Healthy self-measurement & self-manipulation

By Esther Dyson

In the field of diet and nutrition, it is possible to work out what is best for you – if you think about it

Recently I met with two nice slim men who have just launched a weight-loss app that provides daily menus and recipes, and offers some substitutions in case the user does not like a particular food. The two are programmers who have little understanding of their target market and have not read much of the relevant literature.

I must confess that I was appalled at their ignorance of nutrition, psychology, game dynamics, and even women’s magazines. Yes, they mean well, and they feel their users’ pain. “We get letters…” one said. “One lady wrote that she follows the menus properly, but then she wakes up at midnight and goes to the refrigerator….I don’t know what to tell her!”

Well, for starters, he could suggest that she keep sweets out of the house to avoid temptation, or that she put aside part of one of each day’s meals for a midnight snack. The idea is not to get overly scientific or precise, but to help people change their habits.

I think about this challenge a lot these days, because my new startup, called HICCup (Health Initiative Coordinating Council), aims (in part) to help people do just that on a massive scale, though initially concentrated in just a few communities. The point is not to turn everyone into an obsessive calorie-, weight-, or step-counter, but to get people to be better self-manipulators.

The way to do that is to replace temptations with safe choices. Give people rules of thumb, not product manuals. Suggest new habits to replace old ones. Let people see how they are being manipulated already by advertising, product formulations, and the media to buy more, consume more, and want more.

In the field of diet and nutrition, there is a fundamental debate between calorie counters and proponents of specific diets, whether low-fat, low-carbohydrate, or buy-my-line-of-expensive-formulated-products. The issue is less whether any such diet works in general (though some of them are actually unhealthy) than whether more than a few individuals can follow such a regimen over the long term.

Calories do count; the physics of energy works even in the human body. But the kind of food you eat and when you eat it does influence how hungry you feel (and thus your self-control), and whether you use up the calories you eat or turn them into fat even as you still feel hungry. (Sugar is the main culprit, as Robert Lustig, the author of Fat Chance, has argued.)

So our approach at HICCup will be to help people figure out for themselves what works. Maybe it is using smaller dinner plates; or keeping temptation out of the house, store, or workplace; or following the increasingly modish (but actually ancient) creed of eating breakfast like a king, lunch like a prince, and dinner like a pauper.

Then there is the simple tactic of restricting your options in advance, when you have the strength. Avoid shopping for food when you are hungry. Tell the waiter in advance that you do not want dessert.

Or read Predictably Irrational, by Dan Ariely, and apply it to your own health and behavior. As Ariely points out, general advice is generally useless. Individuals need their own tricks, and each person knows best what will work for them – if they think about it.

For example, I face my own dilemmas, and I do my own experiments. I have a seemingly dangerous condition called Barrett’s esophagus – mysterious “lesions” around the entrance to my stomach that were discovered by chance (during medical exams for my cosmonaut training).

Not much is known about it, but it is probably not a good idea to swim – as I do every morning – with coffee in my stomach. Yet my swimming time is definitely better after having coffee. So I take my chances on mornings when I am really tired; otherwise, I do not.

For many people, the next big development will be non-invasive blood analysis, so that everyone, not just super-motivated diabetics, can test their own blood and understand their own metabolic chemistry. Just what does a doughnut do to your blood sugar? If Lustig is right and eating sugar just makes you hungry, you can see the mechanics for yourself.

I do not expect everyone to carry a blood-sugar monitor; freedom from such devices is surely what diabetics crave as much as sugar. But if HICCup can set loose a bunch of schoolchildren to study sugar metabolism for themselves, they are likely to spread the message far and wide in their own communities, to friends and family alike.