Integrative Clinical Psychologist Ashley Mason, PhD. is back on the podcast to discuss her clinical work and research within the UCSF Department of Psychiatry. She is now the Co-Director for the UCSF Center for Obesity Assessment, Study, and Treatment, and the Director of the Sleep, Eating, and Affect (SEA) Lab. Her areas of interest include problematic eating and sleep-related behaviors, and nonpharmaceutical interventions to address them. In this interview, Ashley and I discuss her current research, which focuses on treating individuals with type-2 diabetes using reduced-carbohydrate diets, mindful eating techniques and environmental management. She shares her insights on some of the root causes fueling the diabetes epidemic, and the factors that keep her research subjects motivated to make difficult lifestyle changes. We also discuss her clinical work treating people struggling with sleep, and the behavioral methods she uses to help them turn things around in a matter of weeks. Support Ashley’s work. Here’s the outline of this interview with Ashley Mason: [00:00:18] Ancestral Health Symposium 2014 in Berkeley. [00:00:39] Assistant Professor at UCSF. [00:01:27] Osher Center for Integrative Medicine. [00:02:19] Pairing diet change with behavioral change for type 2 diabetes. [00:04:00] How are people becoming diabetic? [00:05:20] Only 12% of the population is metabolically healthy; Study: Araújo, Joana, Jianwen Cai, and June Stevens. "Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016." Metabolic syndrome and related disorders 17.1 (2019): 46-52. [00:07:02] Grubhub; DoorDash. [00:01:50] Food reward; hyperpalatable foods. [00:08:11] Ashley’s previous podcast: Paleo Psychology with Ashley Mason PhD. [00:11:07] Getting people to change their behavior; identifying the why behind wanting to change. [00:11:49] Low carbohydrate diets can result in reduced need for diabetic medications; Virta Health Studies: McKenzie, Amy L., et al. "A novel intervention including individualized nutritional recommendations reduces hemoglobin A1c level, medication use, and weight in type 2 diabetes." JMIR diabetes 2.1 (2017): e5; and Hallberg, Sarah J., et al. "Effectiveness and safety of a novel care model for the management of type 2 diabetes at 1 year: an open-label, non-randomized, controlled study." Diabetes Therapy 9.2 (2018): 583-612. [00:15:54] Motivational interviewing. [00:16:15] Stages of change model (diagram). [00:17:40] Fundamental reasons for wanting to change. [00:18:30] Handling the social pressure of eating differently. [00:24:39] How to work with people in the pre-contemplative stage. [00:28:01] USDA Dietary Guidelines for Americans 2015-2020, eighth edition. [00:29:25] Taste and price drive decision making. [00:30:01] Arranging the environment to support better dietary choices. [00:31:56] Companies with self-insured health plans have incentive to keep employees healthy. [00:33:05] Mindful eating; paying attention while you're eating. Studies: Brewer, Judson, et al. "Can mindfulness address maladaptive eating behaviors? Why traditional diet plans fail and how new mechanistic insights may lead to novel interventions." Frontiers in psychology 9 (2018): 1418; and Mason, A. E., et al. "Examining the Effects of Mindful Eating Training on Adherence to a Carbohydrate-Restricted Diet in Patients With Type 2 Diabetes (the DELISH Study): Protocol for a Randomized Controlled Trial." JMIR research protocols 8.2 (2019): e11002-e11002. [00:43:39] Sleep as a lynchpin to health behavior. [00:45:54] Cognitive Behavior Therapy for Insomnia (CBTI); Improving sleep as a platform for making other behavior change possible. [00:46:30] Getting people off of benzodiazepines. [00:49:50] Previous podcast episodes on chronotypes, meal timing, and sleep hygiene: 1, 2, 3, 4, 5. [00:50:16] CBTI strategies for improving sleep. [00:54:51] Oura Ring; the value of self-report over electronic d