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H is for Health Maintenance—why don’t we do what we should do?

Posted on October 18, 2010 by laurakastner Leave a comment


By Laura Kastner, Ph.D.

Parents often neglect their own health while caring enormously about the health of their children. Since children and teens learn from and model their parents’ behavior, parents’ personal health behaviors can be critical determinants of their children’s health profile. Furthermore—and this is a “duh”—parents make decisions related to their children’s health every day.


Since health guidelines are a dime a dozen, let’s get that easy part over first, and then I want to address the nitty-gritty of why optimally healthful lifestyles are so hard to come by, even for the most competent, loving parents among us. First, a checklist for you and your child or teen:

don’t smoke
don’t drink
use a seat belt
eat balanced and healthful meals, avoiding junk
sleep 7-8 hours a night
practice firearm safety
exercise 30-60 minutes a day
practice safe sex
seek health advice when needed
? think carefully about health decisions


(For nine other measures parents can take for strengthening a family’s psychosocial and immunological health, check out my acronym “REAL STRONG” in the blog article posted on 9/8/09 addressing flu resistance.)

Creating a checklist is easy. Doing it is another. Rather than citing research on fitness and kick-starting new healthful habits (also easily accessible on the web), I am going to focus on the role of emotions in decision making.

The checklist is evidence based and fairly non-controversial. Since practicing these habits is associated with significantly better health, we must ask ourselves, for the sake of ourselves and our beloved children: “Why don’t we do what is good for us to do?”

Adults have a tough time doing what is in their interest health-wise, and of course children and teens have even greater difficulty. Young children reason that “good is what I want”, which is the first stage of moral reasoning. Basically, kids are hedonists. Luckily, parents control a lot of the decisions related to a child’s food intake, athletic commitments, seat-belt usage, and sleep routines.

By the time teens are mature enough to control these decisions, they have better cognitive equipment for this deliberation and ideally, established good habits to draw on. Given that parents model, teach, decide and broker health decisions in such a central way, they can be considered the lynchpins for family health practices.

The excuse many people give for failing to give adequate emphasis to health—say, exercise, healthful meals, and sleep—is “not enough time”. However, we know that we have choices of how we spend our time and money, so isn’t our health emphasis just a matter of choice?

Yes, and no. It depends on what you mean by “choice”. Neuro-imaging and cognitive science research shows us that emotions dictate a lot more of our choices moment to moment than we ever imagined. Do you think you made a purely cognitive choice (e.g. contemplating the costs, benefits, risks and the consequences) when you clicked on the TV, ate those cookies or hit the snooze button to avoid your exercise class? Think (and analyze that “choice” idea) again.

The emotional centers in our brain often have more power over our behavior than our reason centers. Neurons in the emotional “old” brain, whether reacting to danger or pleasures, trigger faster than the neurons in the analytical parts of the neo-cortex. And when we are faced with personal pleasures like a new love interest, favorite junk food, or compelling acquisition, the emotional centers are fueled by the powerful neuro-chemical dopamine.  Dopamine sends the message, “Go get it now!”

The draw of sex, food and novelty may have insured our survival over the millennia, but our pleasure drive may also represent our modern undoing. Let your mind roll to obesity, addiction, greed, and all manner of hedonistic impulses for musing on that last sentence.

No wonder reasonable people philander, watch too much TV, over-eat and drink too much. Our brains remember pleasurable things; it often just wants what it wants when it wants it. Our only protection is the “executive functioning” capability of our prefrontal cortex, which allows us to recognize and inhibit the impulses of pleasure gluttony. The thinking capacities of our prefrontal cortex made the development of our moral compass possible. That is—when it is fully engaged. Oh, but then again—I already emphasized that emotions can trump reason and judgment—frequently.

Too bad for us that emotional urges are often stronger than our moral and cognitive judgments and frequently operate underneath our “conscious” decision-making apparatus. Remember how much we used to laugh at that old monologue of Flip Wilson’s when he said, “The devil made me do it!”? In this brain research era, will we grab the chips and remote control (for hours), and declare, “My nucleus accumbens and dopamine reward pathway made me do it”? Perhaps, but we also need to acknowledge that we didn’t full engage our thinking brains and activate self-restraint.

Our health decisions also get bogged down by the “danger” triggers in our emotional brains. For instance, if we perceive that we’ll lose our job if we don’t spend six extra hours on a project tonight, forget the priority of healthful food, exercise and sleep—not to mention playing and reading books with Johnny.

If our brains are triggered emotionally by the perceived dangers of neglecting our work demands, they certainly can—and do—become triggered when it comes to our children’s need to stay up late due to homework and extracurricular activities. Our emotional brains perceive the consequences of not acting on these needs as practically life threatening: “They can’t sleep as much as they need to because of the importance of homework, three athletic teams and developing their resume for college!”

We could argue that with chronic stress and the damage done to health, we can’t function optimally at our jobs and our children won’t thrive in college. And in these shaky economic times, our anxiety-saturated decisions to prioritize job retention and scoring A’s in school do seem to have a top priority. However, we’ve just re-created our pretzel thinking—to be healthy, we need to balance our lives with a value on health, but to survive, thrive and excel, we must stay on the fast-lane treadmill, which means mania, stress and the time famine for health pursuits. Argh.

The “health-indulgence-mania” trifecta means we must choose our priorities carefully. We must understand emotions and how they can trump reason and wise judgment. Only then can we understand how our daily lives can fall so short of our stated values about the importance of health.

With our emotions influencing so many of our health-related decisions, what can be done? Choice architecture enthusiasts would say we need “default settings” to steer us toward better living. We probably need to sign up for “AA” type public meetings to declare and get support for our intentions, receive regular rewards for following through, and buy computerized filter systems that shut down our various distractions at home so we can eat, sleep, and enjoy our family members in more healthful ways.

At the very least, we need to think deeply about how we set up our daily lives for success—for our own health and our children’s. We can use our top notch executive functioning skills (posted on  9/25/10), review the psycho-neuro-immunology boosters (posted 9/8/09) and brush up on the parenting checklist (posted 2/26/10) to organize our lives for health. Then we need to forgive ourselves for coming up short, because no one is perfect and curve balls happen every day to throw us off our schedules. But the checklists are good reference points, and after that—well, I guess it’s up to you and your prefrontal cortex.

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