November 20, 2013

Mental models

Grit

What do passion, persistence, and deliberate practice have to do with our health?

Read Time 8 minutes

One of my readers posted a link to this short talk from TED Talks Education. (You’ll want to watch it to understand the rest of the post.)

I found the talk interesting, and in the talk Ms. Duckworth makes a reference to a Stanford psychologist, Carol Dweck, who has been very influential in my thinking about children and childhood learning.  In fact, when I became a father one of the first books I read (and have since recommended to every parent I know and even my daughter’s kindergarten teacher) is a book by Dr. Dweck, Mindset.

Now, I don’t know if everything Ms. Duckworth says or suggests is correct.  Her work is well outside of my area of knowledge.  But it’s a topic I think about so much, and since watching this video I’ve been reflecting on my life and the implications of this idea to our health.

First, some background

Shortly after my twelfth birthday, boxing fans around the world were given a gift unlike anything before or since, the showdown between Marvelous Marvin Hagler and Tommy Hearns (don’t watch this unless you can handle a violent boxing match). To this day most boxing experts agree the first round of that 3 round war remains one of the — if not the — greatest round in boxing history.  I was a huge Hagler fan, and this fight galvanized in me two things:

  1. I wanted to be a professional boxer (something I pursued relentlessly enough to nearly forgo college), and
  2. I wanted to be just like Marvin Hagler, the grittiest fighter of my generation.

You see, I was not the fastest when it came to hand speed or foot speed.  My punching power was good, but not George Foreman or Sonny Liston good.  There was no special “gift” or talent I had that was ever going to make me the next Mohammed Ali or Mike Tyson.  But, Hagler didn’t seem to possess any God-given ability and, in my 12-year-old opinion, he was the greatest fighter on Earth.  Sure, Sugar Ray Leonard was the media darling and wealthiest fighter of the era, but Hagler was the grittiest. (Anyone tempted to point out that Leonard was awarded the split-decision over Hagler when they met in 1987 need not bother.  In my mind – and the mind of many — Hagler won 115-113.  If you want to read more, here’s a great summary.) He out-trained everyone.  He never got out of shape between fights. He was always ready for combat.  He was pure grit.

So, this became the defining feature and mantra of my youth.  No one was going to out-grit me. I would run 6 to 10 miles at 4:30 in the morning (imagine how dark and cold that was in Canada) because I knew the other guy was still sleeping.  I did 400 push-ups every single night (except one night in 11th grade when I was too sick to move) before bed from age 13 to 18 because I knew the other guy would not.

When I did decide, ultimately, to go to college instead of pursuing a career as a professional fighter (something I attribute to the most influential teacher in my life), it was such an easy transition, because I had already built a mental and emotional infrastructure of grit.

Perhaps because of some deep insecurity I always felt the need to out-grit everyone at everything, even surgery.  In residency, while my peers would (rationally) try to catch a nap any time there was a free moment during call nights, I would practice anastomosing 3 mm Dacron grafts together with 8-0 proline, over and over again. I even built a model heart with a deep mitral valve to practice – a hundred times a day – one of the most difficult stitches in surgery, the “A-to-V” and “V-to-A” sutures through the mitral annulus.

You get the picture.  I was (and remain) a freak.  The ‘why’ is beyond me, though I’ve never stopped trying to understand it. Even when my daughter was only 5, I spent a lot of time talking with her about ‘mastery’ and the joy that comes from the journey of mastering a skill (versus the need to seek pleasure in the outcome or final result).  This is not a natural phenomenon and I think, unfortunately, most of our education is based on the result and not the process.

I’ve read countless books on this, both out of desire to better myself and out of a desire to ignite this spirit in my children, and to date the best one I’ve read is The Talent Code, by Daniel Coyle. It’s the only book I’ve ever read where the moment I finished it, I turned to the first page to read it again.   In this book, Coyle argues that grit – practice – may not be enough.  It’s necessary, but not sufficient for mastery. The other component essential for mastery is the right kind of practice — deliberate practice.  This topic is worthy of a book, of course, and not just a few sentences, but suffice it to say, deliberate practice is a very specific type of practice that leads to change. Mastery. While I disagree with this writer’s view that the book, Talent Is Overrated does a better job explaining the concept than The Talent Code, he provides a quick overview for those not familiar with the concept.

How does this apply to our health?

First, if you don’t practice correctly, no amount of practice is going to achieve mastery, whether it’s swimming the 200 IM or playing the piano.  A disciplined approach to eating the wrong foods may be better than an undisciplined approach to eating the wrong foods, but it’s no substitute for the correct approach to eating the correct foods.

In 2009, when I was at the height of my unhealthiness – I was overweight, insulin resistant, and had Metabolic Syndrome – it was not because I was not ‘trying hard enough’ to eat well.  I had all the grit in the world when it came to eating. I wanted so desperately to be lean and healthy. The problem, of course, was that I was not eating the right foods. It’s the difference between gritty practice and gritty deliberate practice.

Second, let’s posit you figure out what the ‘right’ foods are.  Is this sufficient to achieve your health?  Well, here I have to include not just my experience, but the experience of my friends, family, and clients. Some people, once introduced to the ‘right’ foods, experience almost an immediate change.  The pounds melt off. Their biomarkers improve seemingly overnight. They feel rejuvenated and renewed.

Let me assure you, these folks are the exception and not the rule. For most people the pattern of going from metabolically broken to fixed, which often includes a loss of fat mass, is very slow; slow enough that on a day-to-day and even week-to-week basis it seems negligible.

To explain this, I’ll use fat mass as an example, since it’s the metric most people understand best.  In my experience, outside of profound caloric restriction or outright starvation, the typical amount of fat loss I see in a person is about one pound per week, or about 60 g per day.  That might not sound like much, and over a week or day, it’s not. (Though, hold 60 g of almonds in your hand and imagine a net loss of this much fat every day from your collective fat cells, and you can start to appreciate how impressive it is physiologically!)

But, we can’t track fat mass directly, at least not on our bathroom scales, and frankly not even with DEXA scans unless they are really spaced out.  Certainly not at the level of a few hundred grams. Furthermore, our bodyweight – what we typically do track – fluctuates a lot.  In me, for example, it fluctuates by 5 pounds per day.  How, you ask? Water. Not just the difference between what I drink and what leaves my body (urine, perspiration, respiration), but also interstitial accumulation, which manifests as minute amounts of swelling, typically in muscles, and elsewhere, too, often in response to exercise, travel, stress, and even foods I eat.

So, if your bodyweight can fluctuate 5 pounds in a day, is it possible to track 60 g per day of net fat loss? It’s like me blindfolding you and putting 50 pennies in your hand and asking you if there are 49, 50, or 51 there.  No chance.  Furthermore, 60 g is so far outside of the measurement spec of a bathroom scale that even if your weight did not fluctuate much due to fluid shifts, you would never be able to appreciate the net fat loss over the course of a few days and barely over a week.

What does this look like in real life? Consider the graph, below, which shows the actual (and completely achievable) weight loss of a person over 7 months. This person went from 227 lb to 195 lb in 7 months, which represents an average of about 4.6 lb per month, or about 69 g of net fat loss per day (as confirmed by DEXA).  This was not a starvation diet or something radical. This was a change in macronutrients – from a standard American diet to a ketogenic diet — that led to a change in net fat flux. But, the change is subtle over any short period of time.  It’s only over months that the change becomes life-changing.

 

Now, imagine the day-to-day frustration this person (I know, because I was working with this person) experienced with the fluctuations in scale readings!  It was tempting on many occasions to say, “Forget it, I’m going back to what I was doing before.”  Just like there were many days I didn’t feel like going to swim practice, or days I didn’t feel like deliberately practicing my surgical technique.

If you remember nothing else, remember this: the game is won – or lost – not by the infrequent big changes, but by the frequent, deliberate, and repeatable small ones. This is where grit comes in.

Sure, there are genetic freaks and lucky ones out there, for whom none of this matters. But for the rest of us – because we live in, and are surrounded by, a food environment that is chronically toxic to about two-thirds of us – re-building our bodies requires consistent and deliberate change.

Are there people with all the grit in the world who can’t achieve health? Absolutely. And I put them into two categories:

  1. Those who are not eating the ‘right’ foods for them (recall: I was in this camp until 2009).
  2. Those who have underlying issues – usually hormonal – which are working against them and preventing their fat cells from liberating fat.

I will not get into these categories in great detail, because the topic is beyond the scope of this post and, frankly, it takes me months to diagnose this in people I work with weekly.  So I can’t responsibly spout out blanket statements about ‘fix this’ or ‘fix that.’  However, far and away the most common causes I encounter in my practice for persistent metabolic derangement, often but not always accompanied by adiposity (excess fat), in the presence of seemingly correct eating and true grit are as follows:

  1. An insulin resistant and/or hyperinsulinemic person eating foods that stimulate significant amounts of insulin;
  2. Hypothyroidism (in my book, TSH > 2 accompanied by basal morning axillary temperature below about 97.8 F);
  3. Hypogonadism in men (which I diagnose with not only total testosterone, but also free testosterone, DHEA, and estradiol), or PCOS in women;
  4. Disruption of the HPA axis, most commonly manifested by “adrenal fatigue” and/or elevated cortisol levels.

Again, I’m not going to get into the nuance of these, but I list these to give those folks who believe they are A) eating the ‘right’ foods, and B) full of grit, yet not seeing results, some hope. These issues are fixable, but you need to see a doctor who knows how to fix them.

Fortunately, such situations are very rare! Most people, with the correct dietary intervention, armed with sufficient grit, and the confidence to stay the course, despite the day-to-day and week-to-week fluctuations, will emerge as renewed people.

Parting shot

Unfortunately, as long we live in a world where (i) the conventional wisdom, (ii) dietary recommendations, and (iii) the market forces enabled by them create an eating environment that is not suited to what most of us should eat, we need to guard against the desire to give up when the results are not what we expect in the timeframe we expected.  As a result, about 90% of people who make a dietary change – and even see results – end up gaining the weight back.  Why? I suspect it’s a bit of what I’ve written about here, and two other phenomena:

  1. The fall-off-the-wagon-and-get-discouraged issue, and;
  2. The I’m-better-now-I-don’t-need-to-do-this-anymore issue.

In the former, folks get very discouraged when they make a ‘mistake.’ Rather than immediately getting back on the program, they get frustrated, and over time – sometimes quickly, sometimes slowly – revert back to their old eating habits.

In the case of the latter, there is this belief that once the goal is achieved, one need not continue the practice. It’s like me training for a year to win a time-trial race on my bike, winning the race, and then deciding I don’t need to train anymore and I can still compete successfully. Not going to happen.  If I want to win, I need to train.  If I’m going to train, I need to train deliberately and persistently. Even on the days I don’t want to.  When I miss a workout or have a bad one, I can’t beat myself up over it. I have to let it go and remember that tomorrow is a new day.  The sum of my days determines my success.

Grit by Crystian Cruz is licensed under CC by 2.0

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.

253 Comments

  1. Hello Peter.
    I have previous thought, that thermally processed unsaturated fats are harmful to health, but this have changed, when I have read this article (http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=7961511). Oxidised fats bound to and activates PPAR-alpha receptor (http://en.wikipedia.org/wiki/Peroxisome_proliferator-activated_receptor_alpha), which then decrease many factors of inflation e.g. recruitment of monocytes, LDL cholesterol, improve state of cardiovascular system, increase HDL and etc., also this receptor is activated in starvation and ketosis. Of course this experiment has been conducted in mice, so it’s possible that in human this mechanism is weaker, also to much consumption of oxidased fats is harmful. I think, that PPAR-alpha pathway is human adaptation to thermally processed foods and starvation.
    In the past I have thought, that healthiest oil for cooking is which one, who have least unsaturated fatty acids ( http://articles.mercola.com/sites/articles/archive/2003/10/15/cooking-oil.aspx), but now I’m calm, when I’m cooking on vegetable oils.
    Sorry for my English.

  2. Thanks for the encouraging article. It made me think of an article I once read, but can’t find it. It describes how there are two types of personalities when it comes to dieting (and other things). There is the type that if you say you can’t have X food group, they are OK with that. They can go long periods of not eating sweets, carbs, fats, etc but when they do cheat, they cheat hard. And it is harder to start up again and get back on the wagon.

    The other kind is someone who if you said you can’t eat x,y,z – they have a hard time with that. All they can think about is eating x,y,z. But these people when they cheat, it’s quick, small and they are right back to eating right. They just cheat more often.

    I am the former and my wife is the latter. Just knowing that we are wired differently helps us during our weight loss journey. I can’t hold her to the standard I set for myself when she eats more carbs than she should when we are out with friends. But I admire how she gets right back to it where I might say to my self “well I’m off now, I’m going to eat pancakes before I get back on. Then the next meal it’s nachos, etc”.

    With your grit, I bet you are the best of both personalities – you cheat rarely and when you do, you get right back on 😉

    • Funny observation, Tim. Yes, that seems to describe me. But the more important point I hope folks take from your comment is that there are several ways to make progress. Not a one size fits all.

    • I find that when I keep my net carbs under a certain level- usually about 60 grams/day- I have very little desire to cheat. However, when I “push it” (usually for social reasons) and eat too many carbs I can get thrown right back into that “carbs beget carbs” thinking and the cravings come right back.

      I find it helpful during those times to go into an “induction” cycle and reduce my carbs to >20 grams for a day or two. That sense of control tends to come right back.

      Sean

  3. Very good points!

    >> If you remember nothing else, remember this: the game is won – or lost – not by the infrequent big changes,
    >> but by the frequent, deliberate, and repeatable small ones. This is where grit comes in.

    how would you relate it, or perhaps not, to the ideas by Taleb and de Vany, who stress the importance of infrequent but extreme factors?

    • Taleb is talking about world events and financial markets. I’m talking about changing health through diet. An example of a Taleb force on the body would be a car accident or plane crash. Not an apples to apples comparison.

    • Well, Taleb, following de Vany, also advocates infrequent but extreme workouts. E.g. one heavy lifting session every 7-10 days instead of regular possibly daily less extreme workouts. Also the concept of weekly, or periodic fasts over 24hrs or more goes in this direction, instead of e.g. daily intermediate fasting/skipping breakfasts, etc.

    • Two quick notes on the Taleb point:
      1) Extremistan vs Mediocristan (spelling?) — Extremistan like Peter implies is about financial markets or areas without known limits. Taleb talks about this is Black Swan – wealth (extremistan) vs weight (mediocristan). Bill Gates might have 100,000x more money than the average person, while wight is restricted to maybe a 10-20x range (50 vs 1000lbs on the extremes of people).
      2) Cause vs Effect – Even these ‘extreme workouts’ only have effects of the type Peter refers to (slow steady progress). No one doubled their squat maximum from one heavy lifting session, while people routinely double their wealth (or lose it all) from risky financial bets. There’s nothing wrong with what Taleb is recommending for human fitness/nutrition, but it still very much lies in the Mediocristan realm of results.

  4. “…persistent metabolic derangement, often but not always accompanied by adiposity (excess fat)…”

    And this is why your site is such a wonderful oasis in the desert of nutrition and health information. If only we could convince the *rest* of the world that excess body fat isn’t the only sign of metabolism (or, heck, even just *digestion*) gone awry. No one seems to connect the dots to their brain fog, fatigue, anxiety, indigestion, or infertility.

    Great stuff, as always, and much appreciated, Dr. Attia.

  5. Greetings from Canada Peter! It’s definitely cold and dark on these November mornings.

    A smile blooms on my face every time one of your blog posts comes into my inbox. For me, as a layperson who is just struggling to understand all of the science and do my best everyday to make the right decisions for my health, this was one of the best. I really needed the inspiration to continue down this path, and your post delivered that in spades. The pressure to eat “normally” is enormous – friends, coworkers and family view my (ketogenic) choices as inconvenient and unhealthy – and it’s tempting to eat as they do. The temptation is even greater when the “reward” for following a ketogenic diet seems slow in coming. I needed this pep talk about grit to persevere in the face of this. Thank you.

  6. In my opinion we overrate grit because that’s what many of us don’t have enough. But the other side is just as important. We also have to be able to give up our goals or dreams. We need a balance between grit and giving up things in our life.

    Whenever I have given up something I felt shame. But after the shame faded away giving up turned to be the good decision. With giving up something that did not go perfect I had a chance to start something better. I saved time for a new hobby that I was better at, I started a better relationship with someone better suited to me, or got a better job. I have started a low-carb-high-fat diet after giving up the regular low calorie one :-). If I didn’t give up some unachievable goals then I would have missed many opportunities in my life.

    Have you heard about “Body By Science”? ( http://www.bodybyscience.net/home.html/?page_id=18 ) Their basic foundation is that we require much more regeneration after workout than common wisdom suggests. The other is that “there is no such thing as cardio” and Cardiovascular health can be achieved through proper strength training. Their recommended training protocol is a 12 minutes High Intensity Training each week. (Just the opposite of what you do. From that point of view you are surely overtraining yourself.) What do you think about their training method?

    I have started doing BBS because my only goal with training is to achieve good health without spending too much time. It turned to be so easy that I will not give it up soon for sure.

    • I have not read it, but I’m very familiar with the work and even the folks who matured some of this thinking 40 years ago. I think it makes sense, in some circumstances, but context really matters. If one is training to look good in a swimsuit, that is very different that training for Ironman. One is not better or more righteous (for lack of a better word) than the other, but these 2 things have virtually nothing in common, so their training can’t be similar. Some overlap, perhaps, but otherwise quite different.
      I don’t disagree with your point that too much *unintelligent* grit is bad. Nothing heroic about banging your head against a wall repeatedly. Quitting can be very good — and essential — to progress. Many approaches to space travel had to be “quit” before success was met. But the overarching goal was not quit. That’s probably where the crucial amount of grit comes in.
      So when it comes to nutrition, experiment, tweak, quit this, or start that, but be sure to give each thoughtful endeavor its fair shot.

  7. Peter, so if I am someone with grit and who despite eating VLC etc. for 18 months and working with a trainer for over a year can’t seem to lose an ounce of fat, how do I go about understanding what hormones may be hindering my progress. Insulin is likely the easy one to test, but do you mean leptin, sex hormones, etc.? It would be helpful to know where to start so when I see a doc I can steer him/her to where I need to go.

    Many thanks,

    Sam

  8. Thanks Peter,
    This is a very timely topic for me. I came to keto through Atkins hoping to lose weight (started at 220, 5’9″) and improve blood chemistry as my previous physical was not good with fasting glucose at 114 and ldl 130 hdl 32 and triglycerides at 170. my new physical, after being in ketosis for 8 weeks was weight 198, glucose 92, ldl 100 hdl 33 and triglicerides 100 so I was very happy. Since the physical though I’m seeing fat loss (by scale) be very inconsistent, very much like your example. I know this is normal fluctuation and I know everyone goes through it but that make it no les frustrating. I just need to stay determined and keep my eye on the trend line. I can get to my goal. Thank you, David

  9. Thanks for another wonderful mind stretcher. Put the Video from the guy that didn’t give, who was blessed to find somebody to help him believe in himself. Watched the TED talk by ms Duckworth . I didn’t read Mindset, but it sounds a bit familiar. You’re too young probably 🙂 to remember the discussions between Tolman, Hull and Skinner back in the mid 1900’s . Tolman (a moderate behaviorist) lost out to the stimulus -response theory. I did some post graduate studies on it in TO in the early 70’s. It seems to me that Tolman’s ‘map’ is finally finding a home in present day theories of behaviour. How do you develop grit was the question. I think you still have to first get at the ‘map’ that people are operating from. A map that has been developing from the day you were born. You will never develop grit if not somebody helps you to change that map. (like the yoga teacher did). Chances are you will negatively influence that map continuously from early on because of your deep love for your child : we hurt when our kids are hurting, we want to help when they are struggling, we cry when they really messed up, etc. etc. But every time we help, every time we say let me do that, we reinforce the map negatively towards developing grit.. I have a feeling what you are doing with your daughter is the right thing. Ask (suggestive or not) questions about the process, enjoy the process . Doing the dishes while doing the dishes. Of course there is a lot more to it. Schools, education, learning, etc. is still largely based on the old S-R theory, and the reward in grade is the ultimate deciding factor. I’m 72 Peter, and it still upsets me. Keep up the good work. I think you just got a bit of help from Tom O’Bryan. http://theglutensummit.com/Tom-OBryan-DC-CCN-DACBN/

    • James, one of greatest joys of writing a blog is all the people like you I get to learn from. Thank you so much for sharing this wisdom. As you can imagine, I lose so much sleep over how to be best possible father and help prepare my girl to thrive in a world I can’t protect her in.

  10. Why are we so averse to reality? I think we all know that you can’t make meaningful changes in your health, body composition or athletic endeavors quickly and with little effort, yet we repeatedly buy into products and schemes that promise rapid, amazing results. More people need to be exposed to the message in this inspiring post and accept that achieving anything worthwhile is almost never easy, but with “grit” and “consistent and deliberate change”, you will succeed. Thanks Peter.

  11. Thanks Peter, this is what I needed, rigth now.
    Got grit!
    Very big plateau and sudden high A1c., while eating HFLC/ Ketogeen
    I do not expect any advice. Too long distance. Too complicated to explain it (in another language) I read all your posts and love it. So exactly explained. Thank you very much.

    But grit, I do need. 😉

  12. Thank you so much Dr. Attia, fantastic post, inspiring as always. You, along with the collection of nutrition and health experts promoting ketosis, have helped me go from 300 to 200lbs, conquer pre-diabetes, high cholesterol, and metabolic syndrome, and feel better than I have in my entire life. Dweck’s work in Mindset is an inspiration and guide to me as an educator and in life in general, I really appreciate you supplementing the heavily scientific nature of your blog with a look at the mental side of things.

    Please keep doing what you do, you’re making an incredible impact in the lives of many. Thank you again.

    • Thank you, Christopher. I hope you realize my understanding of the mental side of things is a fraction of my understanding on the physiologic side. That said, I’m glad folks are equally curious!

  13. Wonderful post Peter,

    I don’t know if I should be worried about having issues with hypothyroidism, but I have been in LCHF diet(75% fat, 20% protein, 5% carbs) for almost 4 months, eating around 1600 cal per day, lifting weights 4x a week plus cardio 2x a week and I am not able to reduce my body fat %. I am 30 years old, 57 kg and 1.63 mts tall. I am not obese so just wondering if I might have hypothyroidism issues that are not allowing me to lose fat.

    • If you’re lifting 4x a week and cardio 2x per week and eating only 1600cal/day your possibly converting a lot of your protein intake into energy rather than muscle mass on your body(gluconeogenesis). If you smell an Ammonia type smell from your armpits instead of a smell of Acetone (ketosis), then this is quite possibly the case.

  14. I know that the metric system is alien to many Americans but writing 60 grams as 60 gm just looks weird. The correct abbreviation is 60 g. The Wiki entry for gram also explains why this could be a non-trivial matter.

    • Lennie, I’m happy to change to g or convert to oz. You last point is a bit (a lot) out of context, but just to be clear: if anyone mistakes 60 gm for 60 mg of almonds, please call 9-1-1 immediately! 🙂

    • Ha! Although, more often than not, I believe the American unit of measurement for nuts is cups. It drives me crazy in recipes… half a cup of this, a stick of that, three tablespoons of the other. Madness! Now if only we could get you to drive on the left like we sensible Brits do. 😉

      • Ha ha! Cups, I agree, is silly. Nuts need to be measured by mass, not volume. Better yet, though why not just refer to them in stone? 60 g is about 0.00944838 stone, right?

  15. Dr. Attia, I agree with you, but my friends mention that Olympic Swimming Champ Michael Phelps – who has single digit body fat percentage – ate 12,000 calories a day of mostly bad food (i.e. one pizza, 2 lb. of pasta) during training. How could I explain this?

    • Jethro, I’m missing your point, as this fact (likely incorrect, by the way) seem irrelevant to the point of this post. That said, consider the following example for your friends: 5 of out 6 people who smoke don’t die of lung cancer. Knowing this, is it a good idea to smoke?

    • Phelps doesn’t have single digit body fat. I’ve seen him numerous times at swim meets up close. And the oft repeated 12,000 calories a day has been thoroughly debunked. It isn’t a secret that many endurance athletes doing high volume can consume massive quantities of carbs without gaining fat, but is a losing strategy for less active or hormonally damaged folks.

  16. Angela Duckworth makes several valid observations. Thanks for posting the link. My daughter’s performance in school is proportional to her motivation and the effort she dedicates to her study, and these are of course related. But her interest level is not just intrinsic; it is strongly influenced by external factors. Ms. Duckworth questioned how to motivate the “grit” in her students. I think a teacher can be a great motivator, but during the formative years the majority of this influence comes from the parents. For example, I am convinced that reading to my daughter daily since she was a baby is now paying off as she devours books. I have many other examples, but suffice it to say that motivation is a learned skill that is taught in subtle ways by those who care for us (family, primarily) or care about us (teachers, secondarily). This applies to adults as well, I believe, and that is why community is so important in helping to motivate change. I find your blog motivating for this reason, being a kind of electronic community without which it is more difficult to sustain eating habits that build rather than undermine health.

    • Carol, I really appreciate this. I love hearing from other other parents and learning what worked (and what didn’t).
      Earlier today a very close friend — and frankly, a guy I idolize — sent me the following (below). Talk about inspiring. Today his son is a pretty remarkable young man. At least in this case, the approach was correct.

      “My (grossly unscientific) thoughts on this subject. I think the closest parallel is entrepreneurs — they can be born or made.

      I was born with it. I never had a mentor or a teacher of this behavior, but I always valued it and exhibited it. I have always been “constructively competitive.” I hated losing much more than I loved winning. I would go to war with you on the basketball court and try to kill you, then hug you when it was over. I would want you to win because I loved you and it meant more to you to win than it did to me, but I still wouldn’t let you win because I didn’t want to lose.

      If you don’t come out of the womb with it, you can cultivate it. My son is a great example. He was always a laid-back, non-competitive sort. You couldn’t discipline him because he didn’t care what you took away. I used the “Education is not filling a bucket, its lighting a fire” approach with him. I helped him cultivate interests, and then showed him the joys of knowledge (astrophysics), or technical prowess (programming computers), or being articulate and persuasive (winning debates with his friends) or raw excitement (racing cars). He then began to seek this higher-level reward-state on his own. I also used his “anti-establishment” adolescent rebellion phase to get the same result (too much detail to get into here about how that was done but I will tell you over a beer someday – but the side benefit was that he turned into a libertarian).”

  17. Your comment on practice reminds me of a saying I have herd but I don’t remember where. Practice doesn’t make perfect, perfect practice makes perfect.

  18. i was one of the people you referred to here:

    “Some people, once introduced to the ‘right’ foods, experience almost an immediate change. The pounds melt off. Their biomarkers improve seemingly overnight. They feel rejuvenated and renewed.”

    in the span of 24 weeks, i lost close to 63 lbs. my energy level is pretty much rock solid throughout the day with none of the disastrous high/lows i got from a high carb diet. however, over the last few weeks, i’ve seen the weight loss slow down to about 1 lb per week. this post just reminded me that i don’t need to lose weight that fast any more. and, i don’t need to make huge changes to what i’m doing. the weight is still coming off, just slower. you’ve reminded me that i’ve still got the grit and confidence to stay the course and keep getting healthier. thanks for that and you awesome posts!!

    now, if you could just tell me where to find Kerrygold butter at a reasonable price. 😉

  19. Dr. Attia,

    Great post !!! After running into your blog about a year ago, my diet completely changed! My wife’s too! I did not lose much weight because I was not overweight to begin with. But my wife did lose weight because eating the same as I do. Both of us become body-tight and energetic. We do not need to force ourselves to exercise any more. We want to exercise and enjoy exercise. We both thank you very much.

    This post on grit is another mind opener. I did read “Talent is overrated” and it is a great book. I pasted “the game is won – or lost – not by the infrequent big changes, but by the frequent, deliberate, and repeatable small ones. This is where grit comes in. —Peter Attia” on my computer screen. Tomorrow I am going to print it in big letters and hang in my study room.

    • That’s funny, Alex, but I’m flattered. When I was in high school my wall was covered in quotes (I wrote them on the wall with a thick black marker — how my parents tolerated me, I’ll never know). Stuff like, “When the punch is thrown, don’t be there,” and “Don’t stop punching till he hits the ground.” How I’ve evolved…

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