Mature couple sitting in a park with their dog

Practice of the Month: Create and Maintain Your New Healthy Habit

By Sharon Brock, MS, MEd

At the start of the year, thinking about all the changes you want to make in your life can be overwhelming. You might think, “I have to start walking every day, eat more vegetables, get more sleep, and start a gratitude journal.”  With so many things on this list, it’s no wonder we end up feeling stressed and flopped on the couch eating potato chips and watching Netflix into the night by February.

Don’t worry, we see you. And we’re here to help. Rather than rely on willpower, Stanford behavior change expert, BJ Fogg, PhD, suggests the following steps to create and maintain a new healthy habit:

  • Choose something you already want to do and enjoy doing (e.g., walking as exercise).
  • Set the bar low to promote consistency (e.g., commit to walking to the end of your driveway and back every day).
  • Anchor the new habit to something you already do every day (e.g., walk right after you drink your morning coffee).
  • Redesign your environment to make the healthy habit more convenient (e.g., put your walking shoes by the front door).
  • Set up a visual prompt (e.g., put a Post-it note on your computer to remind you to take a lunchtime walk).
  • Allow yourself to feel good about any positive action you take, no matter how tiny.

Journal Prompt: What is ONE habit you’d like to create and maintain this year, and which of the above strategies will you employ to set yourself up for success?

A Different Twist on New Year’s Resolutions

At the start of the year, rather than answer the question, “What’s your New Year’s Resolution?”,  Dr. Fogg invites us to contemplate the following:

Journal Prompt: What is ONE thing you can change in your home environment today that will have the BIGGEST positive impact on your health for the rest of the year?

To help spur inspiration, here are sample answers from each of the seven Lifestyle Medicine pillars:

  • Movement & Exercise – Get a dog!
  • Restorative Sleep – Move the television out of the bedroom.
  • Stress Management – Move your cell phone out of arm’s reach from your bed to prevent late-night scrolling.
  • Healthful Nutrition – Keep fruit in a bowl on the dining table for convenient healthy snacking.
  • Gratitude & Purpose – Frame a photograph of someone who makes you smile and place it next to your work computer.
  • Cognitive Enhancement – Place a good reading lamp beside a comfortable chair to promote nightly reading.
  • Social Engagement – Schedule a weekly walk with a friend (two-for-one!).

“It’s important to remember that habit formation is a practice-and-revise process,” says Dr. Fogg.  “You probably need to try out various new habits to find the ones that work for you. Think of it like trying on new shoes. If the first selection doesn’t fit you, that’s okay. Just keep going and try others. Find what works best for you.”

 

 

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Father and two children arranging fruit in a bowl on kitchen counter

How to Redesign Your Home to Achieve Your Health Goals

By Sophia Fay, BS

Forget relying on willpower—your environment can do the heavy lifting when it comes to building healthier habits. By making good behaviors easy and convenient, and bad behaviors difficult and less accessible, you can set yourself up for success without constantly battling self-control. Instead of focusing on which habits are good or bad, this approach focuses on methods and new ways of thinking to simplify healthy choices.

Think about it: Is your phone right next to your bed, tempting you to scroll at night? Is junk food or fruit sitting on your kitchen table? Are your running shoes by the door, reminding you to go for a morning jog? These small changes can make a big difference.

BJ Fogg, PhD, New York Times bestselling author of Tiny Habits and founder of Stanford’s Behavior Design Lab, explains, “People often think, ‘I’ll just use willpower to change my bad habits,’ but that rarely works.”

“Instead of relying on willpower, we take a different approach. We redesign our environment to make healthy behaviors easy and natural, and in doing so, we transform our habits—and our lives,” says Dr. Fogg.

It’s important to recognize that our environment drives our behavior. For instance, seeing an apple on the kitchen table prompts a healthy snack, placing running shoes by the door encourages morning runs, and putting a photo of your family by the phone reminds you to call your mom.

Rather than relying on fleeting willpower to create healthy habits in 2025, invest some effort upfront to make changes in your physical surroundings. Walk into each room of your house and identify something that is prompting an unhealthy habit, such as having junk food on the kitchen table, making it easily accessible for a snack. Also, identify what you can add to that room to make a healthy habit more convenient, such as placing fruit in a bowl on the kitchen table instead.

So, how do you make good behaviors easy? Here are some examples from our expert team for things they’ve taken OUT and added IN to prompt healthy choices in each room of the house.

Make Healthy Habits Easier in the Following Rooms:

Kitchen

OUT: Throw away junk food (or put it in the back of the cupboard).

IN: Place fruit in a bowl on the kitchen table for a quick snack.

IN: Redesign fridge and cupboards to make healthy options more visible.

Living Room

OUT: Remove the TV remote from the coffee table.

IN: Add a stationary bicycle or rebounder to use while watching TV.

IN: Create a cozy reading nook with books and good lighting.

Bedroom

OUT: Take out the TV.

OUT: Charge your phone outside the bedroom.

IN: Place a glass of water on your nightstand to stay hydrated first thing in the morning.

IN: Optimize for quality sleep with blackout curtains, cool temperatures, and comfortable bedding.

Bathroom

OUT: Remove clutter from counters. Store products you don’t use daily out of sight to create a clean space.

IN: Place floss next to your toothbrush to create a visual cue for dental hygiene habits.

Office

OUT: Remove snacks that encourage mindless eating.

IN: Set a timer every hour and keep weights or resistance bands within sight to prompt quick exercise breaks.

IN: Consider adding a standing desk or treadmill to encourage movement.

 

Making these small changes to your environment in January sets you up for success to lead a healthier lifestyle all year!

 

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Diverse group of five women standing arm in arm as they hike a nature trail

5 Ways to Make Healthy Habits Stick—No Willpower Required 

By Sharon Brock, MS, MEd

If you’ve already given up on your New Year’s resolutions, you’re not alone. Studies show that 88 percent of resolutions are broken within the first two weeks of January, and 95 percent are abandoned by the end of the month. Many people start a protocol on January 1st, stick with it for a couple of weeks, but then drop off and feel like a failure.

Stanford behavior change expert BJ Fogg, PhD, shows us a different way. “Research shows that relying on willpower is not how behavior change works,” says Dr. Fogg, founder of the Stanford Behavior Design Lab. Rather than give up on your health goals after you (inevitably) get off track, Dr. Fogg recommends trying a few of the following strategies to help make your new healthy habits last.

1. Help Yourself Do What You Already Want to Do

Everyone has a part of them that wants to eat healthy and exercise and another part that wants to eat junk food and sit on the couch. We have conflicting motivations. So how can we help the part of ourselves that wants to eat healthy and exercise? Dr. Fogg recommends choosing a healthy habit that you already enjoy doing.

“If you don’t like running, don’t have ‘go for a run every morning’ as your new year’s resolution. There are a hundred other ways to be active, so pick something you already enjoy,” says Dr. Fogg.

It may be helpful to reflect on which healthy habits would work for you in a sustainable way and write down behaviors you already enjoy doing. For example, if walking on a treadmill doesn’t work for you, try walking in nature. Or if you’re not a morning person, don’t set your alarm for 5 a.m. to workout; instead plan to exercise at the end of your workday.

“Most protocols, such as strict diets, don’t work long term because they are too prescriptive,” says Dr. Fogg. “When it comes to behavior change, one size does not fit all. A new habit only sticks when it makes sense at the individual level.”

2. Set the Bar Low

The best way to create a lasting habit is to set the bar low so that you can be consistent with it every day. For example, if you want to start jogging, commit to putting on your running shoes and walking to the end of your driveway and back. If you feel overwhelmed about cleaning your house, commit to tidying up just one piece of furniture every night before bed. If you’re not motivated to floss your teeth, commit to flossing just one tooth. It might sound silly, but making the habit small lowers the amount of motivation required to complete the behavior. With consistency, the behavior becomes a habit that eventually becomes part of your automatic daily routine.

“The key is making the habit so small that you can do it even when you’re sick, busy, preoccupied, or just low motivation,” says Dr. Fogg, explaining the habit-forming technique from his bestselling book, Tiny Habits. “Let’s say the new habit is flossing. You don’t have to stop at one tooth; you can always do more if you feel like it, but it’s not necessary to feel successful. Simply put, you have a minimal habit that you do every day, and when you want to do more, then you do more.”

3. Positive Emotions Create the Habit

It’s important to recognize that habits are created when we feel successful, so the key is to make the feeling of success easier to attain (see Tip #2).  As we are on our habit-forming journey, Dr. Fogg encourages us to feel proud of ourselves even for the tiniest of successes because when we feel good about a new habit, we will become more motivated to keep doing it—and eventually, willpower is out of the picture entirely.

“Most people are so hard on themselves, and they use guilt and shame to establish new habits, but that doesn’t work,” says Dr. Fogg. “They think that identifying their short comings rather than their successes will help motivate them. What works better is finding every excuse to seeing you’re doing a good job so that you continue doing the new habit.”

Also, many of us have heard that it takes 28 days to establish a new habit, however, this theory has been debunked. Dr. Fogg says that if we feel successful at a deep and authentic level, even for the tiny version of the behavior, the habit can form at a much faster rate.

4. Anchor Your New Habit to an Existing Habit

If there’s a habit that you already do every day (I see you, coffee drinkers), you can anchor your new habit to the original one. Dr. Fogg calls this “anchoring” because you’re tying a new habit to something already stable in your life. This technique has also been referred to as “habit stacking”.

Regardless of what you call it, this is what you do. Identify something you already do automatically and then perform the new habit afterward. Here are some examples:

After I make my coffee, I meditate

After I turn on the faucet for my nightly bath, I floss my teeth

After I press “start” on the microwave to heat my lunch, I do 20 jumping jacks and 20 squats

After I turn on the television when I’m done with work, I hop on a stationary bike

Write down a few of the habits you already do automatically and see if you can anchor a new habit after them. The anchoring technique provides a great way to incorporate many new habits simultaneously into your daily routine.

5. Try to Change Together, Not Alone

We’ve all heard of the concept of “accountability buddies,” but Dr. Fogg says this strategy actually works. So, if you have a friend with the same health goals as you, it would be wise to sync up your efforts. For example, if you want to walk for 30 minutes daily, finding a friend to walk with can help you both become consistent. Also, since we now know that positive emotions help establish new habits, try and find a walking companion who adds laughter or interesting conversations to the experience so that you associate walking with feeling good.

Also, Dr. Fogg explains that changing together is especially important in certain domains, such as sleep (i.e., going to bed and waking up at the same time as your bed partner), nutrition (i.e., eating similar meals with other members of your household), and media use (i.e., how much television you and your family watches every night).

 “We can change alone, with a friend or partner, or even with a group,” says Dr. Fogg. “If you want to change as a household, I invite you to hold a family meeting to discuss one behavior change the entire family can agree on for the entire year. Changing with others can make establishing new habits easier and potentially even fun.”

 

 

 

 

 

 

 

 

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sleep

How Sleep Deprivation Affects Your Metabolic Health

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By Nicole Molumphy, BS and Sharon Brock, MEd, MS

Do you ever get those late-night cravings or feel like your hunger is never satiated? Research shows that consistent short sleep duration (less than 7 hours per night) can influence metabolic health, affect the function of appetite hormones, increase food cravings, and lead to a 38 percent increase in obesity in adults.

Consistent sleep deprivation can lead to altered functioning of the appetite hormones ghrelin and leptin. Ghrelin increases our appetite and is released by cells in the stomach lining. When your stomach is “growling,” that is the ghrelin hormone talking. Conversely, the hormone leptin, made by our fat cells, lowers our appetite. Studies have revealed that sleep deprivation can lead to increased ghrelin and decreased leptin, resulting in an overall experience of constantly being hungry.

“There are so many health conditions associated with poor sleep,” says Rob Oh, MD, Clinical Associate Professor (Affiliated) and family physician at the Veterans Affairs Health Care System in Palo Alto. “With chronic sleep deprivation, your metabolism becomes dysregulated, leading to cravings for processed foods. Also, you’re less likely to exercise, you feel more stressed, and you’re more likely to think poorly. The combination of these factors can lead to metabolic health problems like obesity and type 2 diabetes.”

Sleep Deprivation Increases Stress Hormones

Our cortisol levels are typically lowest near midnight and then increase towards waking hours, ultimately peaking around 9 a.m. Studies demonstrate that reoccurring poor sleep is associated with an altered cortisol secretion pattern.

For example, delaying your bedtime could lead to high cortisol levels in the middle of the day, rather than just in the morning. Sustained high levels of cortisol can lead to an increased amount of insulin in the blood, which promotes the accumulation of belly fat and has the potential to lead to prediabetes, type 2 diabetes, and other metabolic disorders.  An increase in cortisol levels during the day may induce prolonged feelings of stress, increased food cravings, and further insomnia—promoting a recurrent, cyclical pattern.

“Inadequate sleep disrupts hormone levels, which dysregulates one’s metabolism and makes individuals hungrier,” says Dr. Oh. ” When we are hungrier, we eat more, which leads to weight gain and potentially metabolic disease.”

If that’s not bad enough, cravings for ultra-processed foods, sugars, and alcohol become more of a tease with sleep deprivation. A possible mechanism for this added hunger is an increased activation of the endocannabinoid system, which is found throughout the body and controls several biological systems, including sleep, mood, and appetite.

Sleep Deprivation and Increased Risk of Diabetes

Research shows that a lack of sleep may also result in insulin resistance, a driving factor in prediabetes and type 2 diabetes. Insulin is a hormone made by the pancreas that regulates blood glucose levels. Insulin resistance occurs when cells in the liver, fat, and muscles do not respond well to insulin, and in turn, glucose is not taken up into the blood.

The exact mechanism behind the causal relationship between insufficient sleep and insulin resistance is still being studied, however, some studies note that increased inflammatory markers, like C-reactive protein and hormone dysregulation, such as cortisol may be involved.

Currently, prediabetes affects one in three adults in the US. While many mechanisms contribute to the development of prediabetes and type 2 diabetes, some of the more prominent ones include impaired cellular insulin sensitivity, modified gut microbiota, and overly-sensitive sympathetic nervous system (fight-or-flight) activation. When the sympathetic nervous system is activated, it signals the liver to release more glucose into the bloodstream, leading to higher blood sugar levels.

What Can We Do About It?

Unfortunately, research finds that “weekend recovery sleep” is not enough to bring your metabolism back into balance after a lack of sufficient sleep throughout the week. Instead, Dr. Oh recommends taking a holistic approach and examining not only your sleep habits but also your nutritional choices and workout routines to support the restoration of metabolic health.

For those with pre-diabetes and type 2 diabetes, a diet focused on whole foods and low refined carbohydrates is critical for weight loss and glucose control.

Specifically, Dr. Oh recommends a low carbohydrate diet, such as consuming 75 to 100 grams of carbohydrates per day, to control and balance blood sugar levels. He also recommends quick, 20-minute, high intensity workouts for time-efficient and effective exercises that promote metabolic health. Regarding supplements, Dr. Oh recommends magnesium to promote muscle recovery and relaxation before bedtime.

“Optimal sleep is so intertwined with athletic and exercise performance, brain health, and metabolic health,” says Dr. Oh. “Sleep really is a keystone area where many of us can do better and hence reducing our risk for metabolic diseases and lengthening our healthspan.”

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Don’t Hit Snooze! And Other Practical Tips for Optimal Sleep

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By Sharon Brock, MEd, MS

Millions of Americans share a similar experience every morning. The alarm goes off, but they’ve already been awake for hours in bed. They hit the snooze button to squeeze in a few more minutes of precious rest, not realizing they were making their sleep problems worse.

“Hitting the snooze button is one of the worst things you can do because it prolongs morning grogginess and associates the bed with being awake,” says Fiona Barwick, PhD, DBSM, Stanford Clinical Associate Professor, Psychiatry and Behavioral Sciences – Sleep Medicine. “Rather than hitting snooze, it’s important to get out of bed within 15 minutes of the alarm going off and get some natural light to stop melatonin production.”

You may not think that something you do first thing in the morning will affect your sleep that night; however, Dr. Barwick says that the behaviors we engage with throughout the day can impact the quality of our sleep at night.

“Getting a good night’s sleep is a 24-hour endeavor,” says Dr. Barwick.

How Does Sleep Work?

According to Dr. Barwick, we fall asleep when these three biological systems are in working order:

  • Circadian Rhythm (CR)
  • Sleep Drive (SD)
  • Stress Management (SM)

 

Here is a list of behaviors that can negatively affect the three systems (CR, SD, SM), as well as alternative behaviors that have a more positive impact:

Since it may be difficult to change all the behaviors in this table, Dr. Barwick shares the top two behaviors that are most important for each system:

  • Circadian Rhythm
  1. Sleeping in the right window for your body clock (e.g., 10pm – 6am, 11pm – 7am, or 12am – 8am, etc.) and staying consistent with those sleep and wake times.
  2. Appropriate exposure to light and darkness to sync the release of melatonin with wake and sleep times (e.g., getting morning sunlight, not looking at screens one hour before bed, and making sure the bedroom is dark).
  • Sleep Drive
  1. Increase sleep drive by tiring the body with regular physical exercise and outdoor light exposure.
  2. Getting out of bed promptly (no hitting the snooze button) and making sure you spend the appropriate amount of time in bed (anywhere from 6-10 hours depending on your individual genetics and age).
  • Stress Management
  1. Physical relaxation—Deep breathing throughout the day to relax the body.
  2. Mental/Emotional relaxation—mindfulness meditation or journaling to process emotions before going to bed.

Practice of the Month:

Avoid hitting snooze (i.e., get out of bed when the alarm goes off) and create morning, midday, and evening routines to optimize the three key systems for sleep.

From the table above, write two behaviors you can do in the morning, midday, and at night. Make sure that you’re addressing all three systems (CR, SD, and SM).

What to do in the morning for good sleep:

1)

2)

What to do during the day for good sleep:

1)

2)

What to do at night for good sleep:

1)

2)

Here is a sample:

What to do in the morning for good sleep:

1)  Put phone out of arm’s reach and get out of bed right after alarm goes off (CR, SD).

2)  Go for a walk around the block, then eat breakfast (CR, SD).

What to do during the day for good sleep:

1)  Stress reduction: do a 10-minute mindfulness meditation at lunch (SM).

2) Physical exercise: do a 45-minute workout right after work (SD, SM).

What to do at night for good sleep:

1) Turn off all screens one hour before bed and write in my journal while listening to relaxing music (CR, SM).

2) Take a luxurious candle-lit bubble bath while taking deep breaths and counting my blessings (CR, SM).

“These are behaviors we can do to increase the likelihood of getting better sleep, but there may be times when we do everything right and still not sleep well,” says Dr. Barwick. “The most important thing to remember is that we will be fine the next day. We are evolutionarily adapted to deal with insufficient sleep, and we can still do what we need to get done, even without the full amount of sleep that we normally get.”

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