Big ambitions don’t always yield big results. Just ask anyone whose pursuit of healthy eating started with a ban on carbs and fat and ended wrist-deep in a pile of cheese fries. If you have diabetes—and type 2, in particular—you may have been told that you need to make some pretty major lifestyle changes. Well, easier said than done. “Many of us find that the bigger the change, the bigger the fall,” says Robert Maurer, PhD, a clinical psychologist with the David Geffen School of Medicine at the University of California, Los Angeles, and author of One Small Step Can Change Your Life: Using the Japanese Technique of Kaizen to Achieve Lasting Success. According to Maurer, substantial change is more easily attained when you take small, slow steps toward your goal. “What you’re really trying to do is build a lifetime habit. You can do this by doing things every day, even one minute a day,” he says.
Below are 10 ways of baby stepping toward better health. Don’t try them all at once; making too many changes at the same time can be overwhelming. Begin by picking one or two you can do without too much effort, and watch how pacing yourself can turn even the biggest hurdles into major successes.
1. Big idea: Exercise more
Why it matters: Studies have shown again and again that physical activity can do more than just help you lose weight. It can improve your cholesterol, reduce stress, prevent osteoporosis, lower your blood pressure, help you sleep, boost your immune system, and give you more energy. Plus, when you engage in physical activity, your muscles use glucose for energy, reducing your blood glucose levels. Exercise also increases your insulin sensitivity, which means you’ll need less insulin to get glucose to your cells.
Small step: When researchers at the Mayo Clinic studied how thin people burn calories, they found that they incorporate more random spurts of activity (including actions as seemingly insignificant as fidgeting) into the day than their heavier counterparts do. Thanks to all of that spontaneous exercise, the lean group burned 350 more calories per day than the overweight set. What that means for you: Adding little bursts of activity to your day—delivering a message to your colleague in person instead of by e-mail or picking the stairs over the elevator—can make a big difference.
Try this: Each time you find yourself glued to the tube, exercise during one set of commercials. Within a month, increase your workouts to two commercial breaks.
2. Big idea: Get more sleep
Why it matters: You need sleep to recharge your body. Cutting your nightly rest short by even a couple of hours could impact your decision-making and work performance, increase your risk of high blood pressure and depression, or make you gain weight. And in a 2006 study published in the Archives of Internal Medicine, researchers found that people with type 2 diabetes who reported shortened periods of sleep or poor sleep quality had higher A1Cs than those who had a long, restful slumber.
Small step: When life gets busy, sleep is often the first thing to go. Because going to bed an hour earlier is brilliant in theory but hardly ever possible, try setting a super-easy goal. Maurer suggests going to bed one minute earlier than your normal bedtime. Getting one extra minute of sleep may sound silly, but, Maurer says, “you want to make sure the step you take is so ridiculously small that you’re 100 percent sure you can do it.” If you can realistically alter your bedtime by, say, five or 10 minutes, go ahead.
Try this: This month, move your bedtime up by one minute—or five, if you want. Next month, shift the time by another minute or two, and repeat each month until you reach your goal.
3. Big idea: Eat healthy
Why it matters: Eating good-for-you foods can boost your health in many ways, including reducing your chances of developing heart disease. Modifying your diet with healthier fare could also help you lose weight and better control your diabetes.
Small step: Upping your meals’ nutritional value sounds like an easy idea until you’re face-to-face with a box of jelly doughnuts calling your name. Instead of shocking your system by totally upending your diet, start with small changes you can easily achieve. “Each meal, add something that’s healthy for you, such as a piece of fruit with your hamburger and fries,” says Maurer. At the start of each new month, add a new healthy item to your meal. “What you’re hoping eventually is that the good foods will win out.”
Try this: Integrate one fruit or vegetable—any variety that will excite your taste buds—into your dinner each night. It doesn’t matter if you choose raspberries or radishes, just pick a good-for-you food and make it part of your meal. Next month, add another healthy food to your supper. (But remember to account for the extra carbs.)
4. Big idea: Check your feet
Why it matters: If you have nerve damage in your feet, you may not be able to feel injuries that would typically make you yelp in pain. Ignore the injury for long enough and you could get an infection. People with diabetes are also at an increased risk for foot blisters and ulcers.
Small step: You take your shoes off every day, so why is it so difficult to squeeze in a foot exam? The simple answer is that many people just don’t think about it because their feet are healthy. “It’s a good habit to get into,” says Janis McWilliams, RN, MSN, CDE, BC-ADM, an advanced practice nurse at the University of Pittsburgh Medical Center’s Diabetes Institute. Establishing a routine now could make it easier for you to remember foot checks should you develop neuropathy or other foot problems in the future.
Try this: Set aside one day a week for a foot check. Then, on the designated day, look at your feet (checking the bottoms and between the toes) before getting into bed. The following month, increase your frequency to twice a week.
5. Big idea: Be happy
Why it matters: A recently published study in the Journal of the American Medical Association links having diabetes with a greater incidence of depression. And research published in a 2001 issue of the journal Psychosomatic Medicine shows that depression not only makes it harder for people to control their blood glucose, but it also increases the risk of diabetes complications.
Small step: It’s sometimes hard to feel like a little ray of sunshine when you’re dealing with a chronic illness. But finding ways to look at life more positively can improve both your mental and physical well-being. Maurer suggests using daily questions to remind yourself that there are plenty of things to be cheerful about. “The brain starts paying attention to the answer to these questions,” he says. “Eventually the brain … starts giving you things to be happy about.”
Try this: Start by asking yourself “What am I grateful for, and what could I be grateful for?” one day during the week. Take time to reflect on the question and answer honestly. At the beginning of the next month, ask yourself the question two days a week.
6. Big idea: Cut out salt
Why it matters: Having diabetes ups your risk of high blood pressure, and eating too much sodium makes blood pressure worse. People with high blood pressure have a greater chance of developing diabetes complications like kidney disease, heart attack, and stroke.
Small step: A few shakes of salt on your chicken at dinner isn’t going to put you over the edge, right? Wrong. Table salt has a lot more sodium than you might think —and you probably already get too much “hidden” salt from processed meat, soup, condiments, and even sweet-tasting food like instant oatmeal. At the same time, reducing sodium can be difficult since it makes food more flavorful. A good first step is to take the salt shaker off the dinner table and opt for spices instead. Learn to make smarter supermarket buys, such as picking low-sodium soup over regular.
Try this: Declare one day a week Lunchmeat-Free Day. Scrap your sandwich of high-sodium processed meat and pick something healthier instead.
7. Big idea: Floss daily
Why it matters: Research links bacterial gum disease with poor glucose control and an increased risk of diabetes complications.
Small step: When you consider the benefits of flossing—it’s the best way to get rid of the plaque between your teeth—you should have no reason to avoid the simple task. If you find it hard to remember, try incorporating the act into your nightly routine.
Try this: Begin by flossing one night a week after you brush your teeth (consider the brushing your mental cue). When flossing becomes routine, tack on another day.
8. Big idea: Build a network
Why it matters: If you survive a heart attack, you’re half as likely to have a second heart attack within a year if you have close friends and family, says a 2004 study published in the journal Heart. Maintaining a network of friends you can count on can help you live longer in old age, too, according to research published in the Journal of Epidemiology and Community Health.
Small step: If you already have a close group of friends, count your blessings and then give them a call. Your schedule may be tight, but make an effort to squeeze in one visit or phone call per week or two. Don’t have a close group of friends or family? Now is the perfect time to get social. Join a softball league, head to a community center for a once-a-week sewing class, or visit an online diabetes forum or blog.
Try this: Pick up the phone and call one friend or family member once this month. Next month, up the ante by making two calls—or by scheduling some face-to-face time.
9. Big idea: Cut back the coffee
Why it matters: Coffee is a powerful drug, and if you’re drinking too much of it, it could be interfering with that all-important sleep (see Big Idea #2). The jury is still out on caffeine’s effect on diabetes. A small 2008 study found that drinking four or more cups of coffee a day could increase blood glucose levels in people with diabetes. Other research has found a benefit to small amounts (i.e., not a quadruple-shot venti latte).
Small step: The caffeine kick you get from your morning cup is the only thing that will get you going in the morning. And another three cups get you through the day. Sound like you? If so, you may be getting too much caffeine. Instead of trying to quit cold turkey, start by subbing a cup of decaf (or tea) for one cup of coffee. “You’re counting on the body to make the leap on its own,” Maurer says. “All you’re doing really is programming the brain to do what you want it to do.”
Try this: Make your switch super easy by buying decaf instead of regular just one day a week. If you guzzle multiple cups of coffee a day, just replace one of those with the caffeine-free brew. Next month, trick your system again by replacing a second cup.
10. Big idea: Eat breakfast
Why it matters: Fill up on a high-fiber breakfast each morning and you could better regulate your blood glucose, avoid midmorning cravings, protect against heart disease and stroke, and lose weight. The main reason: Skipping breakfast can lead to hunger, cravings, and overeating later in the day.
Small step: You may not be hungry for breakfast, but training your body to eat in the a.m. is important for weight control.
Try this: Pick one day a week this month to eat breakfast—whether that means oatmeal at your desk or a banana and whole-grain cereal bar in the car. After a month, add the morning meal to another day of the week. You’ll be much more resistant to the 11 a.m. vending machine run with a full stomach.
If these ideas sound too meager to make a difference, consider the big picture. “These small steps are going to lead to a lifetime of habits. We encourage people to be optimistic about the long run and very gentle and patient with themselves,” says Maurer. “Don’t think you’re going to have overnight changes. But be positive [about] the lifelong changes you’re making.” And resist dwelling on the failures. “Don’t beat yourself up if you’re not perfect, if you have lapses, or make mistakes,” says McWilliams. “It happened, let it go and start again.” The good news, says Maurer: “What the small step model does is make it almost impossible to fail.”