Commitment devices - helpful but still limited

Commitment devices have been around for centuries. One of the most famous is how Odysseus, as recalled in Homer’s the Odyssey, had himself tied to the mast of the ship while the crew had beeswax in their ears. This allowed Odysseus to hear the Siren’s enchanting music and voices but he could not shipwreck the boat because he was tied up and the crew could not hear his cries to release him or the Sirens because they had beeswax in their ears.

It has been well studied that using will-power is hard work. Your brain and nervous system uses glucose, one of the main power sources of the body, to help us consciously overcome temptations by using our cognitive abilities to help us with what some call “free won’t”. Because if left to do things freely, we will often do the wrong thing for present self’s gain at the expense of future self, thus the term “free won’t” as compared to “free will”. The actual increase energy expenditure has been measured and thus we realize that will-power is an expendable resource. Just like going for a run, at some point everyone will deplete their energy source and not be able to continue.

Commitment devices are used to help create a better environment for us to function and reduce the energy needed for our will-power to have to work. Commitment devices are used to avoid akrasia. Akrasia is a big fancy word that you probably have never seen used before, but unfortunately have done what it means many times. Akrasia is the state of acting against one’s better judgment.

One example of a commitment device is not buying unhealthy snacks when at the grocery store. When you are tired and exhausted at night and your will-power energy stores are minimal you won’t do akrasia, by choosing an unhealthy snack because it is not in the house. It requires more energy to get in the car and drive to grocery store to get a bag chips or some ice cream so you are more prone to choose what you do have in the house. Which if you set up your commitment device properly is some fruits or vegetables. If our will-power is really low we may still drive to the store and get an unhealthy snack. In that case we may need a new commitment device such as having someone hid your car keys at night.

This brings us to a problem with commitment devices – we can almost always weasel our way around them. Also they are a reminder that we lack some self control and this takes away from our self-efficacy. So while commitment devices can be helpful, we also need to understand their limitations. Next week we will look how to help future self beyond just using commitment devices.

Is your present self working for your future self?

Everyday we make decisions about choices we have that will have good or bad consequences for our present and future self. Often times we make decisions that benefit our “present self” with great expense to our “future self”, especially when these choices are repeated. Many of our decisions are emotionally based and taking care of our immediate emotional state of present self, this often time trumps future self potential needs.

Let’s look at a few simple examples in regards to health that many of us can relate to.

• I go to the fridge for a bed time snack. I can choose an apple or some chocolate cake with ice cream. Present self will be much more satisfied with the decedent taste of the cake and ice cream over the apple. Future self will appreciate the apple as it provides many valuable nutrients to assist in keeping your self healthy long term.
• I get home from work and make dinner, after dinner the decision of what to do comes up. I can go for a walk and get my daily cardiovascular exercise in or begin watching “The Office” on TV. Present self sees the importance and simplicity of sitting and watching the TV program (it is the last season of “The Office”, can you imagine missing an episode during its last season!). Future self would much more appreciate the walk and all the health benefits it provides.

Present self likes to consume things and looks for immediate pleasure and gratification at the least amount of effort. Future self on the other hand is more concerned with health and safety and willing to forgo some instant gratification to ensure that it can enjoy long term health even at the expense of some increased effort. Present self many times will neglect future self due to beliefs that may be inaccurate or rationalize that one time doing it doesn’t make a difference to future self. One piece of chocolate cake while watching the office just this once isn’t really going to make me obese and won’t make me get a serious disease latter in life. While present self is correct that doing something once most often will not have a significant affect on future self, but if present self repeats daily this choice then future self is in trouble. When present self repeats habits that are not good for future self, it walks us down a path of obesity and increasing risk for significant diseases. Pretty soon cake and ice cream is our bed time snack as we watch 4 hours of TV every night, and future self is doomed.

Next week we will look at commitment devices, tools to help future self overcome present self. Also at the potential pitfalls and concerns with commitment devices.

Your getting sleepy, very sleepy...

One important health habit that often gets overlooked is getting enough sleep. Some surveys reveal that upwards of 60% of Americans have some sleep difficulties at least a few nights a week or more. Writing about sleep is always an interesting topic, because if it is uninteresting it might put you to sleep. So we will see if we can keep your interest just long enough to learn why getting enough sleep is so important to your health.

So why is sleep so important? Of course there is the obvious, the day after not sleeping enough you will experience moments of drowsiness and may fall asleep or have slowed performance while doing important tasks. According to the DOT (Department of Transportation) 25% of all highway crashes are due to sleepiness. It is estimated that there is around $50-100 billion in indirect costs each year due to sleepiness with decreased productivity and other related costs. But there are other physiological changes that happen when we don’t sleep enough. A research report that came out in the July issue of the journal of Sleep showed that a decrease in sleep also affects our immune system. Our immune system will react to various physical stresses (i.e. flu virus, strained muscle, etc.) that are placed on it. Lack of sleep acts as a physical stress to our bodies and thus kicks in our stress response by increasing activation of our immune system with the granulocytes. This long term increase in immune system stress response has been linked to future health problems such as: obesity, diabetes and high blood pressure.

So how much sleep do you need? On average most people will require 7-8 hours of sleep, but some can do fine with as little as 6 hours and others need up to 10 hours. After a nights rest you should be able to work the next day without any bouts of sleepiness or drowsiness. If you do experience this then it would be a sign that you may not be getting enough sleep and starting to kick in your immune system a little extra as a response to the extra physical stress you’re placing upon it. If you do have difficulty sleeping you may want to consult a health professional to look at treatment for it. Often times our thought is that getting a sleeping pill is all we need. But a research article in The Archives of Internal Medicine published in October of 2004 showed that Cognitive Behavioral Therapy (CBT) actually outperformed the sleeping pill. So keep that in mind when looking at treatment options.

So hopefully you were able to make it to the end of this and not fall asleep and learned why getting good rest is so important. If you did fall asleep, it may be a sign you are not getting enough sleep at night; or we need to make the article more interesting.

Superman's cape vs. Batman's utility belt

Another guest post on my blog.  Today's post comes from John Rounds, SPT.  John currently is doing one of his eight week clinical rotations with me as part of his final year of Doctor of Physical Therapy schooling through the University of South Dakota.  As with any guest post I want writers to write what they think, not what they think I want them to think, think about that!!!  Enjoy, I like his thinking...

A common theme being displayed among health gurus and marketing agencies is the term "superfood." But what are we really getting with these that we aren't with everyday "regular" healthy foods? Many media outlets have been filling our minds with ideas that by consuming "these 7 foods regularly, you can reduce your look of aging or lose 10 pounds in 10 days." Unfortunately, what holds true for most things that sound too good to be true, so are a lot of these.

Now don't get me wrong, if you are researching "superfood" lists (which I have) you will find apples, oranges, broccoli, avocados, nuts, salmon, etc. But you will also find other items like acai berries, raspberry ketones, mangosteen and noni berries, and supplements such as fish oil. A lot of these foods and supplements also claim to have scientific research backing them. However, the validity behind this research is lacking in practical use.

According to a study published in the Hawaii journal of medicine and public health, it looked at the research backing these "superfoods" and supplements, and discovered that much of the research done was comparing their product to a placebo group, and not revealing the side effects noted by the participants in these studies. Most side effects were minor, with the occasional headache, dizziness, or fatigue being noted; however, one study found in a follow up study, that the amount of the supplement needed to produce the beneficial effects in these commercialized products was leading to hepatotoxicity in some people taking them. This would be reason enough for me to avoid these foods, let alone I can eat an apple for lunch and feel more energized rather than fatigued and not have to worry about getting a headache.

Additionally, on a recent Dr. Oz episode they were pushing raspberry ketones as a "miracle" fat loss supplement. Fortunately, a member of the audience asked why they can't just eat fresh raspberries, and we're answered with, “it will take 90 pounds of raspberry to get the same amount of ketones that you will get in this one small supplemental pill." As far as I know, if it is going to take me 90 pounds of raspberries to get the amount of ketones in these pills, there may be a reason for that. Potentially, that amount of the supplement at one given time may not be healthy.

Thus, if you are looking for that new miracle pill to make you look younger or thinner, it's simple, EAT HEALTHY! Remember the old adage, "an apple a day, keeps the doctor away"? Well, that may be true, but it has been shown to give you just as much if not more energy than a cup of coffee, not to mention, that apples along with most fruits and vegetables actually have negative calories, meaning that you burn more calories eating them, than they actually contain.

Therefore, I return to how I began, "Superman's cape" or "Batman's utility belt." As hard as it is for me to say, as I prefer Superman, in this case I'd go with the "regular" utility belt. Just because these foods have been dubbed "super," there still isn't sufficient scientific evidence that show they are better than a "regular" apple or celery stalk. Essentially, the choice is yours; however, know your choices.

Exercise: Have your cake and eat it!

We have all heard the benefits of exercise for long term health: reduce risk of heart disease, certain cancers, type 2 diabetes, stroke, and the list goes on. But let’s be honest the immediate gratification of sitting on couch with a bag of potato chips a large ice cold pop and vegetating out for a couple hours while watching a marathon of Pawn Stars seems a lot more enticing. Here in lies the challenge we face every day: the immediate gratification of poor health choices over long term benefits of exercising.

We live in a mostly immediate gratification society here in America. If I want to watch a good movie I can go to the Movie Theater and pick from 12 different flicks each having 3 or 4 different times to pick from. If I want a bigger selection and don’t want to wait for the times it is offered, I can go to the video rental store and pick from 100’s of titles. Heck I don’t even have to go out of my house or worry the movie I want is being rented by someone else; I can just get Netflix and have the movie delivered instantly right to my TV. I don’t even need to be tied to my TV to watch the movie I can get it on my phone and go where ever I want and still get the movie I want when I want it. Now that is instant gratification at its best.

So we can see that we are used to instant gratification and benefits from the things we do these days and exercise doesn’t seem to fit into that category, so no wonder we like to skip past it. But actually it does give us some instant benefits!

Immediately following your 30 minute walk (or whatever form of exercise you choose) you will start to experience some very enjoyable effects to your body and brain. You will produce an increase in the “happy” neurotransmitters serotonin and dopamine. These neurotransmitters will improve your mood and reward/pleasure centers of the brain and reduce stress and anxiety feelings you may have. Insulin sensitivity improves so your muscle cells take in glucose (the energy molecule your body uses) floating through the blood stream. This makes your pancreas (what produces insulin) happy since it doesn’t have to work as hard to produce as much insulin (the chemical that allows for the absorption of glucose into the muscle cells). You will also get an increase in HDL-cholesterol, which is the good cholesterol that we want. You will see a reduction in blood pressure immediately following your exercise bout. Heck even your bowels will move better after you exercise.

So if immediate gratification is what you like, then exercise may be just the thing you need instead of being a couch potato and eating junk food. Immediate and long term benefits with exercise, how cool is that. Maybe I can have my cake and eat it too, as long as that cake comes in the form of exercise.