In the next few months, many will attempt New Years Resolutions, gyms will be packed and many will try new diets. How do we keep these new habits? How do we not end up with an unused gym membership and diet books stacking up, gathering dust?  Don’t just bank on getting past 21 days on your new habit and hope to have it stick.

Most have heard that it takes 21 days to form a habit, but according to research published in The European Journal of Social Psychology this is a myth.  The myth seems to have originated in the 1960 book, Psycho-cybernetics, by Dr. Maxwell Maltz.  The plastic surgeon turned psychologist noted a 21-day time frame in which patients got used to their new face, amputations and the like.  He extended the idea to other things and said this is the amount of time to get used to a new home for example.  Somewhere along the line, this was translated into "a habit requires 21 days to form."

New research shows that there really isn’t a magical number for habit formation, with time spans ranging from 18 to 254 days for study participants and an average of 66 days. The study also found that the participants with the simplest habits (such as drinking water after breakfast) peaked quicker than those with more complex habits (such as running for ten minutes before dinner etc).

So the take home here is to not be discouraged if it doesn’t feel automatic by January 21^st.  Don’t assign a number and don’t give up.  Also, push for realistic goals that you will be more prone to fulfilling.

More Tips for Success

• If you haven’t run before, instead of declaring you will run for ten minutes, maybe attempt to build up to ten minutes over a few weeks.  Perhaps gradually cut out fast food instead of cutting it all out at once.  Take it slowly and perhaps you will fulfill your goal better.
• Remember that there is a reason for this goal, whether it is for physical or mental health reasons, personal or professional reasons you name it.  If you remember what you are doing it for, it may push you towards completing it.
• Research has shown that missing one day at the gym does not ruin the habit.  So don’t get discouraged and keep at it.
• Enlist a friend with the same goal.  You may feel as if it’d be okay to skip the gym if it were just you, but you may not be so inclined to ditch her.  She may challenge you (and you her) and support you.
• Remove any and all temptations.  Throw away all cigarettes and clear out the junk food from your house.  Conversely, if you are trying a form a good habit, such as taking a multivitamin, strategically place them next to cup by the sink so that you will see them daily.  Make the good habits accessible and the bad habits inaccessible.

Lastly, it may be hard and there will be rough patches, but keep at it.  Good luck and Happy New Year!

Citations

UCL: http://blogs.ucl.ac.uk/hbrc/2012/06/29/busting-the-21-days-habit-formation-myth/

How to Form a Good Habit: http://www.wikihow.com/Form-a-Good-Habit

Many African-American women in a small survey said they avoided exercise at least sometimes because it could ruin their hairstyles, researchers reported.

Among 103 African-American women interviewed in a medical center waiting room, 39 said they had kept from exercising at some point because it would interfere with their hair-care practices, according to Amy J. McMichael, MD, of Wake Forest University in Winston-Salem, N.C., and colleagues.

On the other hand, half the respondents indicated that they had considered changing their hairstyles to accommodate exercise, the researchers reported online in Archives of Dermatology. Thirty-one said they exercised less than they would like because of their hair.

The findings emerged from a more general inquiry into hair-care practices among African-American women. McMichael and colleagues -- mostly dermatologists -- noted that Americans cite a great many reasons for not exercising as much as they know they should, such as interference from work or household responsibilities and lack of access to appropriate facilities.

"Dermatological barriers are not as well explored in the literature," they wrote, although at least one previous study had found that some African-American women had reported that heavy exercise was incompatible with their hairdos.

To fill this gap, the investigators developed a 40-item survey and sought to administer it to a total of 123 African-American women in a dermatology clinic waiting room. Of those, 20 did not give responses, leaving 103 for analysis. Their mean age was 42 (range 21 to 60).

Only 27% of the respondents said they left their hair natural. Some 62% had adopted a relaxed look, with 18% using weaves or wigs, 22% using hot-combing or flat-ironing, 19% having braids, and 6% using chemical curling (numbers add up to more than 100% because hairstyles could have more than one of these features).

Most of the women reported some problems with their hair or scalp such as strand breakage with normal styling (55%), itching (55%), flaking (32%), hair falling out (23%), and pustules or bumps (10%). About one-third of those reporting itching said it worsened with exercise or heat.

Among the 39 respondents who said they had avoided exercise because of their hair, the following specific problems were cited as the root of the conflict:

• Sweating out the styling: 38%
• Time needed for washing/drying afterward: 22%
• Itching/burning: 5%
• Bumps on scalp: 3%

McMichael and colleagues concluded that there may be a role for dermatologists in helping African-American women exercise more regularly.  Noting the substantial number of respondents with scalp complaints, they suggested that dermatologists should be attentive to such symptoms with their African-American patients.   Moreover, they argued, "dermatologists can discuss hair management strategies that facilitate routinely performing exercise."

The researchers reported some limitations to the study. It may not be generalizable to African-American women in other parts of the country, they noted. Also, because respondents were recruited in a dermatology clinic, individuals with hair and scalp complaints may have been overrepresented.

Using a mobile app that tracks eating and activity helped people lose an average of 15 pounds and keep it off for at least a year, according to a new Northwestern Medicine study.  But the technology only aided weight loss when its users also attended regular classes about nutrition and exercise. The app alone didn’t help.

“The app is important because it helps people regulate their behavior, which is really hard to do,” said Bonnie Spring, lead investigator of the study and a professor of preventive medicine at Northwestern University Feinberg School of Medicine. “Most of us have no idea how many calories we consume and how much physical activity we get. The app gives you feedback on this and helps you make smart decisions in the moment.”

“The ‘widget’ is critical but it is not magical by itself,” Spring added. “People need all the tools at their disposal.”   The study was published Dec. 10 in Archives of Internal Medicine.

This is the first study to show that technology added to an existing program of weight loss classes can produce sustained weight loss. Spring believes the weight loss app is the first proven to be effective in a published randomized clinical trial. Commercially available apps are not usually evidence based or tested for effectiveness in rigorously designed research, she noted.

In addition, the Northwestern technology is based on validated behavior change techniques including self-monitoring, goal setting, feedback and social support.

The study included 69 overweight and obese adults who were an average age of 58 and primarily men. All participants were offered health education classes on nutrition, exercise and behavior change twice monthly during the first six months and once monthly for the remainder of the year. (EDITOR'S NOTE:   We will encourage the researcher to expand the study to more women to see is there are gender differences in access to social media tools).

Each participant received weekly calorie goals based on his current weight and weekly activity goals based on his current level of activity. Participants receiving treatment as usual recorded their eating and activity on paper. Those in the experimental treatment used the mobile device to transmit their data to a behavioral coach, who monitored their information and provided scheduled telephone coaching for 10 to 15 minutes about twice monthly.

People who used the mobile phone technology and attended 80 percent of the health education sessions lost 15 pounds and maintained the loss for one year. The average weight loss for the mobile phone group -- including those who did not attend the education sessions -- was 8.6 pounds. The control group -- which received the education sessions but no mobile app -- did not lose weight.

The time people spent interacting with the remote coaches was minimal.

“The coaches’ most important role was being in the wings,” Spring said. “The patients know the coaches are hovering and supportively holding them accountable. They know somebody is watching and caring and that’s what makes a difference.”

The participants, who were older, did not have prior experience with mobile phone technology and easily mastered the technology. “Some people think older people won’t use technology interventions, but that isn’t so,” Spring said.

One big challenge in treating obesity is the need to provide intensive behavioral treatment in a health care system where physicians don’t have the time and training to do it.

“This approach empowers patients to help themselves on a day-to-day basis,” Spring said. “We can help people lose meaningful amounts of weight and keep it off.  To do that we need to engage them in tracking their own eating and activity, learn how that governs weight, and take advantage of social support.”

The study was supported by grants from VA Rehabilitation Research and Development and grant HL 075451 from the National Heart, Lung, and Blood Institute of the National Institutes of Health.

When female childhood cancer survivors grow up, are they more likely to experience an earlier onset of menopause?  If so, what are the risk factors associated with early menopause?  These were the questions asked by researchers at the French public hospital organization (AP-HP), the Institute Gustave Roussy, and the Universite Paris-Sud.  Their study, published in the November 12th edition of Human Reproduction (http://humrep.oxfordjournals.org/content/early/2012/11/14/humrep.des391....) and summarized on the Science Daily  website, provides valuable answers.

Researchers looked at data from Euro2K, a French cohort of 3402 survivors of childhood cancer, who were under 18 at the time of diagnosis, between the years 1945 and 1986.  706 female survivors (32% had already reached the age of 40, and 7% were over 50 years old)  participated in this study and filled out detailed questionnaires about their health (age of first period, current menstrual status, etc.). Researchers studied the age at which each of these women started menopause and also took into account any possibly associated risk factors. All the data were self-reported, and researchers did not confirm the menopausal status of study participants with medical reports or hormonal tests.

Data analysis revealed that 97 women (13.7%) went through menopause at a median age 44 years.  This is 7 years earlier than the median age of menopause in the general European population, which is 52 years.  Menopause was surgically induced for a third of these women (36%).

Researchers concluded that the women most at risk for early menopause were survivors treated after the onset of puberty using alkylating agents (http://www.cancer.gov/dictionary?cdrid=45589 ) (with or without even a small dose of radiation to the ovaries).  They found that the primary risk factors linked to cases of early menopause include the dosage of alkylating agents received during bone marrow transplant, the radiation dosage received at the ovaries, and the older the patient is when receiving childhood cancer treatment.

While these results are in agreement with the results of earlier American studies, they differ with regard to the fact that the French research team did not find that women who had suffered from childhood cancer had a significantly increased chance of premature menopause (i.e. menopause that occurs before the age of 40).  Researchers suggest that a possible reason for this difference in findings is that patients from the French cohort were diagnosed with cancer at a lower median age than the participants in American studies (4 years old as opposed to 7 years old in a similar American study).  This could partially explain the lower incidence of premature menopause in the study population.

This study is significant because it provides us with additional information about the risk factors that affect the fertility window of female survivors of childhood cancer.  After assessing their risk of premature menopause, patients can make informed decisions regarding the timing of their family planning.  For example, women at high risk might consider trying to get pregnant at a younger age than women at low risk.

To learn more about fertility preservation before, during, and after cancer treatment, including which chemotherapy regimes are most likely to affect fertility, please visit SaveMyFertility.org (www.savemyfertility.org)

Author:   Cathryn Smeyers