I first brought up the idea of eliminating ultra-processed foods to my husband three weeks ago.  He is always supportive of my diet adventures and was immediately on board.  His motto is ‘if someone else cooks it, I’ll eat it and be thankful’.  I am a lucky woman.

However, when I brought it up again last week, he balked.  I mean he spun around, took a step back and sputtered ‘a year?!?!’  It is possible that when I first brought it up, I did not mention a timeframe.  I know in my head I was thinking that this was going to be a permanent change.  We dietitians do not like to think in terms of ‘short term diets’ because we know they don’t work.  Instead, we think in terms of ‘life long healthy habits’ so that’s the mindset I was in when I decided I’d like to live a life less processed.  But I can see it from his perspective.  Both he and my daughter eat more of the ultra-processed foods in our house.  He likes the idea of eating healthily, but he also likes ice cream and chips.  He was willing to get on board if it meant a month without his favorites, but a year made him do a double take.

I could see that I was going to have to rethink my plan.  It is not possible to have separate diets in the family.  Of course, everyone has preferences, and not everyone is going to want to eat exactly what the others are eating throughout the day, but we all have to be on the same overall page.  Otherwise, eating becomes disconnected from the social/emotional aspect of the family.  Since I want to maintain that connection, I am going to have to compromise.

This compromise turns out to be closer to what I had in mind in the first place.  Radical dietary changes are rarely sustainable.  I am not interested in rearranging my whole life so that I can start grinding my own grain and making my own wine.  Instead, I want to take a fresh look at what we eat and whether it moves me towards or away from my health goals.  I also want to be sure that I am the role model I want my kiddo to follow.  The number one predictor of healthy eating habits in children is the eating habits of their parents.  I don’t want my daughter to watch me jump from food fad to food fad.  I want her to be part of my reflection process.

That is the educator in me.  I know that adult learning requires three critical processes. First, there must be a discrepancy, a disrupter large enough to move me to action.  For me, the discrepancy was my recent work as a dietitian.  In September I went back to clinical practice working with low-income patients around the country.  After years of working with students, most of whom were in my course because they were fairly health conscious to begin with, I was now working with a population that had very little nutrition education and body knowledge.  It makes me so angry to listen to people go over their usual intake full of chips, soda, fast food, and middle of the grocery store fare.  Many of these patients had been motivated to come see me because they had out of control blood pressure or blood glucose.  And most of them had only a vague understanding of the relationship between the ultra-processed foods they were eating and their health condition. 

As I worked with patient after patient, I realized that many of these foods had crept back into my cupboard during Covid.  Wanting to make fewer trips to the grocery store to avoid getting sick, I had started buying more of the shelf stable foods.  And since food was one of our main entertainments during Covid, I also bought more ‘treats’.  (We also probably did a good amount of stress eating of comfort foods during Covid, now that I think about it.)  Even though the pandemic had passed, and we were back in our pre-covid routine, many of the ultra-processed foods were still finding their way into my grocery cart and ultimately our bodies.  Listening to my new patients remind me day after day of the health implications of those empty foods was enough of a discrepancy to move me to action.

The second part of the adult learning process is reflecting on the discrepancy.  This reflection deals with the cognitive dissonance between seeing that my current behavior is not in line with my cognitive structure, or what I believe to be true.  This is where many people get stuck in unhealthy behaviors.  It takes mental effort to reflect on discrepancies.  And when I say mental effort, I mean actual calories being burned by the brain.  If the energy need is high, motivation to make change will be low.  The energy need tends to be high when the discrepancy is large.  For example, if aliens landed on my lawn tomorrow, it is very likely that my brain would jump to some reasonable explanation and ignore the possibility that they could be aliens.  I have no frame of reference for aliens landing on my lawn, so my brain would need an extreme amount of calories to process what my eyes were seeing.  It would be easier for me to decide that I was part of some elaborate prank, or at the most accidentally involved in some serious military technology training exercise, so I would choose those explanations instead.

Luckily, the discrepancy between what I am seeing in my kitchen and what I know I should be eating is not huge.  I like healthy foods.  I know there is a time and place for chips or cookies, but it is not every day or even every month.  The main barrier to choosing less ultra-processed foods is convenience and my family’s preferences.  It won’t take me a whole lot of energy to shift my behavior to be more in line with my goal to eat healthy.

The last step in the adult learning process is changing the cognitive structure.  This is another step that takes mental energy and the amount of energy necessary varies.  For example, I already know how bad for my health ultra-processed foods are and I know why.  I do not have to learn the concept of nutrient density.  I’m even skilled enough to make many of the calculations quickly in my head so I can make comparisons while at the grocery store.  I have a broad knowledge of alternative foods that I enjoy but also provide lots of vitamins and minerals, so I am simply reorganizing my thinking, attempting to move from the motivator of habit to the motivator of health.  It takes a bit of effort, but the idea does not overwhelm me.

On the other hand, think of the patients that I described earlier.  They lack understanding of what vitamins and minerals are and what they do for the body.  They lack knowledge of what foods contain vitamins and minerals.  They lack the tools to help them identify healthier foods, much less make side by side comparisons while at the store.  And many of them lack the resources to buy a bunch of foods that they may or may not like that may or may not be healthier for them anyway. 

The situation reminds me of a patient I had back when I was in training.  I was sent to see a middle aged African American man with cognitive issues who had recently been diagnosed with diabetes.  He was so eager to see me.  He welcomed me into his home, showed me the food in his fridge and cupboards, and asked many, many questions about how he could change what he was eating so that his diabetes was controlled.  He relayed the story of his mother’s struggle with diabetes.  She had ultimately died from the disease, and he was understandably scared.  He then went on to explain that he had already tried to buy new, healthy food at the grocery store.  But when he got there, he had what sounded like a panic attack.  He had no idea where to begin, the store seemed large and overwhelming.  As he stood there, frightened by his new diagnosis, and overwhelmed by foods that he now perceived as dangerous, the security guard walked up and asked what he was doing there.  Ultimately, they asked him to leave, and he had been living on packaged macaroni and cheese since then, waiting for his appointment with me so that he would not be afraid to go back to the store, or to eat for that matter.

For a person like that patient, the mental energy to make change is very high.  He is being asked to create an entirely new cognitive framework.  This is much harder than shifting behavior within a current cognitive framework.  It is even harder than expanding a framework, for example learning that frozen vegetables are often healthier than the fresh because the vitamins and minerals are preserved in the freezing process, while they may be lost in products that travel long distances without being frozen.  This concept is not familiar to many people, but given a short explanation, their current cognitive framework can expand to incorporate the new information.  But when you must create an entirely new framework, it is sometimes so cognitively taxing that it is not possible. 

Bringing it back to me wanting to be a good role model for my daughter and include her in the reflection process, it is important that children see not only behavior change, but also see the work that goes into the behavior change.  Change is not easy, and it gets more difficult the older you get.  Children who see this kind of behavior from their parents are more likely to approach problems with critical thinking, rather than emotion.  This is important for creating kids that can persevere and are internally motivated.  All of that mental energy that I have been talking about is a huge part of childhood.  Everything is new to them; they are constantly encountering ideas that don’t fit in their cognitive structure and they are laying down new structures as they learn to navigate the world.  Children who learn to lean into this process create a greater neural framework than children who shy away from new processes.  And children who create that larger neural framework become adults with a stronger cognitive structure on which to rely.  That means that when they come into situations such as a new diagnosis, or a family change, or a new job, anything that requires reflection, they are more likely to be able to deal with the change and come out stronger on the other side.  Basically, they are learning as children to do what many adults cannot do.  They are accepting the cost of mental energy and pushing through to gain better understanding of the world around them.  And that struggle in childhood makes the mental energy cost of challenges faced as adults lower, because they have an expansive structure on which to draw, and they better know the benefit of spending that mental energy.

What is the benefit of spending that mental energy?  It is peace of mind.  When we shy away from change, we experience higher levels of cognitive dissonance.  We all live with some levels of cognitive dissonance, the mental discomfort when our current ways of thinking are not consistent with our behavior or what we see in the world.  Some level of cognitive dissonance is good, as it keeps us motivated.  For example, I don’t love brushing my teeth even though I know it is good for me.  But I also don’t love going to the dentist, and my general dislike of dentist office visits overwhelms my general dislike of brushing my teeth.  Cognitive dissonance is part of the multifactorial decision-making process that goes into my decision to brush my teeth every night.

But higher levels of cognitive dissonance can be detrimental to mental health.  At high levels, we are spending large amounts of mental energy perseverating on a problem, but not coming up with a solution.  This is a clinical description of the anxiety that we see in such high amounts in our culture.  On the other end of the spectrum of excess cognitive dissonance is depression.  A person can become overwhelmed by the amount of mental energy needed to respond to a discrepancy and shut down.  The motivation to do anything is gone because they are unable to consider any actions without being overwhelmed by the discrepancy.  Again, this disorder is widely prevalent in our society.

My exercise in a life less processed is a learning experiment for my family.  My husband and child have reserved the right to ‘cheat’ and I have reserved the right to blog about said ‘cheating.  I don’t think about it as cheating, instead I see opportunities to refine our experiment.  This is all so professor designed, it feels a little academic.  But the design was incidental, part of my natural process toward change, so I will let that go.  I am excited to take this on, and we plan to begin January 1, 2024.  Over the next few weeks, I will be looking around my kitchen and deciding what has to go and why.  My hope is that as we take this on, I can help the general public get a better idea of where ultra processed foods are in our diet, if there are alternatives that are relatively inexpensive and easy to make, and if not, should they be included at all.  I’m not looking for radical change, I’m looking for achievable change.  That is the kind of change that sticks.