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改变行为的关键是情绪,而不是营养课

Emotions, Not Nutrition Classes, Are Key to Behavior Change
改变行为的关键是情绪,而不是营养课
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2019-09-07 18:17
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改变行为的关键是情绪,而不是营养课

New research, presented by the European Society of Cardiology suggests that we have been going about addressing childhood obesity all wrong. Instead of focusing on nutritional knowledge, we should be teaching children self-regulation and emotion management skills.

欧洲心脏病学会(European Society of Cardiology)提出的一项新研究表明,我们一直在错误地解决儿童肥胖问题。我们应该教孩子们自我调节和情绪管理技能,而不是关注营养知识。

Consider the following typical scenario: Jason is ten years old, and in the 90th percentile for weight. His pediatrician has asked his mom, Andrea, to put him on a diet.  

考虑以下典型场景:Jason,10岁,体重超过90%的人。他的儿科医生已经要求他的母亲安德里亚(Andrea)给他节食。

“My son can’t plan five minutes ahead!” Andrea exclaims. “How is he supposed to relate to the concept of “eat healthy now, so you won’t die of a heart attack in ten years?” Sarah chimes in: “My son is so impulsive. He sees something he wants, it’s in his mouth. Instant gratification is pretty much the hallmark of my son’s ADHD profile. And he’s so resistant to change! How do I get him to taste a vegetable, let alone make them the majority part of his diet? It breaks my heart to see him pause for breath halfway up the steps, but realistically, how do I help him change?"

“我儿子连提前五分钟计划都不行!””安德里亚声称。“他现在如何看待“吃得健康,十年后不会死于心脏病”这个观念?萨拉插话说:“我儿子太冲动了。看到什么想要的,就放自己嘴里。即时满足几乎是我儿子多动症的特征。他特别抗拒改变!我都为他吃蔬菜犯愁,更不用说让它们成为他饮食的主要部分了?看到他在台阶上停下来喘口气,我的心都碎了。但实际上,我该如何帮助他改变呢?”

Andrea and Sarah are not alone. The CDC estimated the prevalence of obesity at 18.5% among young people in 2015-2016, affecting about 13.7 million children and young adults.

安德里亚和萨拉并不孤单。美国疾病控制与预防中心(CDC)估计,2015年至2016年,青少年肥胖患病率为18.5%,影响约1,370万儿童和年轻人。

The correlation between ADHD and obesity is somewhat controversial, but researchers point to a clear link, as well. Despite the stereotype of ADHD children as skinny, hyperactive, always-on-the-go bundles of energy, many children with ADHD are overweight. With the  sophistication of today’s gaming systems, it’s possible to be hyperactive without ever leaving the comfort of your chair, or your snacks! In my Targeted Parenting: The Distractible Child classes, parents frequently ask about how to help ADHD children remain committed to goals like healthy eating, when their neurology doesn’t support it. (To learn more about helping children remain goal-directed, click here.)

多动症和肥胖之间的关系是有争议的,但研究人员也指出了一个明确的联系。尽管人们对ADHD儿童的刻板印象是骨瘦如柴、极度活跃、精力充沛,但许多ADHD儿童都超重了。随着当今游戏系统的成熟,你可以在不离开舒适的椅子或零食的情况下变得极度活跃。在《我的定向教育:注意力分散的儿童课程》(Targeted Parenting: The distraction - ble Child classes)中,家长们经常询问如何帮助多动症儿童在他们的神经系统不支持的情况下保持对目标如饮食健康的专注。(要了解更多关于帮助孩子保持目标导向的知识,请点击这里。)

Enter Kurbo:

进入 Kurbo:

Recently, Weight Watchers (WW) launched an app called Kurbo, aimed at helping children lose weight. Reaction came fast and furious, from advocacy groups, physicians, and therapists. An online petition calling on WW to withdraw the app quickly garnered 87,000 signatures. The app was accused of promoting unhealthy eating behaviors and possibly fostering eating disorders. A particular problem was the app’s categorization of foods using a classic “traffic light system.” Green means “Go, eat more of this!” Yellow means “Go slow – eat in moderation” and red means “Stop or limit to occasional treats.”  

最近,慧俪轻体(WW)推出了一款名为Kurbo的应用程序,旨在帮助儿童减肥。来自倡导团体、医生和治疗师的反应迅速而激烈。一份呼吁WW撤回该应用的在线请/愿书迅速获得了8.7万个签名。该应用程序被指控促进了不健康的饮食行为,并可能导致饮食失调。一个特别的问题是,该应用程序使用经典的“红绿灯系统”对食物进行分类。绿色的意思是“去,多吃点这个!”黄色的意思是“慢慢来——适量”,红色的意思是“停止或只偶尔吃”。

The concept of “sinful” or “bad” food is one that many researchers point to as problematic. So many teenagers or adults will talk about “badness” and “goodness” in terms of diet. “Today I was bad, I need to run an extra mile tomorrow,” or ascribe a sense of virtue to being “good” on their diet. With orthorexia on the rise, this can be a problem.

许多研究人员指出,“罪恶的”或“坏的”食物是一个有问题的概念。很多青少年或成年人会在饮食方面谈论“坏”和“好”。“今天我很糟糕,明天我需要多跑一英里,”或者把一种美德归因于饮食“好”。随着标准食欲症的增加,这可能会成为一个问题。

Is NutritionEducation Sufficient To Cause Behavior Change?

营养教育是否足以导致行为改变?

There’s another problem with Kurbo that most have not picked up on. Knowing which are the “good” and “bad” foods doesn’t actually help children make healthier choices. Research recently published by the European Study of Cardiology reveals that simply teaching children about nutrition is an ineffective means of changing behavior.

Kurbo还有一个大多数人都没有意识到的问题。知道哪些食物是“好”的,哪些是“坏”的,并不能帮助孩子做出更健康的选择。最近发表在《欧洲心脏病学研究》(European Study of Cardiology)上的一项研究显示,仅仅教授孩子营养知识改变行为是无效的。

The Happy Life, Healthy Heart Program randomly allocated ten public schools in Brazil to either an intervention or control group. The control group schools simply used a standard nutrition and health curriculum.

“快乐生活,健康心脏”项目将巴西的10所公立学校随机分配给干预组和对照组。对照组学校只是使用了标准的营养和健康课程。

The researchers added an interesting component to the intervention group – they trained teachers to teach nutrition and physical activity, but also taught them how to teach concepts such as habit change, stressmanagement, emotional health, and how to manage quality of life.

研究人员给干预组增加了一个有趣的部分——他们训练教师教授营养和体育活动,但也教他们如何教授一些概念,如习惯改变、压力管理、情绪健康以及如何管理生活质量。

Prior to the study, in both control and intervention groups, all participants – both students and teachers were assessed for baseline data, including weight, height, physical activity, and food intake. Students, but not teachers, were also assessed for prior knowledge of nutrition and healthy practices.

在研究之前,在控制组和干预组,所有参与者——学生和老师——都被评估为基线数据,包括体重、身高、体育活动和食物摄入量。研究人员还对学生(而不是老师)的营养知识和健康习惯进行了评估。

The teachers in the intervention group were encouraged to modify the material and make it their own, and could incorporate the lessons in their own way. To encourage greater participation, the teachers were invited to a social media network to share ideas and communicate with the researchers. 

干预组的老师被鼓励修改教材,使之成为他们自己的,并能以他们自己的方式融入课程。为了鼓励更多的参与,老师们被邀请到一个社交媒体网络上与研究人员分享想法和交流。

Social and Emotional Learning Added Significant Benefit:

社交和情感学习增加了显著的好处:

In both control and intervention groups, the students learned a lot about nutrition and health. However, only the intervention group changed their behavior. In the intervention group, the proportion of students following the recommendation to avoid fast-food increased by 15%, and the proportion of students following the recommendation to avoid sugary soft drinks increased by 20%. In addition, there was a 28% increase in teacher physical activity.

在对照组和干预组,学生们都学到了很多关于营养和健康的知识。然而,只有干预组改变了他们的行为。在干预组中,按照建议不吃快餐的学生比例增加了15%,按照建议不吃含糖软饮料的学生比例增加了20%。此外,教师的体育活动增加了28%。

To Change Behavior, Look At Why:

要改变行为,需要看看为什么:

In behavior therapy, we look at the function of the behavior, in order to create lasting behavior change. (To learn more about functional assessment, click here.)  Who hasn’t eaten their way out of a bad mood, at some point in their life? Kids are just like adults – food can be a potent self-soother. It’s no accident that most “comfort foods” like chocolate or ice cream (or chocolate ice cream!) are loaded with carbs – they tend to raise our serotonin levels when we’re feeling down.

在行为疗法中,我们着眼于行为的功能,以创造持久的行为改变。(有关功能评估的详情,请点击此处。)谁还没有吃东西来摆脱坏心情的经历呢?孩子就像成年人一样——食物能有效地进行自我安慰。大多数“安慰食品”,如巧克力或冰淇淋(或巧克力冰淇淋!)富含碳水化合物,这并非偶然——当我们情绪低落时,它们往往会提高我们的血清素水平。

By attending to the function of food as a self-soother, the Happy Life, Healthy Hearts program offers an exciting new take on curbing the obesity problem. Let’s teach children adaptive self-soothing skills and teach them the soothing powers of physical activity.

通过关注食物的自我安慰功能,“快乐生活,健康心脏”项目为控制肥胖问题提供了一个令人兴奋的新视角。让我们来教孩子适应自我安慰的技巧,并教他们身体活动的抚慰能力。

Gamifying Weight Loss:

游戏化减肥:

Those who demonize the Kurbo app are looking at all children as monolithic. But there’s no such thing as a “child”, there’s only a specific child with specific neurobiology. In my Targeted Parenting classes, where parents learn about how to parent specific profiles of children, one of the thorniest problems is health and eating behavior. Andrea and Sarah are typical of the mothers who attend my classes for parenting the Distractible Child, all of whom are struggling with helping their diagnosed children learn to develop healthy eating habits.

那些妖魔化Kurbo应用程序的人认为所有的孩子都是铁板一块的。但是没有所谓的“孩子”,只有一个具有特定神经生物学的特定孩子。在我的有针对性的育儿课上,父母们学习如何对孩子的具体情况进行育儿,其中最棘手的问题之一是健康和饮食行为。安德里亚(Andrea)和莎拉(Sarah)养育的孩子无法专心,她们参加我的课程,努力帮助确诊的孩子养成健康的饮食习惯。

We have found that gamifying behaviors like activity and step counts for a day works very well.  Using simple fitness trackers, available at any drugstore works well. If we set a goal – a certain number of steps per hour, per day, and a certain period of aerobic activity – and set up both virtual rewards (badges, stars, emailed congratulations) as well as behavioral reinforcers, Distractible Children will comply. Kurbo seems to be an attempt to gamify healthy eating behaviors. (To learn more about using reward systems to create behavior change, click here.)

我们发现,像活动和步数这样的游戏化行为在一天内效果很好。使用在任何药店都可以买到的简单的健身追踪器,效果很好。如果我们设定一个目标——每小时、每天一定的步数和一定的有氧运动时间——并设置虚拟奖励(徽章、星星、电子邮件祝贺)和行为强化,那么容易分心的孩子就会遵守。Kurbo似乎是一种将健康饮食行为游戏化的尝试。(要了解更多关于使用奖励系统来改变行为的信息,请点击这里。)

In our Targeted Parenting classes, we also learn about how to help children attain stress management, emotion regulation, and self-acceptance skills. While these skills are taught as life skills, the Happy Life, Healthy Heart program demonstrates that they can also be weight-management tools. (To learn more about teaching kids emotion regulation skills, click here.)

在我们针对性的家教课程中,我们还学习如何帮助孩子获得压力管理、情绪调节和自我接纳技能。虽然这些技能是作为生活技能来教授的,但“快乐生活,健康心脏”项目表明,它们也可以作为体重管理工具。(要了解更多关于教孩子情绪调节技巧的知识,请点击这里。)

Before demonizing the app, consider those children who lack the capacity to plan for the future, and who can’t relate to the “nutrition now, health later” argument. Instead, let’s be pragmatic and learn from a variety of sources. Let’s teach children emotion regulation. Let’s gamify nutrition and physical activity. Let’s use every resource at our disposal, instead of scorning potential tools out of hand.

在妖魔化这款应用程序之前,先考虑一下那些没有能力为未来做计划的孩子,以及那些无法认同“现在营养,以后健康”观点的孩子。相反,让我们务实一点,从各种资源中学习。让我们来教孩子们情绪调节。让我们把营养和体育活动游戏化。让我们利用我们所拥有的每一种资源,而不是对潜在的工具嗤之以鼻。

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