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Top Ten Things a Personal Trainer Should Know About Working with Eating Disorders

Eating Disorders Resource Catalog/11 June 2018/ All MFN blog/

Having worked as a certified personal trainer and strength and conditioning specialist early in my career, and now as a certified specialist in sport dietetics who specializes in treating clients with eating disorders who are often over-exercising, I feel it is critical for trainers to have some training about how to deal with their clients with these issues because you will be seeing these clients. Given eating disorders can present as over-exercise and under-fueling, a personal trainer is in a position to be the first identifier of these issues and can be a key player on an eating disorders treatment team. I often utilize personal trainers to help these clients develop exercise limits, boundaries, or assist with reiterating the “fueling and hydrating” messages the dietitian may be providing the client. I have helped in developing a new tool available to those who work in the fitness and coaching field called Running on Empty,an online eating disorders awareness and prevention program for coaches and exercise professionals, through a non-profit eating disorders outreach and prevention organization, Eating Disorders Information Network. I have also invited one of our recovery speakers to share her tips in this article. She is both an ACE certified personal trainer and a recovery speaker for EDIN. She, Kristy Wegert, shares her thoughts as a professional who currently treats clients who are on their recovery path.

A key reference on this topic is the new International Olympic Committee’s position statement on RED-S, Relative Energy Deficiency in Sport. Many of us will work with people with sub-diagnostic cases of eating disorders who may present with many of the negative energy balance physical issues discussed in this consensus statement. Working with an exercising population means helping this population stay in energy balance or eating appropriately to fuel for the level of activity in which they are engaging without harming the body because of lack of energy for basic body systems to function. All body systems are affected when limiting the body to too little energy to function fully, including the systems visually represented below. It is the job of the eating disorders treatment team, including the exercise professionals, to be aware of this set of possible consequences and treat/refer to treatment accordingly.

A sport dietitian’s top 5 tips for working with the exercising client with an eating disorder:

1. Keep your client in energy balance by reminding them about appropriate fueling, recovery, and hydration. Complex carbs rule before exercise. Encourage your clients to fuel on these before they train vs. training on empty. Common “on the go” examples of this can be as simple as a slice of toast or a higher carbohydrate energy bar. Encourage your client to drink hydrating fluids and even an electrolyte beverage during their training session with you. Also, most active clients need to drink 4 oz. of fluids every 15 minutes. Encourage your client to take these breaks. Encourage your clients to have a protein recovery choice within 15-45 minutes after they finish their workout. This could be a glass of chocolate milk or a smoothie with protein.

2. Encourage and educate your clients with a non-diet mentality. This means “All Foods Fit” and that there are “No Bad Foods.” All foods have some energy value and can fit into our performance plan. In fact, when we exercise, we have need to eat more energy. If we adapt the mentality that all foods fit, then we will have less chance of sabotaging ourselves with exercise or restriction. Check out the references Moving Away from Diets by King, Katrina, and Hayes and Intuitive Eating by Tribole and Resch for more on this way of working with clients.

3. Be aware of different types of eating disorders or disordered eating that may present to you. An individual with Binge Eating Disorder may be a common client seeking a trainer’s help for weight loss. Be sensitive to this type of client’s energy needs, orthopedic limitations, and potential resistance to traditional exercise and Health at Any Size®.

4. If you must take any anthropometrics, make sure you discuss amongst the team who is the best person to take those measurements.Often the dietitian is the best fit on the team to do this, to discuss these results, and to comment on realistic body weight ranges and appropriate food intake to fuel activity with a sport nutrition approach in a way that is focused away from calories.

5. Set reasonable boundaries on movement to include at least 2 rest days per week; sessions not exceeding 1 hour in duration; alternate cardio and strengthening to not over-exercise; consider cross training or varying types of activities to lower risk of over-training (such as outside, non-gym activities like road biking, climbing, kayaking, etc.); encourage gentle and restorative activities during the week as well, like yoga, barre, and Pilates; support varying types of classes (dance, kickboxing, karate, etc.) that have appropriate warm-ups and cool downs and are led by a certified instructor; and lastly, exercise with others who have reasonable exercise boundaries to give one appropriate containment and normal exercise boundaries.

A personal trainer’s top 5 tips in working with an exercising client with an eating disorder:

1. Exercise will bring up past trauma in the body. It can get emotional. Be prepared for some distress and perhaps, some crying. Hence, it is important to consult with the treatment team so you are prepared and can offer the appropriate type of support.

2. Don’t assume that a small person is weak; that a larger person cannot move or has never worked out; that someone in a larger or smaller body doesn’t purge. Bottom line…never assume. Check out the Health at Any Size® movement to learn more about this mindset.

3. Offer privacy when possible. Many people in early recovery feel awkward in their own bodies. Try to help them feel as comfortable as they can during a workout. This may mean taking them out of the traditional exercise environment and away from mirrors, or going outside.

4. Get written permission to speak with therapists, doctors, dietitians, sponsors, partners, and parents. People who are in recovery from anorexia, bulimia, binge eating disorder, and OSFED need well-defined, appropriate boundaries and you may need help from the treatment team in determining this. People who are in recovery need a team to help them.

5. Fitness is about function, healthy lifestyle, and feeling good. No matter what the client asks for, focus away from aesthetics. Have fun! Exercise should be a good time for your clients. Help them have a positive experience!

This article was co-written by Page Love, Vice President of the Board for Eating Disorders Information Network (EDIN) and Kristy Wegert, recovery speaker for EDIN. Originally printed on ED Resource Catalog. Reprinted with permission.

Page Love is a registered dietitian, certified specialist in sport dietetics and nutrition therapist, and runs a thriving private practice specializing in eating disorders nutrition therapy, sports nutrition, and weight management nutrition counseling in Atlanta, Ga. She served as a clinical dietitian for Atlanta Center for Eating Disorders for 20 years and has run ANAD groups in Atlanta for 25 years, and has served as a consultant to The Renfrew Center and Veritas Collaborative. She has developed materials for the NEDA, Renfrew Center, and EDIN and has been published in the Renfrew Perspectives, International Journal of Sport Nutrition, and International Journal of Sport Science for Tennis Medicine. She currently serves as the Vice-President of the board for EDIN, Eating Disorders Information Network. She also serves as a consultant for the International Women’s Professional Tennis Tour (WTA) and the Men’s Tour, Association for Tennis Professionals (ATP), the Atlanta Ballet, The Atlanta Falcons Cheerleaders, and formerly with the Atlanta Braves. She has recently co-authored Running on Empty, an online education program for the exercise professional working with eating disorders through Eating Disorders Information Network, a non-profit for the prevention and outreach for eating disorders in Atlanta, Ga.

At 40 years old, Kristy Wegert made some decisions that caused a mid-life career change. She decided after some much needed deep thought, that she was meant for the fitness industry. She holds an ACE Personal Trainer Certification. While she was studying for the ACE exam, she decided to get herself into the industry. There was just no point in waiting (and she was too excited!) so she became a certified Cycle Instructor. (A little back story: Kristy lost 100 pounds after being heavy most of her life and has kept off that weight since 2008). Kristy loves to exercise and loves being an inspiration to others. Her current passion is to help others in a safe, fun way and watch them transform. Her company, My Workout Buddy, embodies everything she feels is important in the fitness industry…rigorous yet fun physical activity, a well balanced lifestyle, and the safety of a properly educated personal trainer at your side.

References

The IOC consensus statement: beyond the Female Athlete Triad

bjsm.bmj.com › Archive › Volume 48, Issue 7

Running on Empty; A online eating disorders awareness and prevention program for coaches and exercise professionals, Love and Gunter, myedin.org http://www.myedin.org/athletes.html

Moving Away from Diets Hayes, Katrina, and King

Health at Any Size Bacon

Intuitive Eating Tribole and Resch

Sports, Cardiovascular, and Wellness Nutrition dietetics practice group of the Academy of Nutrition and Dietetics Practice Manual: https://www.scandpg.org/e-learning-and-events/a-practice-manual-for-professionals/

American Council on Exercise Podcast on Why We Eat: https://www.acefitness.org/health/resources.aspx

Squats: Five Things to Consider

Dominick Nusdeu/8 June 2018/ All MFN blog/

The fitness community has some how deemed the squat the king of all exercises. “They” say it’s great for your glutes (Butt), Quads, hamstrings, total body challenge, it’s “functional” weight loss, etc. The list goes on. I’m not saying there isn’t some truth to all those things in the right context. They just aren’t absolute truths like some magazines or trainers may claim. Here’s a list of 5 things to consider when squatting or even deciding if a squat is an appropriate exercise for you.

1. What’s Your Goal?

What part of your body are you trying or wanting to work? If you have a specific target area you would like to address, your squat should match that goal. Not every squat is the same or works the same things, especially with each person having different limb lengths (Tibia, femur, & trunk). Picture this, if you squat down and your line of force is further away from your knee joint (Big Moment Arm), you’re mostly working your anterior knee muscles. Conversely, if you squat down and your line of force is further away from your hip joint (Big Moment Arm), you’re mostly working posterior hip/low back muscles. Neither are good or bad, right or wrong. It just depends on your goal.

2. Lever Lengths (Limb Lengths)

Your proportions play a role in how you’re going to squat. If your tibia (shin bone) is a lot shorter than your femur (leg bone), and your trunk (torso) is very long, your squat will look vastly different from a person who has equal length from there tibia, to there femur, and trunk. The goal of the body when it’s standing is not to fall. It’s about keeping your center of mass over your base of support. In order for that to happen, you’re going to have to modify the way you fold up in a squat to not fall over. While you do that, the forces at other joints are going to change, for example hips, knee, spine, etc… again, what’s your goal?

3. Resistance Profile/ Strength Profile

A squat has a very distinct profile. Relatively balanced at the top of the motion and very hard at the bottom. There are several ways to account for this. Many people think they have to do everything through a “full range of motion”, but you don’t. In a situation like this, you can simply use different loads (weights) at different points in the range of motion to match the profile. For example, at the top of the motion use a heavier weight where your strongest and go down a little bit. Then drop the weight and go down lower where you are weakest with the lighter load. This way you can challenge the full range of motion you have available without sacrificing the load. Your joints will thank you.

4. Holding Dumbbells/KettleBells vs. Bar on Back/Front

This is a topic that I don’t think is discussed a lot. If you’re holding a dumbbell/kettlebell while doing a squat, what do you think is going to give out first? Your ability to grip and hold the dumbbell/kettlebell or the tolerance of your whole lower body and spine? Again, it goes back to what’s your goal? If your goal is hypertrophy and/or strength in those muscles then using an appropriate load to challenge them is necessary. I’m not saying you can’t hold dumbbells or kettlenbells, I’m saying this is something to consider. If the bar is resting on your upper back or front, you don’t have to worry about holding it. You just have to balance it.

5. Available Active Range of Motion

Before you decide to squat, I would suggest checking all the motions of the squat and making sure you have those ranges available to you (Dorsiflexion, Hip Flexion, Knee Flexion, Spinal Flexion, Spinal Extension, Hip Extension, Knee extension, PlantarFlexion). If you see a difference relative to the other side, assuming there is no structural abnormalities, you may want to consider doing an isometric. You can use that as a warm-up. For the isometric, contract into the position of limitation for about five seconds at approximately 50% of effort. Repeat 3-5 times.

I hope these tips will help you, or at least make you think about some things that otherwise you may not have considered.

Dominick Nusdeu has been certified as a Personal Trainer for over 20 years. He holds the distinction of Muscle System Specialist, Resistance Training Specialist, ACE Orthopedic Exercise Specialist, as well formally being one of only 14 Instructors of Muscle Activation Techniques worldwide and was one of only 85 Master Level Muscle Activation Techniques Specialists in The World. Dominick has completed well over a 2000 hours of advanced coursework in biomechanics, exercise mechanics, neuroscience, anatomy, physiology, and muscle function. Dominick is a trainer to the trainers, teaching his highly successful course, “Decision Making 101: From the Table to the Floor.” He currently owns and operates MotionMechanix (MMX), Muscular System Optimization LLC, and MotionMechanix Academy, which was formed out of a need to give fitness enthusiasts and current exercise professionals quality, high level education backed my science, not what’s currently trendy or “cool”.

MS and Tai Chi

Matt Cavallo/5 June 2018/ All MFN blog/

It cannot be stressed enough how important it is to stay active with MS. Movement is the key, even if you are limited in doing so. Exercise has been shown to help with strength, mobility, fatigue and depression. Exercise also has can help develop a positive attitude and make you more likely to participate in group activities. These positive attributes of exercise can really help a patient overcome some of the isolating symptoms of MS.

As someone living with MS, I am always trying to find something new and interesting that may be beneficial to those of us living with the disease. In this installment, we will learn how an ancient art may provide therapeutic healing to those of us living with MS today.

Tai chi, an ancient Chinese tradition that was originally a form of self-defense, has been transformed into a form of exercise that is considered good for people of all ages and fitness levels. Tai Chi is a series of slow movements combined with deep breathing.

Tai Chi is considered to be low impact, meaning that it does not put a lot of stress on the muscles. If you have MS and have tried yoga, but struggle to hold some of the poses, then you may want to try Tai Chi. Much like adaptive yoga, adaptive Tai Chi can be done either standing or sitting.

Tai Chi is thought to have many health benefits for people living with MS, including:

• Improved strength and balance
• Increased energy and mood
• Decreased stress, anxiety and depression

To get started in Tai Chi, it is recommended that you take a class. There are videos available, but working one-on-one with an instructor will give you a great head start. Instructors can also provide safe modifications for your ability level. If you start a Tai Chi class, meet with the instructor ahead of time. Let the instructor know of any physical limitations that you may have with MS, like balance issues.

If your instructor learns your limitations, they will ensure that they teach you a routine that is safe, yet gives you the benefit of the workout. Then, over time, you may feel yourself becoming stronger and be able to take on more of a routine with less modifications.

If you have MS and have struggled in other forms of exercise, it may be time to try Tai Chi. The health benefits associated with the ancient form of low-impact movements can help you with your battle against MS, but make sure that you let your instructor know of any limitations you may have. The key to winning the battle against MS is to stay moving which is exactly what the ancient art of Tai Chi can help you achieve.

Originally printed on MS Focus Magazine. Reprinted with permission from Matt Cavallo.

Matt Cavallo, MPH is a patient experience speaker, author, and podcaster who motivates audiences worldwide with his personal patient experience and genuine storytelling style. At age twenty-eight, Matt was diagnosed with Multiple Sclerosis. Seemingly overnight he went from a fully-functioning, healthy man to someone who was numb from the waist down and unable to walk. As a result of his diagnosis, Matt has dedicated his life to improving the patient experience. Matt is the founder of PatientActivation Network.

Personal trainer and her client with dumbbells

Metabolic Syndrome: A New Focus for Lifestyle Modification

Tammy Petersen/4 June 2018/ All MFN blog/

Personal trainers have the opportunity to do more than just help people they train become more active. We need to be prepared to also help our clients implement lifestyle behavior changes related to stress, family history of coronary heart disease, obesity, smoking, high blood pressure and high cholesterol.

A look at what is called metabolic syndrome will help you understand why, even though increasing physical activity levels is the overall best thing you can do for any client, there are additional ways to guide them to a healthier lifestyle. Sometimes you may be able to help them make the changes yourself; and, sometimes you will need to refer them to another health professional like a doctor or dietitian for guidance. Either way, knowing how to help them or when to direct them to someone who is more knowledgeable than you is important. So, first let’s become familiar with the syndrome and the clinical criteria that the doctor uses to diagnose it. Your goal is then to help your clients understand and make the necessary changes so that they don’t progress to cardiovascular disease and the almost certain heart attack heart that will be the end result.

Cardiovascular disease is still the number one cause of morbidity and mortality in the United States and much of this burden of disease can be linked to poor nutrition and a dramatic increase in sedentary lifestyles, leading to overweight and obesity. This increase in weight leads to an increase in the incidence of type 2 diabetes, and blood pressure and cholesterol problems, which are all well-established cardiovascular disease risk factors. The National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III has updated the recommendations for the evaluation and management of adults dealing with high cholesterol, renewing its emphasis on the importance of lifestyle modifications for improving cardiovascular risk. The NCEP has coined the term “therapeutic lifestyle changes” (TLC) to reinforce both dietary intake and physical activity as crucial components of weight control and cardiovascular risk management.

As well as focusing attention on the LDL cholesterol (also called bad cholesterol) levels, the NCEP also identified metabolic syndrome as a secondary target of therapy. Metabolic syndrome (also called insulin resistance syndrome and syndrome X) is characterized by decreased tissue sensitivity to the action of insulin (pre-diabetes), resulting in a compensatory increase in insulin secretion. This metabolic disorder predisposes individuals to a cluster of abnormalities that can lead to such problems as type 2 diabetes, coronary heart disease and stroke. The prevalence of the syndrome has increased 61% in the last decade. It is crucial for medical professionals to identify patients at risk and follow these patients closely and counsel them about making lifestyle changes to lower the risk of type 2 diabetes and cardiovascular disease.

GUIDELINE: According to the NCEP, the criteria for metabolic syndrome includes at least 3 of the following 5 clinical factors

Risk factor	Defining level
Abdominal obesity Men Women	Waist circumference >40 in (>102 cm) >35 in (>88 cm)
Fasting triglyceride level	>150 mg/dL
HDL cholesterol level Men Women	<40 mg/dL <50 mg/dL
BP	>130/>85 mm Hg or taking antihypertensive medication
Fasting glucose level	>100 mg/dL or diabetes

Source: Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda, Md: National Institutes of Health; 2001. NIH publication 01-3670.

Millions of Americans at risk for metabolic syndrome can sharply lower their chances of getting this disease by adopting a healthy lifestyle (stop smoking, low-fat diet, weight loss/maintenance and increased physical activity). Without diet and exercise modifications, most patients will eventually fail and progress to type 2 diabetes within a decade and experience a heart attack about 10 years later. Experts recommend a diet reduced in saturated fats (<7%), low in cholesterol (<200 mg/day), high in fiber (20-30gm/day) and reduced in simple sugars. Weight loss of only 5-7% (less than 15 pounds) can make a big difference in health markers like cholesterol and blood pressure. A program that includes daily exercise reaching 85% of heart rate for age is reported to be of benefit too. However, any exercise is better than none, and a target of 30 minutes every other day is a reasonable level for most people.

As a fitness professional reading this, hopefully you are not asking yourself “so what?” but are instead seeing an opportunity to educate and motivate your current clients and to use your knowledge to help attract future clients. The medical community is good at diagnosing this syndrome, but not necessarily equipped to provide patients with the tools to be successful with the lifestyle changes they recommend. There exists a wonderful opportunity to build a partnership with physicians in your area. Most physicians will gladly refer patients to you for help with the all-important exercise and nutrition portion of the treatment program. In many cases, you have more knowledge in this area than the physician who has been trained in tertiary, not preventative, (i.e. most MD’s know very little about diet and exercise since this is not a focus in medical school) medicine. Often times all that you will need to get a referral is for the doctor to be aware of your existence and to give them an easy way to get the patient to you. A short introduction letter outlining your qualifications and showing your desire to help people make lifestyle changes is a good start. A personal visit to your primary care doctor and others in your area is even better. But, be prepared to take up just a few minutes of their time to introduce yourself, your idea, and leave your letter and cards.

Tammy Petersen, MSE, is the Founder and Managing Partner for the American Academy of Health and Fitness (AAHF). She’s written a book on older adult fitness and designed corresponding training programs. SrFit Mature Adult Specialty Certification is used nationwide as the textbook for a college based course for personal trainers who wish to work with mature adults. SrFit is also the basis for a specialty certification home study course that qualifies for up to 22 hours of continuing education credit with the major personal trainer certification organizations.

References

Centers for Disease Control and Prevention. Early release of selected estimates based on data from the January-June 2003 National Health Interview Survey. URL: cdc.gov/nchs/about/major/nhis/released200312.htm.
Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2016 https://www.cdc.gov/nchs/nhis/SHS/tables.htm 16 Apr. 2018.
Centers for Disease Control and Prevention. Prevalence of health care providers asking older adults about their physical activity levels—United States, 1998. Morbidity and Mortality Weekly Report. 51(19):412-4, 2002.
Huang, Paul L. “A Comprehensive Definition for Metabolic Syndrome.” Disease Models & Mechanisms5-6 (2009): 231–237. PMC. Web. 16 Apr. 2018.

3 Keys to Healthy Aging

Nicholas Prukop/1 June 2018/ All MFN blog/

No one really knows why we age other than to acknowledge that as our cells die and don’t get replaced, organs – and ultimately our bodies – do indeed die. The role that disease plays in this process is obvious – especially if there is no successful treatment available that can address the underlying causes of the problem. I believe in the “art of prevention” as a strategy for helping not only extend our lives – but also improving the quality of the time we have to live.

I did not come to this understanding in my early years because when we are young we assume we will “live forever”. It is only as we grow older and have to face the challenges of aging that we begin to appreciate the beauty and mystery of our own bodies – and what we “could” have done better along the way.

I decided that based upon my own experiences over the past 7 plus decades of life that we ARE in control of much of the aging process as we currently know it. I could assign a number to it (i.e. 80, 90%) but I would most likely be wrong. I will therefore ask instead what if we could control the “majority” of the outcomes we might face, then how would WE choose – and act – today to prevent problems in the future? When we REACT rather than RESPOND to life’s “urgings” we are always going to be “behind the curve” and face unintended consequences.

There are people who live to be hundred or more and then there are those of us who “die before their time”. How do we distinguish between being “lucky” and making good choices and does making thoughtful choices always work? I believe it does and this is why I thought I would share with you what I consider to be the three most important keys to healthy aging as I have lived them.

BEING PHYSICALLY ACTIVE

From a purely practical standpoint this key is what I would call a “no-brainer”. I started life on Maui in the mid 1940’s (1946) and was introduced to swimming before I could even walk. I remember a man holding me by the stomach in a half empty pool teaching me to kick my legs and paddle my arms. That man became my future swim coach and his name was Mack Nakano – a former champion himself. He shared his passion and love for swimming that animated his own life and I have carried that love and passion for physical activity within me ever since those wonderful days of my boyhood on Maui.

As I grew and I moved on from swimming to other sports (because of circumstances beyond my control), I found I had formed a love for all forms of physical activity. I discovered other ways to enjoy being active when I was no longer competing and that main form of activity became running. As I adjusted to life on the mainland at Syracuse University in 1964, I began a running campaign that has stayed with me to the present day. I can’t imagine letting even one day go by without stressing my body in some form and even when I was injured as I was last year, I still found ways to train and remain active. This idea is a part of WHO I AM.

I have run over 65,000 miles in the more than half a century I have been a runner. I believe my commitment to being fit has saved my life many times over during my lifetime – even in the darkest of times when I felt lost and without hope. My question to you is: What is your passion when it comes to being physically active and will you honor that passion the way I did with my running program? If you don’t have one – then find one! Being physically fit does NOT guarantee a healthy body but a healthy body does require a FIT body. I am hopeful my “luck” continues into the years ahead. I will do everything in my power to insure that it does!

BECOMING A “CRITICAL THINKER”

This is my second choice for a key to healthy aging because the key to life IS thinking and the corresponding choices that we make leading to the actions that we take as a result. ALL thought is powerful but it is in HOW we CHOOSE to use these “power houses” of life that makes all the difference. With the fast paced changes that are occurring in all facets of life today, it is becoming increasingly difficult to know “what to think”. I say that becoming “aware of our thoughts” is a key to healthy aging because they lead us to our potential choices and it is through our choosing that we can enhance our circumstances – or cause them to do us great harm.

An example of choice gone wrong would be the choice to smoke. We all know the dangers inherent in smoking – or taking drugs for that matter – but many of us do it anyway. My father started smoking during World War II as many service men and women did during that terrible conflict and as a result shortened their lives. My father died in November of 1983 at the age of 64 from cancer which had spread throughout his body but started in his lungs. I saw him the week before he died and it left an indelible impression on me. I was 37 at the time and I vowed to never go out like that. The past 35 years have been healthy ones for me because I cared about my future health and most importantly ACTED on that thought.

Deciding to become thoughtful and critically involved in our thoughts is an important part of the healthy aging process. Don’t “fall into” your choices – make them consciously and with the belief that you are doing what is right for you. People buy pills of all kinds sight unseen, and other potentially dangerous products online all the time “without thinking about the consequences” of their actions. I believe that we MUST “think before we leap”. It is the only sensible way to move forward in life and hopefully “cut the odds” in our favor so my advice is simple: Get in touch with your thoughts and act according to what they are allowing you to see and feel about yourself – and then choose wisely. This is the best any of us can do and it will insure WE are choosing our path in life – and not the other way around!

THE SPIRITUAL LIFE

I am not religious and have never found comfort – or peace for that matter – in any conventional religion but I have found that the spiritual path is available to all of us who seek a different way. I found this path in 1985 through a minister at the Church of Religious Science in Huntington Beach by the name of Peggy Bassett. She introduced me to the principles that would guide my life and choices going forward and that have sustained me to this day 33 years later.

I believe in “quiet time” for myself (meditation and affirmative prayer work – a form of prayer that affirms rather than asks for something). Every day presents me with a new opportunity to get “in touch” with my “inner self”, providing me with the opportunity to receive guidance – and even wisdom – that may give me clarity or a new understanding of some aspect of my life that may be causing me pain or any other challenge I need to address in the present. I will respond only when I can “see my way clear” to a solution and only then will I act on this wisdom or guidance.

The role of the spiritual journey is to bring an expanded consciousness – or awareness – into our life experiences and allow us to contact joy, peace, harmony and love in a way that enriches and sustains us while allowing us the opportunity to “let go” of the baggage of our pasts. Regret, guilt, unexpressed anger, hatred and other forms of negative inner turmoil CAN and DO lead us to an early death. The body responds to all forms of emotion and if these emotions – and thoughts – are not directed by US to a “higher consciousness” they will bring sickness and chronic illness in all their terrible manifestations into our lives.

I have never been in a hospital, had surgery, taken drugs or medication, or had any outside medical intervention that I can recall – ever. I believe that through the spiritual path that Peggy me gave all those years ago – coupled with my ongoing efforts to remain healthy and fit – I thrived and DO wake up each day grateful and hopeful. I am “lucky” but this luck came to me because I ACTED on my BEST instincts – and intentions – at the time I was making crucial choices in my life. What will your choice be when it comes to letting go of “preconceived notions” of what you “think” is true so that you can finally live in the REAL truth of who you are – and are becoming?

IN SUMMARY

I believe the world we live in today is “noisy”. There are too many voices and too little silence. I believe in being quiet and thinking and experiencing my life on more than just the superficial levels available in today’s world. I believe listening is becoming a lost art and that we are never going to “hear” anything of value arguing with another. Sometimes I feel as though I was not meant for this world and look back with fondness on the world as it was when I was a boy learning to swim and ultimately getting to know the me that I am today.

The keys to healthy aging are mine and mine alone. Whether others take what I have shared and “think about” them is for others to know. I believe that there is something greater and wiser than me that created me and is helping me to share what I have learned in my own unique way. This is my mission and this mission – or purpose – is always “on my mind”. I want it to be there constantly so that I may choose to support it in any way that I can in order to bring my life full circle from student to teacher – and back to student again.

What will you do with this information and how will your choices today affect your future? Only you will know but I will tell you that in “thoughtful living” we are ALWAYS rewarded by life with the best that it has to offer. Isn’t that worth your time and commitment? It is to me – and it is PRICELESS! Think about that!

Originally published on Healthy New Age. Reprinted with permission from Nicholas Prukop.

Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach, a fitness professional with over 25 years of experience whose passion for health and fitness comes from his boyhood in Hawaii where he grew up a swimmer on Maui. He found his calling in writing his first book “Healthy Aging & You: Your Journey to Becoming Happy, Healthy & Fit” and since then he has dedicated himself to empowering, inspiring and enabling people of all ages to reach for the best that is within them and become who they are meant to be – happy, healthy and fit – and be a part of a world where each person can contribute their own unique gifts to life.

If you need help in designing a fitness plan, you can contact Nicholas Prukop via email at runningnick@sbcglobal.net or read his inspiring book Healthy Aging & YOU.

Member Spotlight: Cheryl McLea, Personal Trainer in Newark, DE

MFN/29 May 2018/ All MFN blog/

Cheryl primarily trains women with autoimmune conditions. I have clients with all types of conditions, such as MS, Lyme disease, Hashimoto’s, Epstein Barr, breast cancer, chronic back pain, fibromyalgia, Polycystic Ovarian Syndrome, amongst others.

Four Sources of Stress & How to Beat Them

Christine Estrada/23 May 2018/ All MFN blog/

Stress is a normal physical response. Everyone feels stress. You may feel stress when you have too many errands to run, when you are given a promotion at work, or in your daily commute through Atlanta traffic!

During stressful times, your body responds physically by producing hormones to speed up your heart, make you breathe faster, and give you a big burst of energy. That physical reaction is called the “fight or flight” response.

Some stress is good and some stress is bad. But when stress happens too often, it can take a toll on your body. So that’s why I want to discuss where stress comes from and how you can effectively manage it.

Take a look around you. The environment in which you live can cause stress. Pollution causes stress and comes in the form of substances or energy — think trash or smog and noise or light pollution. Your environment also includes your family, home, neighbors, community, and geographic location. The people with whom you choose to surround yourself can either be uplifting and positive or upsetting and negative. Being isolated or overcrowded can also cause stress depending upon which situation you prefer.

Your diet may be causing you stress. The food that you eat either nourishes or starves your body. Do you eat mostly processed foods with chemical additives and empty calories? Doing so creates a toxic environment inside your body and allows you to become more susceptible to sickness and disease.

How much physical activity do you get? Science and medicine have proven that exercise negates the effects of bad stress on your body and in most cases it does so better than any prescription medicine. On the other hand, a lack of physical activity can make even small amounts of stress seem monumental.

Take an inventory of what you’re feeling right now. Are you worried, doubtful, fearful? Do you feel happy, confident, or at ease? Your attitude and how you choose to react to stress can either cause you more stress or help you release stress. Oftentimes people manufacture stress in their thoughts that then manifest themselves in their bodies and environment.

The good news is you have choices here. You can choose to take control of all of these factors in your life. Or you can choose to be a victim to stress and succumb to headaches, ulcers, back pain, sickness, disease, obesity, depression, unhealthy relationships…

Take a moment to look at these four areas of your life. Identify the stress points. Then allow yourself to decide whether you will take control of that stress or simply accept it.

Reprinted with permission from Christina Estrada. Originally printed on yourfamilylifestylecoach.com.

Christina Estrada is a lifestyle coach helping people discover their strengths and reset their mindset for a healthier, more fulfilling life. She is a holds multiple certifications with International Sports Sciences Association (ISSA), including Master Personal Trainer, and Specialist in Fitness Nutrition, Youth Fitness, and Senior Fitness.

Eating Junk Food Raises Cancer Risk, Even for Slim Women

Dr. Joel Fuhrman/21 May 2018/ All MFN blog/

Whether you are slim or obese, one thing is clear: calorie-dense processed foods increase cancer risk, regardless of body weight.

Researchers studied data from 92,000 postmenopausal women who took part in the Women’s Health Initiative, a 15-year study of health in postmenopausal women. They focused on the energy density of the women’s diets – “high energy” diets are synonymous with “high calorie” diets – and noted the number of calories per gram of the total diet.

The researchers made an unexpected finding: Women in the top fifth of energy density were 10 percent more likely to be diagnosed with an obesity-related cancer compared to the bottom fifth, and this relationship was found in women who were at a normal weight at baseline.² These cancers include colorectal, pancreatic, endometrial, ovarian, liver, kidney, gallbladder, and postmenopausal breast cancers.¹ This increase in risk was associated with the calorie density of the women’s diets.²

The results suggested: If you choose low-nutrient, energy-dense foods, it will affect your health even if it doesn’t affect your waistline. Just because you’re slim doesn’t mean junk food isn’t damaging your health.

Energy density vs. nutrient density

Dietary energy density in this study was defined as the number of calories per gram in a food of the entire diet. For the most part, typical high energy-dense foods, such as baked goods, French fries, burgers, pizza and desserts, are low in nutrient density (micronutrients per gram). High nutrient-dense foods, such as vegetables, fruits, and legumes, tend to be low in energy density.

Following a diet that is high in nutrient density and low in energy density is essential for good health. This is the origin of my health equation H = N/C (Health = Nutrients per Calorie). A high ratio of micronutrients to calories is the basis of a healthful diet.

How energy density might promote cancer

Obesity contributes to cancer in a variety of ways: for example, excess fat tissue causes a state of low-grade inflammation, promotes insulin resistance, and produces estrogen.^1,3-5 ⁶ However, calorie-rich junk food has effects – other than weight gain – that could contribute to cancer development:

Elevated insulin and IGF-1 levels: From high-glycemic processed foods and high animal protein foods, respectively. Excess of these pro-growth hormones is linked to an increased risk of several cancers.⁴
Oxidative stress and inflammation.⁷
Nutrient inadequacies:⁸ Many Americans do not meet recommended intakes of magnesium, calcium, vitamin C, vitamin E, and vitamin K.⁹
Lack of protective phytochemicals from natural plant foods (such as glucosinolates from cruciferous vegetables and lignans from flax and chia seeds).^10,11
Excess folic acid from fortified refined foods: Anyone in the U.S. who eats a typical diet (especially those who also take a conventional multivitamin) is exposed to excessive amounts of folic acid due to mandatory fortification of refined grain products. Although rates of neural tube defects have gone down, there are serious concerns about the potential cancer-promoting effects of exposing the whole population to synthetic folic acid daily in the food supply. ^12-15 (Read more: Folate Position Paper)

When you eat a diet with more micronutrients and fewer calories, you age more slowly, and also improve immune system protection against cancer. When you eat excess calories, especially excess calories that do not contain a significant micronutrient load, you accelerate aging and increase your risk of cancer. You can exercise off those extra calories, but they will still negatively affect your health. It is not enough to be at a healthy weight – you must actually eat healthfully to age more slowly, prevent cancer, and live a long healthy life.

Originally printed on DrFuhrman.com. Reprinted with permission from Dr. Fuhrman.

Dr. Fuhrman is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 6 NY Times bestselling books, including The End of Heart Disease. Visit him at DrFuhrman.com

References:

National Cancer Institute: Obesity and Cancer. In 2017 [https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet]
Thomson CA, Crane TE, Garcia DO, et al. Association between Dietary Energy Density and Obesity-Associated Cancer: Results from the Women’s Health Initiative. J Acad Nutr Diet 2017.
Coelho M, Oliveira T, Fernandes R. Biochemistry of adipose tissue: an endocrine organ. Arch Med Sci 2013, 9:191-200.
Cohen DH, LeRoith D. Obesity, type 2 diabetes, and cancer: the insulin and IGF connection. Endocr Relat Cancer 2012, 19:F27-45.
Kolb R, Sutterwala FS, Zhang W. Obesity and cancer: inflammation bridges the two. Curr Opin Pharmacol 2016, 29:77-89.
Cleary MP, Grossmann ME. Minireview: Obesity and breast cancer: the estrogen connection. Endocrinology 2009, 150:2537-2542.
Saha SK, Lee SB, Won J, et al. Correlation between Oxidative Stress, Nutrition, and Cancer Initiation. Int J Mol Sci 2017, 18.
Ames BN. Prevention of mutation, cancer, and other age-associated diseases by optimizing micronutrient intake. J Nucleic Acids 2010, 2010.
Fulgoni VL, 3rd, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr 2011, 141:1847-1854.
Stefanson AL, Bakovic M. Dietary regulation of Keap1/Nrf2/ARE pathway: focus on plant-derived compounds and trace minerals. Nutrients 2014, 6:3777-3801.
Shukla S, Meeran SM, Katiyar SK. Epigenetic regulation by selected dietary phytochemicals in cancer chemoprevention. Cancer Lett 2014, 355:9-17.
Smith AD, Kim YI, Refsum H. Is folic acid good for everyone? Am J Clin Nutr 2008, 87:517-533.
Figueiredo JC, Grau MV, Haile RW, et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst 2009, 101:432-435.
Kim YI. Will mandatory folic acid fortification prevent or promote cancer? Am J Clin Nutr 2004, 80:1123-1128.
Mason JB. Folate, cancer risk, and the Greek god, Proteus: a tale of two chameleons. Nutr Rev 2009, 67:206-212.

Delivering The Behavioral Side Of Lifestyle Medicine Through Wellness Coaching

Dr. Michael Arloski/18 May 2018/ All MFN blog/

If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” –Hippocrates 420 B.C – 370 B.C.

Healthcare providers have been prescribing lifestyle improvement for thousands of years. The evidence has been built from the observations of Hippocrates all the way to the neuroscience of today. We know, from mountainous reams of data, that lifestyle affects the course of an illness or health challenge. The challenge for the healthcare provider of today is to see the “lifestyle prescription” translated into lasting lifestyle change. Many well-intentioned healthcare professionals have attempted to educate and admonish their patients into losing weight, ceasing the use of tobacco, managing their stress better, getting more sleep, being medically compliant/adherent, etc. Seeing actual success in behavioral change happening far too seldom, many have abandoned such efforts and just reach for the pharmaceutical prescription pad.

In recent years, however, there has been an exciting movement in the field of medicine that looks at how to use “lifestyle interventions” as first-line treatment.

“Recent clinical research provides a strong evidential basis for the preferential use of lifestyle interventions as first-line therapy. This research is moving lifestyle from prevention only to include treatment–from an intervention used to prevent disease to an intervention used to treat disease.” –The American College Of Lifestyle Medicine

The Lifestyle Medicine Movement has done much to establish an evidence base and it continues to examine research that distinguishes what appears to work for lifestyle improvement. Much of its attention has focused on nutrition, but more and more the field is realizing the importance of health and lifestyle behavior.

Wellness and health coaching has become the delivery mechanism for wellness programs, and its potential for the same vital role is being seen in Lifestyle Medicine. The reality is that the vast majority of clients that most wellness/health coaches see are already health-challenged in some way. They may already have a chronic lifestyle-related illness, or multiple risk factors that set them up for needing serious preventative help. Wellness/health coaches that work for disease management companies, insurance companies and many corporate wellness programs are already working with caseloads populated primarily by lifestyle medicine patients.

At past Lifestyle Medicine conferences, I’ve presented on “Wellness Coaching And Lifestyle Medicine: Covering The Whole Continuum”. and “Delivering The Behavioral Side Of Lifestyle Medicine: Wellness Coaching Skills & Concepts”. Together with other presenters on wellness coaching we have experienced a strong positive response from an audience made up primarily of physicians.

One of the key concepts of my talks that was especially well received was the idea of how the Treatment Plan needs to be integrated with the Wellness Plan.

Co-creating a Wellness Plan with our clients is one of the primary tasks for the wellness coach. Together we work with a structure that insures the client’s plan for lifestyle improvement will lead to success. A key part of that Wellness Plan will always be the “Lifestyle Prescription” that the client’s treatment team is recommending. What is key is that the Wellness Plan supports The Treatment Plan.

I will be talking further about this concept in my forthcoming book on the more advanced skills and methods of wellness coaching, but here is a sketch of the two plans and the way they overlap.

Treatment Plan

Diagnostically Derived
Treatment Provider Devised
Prescriptive
Responsibility on Provider to administer, responsibility on client to follow
Usually does not accommodate patient’s circumstances or abilities, may accommodate patient’s capacities.
Problem solving, solution finding oriented
Purposed for resolution of illness and disease, reduction of symptoms, healing
“Lifestyle Prescription” focuses on recommended behavioral changes leading to Lifestyle Medicine outcomes
Dependent greatly upon medical compliance/adherence

Wellness Plan

Derived through exploration and self-assessment combined with treatment recommendations.
Co-created by “client” and “coach”
Non-prescriptive – client centered
Responsibility on client to follow with coach’s accountability and support
Not only accommodates, but is derived from client’s circumstances, abilities and capacities.
Designed to eliminate barriers and develop additional support
Possibility, growth and self-actualization oriented.
Purposed for behavioral change and lifestyle improvement
Includes assisting client with medical compliance/adherence

Overlap Of Treatment And Wellness Plans

The Wellness Plan (WP) supports the Treatment Plan (TP)
TP identifies critical areas for recommended lifestyle improvement
Through “client-centered communication” WP aligns with the goals of the TP
Client engages, with coaching support, in lifestyle improvement behaviors that positively affect treatment outcomes
WP helps client with organization, accountability, etc., improving attendance for medical appointments and management of medications, self-testing/self-care
WP helps client make best us of medical appointments (self-advocacy)
WP helps client report more accurately to treatment team about changes in lifestyle behavior (providing more data for treatment decisions)

When clients are operating on a Wellness Plan that they have truly helped co-create with their own buy-in, the opportunity for weaving in Areas of Focus, Goals and Action Steps that support what their treatment team wants to see becomes obvious. Clients then have the structure and support they need to carry out the goals of the Lifestyle Prescription.

Physicians and other healthcare providers can already start making use of wellness and health coaching as a delivery mechanism for the behavioral change they would love to see. Many of their patients already have wellness coaching as an employee benefit. Their company’s wellness program may already provide it, or they may contract with a wellness coaching provider company. More and more employees have wellness/health coaching available through their insurance provider.

Wise medical organizations and practices are hiring wellness coaches to become part of their staff or are outsourcing to them. Healthcare providers are sometime “wearing two hats” and combining their treatment work with coaching. Others are becoming more “coach-like” in their interactions and are then handing the patient off to the wellness coach for the longer process of lifestyle improvement.

The Real Balance Wellness & Health Coach Certification curriculum (http://www.realbalance.com) has included how coaches fit into the Lifestyle Medicine approach for over a decade. Our students come to us as a resource for learning how they can help deliver the lifestyle improvement that their Lifestyle Medicine clients seek.

Wellness Coaching to support Lifestyle Medicine is not just an idea whose time has come, it has already arrived!

Originally published on Real Balance blog. Reprinted with permission.

Dr. Michael Arloski is the CEO and Founder of Real Balance Global Wellness Services, Inc. (www.realbalance.com). Real Balance has trained thousands of wellness coaches worldwide. Dr. Arloski is a board member of The National Wellness Institute, and a founding member of the executive team of The National Consortium For Credentialing Health and Wellness Coaches. He is author of the leading book in the field of wellness coaching: Wellness Coaching For Lasting Lifestyle Change, 2nd Ed.