Vital Sings: Habits

Premieres: March 9, 2020.

DR. SANJAY GUPTA, CNN Chief Medical Correspondent

00:24 Sanjay Gupta:

No matter how disciplined you might be, we all have them: bad habits we want to break, and good habits we want to make. This is Vital Signs. I’m Dr Sanjay Gupta.

Habits can become so ingrained that we often don’t even realise we’re doing them. You can thank your brain for that – specifically, the basal ganglia.

0.43 At the neural level, that’s the part of the brain responsible for habit formation. In fact, once a task becomes second nature, your brain essentially shuts down.

Out of all the habits we have, eating is probably one of the most routine. And you might not realise how much of an impact your environment is having on your eating habits.

01:05 Does this look familiar? The TV is on. You’re engrossed in a show and you’ve got snacks in your hand. Before you know it, all the chips are gone. In this age of binge watching, research shows that mindless eating is on the rise.

01.22 Brian Wansink:

Habits become so automatic, to some extent, that our environment ends up facilitating a good habit, but also ends up facilitating a bad habit.

01:30 Sanjay Gupta:

This group of college students is actually part of the study. It’s all the brainchild of Brian Wansink. Professor, researcher, author, he’s dedicated much of his career to observing our eating habits.

If you take the time to control your environment, how much of an impact can that have on mindless eating?

BRIAN WANSINK, Author, Slim by Design

1.53 Brian Wansink:

We suspect, based on research, that simply controlling your environment ends up influencing about 70% of what you eat on a regular basis.

02:00 So, simply having a fruit bowl sitting out on your counter within three feet of where you typically walk will lead you to eat a whole lot more fruit – actually about 70% more fruit than you otherwise would.

2.12 Sanjay Gupta:

Brian and his team conduct most of their studies on the campus of Cornell University in Ithaca, New York.

Experiment assistant:

Please have a seat.

Sanjay Gupta:

That’s where you’ll find their Food and Brand lab, set up to look like a kitchen at your home.

02.25 Experiment assistant:

In a moment we’re going to watch an episode of The Big Bang Theory…

02:30 Brian Wansink:

But what we can do is we can small changes, we can figure out exactly what influences you, but importantly, what can be done to turn things around.

02.37 Sanjay Gupta:

John Brand is a post-doctoral research associate here. He’s observing the study today. The goal is to see if a visual cue will provide an awareness of how much these students are snacking. In this case, every fifth chip is dyed red.

JOHN BRAND, Researcher, Food and Brand Lab

02:56 John Brand:

The biggest thing when you’re eating or when you’re watching TV is that you’re not actively paying attention to what you’re eating. You’re engrossed in the TV show or you’re reading your book and so you just kind of mindlessly eat. And so what we tried to do today is we try to bring people’s attention to how much food they’re actually eating.

So if you dye every fifth chip red, just the fact of seeing that red chip will highlight the fact that you’ve already eaten 10, 15, 20 chips. And we know that doing that will decrease the amount of chips that people actually eat.

03:26 Sanjay Gupta:

How many food decisions do you think you make in a day? John says most people would answer around 30. But their research shows on average, we make more than 200 food-related decisions every day. Those are habits we don’t even think about, and a lot of that is influenced by our environment.

03.46 Brian Wansink:

I think for a long time people thought that the solution to eating better is to just be really, really mindful and to think of every bite you eat and to study nutrition labels, but for most of us, we’ve got a life going on.

03:59 It’s kind of hard to expect us to sit down and eat half a pea and then ask yourself whether we’re hungry or not.

Instead, it’s just a whole lot easier to just set up our environment so we end up mindlessly acting the right way, and all of our studies have been based on figuring out what trips us up, how can we change things that trip us up so we can gleefully go through life, eat better, be happier without it having to be a full-time job.

04:28 Sanjay Gupta:

And that brings us to our first healthy habits tip. Brian’s research shows that simply using a smaller plate will cut down on the amount of food served by 22%.

What are some other strategies that have come about from some of this research?

04.43 Brian Wansink:

One of the big things that’s happening in schools across the United States – it’s actually in about 29,000 schools – is the smarter lunchroom movement, where the idea was you don’t need $1 million chef. You don’t need to have a new lunchroom to get kids eating healthier.

05:00 We find that simply having the bowl of fruit next to the cash register causes 104% more fruit to be taken.

We find that simply putting a label or a name on vegetables, calling it ‘crunchy carrots’ instead of ‘carrots’ causes about 30% more kids to take the carrots.

05.19 Experiment assistant:

So, at this point, we’re going to ask you to complete a survey…

05.23 Sanjay Gupta:

In today’s study, John found the students overwhelmingly ate less chips with the red visual cue. This simple manipulation of the environment helps slow down mindless snacking.

05:34 John Brand:

Changing your habits is very difficult. Changing your environment is very simple. We know that just by taking your dishes, and making them smaller, you’re going to eat less. Very easy to do. You don’t have to think about it on a daily basis, it’s a one-time thing.

05.48 Sanjay Gupta:

I’m curious – I’m talking to you here in the United States, you’re in Norway right now. How much of this is cultural? How much of this is a United States-centric thing vs around the world?

05:56 Brian Wansink:

One of the things we find is that it has a huge influence on people if they are in a non-patterned environment. In the United States, most of our eating environments are non-patterned. Most of us don’t know what we had for breakfast this morning and every breakfast is a little bit different, stuff’s more random, but to the extent that a culture, maybe Norway or some places in, let’s say Taiwan or China have very prescriptive breakfasts – a piece of bread and milk every morning, you’re not going to be influenced in the morning.

06:28 But insofar as you’re at a party or you’re at a dinner where things are a little looser, you’re just as impacted as we are in the United States.

06.38 Sanjay Gupta:

What about mindfulness in other areas besides eating? Addiction to screens – screen time, for example, comes up. Are there some lessons learned?

06.45 Brian Wansink:

One of the things that I’m stunned with just in the last year that we find is that people who behave the best don’t claim to have any more willpower than the rest of us. They just claim to have some basic rules of thumb or some habits.

07:03 Sanjay Gupta:

So, if it’s not about willpower, then why does it seem like some people can just accomplish more in 24 hours than others? We’re going to link habits and productivity

07.15 Do you ever wonder what habits are common for highly successful people? Mark Zuckerberg, CEO of Facebook, has said that he attacks his busy schedule proactively instead of reactively.

07:30 Oprah meditates for 20 minutes twice a day, every day. And Microsoft founder, Bill Gates, has made reading for personal enjoyment part of his regular routine.

07.35 You don’t have to be the head of a major company to adopt healthy habits, and it’s not necessarily about willpower.

From the personal to the professional, turning a new routine into second nature is all about recognising the reward.

07.56 It’s mid-morning outside San Diego, California. On the base of Camp Pendleton, these Marine Corps recruits have been at it for more than 30 hours already, and there’s still a long way to go. They’re in the middle of the Crucible – the infamous final 54 hours of boot camp.

08:24 By tomorrow, if they make it through, they will officially be United States Marines. Along the way, and throughout all 11 weeks of their training, they are making new habits, and breaking old ones.

08.38 Charles Duhigg:

So, when it comes to breaking bad habits, one of the best ways to think about it is to think of it as changing a bad habit.

08.44 Sanjay Gupta:

Charles Duhigg is an investigative reporter with the New York Times. He’s also author of the book, The Power of Habit.

CHARLES DUHIGG, Author, Smarter, Faster, Better

08:52 Charles Duhigg:

One of the things we know from neurological studies, particularly out of MIT, is that it’s almost impossible to completely extinguish the neuro pathways associated with a habit. So what we have to do is we have to change that behaviour.

By recognising that the cues are still going to be there, we’re still craving the reward, but let’s find a new behaviour that we can insert that corresponds to the old cue and it gives us a reward that’s kind of similar to the old reward.

0916 Sanjay Gupta:

Charles spent years researching how habits are formed in our brains and how that influences our lives. Remember all that advice about altering your environment? It’s not just for eating habits. Here’s another example:

09:30 After the Vietnam War, GIs came back and we were stunned at how many heroin addicts were returning from Vietnam and what they found was that these GIs, these soldiers, when they came back to the United States, the recurrence rate was actually quite low.

09.46 Instead of close to 90%, it was closer to 5%, and they realised these soldiers were not just heroin addicts – they were heroin addicts in Vietnam. And when they came back to the United States, the environment changed, and so did their likelihood of keeping up that bad habit.

10:02 Do we make up rewards or do we give ourselves rewards in order to break a bad habit or make a good habit?

10.08 Charles Duhigg:

In general, the rewards that we find really rewarding are ones that our brain decides, almost without our input, are rewarding. So, I can tell you that if you go for a run I’m going to give you some really yummy kale chips afterwards, because that’s a great reward, and your brain is going to know I’m a liar, because kale chips are not a yummy reward.

10:25 What your brain really wants is a small piece of chocolate or a smoothie or a nice, long shower.

And similarly, the key to changing our own behaviours, to becoming more productive, is to find those rewards that we genuinely think are rewarding without having to talk ourselves into it.

10.41 Sanjay Gupta:

With everything going on in his busy life, Charles was having a hard time managing his priorities, but it seemed like some people, leading similarly busier lives than his, were somehow more productive. And that piqued  Charles’ interest. It’s also the subject of his new book, Smarter, Faster, Better.

10.59 What is the connection then, between habits and productivity?

Charles Duhigg:

Having the right habits makes productivity much, much easier and in fact, in many ways what we’re trying to do with productivity is we’re trying to create the right mental habits.

So, very frequently when people are confronted with some type of choice, our automatic instinct is to simply make the choice that seems easiest to us, right?

11:22 But the people who make really good decisions, people who are very productive at making better decisions, what they tend to do is they tend to envision multiple futures, so they tend to almost subconsciously think ‘I could have this for lunch, or this for lunch, or this for lunch’, and what’s the consequences of those three different things.

They tend to make much better choices as a result. And that’s really a habit. 

11.42 Sanjay Gupta:

Is it triage, just to keep up with the medical metaphor, is it triage saying, ‘ok, look, there’s a thousand things here, but I gotta make choices and that means that these things are going to all fall off the list’?

11:52 Charles Duhigg:

Part of it is triage, and I think a better way of thinking about it is to take the things that really matter and put them at the top of the list. Rather than saying, ‘I’m going to react to what life throws at me, to say, ‘I’m going to proactively decide which ones I actually care about.

12.06 But part of it also is simply training yourself to make decisions faster and better. So part of it is that, when our phone does buzz or when a colleague asks us for a favour or when some story moves across our screen and it piques our curiosity, does our brain automatically have a system where it can say ‘no, actually, repress that need to check your phone or to watch Facebook and see what’s going on’.

12:33 Do you have this automatic ability to allocate your attention and focus much more optimally? And that’s just a matter of training.

12.42 Sanjay Gupta:

Do you find that writing information down by hand helps you focus more? It’s true, and it leads to our next healthy habits tip: taking handwritten notes instead of typing them on a computer commits the information better to memory.

Charles says one of the best examples is a to-do list. He’s going to show me a technique for writing out lists called SMART.

13:04 Charles Duhigg:

So, here’s how I do it. So my stretch goal, my big overarching ambition is to run the marathon. That’s so overwhelming that it’s terrifying to even think about it. It’s eight months away.

13.19 But then what I am going to do is I am going to take the stretch goal and I am going to break it into a SMART goal. And this is easy to remember: SMART. You can use any system.

13:27 But what SMART means is that I’m going to figure out what specifically I want to do in the next week or the next month.

Over the next month what I want to do is I want to is I want to get up to being able to run consistently without getting exhausted about this.

13.40 M stands for measurable. I need actually some type of measurement of this. What I want to do is not only run consistently, I want to be able to run seven miles without getting tired, without stopping.

A stands for achievable. Is that achievable? And I think the answer is ‘yes’, because I can do about four miles right now, and seven miles isn’t that big a leap, so I can definitely do that.

13.59 But to do that I have to have more time in the morning in order to go out and go on practice runs.

The we get to R: Realistic. So, ok, is it realistic? The answer is ‘yeah, it’s realistic but I only get that time in the morning if I talk to my wife ahead of time so that she can take care of the kids and get them to school two days a week, so that I can go on longer runs.

14.19 And then timeline. Well, I’ve already sort of identified that, right? What I want to is over the next week I want to figure out how to have more time to go running in the morning and over the next month I want to get up to running seven miles without having to take a break.

14:31 Sanjay Gupta:

It’s a big, audacious goal, but you’ve broken it down into a more bite-sized piece, and then have a plan on how to get there.

Charles Duhigg:

This list might be a little bit uglier. It doesn’t have things crossed off quite as quickly, but it’ll actually make me more productive, and study after study shows if you write a to-do-list the wrong way, it actually hampers your ability to get things done. Breaking it down this way, reminding yourself of a long-term goal and then making it into a plan? That actually makes it so much more likely that you’re going to achieve it.

15:01 Sanjay Gupta:

For those Marine recruits at Camp Pendleton, their immediate goal is making it through boot camp. And there are things we can all learn from their training. We’re crossing the finish line of the Crucible.

Breaking bad habits is one of these interesting things that psychologists have talked about for a really long time.

15:19 Let me give you just a couple of things: whether it’s breaking a bad habit or creating a good habit, in the beginning it’s always sort of easy. It’s the Honeymoon Phase. ‘I can do this, I don’t have to have ice-cream every night.’

15.29 The problem is when you get to the first obstacle. What you’ve got to do at that point is what’s called the ‘Fight Through’. If you fight through this two or three times, you’ve now gone from the Honeymoon Phase into the second phase of creating good habits and breaking bad habits.

1543 But even after the Fight Throughs, after you get through this a few times, you finally got to get to the phase where it becomes secondary nature. It can take weeks, it can take days – it depends who you are.

15.53  But when you get to that secondary nature phase, the habit has moved from a more transient area of your brain to a more ingrained part of your brain. It just becomes part of who you are.

16.05 For someone in the Armed Forces, training that becomes part of who you are can mean the difference between life and death.

16:18 Back at Camp Pendleton in California, these young men are in the middle of the Crucible. It’s a gruelling test of endurance, strength, teamwork. For 54 hours, the recruits get just three meals, two periods of four hours’ sleep, and complete 24 obstacles simulating combat conditions.

At the core of the training is concept called ‘bias towards action’.

16.46 Charles Duhigg:

Bias towards action is about how we generate motivation. We know a lot about the neurology of motivation, and this phrase ‘bias towards action’ actually comes from the Marines.

16.57  A number of years ago they were trying to reform boot camp for Marines, and the guy who was running the Marines, a guy named General Charles Krulak, read a bunch of research about locus of control.

So it turns out that all of us have an internal or an external locus of control, and depending on which one we have, we either believe that we’re in charge of our own destiny, or that things happen to us and that we’re powerless against them.

17:19 To be motivated, to generate motivation, you have to believe that you’re in control of your own destiny, and the way that we teach people that is by teaching them a bias towards action, that when I see a problem, I go and I solve it; that when someone gives me an assignment, I don’t ask them how to do that assignment, I just go and figure out how to do it – that my first instinct, upon seeing any type of situation, is to act, is to assert myself, because what I’m really doing is then proving to myself that I have control over the situation. That I have control over what’s going on, and that triggers our sense of motivation within our brains.

17.53  Marine driller: 

In just a few hours, you have the opportunity to become a Marine, you understand?

Recruits:

Yes, sir!

17.57 Marine driller:

But first, you have to show that you have what it takes, you understand that?

Recruits:

Yes, sir!

18.03 Sanjay Gupta:

Charles says studies have shown someone’s locus of control can be influenced thought training and feedback. The Marines need to be a motivated group.

Usually the first into a dangerous situation, there’s no time to wait around for orders.

18:20 Decisions need to be made quickly and confidently, so they designed the Crucible in a way that forces recruits to think on their feet and take control.

Captain Nathan Tucker oversees Crucible training at Camp Pendleton.

CAPT. NATHAN TUCKER, Field Company Commander, Camp Pendleton

18.36 Capt. Nathan Tucker: You know, in the military you have to have a bias for action. Are you going to take action and make something happen, or are you going to stand by and let something happen to you?

As Marines, you need to take action, take the initiative and take the fight to the enemy. That’s what we like to do.

18.54  And I will say that it starts from Day 1 of them coming here.

19.00 Sanjay Gupta:

This stage of the Crucible is known as 12 Stalls. These stations are designed to test the recruits mentally, conditioning the brain to figure out how to execute an objective.

The only information the recruits are given is the end goal. The rest, is up to them.

19:19 Capt Nathan Tucker:

We have people coming from the East Coast, from the West Coast, from the North, from the South. And we all need to come together and work as a team. And for that, we need a base of ethos that we all understand and we can all talk the same language.

Because, as you know, everybody’s not raised the same, so we need to build a come-together and work as a team.

19.39 In combat, it doesn’t matter what kind of technology you have, what kind of science you have. At the end of the day, it’s human will. The human dimension. And that’s why the Marine Corps has put so much emphasis on the bias for action and our core values.

19.54 Sanjay Gupta:

Time for our final healthy habits tip. You’ve probably heard it takes 21 days to form a habit, but that’s actually a myth. It really depends on the circumstances, the behaviour and the individual.

One study found it takes anywhere from 18 days to 254 days to form a habit.

20.14 For the Marines, this training takes 11 weeks. If the Crucible is the culmination of that time, then a hike, up what is known as ‘the Reaper’, is the culmination of the Crucible.

20.28 The next morning, under a dense fog, the first group of recruits finishes the hike. By the time all 400 recruits make it, the sun has started to rise.

20.45 It’s here, on top of this mountain, that these young men graduate from training, and officially become United States Marines.

20.55  Marine driller #2: During the past three days, many of you have had to rely on your fellow recruits to find the strength to press on. Together, you have faced the final challenge of recruit training. You now share a bond forged through hardship that cannot be broken.

You have proven that you deserve to be among America’s warrior elite. You have done what many dare to try.

21:21 You have earned the title of United States Marine. Congratulations and Semper Fidelis. Are we ready?

Recruits:

Yes, sir!

Marine driller #2:

Are we sure?

Recruits:

Yes, sir!

21.37 Sanjay Gupta:

The recruits return to formation, where they are given the emblem of the Marines: the eagle, globe and anchor. Emotions are high. They’ve done it. And along the way, they’ve learned to make decisions for themselves.

21.56  Marine driller #3:

You’ve joined our story and grand brotherhood. So I invite you, my fellow Marines, to join me in our Marines hymn.

22.09 Marines:

“First to fight for right and freedom

  And to keep our honour clean;

  We are proud to claim the title

Of United States Marines.”

22:23 Sanjay Gupta:

This idea of bias towards action isn’t just for the Armed Forces. All of us can apply it in our everyday lives. When you’re mindful of your actions, then you’re in control. It will help motivate you to break bad habits and also make good ones. For Vital Signs, I’m Dr Sanjay Gupta.

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