A nutrition and exercise expert and her science writer daughter discuss the motivation to stay healthy

A nutrition and exercise expert and her science writer daughter sit down for a conversation on motivation
Dr. Anne McTiernan
Fred Hutch cancer prevention researcher Dr. Anne McTiernan Photo by Susie Fitzhugh for Fred Hutch

At least six times today, while working on this article, I’ve walked by a table of baked goods a colleague brought into the office. There are cookies, pumpkin bread, and something brown in a pan that looks gloriously sticky with coconut. I’ve been trying not to look at it. I love coconut. And cookies. And sugar, pretty much.

Just a few hundred yards from my desk at Fred Hutchinson Cancer Research Center is a building full of public health researchers, many of whom study the effects of poor diet and other unhealthy lifestyles on cancer risk. I know for a fact that many of them also walk by trays of cookies and donuts on the paths to their offices, because I’ve seen the goodies in that building as well.

At the heart of research like theirs is this truism: Most of us want to be healthy, but it’s really hard. And those public health researchers and their colleagues don’t always know what works to get people to lose weight, eat less sugar, exercise more or eat more vegetables. Even when they do know what works, they don’t always know how to get people to actually stick with it.

I’m totally in that category. I know what I have to do — not eat any of those cookies or the sticky coconut thing, or if I do eat one today, eschew their sugary kin that will show up in the office tomorrow, and the muffins in the coffee shop on my way home, and the cheddar crackers I buy for my kids. But it’s easier said than done.

I realized I have an ace up my sleeve in the health and weight-loss game, though. Fred Hutch public Health researcher Dr. Anne McTiernan has devoted her career to studying the effects of weight and lifestyle on cancer risk, including how to actually get people to lose weight. She also exercises for at least an hour a day, religiously, and has kept diabetes at bay through diet and exercise alone for the 14 years since she was diagnosed as prediabetic. Pretty much, she’s superwoman,* health-wise.

She also happens to be my mom.

Recently, we met for coffee (no muffins) so I could pick her brain about what science and her experience says on the topic of what actually works to stick with a diet, or exercise plan, or any other lifestyle modification.

Below is an edited version of our conversation.

Rachel Tompa: Full disclosure, I have to tell you that before meeting you for this interview, I went to a work event and ate a hamburger and potato chips and some ice cream. And I also forgot to put on sunscreen today. I’m off to a bad start.

Dr. Anne McTiernan: Ha! Are you going to mention that you’re my daughter?

RT: Of course. So what started all this was, a while ago I emailed you for tips on avoiding the baked goods people are always bringing into the office. Can you share those tips again?

AM: Oh yeah, that’s where my neurosis really helps me. If it’s something that’s homemade, I’ll imagine that cats walked all over it, or the cook is a smoker and dripped ashes over it.

RT: My cat did walk on something that I made for a potluck once, did I tell you that?

AM: Oh, no!

RT: So people should know that it’s true, this happens! When you first told me that tip, even though I don’t think of myself as a germophobe, I tried it — someone brought in sweets to the office and I made myself think, somebody didn’t wash their hands after they used the bathroom and then they grabbed a piece of that cake. It totally worked.

AM: So that’s one tip. For a while I convinced myself I was allergic to nuts because they hurt my mouth sometimes. But I wasn’t allergic at all. I don’t know what made me decide to eat some again; I must have been hungry. But the allergy pretense worked for several years; I just didn’t eat nuts, and that worked for me because nuts are very high calorie. I haven’t managed to convince myself I have a chocolate allergy though.

Rachel Tompa
Rachel Tompa Photo by Kelsey Moll

RT: Have there been studies on what helps people stick with a healthy lifestyle long term?

AM: I don’t think there have been long-term studies; there have been a lot of short-term studies, and more of them are kind of prescriptive, like we want to help you lose weight, so here’s what you have to do. Or researchers may test one thing at a time, one variable, and see if that works. For example, there’s an association between eating breakfast and being lower weight. The media turned that around into: ‘If you eat breakfast you’ll lose weight.’ But nobody had ever tested that. So finally there have been a few trials that took people who don’t usually eat breakfast and randomly assigned them to eat breakfast or not. It turned out that breakfast made no difference. If you’re not a breakfast eater and you add it, it’s not going to make you lose weight.

Sleep’s another thing. People who are obese and overweight tend to have sleep problems. You don’t know which came first, is it the sleep problem first that helped them gain weight? Or is it that they’re heavier and then they’re having apnea and having sleep problems from that? Or maybe some common emotional thing that causes both. But people twist it around and say, get more sleep, you’ll lose weight. Well, it’s not necessarily true. It really needs to be tested before it’s told as truth.

RT: What actually works to lose weight, if you can stick with it?

AM: For some of the tricks of losing weight, there’s a common theme of accountability. So weighing yourself regularly, especially if you have somebody overseeing that. Also writing down everything you eat and your physical activity. Writing everything you eat forces you to realize what you’re putting in your mouth and it helps you count calories. People who prepare their own food also do better at losing weight, because you don’t really know what you’re eating at a restaurant.

RT: I have a hard time even motivating myself to do the food diary. In your studies, did you find ways to get people to actually do it?

AM: We had very good nutritionists. They were constantly encouraging people. They were great at telling them, this is how you’re going to know what you’re eating, this is going to help you. And it turned out it did. But we also selected people who we thought would be able to do it. They couldn’t get into the study if they couldn’t give us a week’s worth of writing down what they ate. 

RT: Besides avoiding the treats in the office, how else do you manage to not eat things that are bad for you and to get out and exercise every day?

AM: I get out and walk with friends every morning. We have a set time, so I know I have to get up in time to get out and do that. Again it’s a bit of an accountability thing — you promise somebody you’ll meet them. I also get on the stationary bike and read, sometimes it’s work reading and sometimes it’s fun reading, but it’s a nice reading time. Also I’m not eating while I’m doing that.

Grazing ways

RT: Is it partly about just looking for ways to keep yourself from eating during the day?

AM: Some people are noshers; that’s what I am. And there are some people who will sit down and just eat huge quantities of food, and they need something different to motivate them. So anything that would keep you active in any way can help. It’s hard to be a nosher when you’ve got little kids you are running around after at the playground. I mean how often are you sitting there eating at the playground? You’re running around after the kids.

RT: And I know that they want every molecule of snack that’s in my bag, so I better not touch it.

AM: Yes, that’s right. You can’t have your sweet stash there once they’re aware of it.

RT: Can you tell me about your prediabetes and how that’s affected your lifestyle?

AM: That really helps me to reduce carbs. I can look at a bowl of ice cream and I can see that it would be like shooting glucose into my veins. When I envision that, then the ice cream doesn’t look so good. That works for most carbs, but it doesn’t work for things like nuts and dark chocolate, which I know don’t raise my blood sugar very much.

RT: I guess with all that time you spent tracking your blood sugar and all your scientific knowledge, you know exactly what each meal is going to do to you.

AM: Yeah. And just about the time I became prediabetic, the results of the Diabetes Prevention Program trial came out, and it showed that a lifestyle change through a diet and exercise weight- loss program reduced the risk of getting diabetes by over half.

RT: Oh wow. When I’ve been exercising recently I’ve been thinking, if I keep doing this maybe it’s going to extend my life, but each 20- or 30-minute run I hope is going to extend my life by more than 20 minutes, because otherwise it’s a wash. I’ll want that time back.

AM: It’s not just extending life, but it’s quality of life. Think about somebody who stays very inactive when they’re younger, and their muscles get weak and every pound they’re putting on is all fat. They’re putting a lot of stress on their joints, and if their muscles aren’t strong to handle it, then their quality of life is going to be worse when they’re older. You know, their kid wants to go to Disneyland and they have to walk around with them, they’ll be very uncomfortable. So yeah, you’re making yourself a little miserable for 20 minutes if you don’t like running, but then you might feel better in the short term and the long term.

Competitive fire

RT: Have you heard any other ways people motivate themselves?

AM: Some people are competitive, so they like to sign up for races. I feel like my job is competitive enough; I don’t feel like I need to run a race to incite me, but for some people that really works.

It would be an interesting thing to study, to ask people what motivates them to eat certain ways. There’s not a lot known about what makes people maintain weight.

RT: I feel like for me, most of the time exercise is a little easier to motivate myself to do, because that’s just like one choice a day, and food is constant all day long.

AM: Yeah, and behavioral scientists have shown that in studies. If you have to make choices all the time, like with food, it’s difficult.

RT: Anything else, any other brilliant ideas?

AM: I wish I did have brilliant ideas.

*Note: When she read the first draft of this article, McTiernan said she doesn’t think she’s a superwoman. I’ll let you skim through some of her many recent accomplishments and decide for yourself. I think the term fits.

Found a diet or exercise motivation that works? Tell us on Facebook.



Rachel Tompa is a former staff writer at Fred Hutchinson Cancer Center. She has a Ph.D. in molecular biology from the University of California, San Francisco and a certificate in science writing from the University of California, Santa Cruz. Follow her on Twitter @Rachel_Tompa.

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