The risk of developing atherosclerotic heart disease is directly correlated with plasma cholesterol concentration and up to a third of the weight of atherosclerotic plaques is cholesterol. The most significant information in regard to atherosclerosis has to do with the plasma levels of high density lipoprotein (HDL's) cholesterol and low density lipoprotein (LDL's) cholesterol. "Data from cross-cultural and cross sectional studies clearly show a significant and consistent relationship between elevated levels of plasma total cholesterol and increased incidence of CHD" (Howell and Mcnamara). Generally HDL's and LDL's function for cholesterol transport between the liver and the other tissues that metabolize cholesterol. 70% of the plasma's total cholesterol are in the form of LDL's and can be metabolized by certain tissues. Any remaining cholesterol that goes unused can be carried away by HDL'S. These transport the cholesterol from cell membranes to the liver, where it is metabolized or lost in the intestine in bile. If you will, LDL's are considered "bad" cholesterol and HDL's are considered "good" cholesterol.
In a survey of coronary risk factors, Hopkins and Williams compiled a list of 246 variables that have been reported to have either a positive or negative association with coronary heart disease incidence or mortality. Of the 246 suggested coronary risk factors, 44 are dietary variables. It is then obvious to conclude that practically all aspects of the diet (amount of protein, fat, carbohydrates, vitamins and minerals) have been implicated in either the incidence or protection from coronary heart disease.
What conclusions can be drawn from the plethora of information relating diet, hyperlipidemia, and atherosclerosis? The conclusions are fairly straightforward. "Eat a variety of foods in moderation, meaning a diet low in saturated fat and high in complex carbohydrates and f iber, maintain a healthy relative body weight by balancing caloric intake with caloric expenditure, sustain a level of physical activity consistent with good health and enjoy a glass or two of wine with meals" (Mcnamara and Howell, 1992).
Last year when we lived together, it was convenient for us both to eat at the same time. Neither of us liked to cook and this mere fact contributed to our tendency to order out or simply drive to the nearest fast food restaurant. On average, we dined at fast food restaurants on about four nights out of the week. We were obviously not concerned with how many total fat grams a day we were consuming. More importantly we were totally oblivious to what we were doing to our arteries with all the deep fried foods that we were putting into our systems.
Fortunately this summer I had an epiphanous moment. While I was sitting on the beach, hung over, smoking a cigarette, I looked down to read the paper I had in my hand. As I looked down what caught my eye wasn't the newspaper but rather my gut. It looked so disgustingly repulsive. From that moment on, my ways have changed. I am now running four to six miles a day and I am eating healthy. I do not exceed 3000 calories a day and no more than 40 grams of fat a day. My overall mental and physical health has increased tremendously. I am no longer lethargic and I'm generally happier.
So, the problem doesn't lie with me but with my roommate. Living with him this semester I am forced into watching him pollute his body. Since I consider him not only a roommate but a good friend; I shall attempt at altering his behavior and or attitude through the act of persuasion so that he too can enjoy the pleasures of living a longer and healthier life.
Being that I know my roommate (I will be referring to my roommate as "Jim" from this point on), pretty well I did not have to evaluate his attitude on health. He did have some knowledge about what is "good" for a person as opposed to what is "bad" for a person. This is why I decided to initiate the act of persuasion by using an argument. I figured that Jim could consider the points that I made and evaluate them objectively. He would then be able to see the logic and ultimately his behavior would change.
One day Jim and I were talking, so I decided to gradually slip my argument into the conversation:
Jim, did you know that coronary heart disease has been the leading cause of death in the United States since the early 20th century?
Jim responded, "No I didn't know that, that's pretty interesting though.
Me: Yeah, and did you know that the onset of the disease can be prevented or at least delayed simply by a change of lifestyle?
Jim: "Really." (It seemed that he was interested at first but he changed the subject.)
The next day I tried a different approach. As he was watching television I began asking him about his old girlfriend and if he missed her. He responded the way I wanted and began telling me how much fun they had together. I then asked how long its been since he had a date. He didn't give me an answer. At this point I threw down on the table a copy of a GQ magazine with Van Dam on the cover. As he picked it up to read I began telling him that he should get himself into shape and start working out. I told him that he and I both needed to start going out on more dates. He amazingly agreed with me and told me that he has been wanting to start working out. I then told him that he could come out to the coliseum with me every day to run.
It wasn't as easy as I had thought. For the next week he kept coming up with excuses not to exercise with me. So another evening while we were studying I began telling him about coronary heart disease:
Me: By reducing your fat and cholesterol intake coupled with exercising, one can significantly lower the risk of getting heart disease.
Jim: "Yeah, but I'm only 21 years old, that's for old people to worry about."
Me: Actually it has been proven that initial thickening of some arteries can begin as early as age ten, with an accumulating eff ect as a preventative effect as a person ages, unless of course if a person takes preventative measures like dieting and exercising. Again Jim dropped the subject at this point. It seemed as if he knew that I was right but could not rationally counter my argument.
To my surprise Jim came running with me the next day. In fact he ran with me for about two weeks consistently. And just recently he has been slacking off. I do not know if Jim's recent inconsistencies are simply a short lived trend or is he going to eventually quit working out altogether: and if so, have I failed in changing his attitude?
As I did my experiment, I followed the Elaboration Likelihood Model or ELM. "This model provides a fairly comprehensive framework for organizing, categorizing and understanding the basic process underlying the effectiveness of persuasive communications" (Petty and Cacioppo, 1986, p.3).
The ELM consists of two distinct routes to persuasion: central route and peripheral route. The central route is most likely used when a person is willing and able to think about the information presented. I will refer to it here (as we did in class) as W.A.T.T., that is willingness and ability to think. When a person is high "watt", a persuasive argument should be used. A "strong argument" message is defined as one containing arguments such that when subjects are instructed to think about the message, the thoughts that they generate are predominantly favorable, and a liweak argument" message is defined as one in which the arguments are such that when subjects are instructed to think about them, the generated thoughts are generally unfavorable (Petty & Cacioppo, 1986, p.32).
The peripheral route on the other hand should be used when a person is in a mindless state, or low "watt". And during these conditions a cue should be presented and this cue should have the ability to effect attitudes without any arguments.
When I had begun my persuasion process, I had assessed the subject as being high watt. Thus I began by using an argument. An argument is defined as any information that bears on the central merits of the attitude object. But judging from the response of the subject, he was not high watt. It would have probably been more effective if I had originally used a cue. Af ter this I figured that he was simply not interested in the subject in which I had brought up. So the second approach I decided to use a cue. He was watching television so I figured he was low watt. This time I was right. The picture of the well built man on the cover of the magazine served as a cue. This aspect falls under the trade-offs of the ELM theory. This states that some arguments are more effective under certain conditions: and other times it is allowable to use cues. it simply depends on the circumstance.
I was successful in changing his attitude because my subject did change his behavior, by working out with me. But his behavior did not change indefinitely. This can be explained under the ELM theory as well. The results are the consequences of the persuasive continuum. Attitude changes can be measured by the magnitude of change: how long the change persisted, how the person resists to change and how predictive is the person that he/she will change.
Higgins, M.W. & Leupker, R.V. (Eds.) (1988) Trends in Coronary Heart Disease Mortality. New York: Oxford University Press
Mcnamara, D.J. & Howell, W.H. (1992). Epidemiologic Data Linking Diet to Hypelipidemia and Arteriosclerosis. Seminars in Liver Disease, 12, 347-353
Nowak, T. J & Handford, A.G. (1992). Pathophysiology. Dubuque IA: WBC Publishers
Ockene, I.S. (Ed) (1992). Prevention of Coronary Heart Disease. Massachusetts: Little, Brown and Company.
O'Keefe, D.J. (1990). Persuasion. Beverly Hills, CA: Sage Publications
Petty, R.E. & Cacioppo, J.T. (1986). Communication and Persuasion. New York: Springer-Verlag.
Shavitt, S. & Brock, T.C. (1994). Persuasion. Massachusetts: Paramount Publishing.
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Used with author's permission for the Comm 221 course.