye-level in the fridge where you will see it easily (make it obvious)
- Buy a selection of your favourite fruit each week (make it attractive)
- Pack a few pieces of fresh fruit to take to work, in place of other snack foods (make it easy)
- Track your daily fruit intake so you can see your progress (make it satisfying)
If you want to build a habit of walking in the mornings, you could:
- Set out your workout clothes the night before so they are the first thing you see when you wake up (make it obvious)
- Choose somewhere nice to walk, such as along the beach, around a local park or a bushwalk (make it attractive)
- Rather than aiming for an hour, start with 10 or 15 minutes (make it easy) and gradually increase this over time
- Notice how much better you feel after your morning walk and use this as motivation to keep up your walking habit (make it satisfying)
And if you want to break the habit of staying up late scrolling social media on your phone and not getting enough sleep, you could:
- Delete social media apps from your phone (make it invisible)
- Learn about the impact of excess screen time and inadequate sleep on your health (make it unattractive)
- Put your phone away in another room after a certain time at night (make it difficult)
- Consider how you feel when you wake up tired and lacking energy after another night of poor sleep (make it unsatisfying)
- Make it obvious
- Make it attractive
- Make it easy
- Make it satisfying
To break bad habits:
To create new healthy habits:
- Make it invisible
- Make it unattractive
- Make it difficult
- Making unsatisfying
Other useful tips for building healthy habits
Starting small
Simple actions become habitual more quickly and this can increase your self-confidence for working towards other health promoting habits. Small changes, repeated consistently over time, can also lead to significant health benefits.
Think long term
Rather than trying to overhaul your entire lifestyle at once, start with one or two habits and slowly add more, aiming to build habits and routines that you can maintain in the long-term.
Plan for disruptions
Whether it’s holidays/travel, illness, a busy work schedule or something else, sometimes your healthy habits may be hard to maintain. The key is not to let the habits go completely and to have a plan for how you will re-establish your health routines when the disruption ends (for example, when you return from holidays).
Focus on systems rather than goals
Systems are the collection of daily habits that help you to achieve your desired outcomes. Goals are the results you want to achieve. As James Clear says in his book, “You don’t rise to the level of your goals. You fall to the level of your systems”.
Build identity-based habits
Another recommendation from Clear is to shape your identity to align with your desired behaviours. Every action you take, he explains, then becomes a vote for the type of person you wish to become. For example if you have decided to quit smoking and someone offers you a cigarette, tell them you are a non-smoker rather than that you are trying to quit.
Why healthy habits matter
An important part of optimising health is building routine behaviours that form new healthy habits.
Once a behaviour becomes a habit, it’s easier to stick with it because habits require less conscious effort and decision making.
When presented with a choice, we typically pick the option that is the easiest, quickest and most enjoyable, and this may not be the best choice for our health. Once you build a habit, you have less decisions to make, and it’s more likely that your behaviours will be ones that support rather than hinder your health.
The habit loop
Habits become ingrained through repetition of the habit loop.
The habit loop is a framework for understanding how habits form and how they can be changed. It comprises three main parts: the cue, the routine and the reward.
The cue is the trigger that initiates the habitual behaviour. It can include things such as location, time, your emotional state, the people around you, or your last action. For example, feeling stressed at work could be a cue to reaching for some chocolate to eat.
The routine is the habit or repeated behaviour itself. These behaviours may be conscious or unconscious, but often become automatic with time. For example, when you are feeling stressed, you engage in emotional eating.
The reward reinforces the habit, helping you to maintain your habits. In this example, eating chocolate provides immediate comfort and enjoyment.
If we apply this to building positive health-related habits, the cue could be an alarm on your phone at 9pm that reminds you to start getting ready for bed, the routine is being in bed by 9.30pm and the reward is a good night’s sleep and waking feeling refreshed and with good energy levels to start the next day.
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