Caitlin Whyte (Host): This is Community Connect: presented by Tampa General Hospital. I'm Caitlin Whyte. Joining me is Matt Murphy, the Senior Community Engagement Coordinator at Tampa General Hospital. So today, we are chatting all about New Year's dietary resolutions. And to start us off, Matt, what would you say is the difference between a resolution and a behavior?

Matt Murphy: Yeah. Thanks for asking because that's a good way to kind of set the stage for this conversation today. Resolutions tend to be these big, sort of lofty goals in my mind that are sometimes overinflated, maybe they're not representative of where we are in the moment. So for example, someone might say, "I'm not eating sugar anymore starting January 1st," or "I'm going to start going to the gym five days per week," or "I'm going to give up alcohol completely."

What's missing from this though is the nuance. Health behaviors are not all-or-nothing. And the people with the healthiest relationship with their lifestyle are usually the ones who maintain a flexible outlook and have learned how to adapt to a changing environment. So when we talk about behaviors, we often use the word habit interchangeably, but a habit is a tendency or a usual manner of behavior. That's the dictionary definition. They depend on cues and, usually, they're automatic, so they occur without conscious thought. These are things like buckling your seatbelt when you get into your car or plugging your phone in before you go to bed.

But behaviors are intentional and thoughtful. They require a dynamic response to the environment. So, like grabbing a canned opener when you're using canned beans might be your habit, but the intentional behavior is why you grab the beans in the first place, why you're going to eat the beans. You likely had many other choices, and you had to thoughtfully decide kind of what you were going to do. So, behaviors take these intentional choices, and that's why they have to be a little more specific and not so big.

Host: I've definitely been there and made some resolutions that were way, way too much than I could actually do.

Matt Murphy: Me too.

Host: So, completely understandable, right? Well, Matt, how can someone set realistic health goals without feeling overwhelmed or like we have to do everything or nothing?

Matt Murphy: Yeah, I have some ideas. And it's going to kind of be in a story, so try to stay with me.

Host: All right. Love it. Love it.

Matt Murphy: So, there are a few sort of theoretical models that help talk about behavior change when it comes to counseling. One of my favorites for goal setting and also for self-reflection is called the transtheoretical model. You might have heard it as the stages of change theory, where depending on the behavior, we're all in one of five stages of change. You're either in pre-contemplation, contemplation, preparation, action, or maintenance. Some sources will tack on relapse to the end of this. And we can kind of adjust our behaviors to take us in and out of these stages of change.

So, I'll give an example to help this make a little bit more sense. We'll start with contemplation. So, this is where there's an awareness and a consideration or a desire to change your behavior, but the person is uncertain if changing their behavior is really worth it or not. So, for instance, this might happen, let's say, after you leave the doctor's office and you find out you have high LDL cholesterol. Your doctor recommends eating less saturated fat. They give you a handout. And if this is the first-time you're hearing this information, you might be in a contemplation stage. You've got an awareness of the issue, lDL is high. And you might have a desire to have a healthier heart. But you're really not sure if it's worth giving up your favorite foods, like, I don't know, bacon, deli meats, that sort of thing.

So if we apply that stages of change theory, we want to go to the next stage, we want to go from contemplation into a preparation. So, the person in our example might decide to make a really small goal to just read the handout from their doctor and possibly research some foods that might take the place of their high saturated foods in their diet.

Now, let's say that a year later, this same person goes back to the doctor. They've made a change, they switched their bacon out in breakfast with maybe some pre-made vegan sausage crumbles for the last six months, okay? And their LDLs gone down. Lab report looks good. That person's now in the maintenance phase, which is a sustained lifestyle change with confidence that their health behavior will be sustained.

So if you were to apply this to your own life or to a behavior you want to change, the first question to really ask is, "Where am I on this scale? What are my honest feelings about changing my behaviors?" From there, you can craft some small, simple achievements to help you get to the next stage. It really does feel less overwhelming when you know where you are and you know how you're going to get there.

Host: Wonderful. Well, what else can people do to stay motivated even when that progress feels so slow sometimes?

Matt Murphy: Yeah. It's two sides of the same coin. Like, one side, we know that good sustainable change takes a long time. There's a significant investment in lifestyle change. But on the other side, we know that as humans, because we all are, we are motivated when we get to see results in real-time. This is sort of like a positive feedback loop and it helps to reinforce our behaviors. So when progress is slow, you can think things like, "How can I measure this to see my progress?"

Oftentimes we have to look a little bit smaller rather than larger. So, we talk a lot about making smart goals. These are specific, measurable, achievable, realistic and timely. That spells out the word SMART, so it's easy to remember. And they have to be something that you feel confident in achieving. We usually assess this on a scale of one to 10. Like one is that you are not at all confident, 10 is that you are completely confident that you can achieve the goal. And we always say we won't take anything less than a seven.

So, what do you do if you don't feel like a seven? Well, that's easy. Make your goal easier to achieve. This gives you a chance to kind of assess your barriers, motivations, how you want to measure your progress. For example, if I have a goal to eat one extra serving of vegetables per day for seven days this week, but I know I'm going to go out to eat during the weekend, it might make me feel more confident to change this goal to only three to four times per week. That way, I still feel like I'm making progress, and I don't face the defeat and the uncertainty that comes with failure. Research shows that we're more likely to stick with healthy behaviors when we feel like we're succeeding at them.

Host: I love that. Well, that kind of leads me into my next question here. How can that goal setting be more inclusive and personalized rather than one-size-fits-all?

Matt Murphy: Well, I know we've all seen, you know, the 30-day challenge, the, you know, do a hundred pushups a day challenge or whatever the challenge might be. Those things are great to help kind of kickstart our motivation, but we want to create sustainable goals to help these behaviors keep going, even when the challenge is over. This begins with asking yourself, "Is this something I want to do?"

Host: Right.

Matt Murphy: I know that sounds so simple, but do we really ever ask ourselves that? "Is this something I want to do?" Oftentimes the center of what's demanding our change is not us, but it comes from external factors like billboard advertisements or social media, or perhaps your doctor or your friends, or anyone who's maybe got your best interest at heart and wants you to change. But if we don't have that desire to change, the chances are we'll lose our motivation pretty quickly. So instead of one-size-fits-all goals and challenges, we can craft goals that are personal to us and our growth, while also keeping in mind some of what's in our best interest for our health.

Host: Absolutely. And wrap it up for us today, what are the top three most impactful changes someone could make to their eating behavior starting today?

Matt Murphy: Yeah. And again, goal setting is highly personalized. So, I'm not going back on what we just said in the last question. But if someone's looking for a place to start, maybe you're looking for an idea on what you can do that's small. And again, these come from the perspective of a dietician. So, we look at the literature, and we find out what are these small things that have a big impact that people can do.

We know that number one is reduce the intake of processed meat. There really is a  dose-response relationship with processed meat And the prevalence of disease, even at moderate doses. So, what this means is that any little bit that you can do to decrease your intake of processed meat, you'll improve your chances of not getting a new disease. This is mainly shown with certain types of cancer, like colorectal cancer, breast, lung, endometrial cancer. But we do also see it in diseases like type 2 diabetes, cardiovascular disease, and even all-cause mortality.

The second thing is reduce the intake of added sugar. There's a dietary guidelines, scientific advisory committee who puts together most of the meta-analyses and systematic reviews that give us our dietary guidelines every five years. And they found in 2025, so this year, that two out of three Americans exceed the current limit for added sugar in the diet. This is about 10% of daily energy intake. So if you normally eat 2000 calories, that's about 50 grams of added sugar per day.

My opinion is that we should probably be well under that limit, all of us, but it's a really one tough goal because there are so many added sugars in the processed foods that we eat. Sugar is the cleanest ingredient that we have. I say that really jokingly because it is pure carbohydrates with little to no added vitamins and minerals or fiber or any other sort of benefit. Some added sugars like honey and brown sugar might have some vitamins and minerals, but they're really not good sources of micronutrients when we compare them to overall calories. That means they're low in nutrient density. This scientific advisory committee also found that sugar-sweetened beverages contribute about 50% of all added sugar in the American diet. So, light bulbs are going off in my head. If you drink sugar-sweetened beverages, these are things like soda, coffee with sugar, energy drinks, juice, this might be a really good place to start to make a big impact.

And then, number three, this is the tried and true advice that everyone has heard forever, but adding more fruits and vegetables into the diet, again with that  dose-response relationship. Even a little bit extra that we can have in plant foods in our diet helps to lower the risk of disease and all-cause mortality in almost all chronic diseases as well. This is true for even in type 2 diabetes. Like, an increase in fruit intake has overwhelmingly demonstrated in meta-analyses a decreased risk for mortality and all-cause mortality from cardiovascular disease. So if people with diabetes can eat more fruit and still enjoy better health, all people can benefit from this and any amount helps to put you in the right direction.

So to kind of sum that up, of course, you've got a factor in cost, accessibility, taste preferences, what you're willing to do, what you're interested in. But the moral of the story is that you can do it today. You don't have to wait for the new year. Just choose something small and get started.

Host: Some great tips to kick off the new year right. Thank you so much. That was Matt Murphy. For more information, please visit tgh.org/chw. If you enjoyed this episode, be sure to like, subscribe and follow Community Connect: presented by Tampa General Hospital on your favorite podcast platform. I'm Caitlin Whyte, and this is Community Connect: presented by Tampa General Hospital. Thanks for listening.