A nutrition and exercise expert and her science writer daughter discuss the motivation to stay healthy

At least six times today, while working on this article, I’ve walked by a table of baked goods a colleague brought into the office. There are cookies, pumpkin bread, and something brown in a pan that looks gloriously sticky with coconut. I’ve been trying not to look at it. I love coconut. And cookies. And sugar, pretty much.

Just a few hundred yards from my desk at Fred Hutchinson Cancer Research Center is a building full of public health researchers, many of whom study the effects of poor diet and other unhealthy lifestyles on cancer risk. I know for a fact that many of them also walk by trays of cookies and donuts on the paths to their offices, because I’ve seen the goodies in that building as well.

At the heart of research like theirs is this truism: Most of us want to be healthy, but it’s really hard. And those public health researchers and their colleagues don’t always know what works to get people to lose weight, eat less sugar, exercise more or eat more vegetables. Even when they do know what works, they don’t always know how to get people to actually stick with it.

RT: Have there been studies on what helps people stick with a healthy lifestyle long term?

AM: I don’t think there have been long-term studies; there have been a lot of short-term studies, and more of them are kind of prescriptive, like we want to help you lose weight, so here’s what you have to do. Or researchers may test one thing at a time, one variable, and see if that works. For example, there’s an association between eating breakfast and being lower weight. The media turned that around into: ‘If you eat breakfast you’ll lose weight.’ But nobody had ever tested that. So finally there have been a few trials that took people who don’t usually eat breakfast and randomly assigned them to eat breakfast or not. It turned out that breakfast made no difference. If you’re not a breakfast eater and you add it, it’s not going to make you lose weight.

Sleep’s another thing. People who are obese and overweight tend to have sleep problems. You don’t know which came first, is it the sleep problem first that helped them gain weight? Or is it that they’re heavier and then they’re having apnea and having sleep problems from that? Or maybe some common emotional thing that causes both. But people twist it around and say, get more sleep, you’ll lose weight. Well, it’s not necessarily true. It really needs to be tested before it’s told as truth.

RT: What actually works to lose weight, if you can stick with it?

AM: For some of the tricks of losing weight, there’s a common theme of accountability. So weighing yourself regularly, especially if you have somebody overseeing that. Also writing down everything you eat and your physical activity. Writing everything you eat forces you to realize what you’re putting in your mouth and it helps you count calories. People who prepare their own food also do better at losing weight, because you don’t really know what you’re eating at a restaurant.

RT: I have a hard time even motivating myself to do the food diary. In your studies, did you find ways to get people to actually do it?

AM: We had very good nutritionists. They were constantly encouraging people. They were great at telling them, this is how you’re going to know what you’re eating, this is going to help you. And it turned out it did. But we also selected people who we thought would be able to do it. They couldn’t get into the study if they couldn’t give us a week’s worth of writing down what they ate. 

RT: Besides avoiding the treats in the office, how else do you manage to not eat things that are bad for you and to get out and exercise every day?

AM: I get out and walk with friends every morning. We have a set time, so I know I have to get up in time to get out and do that. Again it’s a bit of an accountability thing — you promise somebody you’ll meet them. I also get on the stationary bike and read, sometimes it’s work reading and sometimes it’s fun reading, but it’s a nice reading time. Also I’m not eating while I’m doing that.

Grazing ways

RT: Is it partly about just looking for ways to keep yourself from eating during the day?

AM: Some people are noshers; that’s what I am. And there are some people who will sit down and just eat huge quantities of food, and they need something different to motivate them. So anything that would keep you active in any way can help. It’s hard to be a nosher when you’ve got little kids you are running around after at the playground. I mean how often are you sitting there eating at the playground? You’re running around after the kids.

RT: And I know that they want every molecule of snack that’s in my bag, so I better not touch it.

AM: Yes, that’s right. You can’t have your sweet stash there once they’re aware of it.

RT: Can you tell me about your prediabetes and how that’s affected your lifestyle?

AM: That really helps me to reduce carbs. I can look at a bowl of ice cream and I can see that it would be like shooting glucose into my veins. When I envision that, then the ice cream doesn’t look so good. That works for most carbs, but it doesn’t work for things like nuts and dark chocolate, which I know don’t raise my blood sugar very much.

RT: I guess with all that time you spent tracking your blood sugar and all your scientific knowledge, you know exactly what each meal is going to do to you.

AM: Yeah. And just about the time I became prediabetic, the results of the Diabetes Prevention Program trial came out, and it showed that a lifestyle change through a diet and exercise weight- loss program reduced the risk of getting diabetes by over half.

RT: Oh wow. When I’ve been exercising recently I’ve been thinking, if I keep doing this maybe it’s going to extend my life, but each 20- or 30-minute run I hope is going to extend my life by more than 20 minutes, because otherwise it’s a wash. I’ll want that time back.

AM: It’s not just extending life, but it’s quality of life. Think about somebody who stays very inactive when they’re younger, and their muscles get weak and every pound they’re putting on is all fat. They’re putting a lot of stress on their joints, and if their muscles aren’t strong to handle it, then their quality of life is going to be worse when they’re older. You know, their kid wants to go to Disneyland and they have to walk around with them, they’ll be very uncomfortable. So yeah, you’re making yourself a little miserable for 20 minutes if you don’t like running, but then you might feel better in the short term and the long term.

Competitive fire

RT: Have you heard any other ways people motivate themselves?

AM: Some people are competitive, so they like to sign up for races. I feel like my job is competitive enough; I don’t feel like I need to run a race to incite me, but for some people that really works.

It would be an interesting thing to study, to ask people what motivates them to eat certain ways. There’s not a lot known about what makes people maintain weight.

RT: I feel like for me, most of the time exercise is a little easier to motivate myself to do, because that’s just like one choice a day, and food is constant all day long.

AM: Yeah, and behavioral scientists have shown that in studies. If you have to make choices all the time, like with food, it’s difficult.

RT: Anything else, any other brilliant ideas?

AM: I wish I did have brilliant ideas.

*Note: When she read the first draft of this article, McTiernan said she doesn’t think she’s a superwoman. I’ll let you skim through some of her many recent accomplishments and decide for yourself. I think the term fits.