Habit Formation and its Application to Lifestyle Patterns such as Diet and Exercise

Jesse Oswald • April 24, 2024

Key Points

  • Habit formation is encouraged by attitudes, goals, and motivation to attain desired outcomes.
  • Habit maintenance is governed by the coexistence of salient environmental cues in a friction-minimizing context and with adequate reward mechanisms, which will make the habit easy and enjoyable to repeat.
  • Habit slips can normally happen under stressful and other unfavourable conditions, but applying effective strategies can create concrete habit change towards adopting good habits.

 

We, as humans, are all creatures of habit. From drinking coffee in the morning to brushing our teeth before bed, much of our lives are driven by habits. Habits are thus these default responses, or more articulately, a specific behaviour's sufficiently frequent or consistent performance in a stable context. Some habits persist for longer periods in the natural course of life, whereas others are not maintained. Habits are essential in regulating desirable everyday behaviour or consolidating long-term behaviour change. However, habits may decay when they are no longer activated or are replaced by other actions.

Habit Formation

Behavioural scientists who study habit formation say that most of us try to establish healthy habits incorrectly. For instance, we make bold resolutions to start exercising or lose weight without taking the steps needed to set ourselves up for success.

 

To begin with, positive, strong, and stable attitudes can be an important starting point for behaviour change, especially if the behaviour is something a person really wishes to form. If successful, such change may be consolidated by turning the newly formed behaviour into a habit (habit formation). Therefore, when we do something new, and it works, or we like it, this behaviour will likely be repeated and ultimately become habitual.

 

Furthermore, goals influence habit formation by energizing and directing action toward a desired end state. For example, if we decide to start eating one fruit every morning, we can actively manage our context accordingly by placing it on the nightstand before bed. Since everyday habits develop as people pursue life goals, habit formation is a product of repeated behaviours in the service of goal pursuit.

 

Although attitudes and goals play an essential role in habit formation, once habits are established, they get automatically activated by context cues independent of attitudes or motivation. Various cues, including locations, particular people, visual cues, and existing good habits, might trigger habit performance. For example, existing good habits, such as having breakfast, can be utilized to more easily stack new habits, such as by supplementing this breakfast with fruits.

 

Apart from cues, habit formation also strengthens through reward-learning mechanisms. Using rewards (extrinsic or intrinsic motivation) can also promote habit formation. Extrinsic rewards, especially when uncertain or unexpected, encourage habit formation by engaging dopamine systems. More specifically, dopamine signals promote habit learning as people repeat responses to extrinsic rewards, such as praise from a friend for going to the gym.

 

Furthermore, adopting a new habit may be rewarding (intrinsic motivation) because it makes life easier by eliminating the need for new learning or decision-making (reduced mental effort). Intrinsic rewards are generally superior to external rewards for habit formation.

 

Overall, habit formation is crucial since it accumulates specific features, such as frequency, thus speed, and fluency, as well as the simplicity of the behaviour, that are more likely to favour the habit over other alternatives.

 

Habit Maintenance

 

For good and constructive behaviours that serve desired goals, such as adhering to a diet or taking up regular exercise, the longevity of the behaviour is desirable, and habit formation is crucial. Once established, habits are not easily influenced by the distraction caused by tempting alternative courses of action, stress, fatigue, or lack of motivation. They are characterized by automaticity and a lack of awareness; they directly happen due to recurring environmental cues without being consciously guided by goals, rewards, intentions, and attitudes anymore.

 

Therefore, individuals who form and maintain good habits can pursue desired outcomes with minimal effort. In other words, habit maintenance makes life work better for the individual and protects goal accomplishment, particularly under depleted mental resources when good habits might otherwise be derailed. So, if, for whatever reason, an individual is less capable of exerting willpower to accomplish desired outcomes, habits become the default behaviour; thus, procrastination and rationalization can be avoided.

 

If, on the other hand, those behaviours have not been turned into habits, they are vulnerable to attitudinal fluctuations, temptations, or rationalizations, hence the possibility of falling back on bad or undesirable habits.

 

Habit Slips

 

Everyone tends to fall back on existing bad habits when they lack the capacity or motivation to make decisions that align with their goals. Habit slips do not happen due to unfavourable attitudes or lack of motivation. They are especially likely to occur when various factors reduce the motivation or ability to deliberately pursue desired goals and thus tip the balance towards relying on bad habits. Such factors include distractions, time pressure, stress, addictions, limited task ability, and limited willpower.

 

Although an ideal scenario would be to keep your good habits one hundred percent of the time, this is highly unlikely to be the case since recurring environmental cues of the bad old habits continue to be activated automatically. However, habit slips are not always bad and should not disappoint the individual, let alone when people can quickly and consciously get back on track.

 

To more efficiently manipulate possible habit slips, the individual should be able to recognize and troubleshoot the reasons that triggered them, as well as move away from the obstacles that disrupted the routine around this habit.

 

Habit Change

 

Bad habits may change or be overcome with sufficient motivation, strong attitudes, and opportunities. Therefore, unless we are distracted, stressed, or fatigued, we can effortfully discontinue a bad habit and think about better alternatives. For example, when existing habits conflict with our current goals, we can use these goals to inhibit the bad habit. This process is cognitively demanding, though, and requires awareness and motivation to deliberately inhibit the bad habit.

 

Habit change depends on three core processes: a) disrupting cues associated with bad habits, b) structuring the environment to make it easy to repeat beneficial habits in stable contexts, and c) linking desired habits to rewards (extrinsic, such as praise from a friend and/or intrinsic, such as the sense of self-esteem and confidence for adopting a good habit).

 

We are more likely to change a bad habit, such as eating a lot of fast food or sitting too much with a good one, such as eating fruits and vegetables or exercising, if we apply appropriate strategies toward that goal. More specifically, if we restructure our environment to make the good habit easily repeatable in a stable context devoid of temptations and to disrupt antagonistic habits and their cues and make the good habit rewarding, we have exploited the core mechanisms for long-term habit change.

 

Therefore, breaking bad habits is less about how much one intends to change behaviour and more about whether one eliminates or disrupts the specific cues associated with the undesired habit. For example, we can modify our environment to make it easy and convenient to eat fruit instead of a sweet by eliminating sweets from our drawers and fridge and leaving fruits on a very visible site in our home (e.g., counter). We can also establish a consistent time and location for exercise each day or some days per week. Lastly, we can find ways to reward ourselves for eating healthy and exercising by emphasizing aspects of the habit that are immediately and unexpectedly rewarding (e.g., a sense of accomplishment or stress relief from constantly looking for food to order).

 

 

Strategies to Avoid Bad Habits

 

The most straightforward strategy to avoid or change an unwanted habit is to monitor the behaviour and the circumstances of its occurrence and effortfully try to inhibit the performance of the habit. This process, known as vigilant monitoring, is the most effective strategy to inhibit unwanted habits. For example, if you go out for dinner and mostly eat junk food, you can hinder this bad habit by having cooked and eating at home before going out. Also, if you return home after work and do not have the willpower to go to the gym, you can have the training bag with you so that you go straight after work instead of crashing out on the sofa watching Netflix.

 

Another critical tool to diminish the likelihood of a bad habit is reducing friction for a more desired course of action by making it simpler, i.e., breaking it into small, achievable, more readily available steps. In other words, to manipulate the environment to increase the likelihood of frequent and consistent execution of the desired habit and minimize the possibility of the antagonistic habit. For example, people are more likely to grab food items nearer to them, even if preferred items are available further away. This arrangement promotes healthier eating habits if the nearby items constitute good-quality food and the less proximate low-quality food.

 

Overall, the creation of new habits which may ultimately lead to lasting behaviour change requires consistent repetition in a stable, friction-minimizing context with solid environmental cues and adequate reward mechanisms.

 

Habits are crucial in terms of valued long-term goals related to diet, exercise, and overall well-being, and they can support or hinder their achievement. By understanding habit mechanisms and building interventions to change such lifestyle behaviours, we may successfully disrupt unwanted habits, such as poor diet and limited exercise, and help people to form better ones that meet their goals for healthy, productive lives.

An Ounce of Prevention - Hyperion Health Blog

A woman is helping an older woman do exercises on an exercise ball in a gym.
By Jesse Oswald January 29, 2025
What is a Kinesiologist?
A woman is wearing an oxygen mask while running on a treadmill.
By Jesse Oswald January 20, 2025
Highlights Healthcare expenses are skyrocketing, with consumers and employers facing the significant brunt. Identifying those likely to get sick is critical as our resource-strapped healthcare system should focus on those likely to become the most significant burden to the system. VO2 max is a crucial longevity indicator that can also accurately predict healthcare expenses. The rampant chronic disease epidemic and the resulting surge in medical expenses is one of the most dire problems of modern societies, probably only second to climate change. Healthcare inflation is on a meteoric rise, and for those with limited or no healthcare coverage, a medical emergency is the equivalent of personal bankruptcy. A dire problem for employers In the US, employers and consumers who face rising health insurance premiums and astronomical out-of-pocket medical expenses feel the brunt of rising healthcare costs. Such is the problem that even large, well-capitalized corporations choose to send employees overseas for specific medical procedures since the cost of traveling and treatment in a foreign country is lower than the cost of care in the US. Another startling example is the infamous "northern caravan," a term that describes people with diabetes in the northern states who travel to Canada to secure their insulin supply. According to McKinsey , a survey conducted among over 300 employers highlighted that the average increase in the cost of health benefits over the past three years has been within the range of 6 to 7 percent. This survey also indicated that any rate increases exceeding 4 to 5 percent were deemed unsustainable. Interestingly, 95 percent of the surveyed employers expressed willingness to contemplate reducing benefits if costs surged by 4 percent or more. The primary cost-control measures that these employers indicated they might explore included elevating the portion of premium costs covered by employees and a potential transition to high-deductible health plans. Why is Breath Analysis relevant? Vis-a-vis this problem, the early and accurate estimation of who will get sick and how much they will cost is as critical as the treatment itself. The reason is that no other method of accurately identifying at-risk populations exists; it helps focus our scarce prevention resources and attention on those most in need. Breath analysis, AKA VO2max or metabolic testing, is an assessment that reveals two key biomarkers that provide significant predictive value for one's likelihood of developing costly chronic conditions. These two biomarkers are VO2max and the Respiratory Exchange Ratio. In this article, we will dive into VO2max to understand why it's a critical reflection of our overall health and, consequently, a window into our future healthcare spend. What is VO2max? Let's start with the basics. What is VO2max? VO2 max is the maximum amount of oxygen the human body can absorb. It is measured in terms of milliliters of oxygen consumed per kilogram of body weight. The below formula below indicates how VO2max is calculated: The numerator indicates the volume of oxygen your heart, lungs, and cells can absorb, expressed in milliliters per minute. The denominator indicates the weight of the individual represented in kilograms. 
There are many different types of fats in this picture.
By Jesse Oswald January 13, 2025
Key points A total fat intake between 20-35% ensures sufficient intake of essential fatty acids and fat-soluble vitamins Omega-6 PUFAs are primarily found in vegetable oils, while omega-3 PUFAs are primarily found in fatty fish and fish oils Both omega-3 PUFAs and MUFAs have established benefits for cardiovascular disease TFAs are the only dietary lipids that have a strong positive relationship with cardiovascular disease Omega-3 PUFA supplementation increases the beneficial bacteria of the human microbiome Over the last three decades, there has been a great revolution against fat due to its suspected association with several nutritional health issues, especially cardiovascular disease. There was a tremendous amount of evidence that indicated dietary cholesterol and saturated fat as the main culprits of cardiovascular disease, thus morbidity and mortality. It was when all the low-fat and no-fat dairy products started to launch, promising even complete substitution of the cholesterol-lowering heart medication if these products were exclusively consumed. Let’s start from the beginning. Dietary fat intake can vary significantly and still meet energy and nutrient needs. International guidelines suggest a total fat intake between 20% and 35% of the daily caloric consumption. This range ensures sufficient intake of essential fatty acids and fat-soluble vitamins. Not only does the quantity of the ingested fat matter, but most importantly, its quality. Some dietary fats have beneficial effects, with a significant role in maintaining good health, while others may threaten it. Which are, after all, the dietary fats? Dietary fats is a rather heterogeneous group of organic compounds, including four main types of fat, which are elaborately described in the following sections of this article. Polyunsaturated fatty acids (PUFAs) Polyunsaturated fatty acids (PUFAs) have two or more carbon-carbon double bonds. Omega-6 PUFAs and omega-3 PUFAs are the main types of PUFAs and are classified according to the location of the first unsaturated bond (sixth and third carbon atom, respectively). Alpha-Linolenic acid (ALA), docosahexaenoic acid (DHA), docosapentaenoic acid (DPA), and eicosapentaenoic acid (EPA) are the most important omega-3 PUFAs. ALA is an essential fatty acid that can only be obtained from diet and can be converted into EPA and then to DHA, but the rate of this conversion is finite, approximately 7.0%–21% for EPA and 0.01%–1% for DHA. In the same way, the most important omega-6 PUFAs are linoleic acid (LA) and arachidonic acid (ARA). LA is an essential fatty acid that, in order to give rise to ARA, needs to be ingested through the diet as the human body cannot synthesize it. The recommended intake for total PUFA ranges between 5% and 10% of the total energy intake, while a total omega-3 PUFA intake of 0.5%–2% and a total omega-6 PUFA intake of 2.5%-5% is suggested. A dietary ratio of omega−6/omega−3 PUFA is recommended to be 1:1–2:1 to balance their competing roles and achieve health benefits. Omega-6 and omega-3 PUFAs Omega-6 PUFAs, in the form of LA, are plentiful in most crop seeds and vegetable oils, such as canola, soybean, corn, and sunflower oils. In contrast to omega-6 PUFAs, omega-3 PUFAs are obtained from a limited range of dietary sources. Flax, chia, and perilla seeds are rich in ALA, with significant amounts also detected in green leafy vegetables. The consumption of fatty fish, such as salmon, sardines, tuna, trout, and herring, provides high amounts of EPA and DHA. Besides fish and their oils, small amounts of omega-3 PUFAs are also detected in red meat like beef, lamb, and mutton. All the above dietary sources provide EPA, DPA, DHA, LA, and ARA in different amounts, and their intake is necessary for normal physiological function. PUFAs play a critical role in many chronic diseases, affecting human cells by regulating inflammation, immune response, and angiogenesis. Omega-3 PUFAs’ role against hypertriglyceridemia has been clarified, and research indicates that systematically consuming oily fish can contribute to general heart protection. Supplementation with omega-3 PUFAs could potentially lower the risk of several cardiovascular outcomes, but the evidence is stronger for individuals with established coronary heart disease. Moreover, adequate EPA and DHA levels are necessary for brain anatomy, metabolism, and function. Although the mechanisms underlying omega-3 PUFAs' cardioprotective effects are still poorly understood, several studies have been conducted in this direction. Unfortunately, that does not hold true for their omega-6 counterparts, for which controversial emerging data tend to show anti-inflammatory behavior that needs to be further studied. Monounsaturated fatty acids (MUFAs) In contrast to PUFAs, monounsaturated fatty acids (MUFAs) are easily produced by the liver in response to the ingestion of carbohydrates. The main MUFA is oleic acid, found in plant sources, such as olive oil, olives, avocado, nuts, and seeds, while minimal amounts are also present in meat, eggs, and dairy products. Specific guidelines around MUFAs’ dietary consumption do not exist. Therefore, MUFAs are recommended to cover the remaining fat intake requirements to reach the total daily fat intake goal. A growing body of research shows that dietary MUFAs reduce or prevent the risk of metabolic syndrome, cardiovascular disease (CVD), and hypertension by positively affecting insulin sensitivity, blood lipid levels, and blood pressure, respectively. Moreover, olive oil contains several bioactive substances, possessing anti-tumor, anti-inflammatory, and antioxidant qualities. According to a meta-analysis, consuming olive oil was linked to a lower risk of developing any sort of cancer, especially breast cancer and cancer of the digestive system. Another study found that an isocaloric replacement of 5% of the energy from saturated fatty acids (SFAs) with plant MUFAs led to an 11% drop in cancer mortality over a 16-year follow-up period. Therefore, including MUFAs in the everyday diet offers multifaceted benefits in chronic disease prevention and management, including cancer and general health promotion.  Saturated fatty acids (SFAs) Saturated fatty acids (SFAs) form a heterogeneous group of fatty acids that contain only carbon-to-carbon single bonds. Whole-fat dairy, (unprocessed) red meat, milk chocolate, coconut, and palm kernel oil are all SFA-rich foods. These fatty acids have distinct physical and chemical profiles and varying effects on serum lipids and lipoproteins. Stearic, palmitic, myristic, and lauric acids are the principal SFAs found in most natural human diets. Dietary practice and guidelines recommend limiting SFA intake to <10% of the total energy (E%), while the American Heart Association suggests an even lower intake of <7 E% because total saturated fat consumption and LDL-C levels are positively correlated. However, the role of SFAs in CVDs is quite complex, and the evidence is heterogeneous. In a recent study with a 10.6-year follow-up period, which included 195,658 participants, there was no proof that consuming SFAs was linked to developing CVD while replacing saturated fat with polyunsaturated fat was linked to an increased risk of CVD. Moreover, according to 6 systematic reviews and meta-analyses, cardiovascular outcomes and total mortality were not significantly impacted by substituting saturated fat with polyunsaturated fat. Even if these analyses were to be challenged, due to heterogenous evidence, the possible reduction in CVD risk associated with replacing SFAs with PUFAs in several studies may not necessarily be an outcome of SFAs’ negative effect but rather a potential positive benefit of PUFAs. Regarding SFAs' effect on different types of cancers, associations of their intake with an increased risk of prostate and breast cancer have been indicated. Conversely, a meta-analysis showed no link between SFA intake and a higher risk of colon cancer; similarly, consuming MUFAs, PUFAs, or total fat did not affect colon cancer risk. Hence, the role of SFA consumption in preventing, promoting, or having a neutral role in serious chronic diseases has not been fully elucidated yet. Trans fatty acids (TFAs) Trans fatty acids (TFAs) are created industrially by partially hydrogenating liquid plant oils or can be naturally derived from ruminant-based meat and dairy products. TFAs are highly found in commercial baked goods, biscuits, cakes, fried foods, etc. Guidelines regarding TFAs are stringent and limit TFA intake to <1% of energy or as low as possible. In 2015, the US Food and Drug Administration declared that industrial TFAs are no longer generally recognized as safe and should be eliminated from the food supply as their consumption is strongly linked to various CVD risk factors. Specifically, TFA intake raises triglycerides and increases inflammation, endothelial dysfunction, and hepatic fat synthesis, leading to a significantly increased risk of coronary heart disease (CHD). A meta-analysis suggested that increased TFA intake led to an increase in total and LDL-cholesterol and a decrease in HDL-cholesterol concentrations. Data also indicates that TFAs may influence carcinogenesis through inflammatory pathways, but the reported data are debatable. A recent study investigated the effects of all types of dietary fat intake on CVD risk. While PUFA, MUFA, and SFA intake were not linked to higher CVD risk, dietary TFA intake showed a strong association with CVD risk. Analysis indicated PUFA intake and CVD risk were inversely correlated, and the relative risk of CVD was reduced by 5% in studies with a 10-year follow-up. Dietary lipids and the human microbiome Dietary lipids also affect human microbiota composition. Studies have identified a close association between the human microbiome and metabolic diseases, including obesity and type 2 diabetes. Diets with a high omega-6 PUFA, SFA, and TFA intake increase the amount of many detrimental bacteria in the microbiome and reduce the amount of the beneficial ones, altering the microbiota composition and inducing inflammation via the secretion of pro-inflammatory cytokines. These bacteria may disrupt the gut barrier function, allowing lipopolysaccharides (LPS) translocation, which are bacterial toxins. This condition is linked to metabolic perturbations such as dyslipidemia, insulin resistance, non-alcoholic fatty liver disease (NAFLD), and CVD. On the contrary, omega-3 PUFA (EPA and DHA) supplementation increases beneficial bacteria and limits harmful ones, enhancing intestinal barrier functioning and preventing LPS translocation and its implications. Omega-3 PUFA supplementation has also been studied as a means of mental health disorders management, but the evidence is still controversial. A possible protective impact of fish consumption on depression has been suggested by various studies, as well as a possible protective effect of dietary PUFAs on moderate cognitive impairment. A recent review of meta-analyses indicated that omega-3 PUFA supplementation might have potential value in mental health disorders, but data credibility is still weak. Dietary lipids and obesity Last but not least, obesity and its management is another field that dietary lipids intake seems to impact with their mechanisms. A diet high in PUFA has been shown to lower the total mass of subcutaneous white adipose tissue (the predominant fat type in human bodies), reduce blood lipid levels, and improve insulin sensitivity. In a study comparing PUFA and MUFA isocaloric intake, PUFA was more advantageous and lowered visceral adiposity in patients with central obesity. By stimulating brown adipose tissue, which aids energy expenditure through its elevated thermogenic activity, omega-3 PUFAs seem to elicit these positive effects in fat tissue, thus being useful in preventing and/or managing obesity. Another related study compared PUFA to SFA overfeeding in dietary surplus conditions that aimed to increase weight by 3%. While SFA overfeeding led to weight gain, primarily through the expansion of the visceral adipose tissue, PUFA overfeeding also led to weight gain, but because of a greater expansion of lean tissue mass. To sum up, dietary fats are an essential part of the human diet with many important physiologic functions, including cell function, hormone production, energy, and nutrient absorption. Moreover, dietary fat consumption is associated with positive outcomes in regard to cardiovascular disease, metabolic syndrome, cancer, and depression. Therefore, there is no reason to demonize this valuable dietary component, incriminating it for irrelevant adverse health outcomes, primarily weight loss failure and obesity. References 1. Astrup A, Magkos F, Bier DM, Brenna JT, de Oliveira Otto MC, Hill JO, King JC, Mente A, Ordovas JM, Volek JS, Yusuf S, Krauss RM. Saturated fats and health: A reassessment and proposal for food-based recommendations: JACC State-of-the-Art review. J Am Coll Cardiol. 2020;76(7):844-857. DOI: 10.1016/j.jacc.2020.05.077 2. Bojková B, Winklewski PJ, Wszedybyl-Winlewska M. Dietary fat and cancer-Which is good, which is bad, and the body of evidence. Int J Mol Sci. 2020;21(11):4114. DOI: 10.3390/ijms21114114 3. Custers, Emma EM, Kiliaan, Amanda J. Dietary lipids from body to brain. Prog Lipid Res. 2022;85:101144. DOI: 10.1016/j.plipres.2021.101144 4. de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS. 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