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Lifestyle changes: all at once or step by step?

Making several healthy lifestyle changes all at once, such as exercising more and eating more healthily, may be easier than adopting them gradually, a new study suggests.
By Kathy Oxtoby

BMJ Group News

What do we know already?

older couple exercising

The benefits of a healthier lifestyle are well known. Eating more fruit and vegetables, avoiding fatty and sugary foods, and exercising more can help keep your heart healthy, control weight, and protect against type 2 diabetes.

But changing behaviour is hard. People are often advised to set small, realistic goals, and not to try to change too much too quickly. However, we don’t know if this is really easier than jumping in with both feet and making big changes all at once.

To find out more, for 12 months researchers studied 200 people aged over 44, who were overweight, did not exercise regularly, did not have a healthy diet, and found it stressful to try to change their behaviour.

People who took part in the study were divided into four groups. After a meeting with an advisor, everyone had regular follow-up telephone calls. People in the first group were advised and encouraged during the meeting and the calls to increase the amount of exercise they did. Four months later they received advice about a healthy diet. The second group was given the dietary advice at the start of the study and then the advice about exercise four months after that. The third group was advised to combine a healthy eating plan with an exercise regime from day one, and the fourth only received counselling to help them manage the stress they felt about trying to change their behaviour.

Researchers then compared the results to see which group had stuck most closely to advice about exercising more, eating less saturated fat, and eating more fruit and vegetables.

What does the new study say?

After 12 months, people in all three of the groups that had received advice to exercise more and eat more healthily had had some success in changing their behaviour, compared with the group that only had advice about stress. But only the people in the group who were advised to change both their eating and exercise habits from day one met all the targets set by the study about exercise, fat, and fruit and vegetables.

How reliable is the research?

Although the results of this study are interesting, there are several reasons why we can’t read too much into it.

  • It relied on what people reported about their behaviour over the phone, rather than on something the researchers could measure more accurately.
  • It included only people who said they found changing their behaviour stressful. People who were less worried about changing their lifestyle might have reacted differently to the various types of advice.
  • The study was quite small.

What does this mean for me?

This study doesn’t show beyond doubt that making a lot of lifestyle changes all at once is easier than changing your habits gradually. What it does suggest is that there isn’t one method that suits everyone, and that if you think you’d find it easier to push ahead and change both your diet and exercise habits at the same time, you might be right.

Published on April 23, 2013

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