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holidays-xmas

Surviving the Holiday Season

/11 December 2023/ All MFN blog/

The hardest time of year for weight management is from Halloween until Valentine’s Day – temptations are everywhere from home to the workplace and everywhere else you go, people wear more clothes and are more covered up because of the weather, and people tend to exercise less because they are stressed, exhausted, it is cold, and they have very little time.

Here are some tips to manage weight during the holiday season…

Plan ahead

  • Eat something before you go out so that you are not inclined to eat everything or anything in sight.
  • Stock your home, office, and/or car with healthy snacks such as fruit in your home, almonds in your office, and a nutrition bar in your car.
  • Plan on making healthy choices for your meals such as mustard instead of mayonnaise or light Italian rather than ranch dressing.

Manage stress

  • Make a list of stress relieving activities that do not include food or eating such as getting a massage, exercising, listening to music, or talking on the phone.

Party responsibly

  • If you are attending a pot-luck party, bring something healthy so you know there will be at least one healthy choice at the party.
  • Eat small portions of your favorite sweets at parties.
  • Try to fill your plate with mostly fruits and veggies at parties.
  • If you want to try new dishes, only take a taster size portion so that you are not tempted to eat more than you should. Then go back and get more of what you like if you are still hungry.
  • Drink a glass of water after each glass of soda or alcoholic beverage in order to cut beverage calories in half.
  • Focus on socializing with other guests rather than eating the food available.

Keep moving

  • If you know you will not have time to exercise, try to fit other small activities into your day such as parking farther away, taking the stairs, and putting the shopping cart away instead of putting it to the side.
  • If you have a stationary bicycle or a treadmill that you haven’t used for a while, take it out and put it in front of the TV, so you can watch TV when you work out.
  • Take a walk alone or with your spouse, kids, or other family and friends after dinner.

Kristy Richardson is a dietitian and exercise physiologist, specializing in sports nutrition and weight management, She is the founder of OC Nutrition and also works as a nutrition professor at Fullerton College.

References

Cleveland Clinic. (2009). 8 Steps to Surviving the Holiday Weight Gain. Retrieved December 22, 2009 from: http://my.clevelandclinic.org/heart/prevention/nutrition/holidayeating12_01.aspx

Zamora, Dulce. (2007). Holiday weight management; Surviving the Feasting Season. Retrieved December 22, 2009 from: http://www.medicinenet.com/holiday_weight_management/article.html

scale

The Habits of Successful Weight Losers

/8 December 2023/ All MFN blog/

In a national television interview with Barbara Walters in 2014, Oprah Winfrey confessed that not being able to maintain her weight loss was her biggest regret. In that interview, Walters asked Winfrey to finish the sentence, “Before I leave this Earth, I will not be satisfied until I…”

“Until I make peace with the whole weight thing,” Oprah replied. Losing weight is hard; keeping it off is even harder. What is unique about those who succeed? The answer is buried deep in the archives at the Weight Control and Diabetes Research Center in Providence, Rhode Island: The National Weight Control Registry (NWCR), the largest database ever assembled on individuals successful at long-term maintenance of weight loss. Founded in 1994, the NWCR includes more than 10,000 individuals who complete annual questionnaires about their current weight, diet and exercise habits, and behavioral strategies for weight loss maintenance.

Habit #1: Live with Intention

Living with intention eliminates the random approach to weight loss maintenance in favor of the systematic and methodical one that leads to results. The NWCR has shown that, when intention is behind weight loss maintenance, 21 percent of overweight people are successful weight losers. [1]

The longer people keep their weight off, the fewer strategies they need to continue keeping weight off. [2] In other words, weight maintenance gets easier. The longer your clients persist in their intention and behave in accord with that intention, the easier it is for that behavior to “stick” and turn into a habit.

What makes one individual persist at a specific behavior while another individual doesn’t? For starters, the persistent individual has a conscientious personality. In the most recent NWCR study published in 2020, conscientiousness was compared between successful weight losers from the NWCR and non-NWCR weight regainers. [3] The successful weight losers were found to be more conscientious than the weight regainers and scored higher on measures of order, virtue, responsibility, and industriousness. The scientists suggest that being conscientious may help individuals maintain their weight loss by improving adherence to specific behaviors.

In a review of 56 studies that contained 58 health behaviors, researchers at Université Laval in Quebec, Canada and the University of Limburg in The Netherlands found that intention remained the most important predictor of health behavior, explaining 66 percent of the variance. [4] In half of the reviewed studies, perceived behavioral control (believing that you have control over your behavior) significantly added to the prediction.

Habit #2: Control Yourself

Being a successful weight loser requires a lot of self-control, delaying gratification now (e.g., dessert) for the more desirable reward later (e.g., a slimmer waistline, better health, enhanced self-esteem, and happiness).

Compared to typical unsuccessful dieters, successful weight losers are better able to resist temptation, control themselves, and push back against the environment. They restrict certain foods, [5] weigh themselves regularly, [6, 7] and use digital health technology. [8]

One of the key factors of self-control is disinhibition, which literally means not being inhibited. Some inhibition is good, because it prevents people from not giving into temptation and eating whatever and how much they want. High levels of disinhibition are bad, because it leads to risky behavior. Disinhibited eating is a failure to maintain control over eating. The opposite of disinhibited eating is dietary restraint. Several NWCR studies have found that increased disinhibition leads to regaining lost weight. [9, 10, 11, 12, 13] Other studies have found strong relationships between a lack of self-control—impulsivity—and obesity. [14, 15, 16]

Habit #3: Control Calories

Successful weight losers consume fewer daily calories than the general population. Table 1 shows the number of calories the NWCR members consume per day, from the several studies that have reported it, along with the amount of weight they lost at the time they entered the NWCR.

Table 1 – Caloric Intake of Successful Weight Losers

 Calories Per DayPounds Lost
 1,381 [17, 18]

1,297 (women)

1,725 (men)

66

63 (women)

78 (men)

 1,306 (women) [19]

1,685 (men)

63 (women)

77 (men)

 1,390 [20]69
 1,462 [21]124
 1,400 [22]62
 1,399 [23]73
Average

Women

Men

1,406

1,302

1,705

79

63

78

Successful weight losers consume a low-calorie diet of about 1,400 calories per day, with women consuming about 1,300 and men consuming about 1,700 calories per day. By comparison, the U.S. adult population consumes an average of 2,120 calories per day (women consume about 1,820 calories per day and men consume about 2,480 calories per day). [24, 25]

Successful weight losers control calories several ways, including limiting how often they eat out at restaurants, [26] rarely eating fast food, [27] and limiting how many calories they drink. [28] They are also more likely than normal-weight individuals to have plans to be extremely strict in maintaining their caloric intake, even during times of the year when it’s easy to consume calories, like during holidays. [29]

Want to learn about more of the habits of successful weight losers? Check out Dr. Karp’s book, Lose It Forever: The 6 Habits of Successful Weight Losers from the National Weight Control Registry

A competitive runner since sixth grade, Dr. Jason Karp pursues his passion every day as a run coach, exercise physiologist, bestselling author of 10 books and 400+ articles, speaker, and educator. He is the 2011 IDEA Personal Trainer of the Year and two-time recipient of the President’s Council on Sports, Fitness & Nutrition Community Leadership award. His REVO₂LUTION RUNNING™ certification has been obtained by fitness professionals and coaches in 23 countries. His new book, “Lose It Forever: The Habits of Successful Weight Losers from the National Weight Control Registry” is available on Amazon.

References

[1] Wing, R.R. and Hill, J.O. Successful weight loss maintenance. Annual Review of Nutrition, 21:323-341, 2001.

[2] Klem, M.L., Wing, R.R., Lang, W., McGuire, M.T., and Hill, J.O. Does weight loss maintenance become easier over time? Obesity Research, 8:438-444, 2000.

[3] Gold, J.M., Carr, L.J., Thomas, J.G., Burrus, J., O’Leary, K.C., Wing, R., and Bond, D.S. Conscientiousness in weight loss maintainers and regainers. Health Psychology, 2020.

[4] Godin, G. and Kok, G. The theory of planned behavior: a review of its applications to health-related behaviors. American Journal of Health Promotion, 11(2):87-98, 1996.

[5] Wing, R.R. and Phelan, S. Long-term weight loss maintenance. American Journal of Clinical Nutrition, 82:222S-225S, 2005.

[6] Wing, R.R. and Hill, J.O. Successful weight loss maintenance. Annual Review of Nutrition, 21: 323-341, 2001.

[7] Butryn, M.L., Phelan, S., Hill, J.O., and Wing, R.R. Consistent self-monitoring of weight: A key component of successful weight loss maintenance. Obesity, 15:3091-3096, 2007.

[8] Goldstein, C.M., Thomas, J.G., Wing, R.R., and Bond, D.S. Successful weight loss maintainers use health-tracking smartphone applications more than a nationally representative sample: comparison of the National Weight Control Registry to Pew Tracking for Health. Obesity Science and Practice, 3(2):117-126, 2017.

[9] McGuire, M.T., Wing, R.R., Klem, M.L., Lang, W. and Hill, J.O. What predicts weight regain among a group of successful weight losers? Journal of Consulting and Clinical Psychology, 67:177-185, 1999.

[10] Niemeier, H.M., Phelan, S., Fava, J.L., and Wing, R.R. Internal disinhibition predicts weight regain following weight loss and weight loss maintenance. Obesity, 15:2485-2494, 2007.

[11] Butryn, M.L., Phelan, S., Hill, J.O., and Wing, R.R. Consistent self-monitoring of weight: A key component of successful weight loss maintenance. Obesity, 15:3091-3096, 2007.

[12] Thomas, J.G., Bond, D.S., Phelan, S., Hill, J.O., and Wing, R.R. Weight-loss maintenance for 10 years in the National Weight Control Registry. American Journal of Preventive Medicine, 46(1):17-23, 2014.

[13] Lillis, J., Thomas, J.G., Niemeier, H., and Wing, R.R. Internal disinhibition predicts 5-year weight regain in the National Weight Control Registry (NWCR). Obesity Science and Practice, 2(1):83-87, 2016.

[14] Chamberlain, S.R., Derbyshire, K.L., Leppink, E., and Grant, J.E. Obesity and dissociable forms of impulsivity in young adults. CNS Spectrums, 20(5):500-507, 2015.

[15] Fields, S.A., Sabet, M., and Reynolds, B. Dimensions of impulsive behavior in obese, overweight, and healthy-weight adolescents. Appetite, 70:60-66, 2013.

[16] Amlung, M., Petker, T., Jackson, J., Balodis, I., MacKillop, J. Steep discounting of delayed monetary and food rewards in obesity: a meta-analysis. Psychological Medicine, 46(11):2423-2434, 2016.

[17] Klem, M.L., Wing, R.R., McGuire, M.T., Seagle, H.M., and Hill, J.O.  A descriptive study of individuals successful at long-term maintenance of substantial weight loss. American Journal of Clinical Nutrition, 66:239-246, 1997.

[18] Wing, R.R. and Hill, J.O. Successful weight loss maintenance. Annual Review of Nutrition, 21:323-341, 2001.

[19] Shick, S.M., Wing, R.R., Klem, M.L., McGuire, M.T., Hill, J.O., and Seagle, H.M. Persons successful at long-term weight loss and maintenance continue to consume a low calorie, low fat diet. Journal of the American Dietetic Association, 98:408-413, 1998.

[20] McGuire, M.T., Wing, R.R., Klem, M.L., Seagle, H.M., and Hill, J.O. Long-term maintenance of weight loss: Do people who lose weight through various weight loss methods use different behaviors to maintain their weight? International Journal of Obesity, 22:572-577, 1998.

[21] Klem, M.L., Wing, R.R., Chang, C.H., Lang, W., McGuire, M.T., Sugerman, H.J., Hutchison, S.L., Makovich, A.L., and Hill, J.O. A case-control study of successful maintenance of a substantial weight loss: Individuals who lost weight through surgery versus those who lost weight through non-surgical means. International Journal of Obesity, 24:573-579, 2000.

[22] Klem, M.L., Wing, R.R., Lang, W., McGuire, M.T., and Hill, J.O. Does weight loss maintenance become easier over time? Obesity Research, 8:438-444, 2000.

[23] Ogden, L.G., Stroebele, N., Wyatt, H.R., Catenacci, V.A., Peters, J.C., Stuht, J., Wing, R.R., and Hill, J.O. Cluster analysis of the National Weight Control Registry to identify distinct subgroups maintaining successful weight loss. Obesity, 20(10):2039-2047, 2012.

[24] Wright J.D., Wang, C.Y., Kennedy-Stephenson, J., Ervin, R.B. Dietary intake of ten key nutrients for public health, United States: 1999-2000. Advance Data From Vital and Health Statistics, 334:1-4, 2003.

[25] U.S. Department of Agriculture, Agricultural Research Service. Energy intakes: percentages of energy from protein, carbohydrate, fat, and alcohol, by gender and age. What We Eat in America, NHANES 2015-2016, 2018.

[26] Wing, R.R. and Hill, J.O. Successful weight loss maintenance. Annual Review of Nutrition, 21:323-341, 2001.

[27] Thomas, J.G. and Wing, R.R. Maintenance of long-term weight loss. Medicine & Health Rhode Island, 92(2):56-57, 2009.

[28] Catenacci, V.A., Pan, Z., Thomas, J.G., Ogden, L.G., Roberts, S.A., Wyatt, H.R., Wing, R.R., and Hill, J.O. Low/no calorie sweetened beverage consumption in the National Weight Control Registry. Obesity, 22(10):2244-2251, 2014.

[29] Phelan, S., Wing, R.R., Raynor, H.A., Dibello, J., Nedeau, K., and Peng, W. Holiday weight management by successful weight losers and normal weight individuals. Journal of Consulting and Clinical Psychology, 76(3):442-448, 2008.

joint-replacement

Proprioception Training: An integral aspect of joint replacement fitness

/6 December 2023/ All MFN blog/

Proprioception refers to the conscious and unconscious perception of postural balance, muscles sense, and joint position and stability. Basically, it is your sense of where you are in time and space for movement. We have found over the years that the best way to explain proprioception to clients comes from Dr. Eric Cobb at Z-Health Performance Solutions:

“Proprioception is the body’s 3D map of itself in time and space. AKA our movement and awareness map”.

The detail and definition of this “proprioceptive map” comes from several specialized mechanoreceptors (i.e. nerve endings) in the muscles, tendons, joint capsules, fascia, and skin. As fitness trainers as we are usually taught about muscle spindles and Golgi tendon organs when we learn about flexibility training, but there is a lot more to proprioceptive input. You are affecting the proprioceptive input to the brain when you use a neoprene knee sleeve (pressure), kinesiology tape (skin stretch), heat or ice packs (temperature), TENS units (electric), etc. 

Why understanding and training proprioception is important for joint replacement clients

Several conditions can alter proprioception, thus “clouding” the map and degrading movement sense and capability, including pain, trauma, effusion, and fatigue. A joint replacement client also likely had poor motor control of the joint in the first place that resulted in compensatory movement patterns and overuse injury over time. Complicating the matter further, although it may have been necessary, the surgery itself is an “insult” to the musculoskeletal and nervous systems.

To move a joint well, you must be able to feel the joint and surrounding tissue well. An extreme example of what can happen without the sense of touch or joint position is the story of Ian Waterman. A rare neurological illness resulted in his losing all touch and joint position sensation, effectively paralyzing him from the neck down even though the motor control area of his brain and the descending pathways to send movement information to his musculature were fine!

Varied stimulus drives improved mapping

We can improve proprioception in several ways:

  • Reduce causes of proprioceptive “inhibition” (i.e., pain, fatigue, and effusion) – Therefore we need to only move in pain-free ranges of motion, and build muscular endurance.
  • Augment sensory information – We can do this by providing novel sensory stimulus to the affected area such as vibration, kinesiology taping, skin stimulation, pressure, or temperature. 
  • Weight Bearing Exercise Therapy – Loading, appropriately and progressively, compound movements.
  • Motor Skills Training – Exercises to target accurate movement such as multi-directional movements based on visual stimulus.

The important take away is that building a “library” of prior movement patterns is especially important for the post-medical joint replacement client. We want to get their new joint moving in multiple directions, at multiple speeds, under multiple loads.

The concept of proprioception and how to harness it is not only for joint replacement, but also for general fitness, performance, and pain clients! Begin learning a neuro-centric approach to medical fitness and how to work with joint replacement clients with our Joint Replacement Fitness Specialist online course, available through the MedFit Classroom!

Pat Marques is a Z-Health Master Trainer and NSCA-CPT specializing in training the nervous system to improve performance and get out of pain.  After retiring from the Active Duty Army, Pat pursued his education and certifications in exercise science, initially working with wounded, ill, and injured soldiers. During this time that Pat discovered the power of using a neurological approach to training to get out of pain and improve fitness and performance. He currently provides exercise therapy, movement reeducation, and strength and conditioning for all levels of clients at NeuroAthlete, from chronic pain sufferers to Olympic-level and professional athletes.

References:

  1. Lephart, SM and Fu, FH. (2000). Proprioception and Neuromuscular Control in Joint Stability. Champaign, IL: Human Kinetics.
  2. Roijezon, U., Clark, N., and Treleaven, J. (2015). Proprioception in musculoskeletal rehabilitation. Part 1: Basic science and principles of assessment and clinical interventions. Massage Therapy (20).
  3. Cole, J. and Waterman, I. (1995). Pride and the Daily Marathon. MIT Press.
  4. Roijezon, U., Clark, N., and Treleaven, J. (2015). Proprioception in musculoskeletal rehabilitation. Part 1: Basic science and principles of assessment and clinical interventions. Massage Therapy (20).
Nutritional label

The Truth About Macro Counting

/22 November 2023/ All MFN blog/

“I’m so fed up with my weight!”
“I am so uncomfortable in my clothes.”
“My fat clothes are beginning to be too tight!”

If you can relate to any of these statements, are you among the millions of people who have tried counting macros to get yourself back “on track?”

female-trainer-senior-client-exercise-ball

Become a Movement Detective!

/17 November 2023/ All MFN blog/

Often clients have nagging pains and aches that do not seem to go away. Pain inhibits seniors from doing more. And they WANT to do more.  You need to find out what is causing pain. You might need a team of referral partners. You might figure it out yourself. You start by becoming a Movement Detective !

Analyzing your clients’ daily patterns and repetitive activities as well as how they spend their “down” time will give you many CLUES into what might be causing the aches and pains of daily living. A careful detective asks the best probing questions in a conversational manner. There once was a 70’s TV detective named Columbo. He was always asking questions to get to the bottom of the crime. You need to get to the bottom of the crimes of poor movement and poor sedentary postures.  

Once you discover a few clues, then you can incorporate alternative patterns and postures that may be less irritating to the joints and safer for the client. Just because they are still climbing stairs and ladders does not mean they are doing it well. Sewing all day in a hunched over position is doing nothing to improve that chronic neck and shoulder pain. Plopping into car seat and grabbing the seat belt with too much force and rotation is not helping with their back pain. See where this is going?

A. WHAT to look for 

Ask your client to answer these questions. Give them a day or two to think about it. Write them down on an index card for them to carry around and be prompted to pay attention to their personal patterns.

Things you do the most often…

  1. Where do you sit? 
  2. Where do you stand and what do you do there?
  3. Where do you move around? What areas of the home?
  4. What tools do you use? Home. Garden. Hobbies.
  5. What do you pick up and put down? Pets. People. Stuff.
  6. What shoes do you wear? Home. Outdoors. Exercise.
  7. What kind of car do you drive?  SUV. Sedan.  Low/High.
  8. In what position do you like to sleep? Side. Back. Tummy.

B. HOW to set up the crime scene for examination. Clues are in the moves.

  1. Have your client demonstrate how they maneuver through their day inside and outside the house.  
  2. Have them demonstrate a few ADLS like picking up and putting things down.  
  3. How they work at a counter and desk.  
  4. How do they talk on the phone and work on their devices. 
  5. How and what do the like to keep clean? 
  6. Have them sit in their favorite chair and get cozy.

C. WHO to refer to if you spot a problem that you are not qualified to address.

Having a strong network of allied health professionals for your client to consider is a level of service most trainers are unable to provide.

Sometimes we notice things that are troublesome like seeing the client wince in pain when doing daily movement. This is when you ask about it and see if they would consider going to the doctor or physical therapist to determine if there is pathology to the pain or other discomforts such GI issues, headaches, etc. (Take detailed notes here. This will help the allied health professional if your client goes to them for diagnosis and treatment).

Important things to remember:

  • Refer not Defer!  
  • When in doubt… Refer Out!
  • Stay in Your Scope of Practice!

D. WHEN and WHERE to begin teaching the client new ways to do these everyday things.
BETTER and PAIN FREE.

Fit Pros: Guide Older Clients as a Geriatric Fitness and Lifestyle Specialist

Millions of people over age 65 looking for guidance from fitness professionals who are knowledgeable in exercise, nutrition and lifestyle principles that can help them improve functional mobility, while also preventing and managing chronic conditions to live their highest quality of life. The Geriatric Fitness and Lifestyle Specialist online certificate course will give you insights, strategies and tools to be a successful professional in this rapidly growing market. Learn how to be a valued part of clients’ continuum of care, working with the medical team to improve functional outcomes and positively impact people’s lives.

Holly H. Benson, BS, is a veteran in the Recreation and Fitness industries with over 35 years of administrative and technical experience. She holds two bachelor’s degrees, Corporate & Community Fitness and Recreation Administration, and numerous fitness certifications. She has developed thriving fitness programs for special populations and has passionately focused her career on the much older adult.  She currently owns and operates Moving Strong Medical Exercise, LLC in Lakewood, Colorado and provides in-home and virtual fitness training to older adults and persons with chronic medical and orthopedic conditions.

lunch-food

Food Shaming: Can We Please Stop It?

/13 November 2023/ All MFN blog/

Once upon a time, food used to be one of life’s pleasures and athletes would eat with gusto. Today, food has become a source of anxiety—Will it ruin my health? Make me fat? Hurt my performance? Food has also become a source of shame—I shouldn’t have eaten so much. I eat well during the day but I’m so bad at night. I’m afraid I’ll eat too much pie at Thanksgiving.

A survey of Gen Z-ers (ages 11-26; born between 1997 and 2012) indicates 60% feel pressure to eat in a way that shows others they eat “healthy.” These student athletes and recent grads —many of whom are fitness exercisers and athletes—feel pressure from social media, if not from their parents, peers, and teammates, to choose a perfect diet (i.e., no chips, cookies, burgers, etc.). And then the binge-eating and sneak-eating happens: shame, guilt, embarrassment.

fruit, avocado, chia seed, bread

At the 2023 Food & Nutrition Conference & Exposition (FNCE) of the Academy of Nutrition and Dietetics (the nation’s largest group of nutrition professionals), food shaming was a hot topic. (This topic that is near and dear to the hearts of most registered dietitians (RDs), given “everyone” seems to scrutinize what we eat. Ha!) Food shaming happens not just among athletes at team meals, but also at family dinners, school lunches, and office coffee breaks. Maybe you, too, have experienced shame-producing food situations where you felt like you did something wrong because you ate, let’s say, a sandwich (tsk, tsk) at a team meal, while your teammates ate lettuce leaves?

Athletes can easily end up feeling awkward, inadequate, and embarrassed about their food choices. As one runner shared, “After visiting xxx college for a weekend, I decided against going there because the women on the track team nibbled on only dry salads with grilled chicken for lunch and dinner. I felt very awkward as I refueled my tired muscles with a plateful of pasta with meat balls.”

Unfortunately, in today’s world, we live with a lot of morality around food. Morality can easily spoil one’s peaceful relationship with food. Athletes who have been food-shamed start to focus on eating only (society-defined) “good” foods and eliminate the “bad.” Consequences of being food shamed include feeling bad about themselves, a desire to eat alone, and increased self-criticism of perceived body flaws. (“No wonder I’m so fat. I should eat better…) The more shame athletes feel about their food choices, the more likely they are to restrict what they eat and cut out “white” foods, fast foods, and all fun foods. This can become a slippery slope into disordered eating, if not an outright eating disorder.

While many athletes might wish they could “just eat normally”, they often hold too much shame to seek guidance from the healthcare professional who could help them: a registered dietitian (RD) who is board-certified in sports dietetics (CSSD). If they feel guilty, anxious, and vulnerable regarding their food intake, they’ll fear being judged. “I would feel too embarrassed to honestly tell a dietitian about what I eat…” If that holds true for you, rest assured, a professional RD will not make hurtful or judge-y, guilt-inducing remarks. (Most RDs have been food shamed themselves for enjoying fun foods, tsk-tsk, like Thanksgiving pies and holiday cookies. They understand how uncomfortable it can feel.)

Food-shamed athletes prefer to eat alone, deprive themselves of their “unhealthy” foods—and end up shamefully over-eating them at a time of weakness. According to FNCE speaker Tammy Beasley RD, shame thrives in secret, lonely places of over-indulgence. The RD’s job is to transform that shame into self-compassion and self-kindness; to let athletes know they are not alone; they are not the only humans who have devoured a pint of ice cream in one sitting.

Solutions

To derail the cycle of food shaming, we need to abandon food morality. Food is fuel; it is not good or bad and what you eat does not determine if you are good or bad. Your goal is enjoy a balanced intake of a variety of nutrient-dense foods with some fun foods included. Please stop scrutinizing and “perfecting” your food intake. Instead, focus on fueling for optimal performance. Trust that eating bread and pasta will not result in your body exploding into obesity, but rather will fuel your muscles and enhance your athletic ability. A cookie or two will not ruin your health forever.

Social media is the number one instigator of food shaming. Given almost all of us use social media, and 57% use it more than 5 hours a week, we can see how food shaming can spiral out of control. Instagram photos with “healthy foods” can easily make anyone feel bad about choosing “imperfect” foods with less nutrient density. Hence, a good place to stop food shaming is at the source: limit the time you spend scrolling through endless triggering posts—and stop following triggering influencers.

Moving Forward

Three tips to help transform your “shameful” eating into pleasurable fueling include:

• Let go of being a perfectionist and enjoy being human, like the rest of us. Stop trying to eat a “perfect diet.” An excellent diet will do the job. The goal is 85-90% quality-calories and 10-15% “whatever”, such as an apple some days, and apple pie on other days.

• An excellent sports diet can include some “evil” sugar. No need to avoid all sweets and treats! The US Dietary Guidelines allow for 10% of total calories to come from added sugar. That’s 240 to 300 calories (60-75 grams) of added sugar per day for most athletes, if desired. That’s the amount of sugar in 3 gels, 36 ounces of sport drink, or 24 gummi bears. Sugar in any form helps (re)fuel muscles during and after a hard workout.

• Enjoy a satisfying breakfast and lunch. Stop eating when your body feels content, not just when the food is gone, you think you should, or you’re feeling ashamed because you are eating more than your peers. Adequate daytime meals can curb afternoon and evening (shame-inducing) binges.

• Finally, bring fun back into your food-style. Yes, please shamelessly enjoy fun foods like Thanksgiving pie and Grandma’s special holiday cookies, keeping balance and moderation in mind.

Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for info.

Caregiver-and-Senior-Woman

Caregivers: The Often Overlooked Gold Mine in the Senior Market

/6 November 2023/ All MFN blog/

Caregivers… what does that mean? Obviously, it means someone who takes care of others. In this case, seniors 65 and older. Now you might say that 65 is a very young age to need caregiving, but not if you have a chronic condition like Parkinson’s, COPD, Multiple Sclerosis, even Type II Diabetes. What happens when these seniors suddenly can’t navigate through their life like they used to and even simple things like getting to the doctor and grocery shopping become extremely difficult to manage? They find they need a break after doing these simple tasks. At this point, they either have their adult children take on these tasks or hire someone to do them. These people — the Caregivers — are a huge untapped market for medical fitness professionals to provide our valuable services.  

Do you have connections to this market? They tend to be overlooked as they are not the end-user of our services.  Yet, they hold the key to introducing us to pre-qualified clients. There is a huge trust already established between these caregivers and their relatives or employers. The client values and relies on their recommendations, therefore, it is very advantageous to cultivate a presence in their world.  

As with all targeted marketing, where do they hang out and what are their needs? Did you know there are entire associations geared specifically toward caregivers with a subcategory of the adult children, or “parents taking care of parents”? If you didn’t, you need to. It is where the goldmine begins, and the subcategory of caregivers we are going to focus on.  I have been a caregiver with both of my parents and with numerous clients I’ve worked with. When you tap into this market, you find yourself becoming a caregiver as well. If you are great at establishing trust, you too become a trusted resource for referrals. This is a compelling reason to develop a network of preferred medical practitioners that hold similar values and approach towards care. 

From the biopsychosocial aspect of where these caregivers are, they are stressed out from providing care for both their parents and their own children as well. Their parents will fall under the category of Condition Impacted Dependent© to Extensively Dependent and Frail©, meaning they need assistance or improvement with their IADLs (Instrumental Activities of Daily Living). The caregiver demographic will be working a full-time job and juggling their own children, they have very full plates. They literally will not have the energy or time to research and find a qualified professional who can provide in-home medical exercise services designed to make their lives easier. They will welcome any respite in managing their parents’ condition; improving function is added frosting on the cake. 

When it comes to getting noticed, start with your message.

  • Preventing further decline – how valuable do you think that is to stressed-out caregivers? 
  • Increasing their parents’ ability to function more independently can prevent further decline, allowing them to take on more of their own IADLs and in the process keep their cognition. 
  • The capacity to bounce back after setbacks is instrumental to all the people involved. 
  • The biggest take-home is that it will reduce the caregiver’s anxiety of having to care for their parent.
  • Have your materials ready to educate people on what medical exercise is and specifically what the benefits are to the caregiver and the client’s lives.

Marketing Plan

  • Research groups that support caregivers, specifically adult children of seniors (see resources)
  • Offer presentations on how-to’s.  Build fall resilience, improve strength for grocery shopping, resources on balance training, presentation on 10 best exercises seniors can do for function. Make sure you have these ready to go, it will save a lot of stress later. 
  • Have a PDF ready of your services and costs. The caregiver might be tech-savvy, but they will need to have something easily accessible to show to their parents
  • Hone your empathic listening. When a potential caregiver calls you up, listen. A lot of times this technique will put you above the competition. Seniors love to chat, it is how they make connections and establish trust. I know that if a trainer is constantly interrupting me or seems to have divided attention when talking to me, they are certainly not going to be listening to my rambling parent/client. 
  • Network within your community. Join a local chamber of commerce, look up villages and volunteer your time. 

This is just the tip of the iceberg, we haven’t even covered other categories of caregivers, CNAs, housekeepers, assisting hands companies, etc. That and more is covered in-depth in the Geriatric Fitness and Lifestyle Specialist online course, available through MedFit Classroom.  

Sharon Bourke has been involved in the health and fitness industry for more than 28+ years presenting, teaching and coaching in fitness clubs and private studios throughout the Washington metropolitan area. She holds certifications in Medical Exercise Specialist, Personal Training Pre-Postnatal fitness, Fitness for Arthritis, and Multiple Sclerosis. Sharon founded the Life Energy Foundation,to utilize her extensive experience and network to create exercise and behavior modification programs and resources to help people avoid becoming immobilized from their chronic conditions.