Hide

Error message here!

Lost your password? Please enter your email address. You will receive a link to create a new password.

Error message here!

Back to log-in

Close
Senior-Woman-Deep-Breath

Weight Loss Happens On The Exhale… The Nasal Exhale

Every person longing to be slim has heard the same advice forever: Eat less and exercise more. So simple, so logical, so what happened? America is the land of the overweight and the frustrated. For millions of people, every road has led to the same locked door. Until now. I’m going to give you the secret to helping you help your clients reach their weight loss goals in a healthy, lasting and fulfilling way.


For reasons ranging from stress to the influence of advertising, the majority of Americans find it difficult to lose the weight and keep it off. In addition, they are famously sedentary. According to the Centers For Disease Control & Prevention, 70% of adults are overweight or obese, contributing to health risks including heart disease, high cholesterol, high blood pressure, diabetes, stroke, and more (1). Either for health or vanity reasons, many of these overweight men and women try to slim down and usually gain back at least as many pounds as they lost. The secret to effectively losing weight and transforming patterns of behavior happens with breath. 

How Breath Influences Fat Burning

The way we breathe, fast or slow, mouth open or closed, shallow or deep affects our biochemical, physiological, biomechanical and psychological states of being. Nasal diaphragmatic breathing signals our parasympathetic branch of the autonomic nervous system while mouth breathing signals our sympathetic branch.  The difference determines whether you’re fat-burning or sugar-burning. Can you guess which turns you into a fat-burning machine? You guessed, nasal breathing.

Most of our clients are living in a stressed state (or the sympathetic branch of our nervous system). Not only is this the sugar-burning system, it also leads to abnormally high levels of cortisol. High cortisol levels promote weight gain (2).

In addition, nasal breathing increases oxygenation while mouth breathing decreases oxygenation. The speed at which your body burns oxygen or fuel for fat-burning benefits depends on how well your body utilizes oxygen. As we diaphragmatically nasal breathe, we stimulate the vagus nerve. “The vagus nerve regulates metabolic homeostasis by controlling heart rate, gastrointestinal motility and secretion, pancreatic endocrine and exocrine secretion, hepatic glucose production, and other visceral functions.” (4)

How The Fat Leaves On The Exhale

Fats are large molecules made up of oxygen, carbon, and hydrogen. When the oxygen we breathe reaches these fat molecules, it breaks them down into carbon dioxide and water.  The blood then picks up the carbon dioxide – a waste product of our bodies – and returns it to the lungs to be exhaled.  Therefore, the more oxygen our bodies use, the more fat we will burn.  

Nasal breathing is more efficient than mouth breathing in terms of supplying oxygen to the body as well as the transfer of oxygen and carbon dioxide between the lungs and red blood cells. When performing cardiovascular exercise, it is therefore preferable to inhale and exhale through the nose. (3)

Have you ever wondered where the fat goes? If you’re like most of us, you probably think the majority of fat is excreted through bodily fluids. Surprisingly, it’s not. Based on the research from the British Medical Journal, the majority of fat turns into carbon dioxide which is exhaled when we breathe. (5)

See My Interview With Ruben Meerman

Transforming Patterns of Behavior

The person who’s been sedentary for years won’t suddenly be persuaded to run a marathon. Core changes must come first in order to make everything else possible.  Using “breath as medicine” to improve health and the training experience, we cultivate the “choosing mind,” where we can alter lifelong patterns. 

People become sedentary and develop poor lifestyle patterns based on habit, boredom or emotional triggers.  So, there’s more involved than just losing the physical weight. Our issues are in our tissues. We’ve got to transform the emotional and physiological weight which is embedded in our unconscious and subconscious minds.  

Mindful breathing while exercising is being “neurofit” meaning we’re influencing physiological changes in the brain related to behavior. Life is a sensory experience and the body keeps score. Focusing on the breath allows a person to slow down, unwind and look inward. This is crucial for people whose lives are chronically hectic and stressful, who eat without thought, regardless of hunger. With deep, powerful breathing, they can break old patterns while cleansing internal systems. How does this happen?  By stimulating the vagus nerve (which only happens through nasal diaphragmatic breathing), we strengthen the areas of the brain responsible for emotional self-regulation. (6)

The body always lives in the present. It will never crave a Twinkie because of unrequited love, an upcoming review with a cranky boss, or an unhappy childhood. It cares only about what it needs from moment to moment to maintain homeostasis. The typical brain calls for millions of automatic acts in a day – from adjusting endocrine levels to blinking to deploying white cells for battle. As the connection between body and mind is fortified with breath, the choosing mind emerges reconnecting with our body to hear its’ objective voice which discriminates between emotional reactivity and true desire.

All that from a simple breath. 

Continuing Education: Breath as Medicine

Ed Harrold’s Breath AS Medicine breath coach training focuses on breath regulation concepts & strategies by applying the principles and philosophy of yoga breathing (or pranayama) to improve breathing rates and patterns. Breath AS Medicine is a highly effective modality for both the prevention of illness as well as therapy for managing and/or reversing existing chronic illness.

Click here to learn more about Ed Harrold’s Breath AS Medicine e-learning courses. Use coupon MedFit20 for 20% off either the 15 or 25-hour trainings.

A shorter 6-hour course is also available on MedFit Classroom. Click here for details.


Ed Harrold is an author, inspirational leader, public speaker, coach and educator. Ed’s mastery in the science of mindful breathing has guided him to apply conscious breathing practices in corporate performance coaching, fitness & athletic training, healthcare trainings, stress reduction and overall health and well-being.

Today, Ed blends the fields of neuroscience and the wisdom of contemplative traditions into effective strategies to improve well-being in Corporate America, Healthcare, athletic performance and individual health. Ed’s fluency in mindfulness-based strategies combined with the belief in the human potential gives him the depth and understanding to meet individuals and group needs across industries and platforms.

 Ed is the author of  “Life With Breath” and “BodyMindBusiness”; he is a contributing health & wellness editor for Huffingtpost, Thrive Global, MindBodyGreen & PTOnTheNet. Ed’s Breath AS Medicine Training offers CE in the healthcare, wellness coaching, fitness & athletic training sectors. Ed is a Faculty Member of the Medical Wellness Association. Learn more about Ed at www.edharrold.com

 

References

  1. National Center For Health Statistics, Health, United States, 2015.  Table 53.  https://www.cdc.gov/nchs/fastats/obesity-overweight.htm 
  2. Sominsky, L. & Spencer, S. (May 2014). Eating behavior and stress: a pathway to obesity, School of Health Sciences and Health Innovations Research Institute, Retrieved from http://journal.frontiersin.org 
  3. Novotny, S. (2007, February 1). The science of breathing. Ideafit.com. Retrieved from http://www.ideafit.com/ 
  4. Harada, S., Yamazaki, Y., Koda, S., Tokuyama, S. (April 23, 2014). Hepatic Branch Vagus Nerve Plays a Critical Role in the Recovery of Post-Ischemic Glucose Intolerance and Mediates a Neuroprotective Effect by Hypothalamic Orexin-A, Retrieved from http://journals.plos.org/ 
  5. Meerman, A. Brown (December 19, 2014).  When Somebody Loses Weight, Where Does The Fat Go? The BMJ. Retrieved from http://www.bmj.com/content/349/bmj.g7257
  6. Porges SW, Doussard-Roosevelt JA, Maiti AK (1994).  Vagal Tone And The Physiological Regulation of Emotion.  PubMed.  Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/7984159 
team hands

Collaborative Thinking in Health & Wellness

Over the past 18 months, I have seen my primary M.D. three times, enjoyed the services of my favorite massage therapist six times, visited my chiropractor nine times, chatted with a local R.D. twice and seen my personal trainer regularly. And not one of them even asked if I was seeing any of the others, much less inquiring what their treatments or approaches to treatments might be. To me, that is like trying to achieve success with a baseball team where the 1st base coach, 2nd base coach, 3rd base coach and pitching coach never communicate with each other.

Success cannot occur in a vacuum, neither can trueindividual health & wellness, yet for decades these medical, fitness & wellness providers have proffered their services in distinct and distinctly separate spaces.

Even as the internet has made access to information easier and facilitated the sharing of knowledge, including private, HIPAA compliant information, these providers continue to operate in “informational silos.”

It is true that in the past some of these providers may have held less than favorable opinions of some of the other providers, but that is, and certainly should be, a thing of the past. No longer will M.D.’s consider Chiropractors “quacks”, R.D.’s claim nutritionists “just don’t know enough”, and Physical Therapists think of Personal Trainers as ”wanna-be P.T.’s who couldn’t hack the education.” Science, knowledge and time have evolved all these disciplines into valuable, useful and incredibly beneficial specialties, each offering specific training and specific methods to apply to their patients/clients. And all those patients/clients typically can benefit from their combined expertise and knowledge.

No longer is it sufficient to simply treat the symptoms. Real wellness needs to encompass the patient/client holistically… address the symptoms, understand the cause, strengthen the mind, examine the diet, resolve the issue and prevent future occurrences. And isn’t that best accomplished by viewing patient/client wellness as a Team Sport?

Over the years I have had the pleasure of knowing and speaking at length with many of these medical, fitness & wellness providers, and not one of them indicated there is anything in their training that says “Thou Shalt Not Collaborate.”

We are not talking about “asking for help.” Rather we are simply saying to include those other practitioners in the conversation. Instead of the M.D. telling the patient to “walk more to improve cardio health”, why not conference call with the Personal Trainer and discuss the walking program that is most appropriate. Let the Physical Therapist inform the Personal Trainer of any specific issues to address or avoid. Allow the Massage Therapist to work with the Chiropractor to ensure optimum results from both. In other words, (and the simplicity of all this may surprise you), just TALK TO EACH OTHER.

So, let’s start to make that happen. For more than 20 years my company has helped health clubs and fitness centers create mutually beneficial relationships with Physical Therapy practices, Chiropractic offices, Registered Dietitians, Nutritionists and Massage Therapists. Now is the time to extend the conversation, and, to return to my baseball metaphor, get ALL the coaches working together to create truly Championship results.


Cosmo Wollan is the Senior Executive at Synergy Cubed, a premiere consulting firm providing customized solutions to the health & fitness, parks & recreation, medical fitness and corporate wellness industries since 1994. His Fitness Industry clients have engaged him as an expert problem-solver in profit center development, retention strategies, customer engagement, sales training, programming design, operational streamlining and health club management.

trainer-resistance-band-senior-woman-client

You Are The Solution

This article is meant to be a wake-up call to the fitness industry. The health of our population and country are at stake. While advancements have extended our country’s overall lifespan, it has occurred primarily through the use of medications and life-saving procedures rather than through lifestyle changes. The stark reality is that the overall health of Americans is declining as evidenced by the $3.5 trillion spent every year on health care expenditures.

Another alarming statistic is that between 1997 and 2016, there were approximately 4.5 billion prescriptions written per year. 70% of Americans take at least one and 20% take five or more prescription medications (Preidt 2017). The majority of these medications were taken to address lifestyle-related diseases and the subsequent impacts of poor nutrition choices and lack of physical activity. Additionally, many prescription and over-the-counter medications are used to treat osteoarthritis, the most common cause of physical disability in the world. While genetics, weight, and age have been considered as underlying factors, the decrease in quantity, as well as quality, of physical activity have been shown to be much greater factors to the onset and prevalence of osteoarthritis in modern society (Wallace 2017, Osar 2018).

While often attributed to causes outside one’s control (i.e. genetics), the fact is that the diseases contributing to the greatest number of deaths (heart disease, cancer, and Type 2 diabetes) and disability (osteoarthritis) are directly related to controllable factors. While each has a genetic component, lifestyle has a much greater impact on the incidence and prevalence of these diseases. One of most important and underappreciated components in the overall decline in one’s physical, physiological, and cognitive health, is the lack of physical activity. Less than 20% of the population meet the daily physical activity guidelines and less than 5% of the adult population participates in 30 minutes of physical activity. Even more disturbing is that more than 78 million U.S. adults and 12 million children are obese.

Dr. Caldwell Esselstyn has been attributed with the quote, “Genetics loads the gun, lifestyle pulls the trigger.” This suggests that lifestyle is as important as genetics in the expression of many chronic diseases. This sentiment is reiterated in a recent study from Bodai et. al (2018). “Epidemiological, ecologic, and interventional studies have repeatedly indicated that most chronic illness, including cardiovascular disease, cancer, and type 2 diabetes, are the results of lifestyles fueled by poor nutrition and physical inactivity.”

The health of our population and country is at stake. This is a call for fitness professionals to step up and recognize that you are the first line of defense against the deleterious impacts of lifestyle diseases. It is your responsibility to educate your communities that lifestyle changes, incorporating proper nutrition as well as increased physical and cognitive exercise, should be the first step in addressing chronic lifestyle diseases. You can continue to change the health of our nation by implementing evidence-based nutrition, exercise, and cognitive training programs. Be the solution your clients, your community, and our country needs by investing in advanced education in nutrition, exercise, movement, and cognitive training. Create relationships with allied health professionals so that we can collectively educate, collaborate, and coordinate the changing of our nation’s health care system.


This article was featured in MedFit Professional Magazine.

Dr. Evan Osar, an internationally recognized speaker, author, and expert on assessment, corrective exercise, and functional movement. Dr. Osar is committed to educating and empowering fitness professionals while helping them develop relationships with allied health professionals. He is author of the Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction and has developed the industry’s most complete training certification, the Integrative Movement Specialist™. With his wife Jenice Mattek, he created the online educational resource. For more info, visit IIHFE.com.

References

Bodai, B. I., Nakata, T. E., Wong, W. T., Clark, D. R., Lawenda, S., Tsou, C., … Campbell, T. M. (2018). Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. The Permanente journal22, 17–025. doi:10.7812/TPP/17-025

Centers for Disease Control and Prevention. Osteoarthritis. Retrieved from https://www.cdc.gov/arthritis/basics/osteoarthritis.htm

Centers for Disease Control and Prevention. Leading Causes of Death. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Centers for Medicare & Medicaid Services. National Health Expenditure Data. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

Osar, E. (2018). The Fundamentals for Training the Older Client with Osteoarthritis. Retrieved from https://www.ptonthenet.com/remote-learning

Preidt, R. (2017). Americans Taking More Prescription Drugs Than Ever. https://www.webmd.com/drug-medication/news/20170803/americans-taking-more-prescription-drugs-than-ever-survey

U.S. Department of Health & Human Services. Facts and Statistics. Retrieved from https://www.hhs.gov/fitness/resource-center/facts-and-statistics/index.html

Wallace, IJ., Worthington, S., Felson, DT., Jurmain, RD., Wren, KT., Maijanen, H. Woods, RJ., Lieberman, DE. (2017). PNAS. 114(35): 9332-9336.

senior-mature-woman-working-out-at-home

What Happened During the Pandemic

The Perfect Pandemic Storm? 

The average weight gain during the pandemic was 1.5 pounds per month, according to a recent study in the Journal of the American Medical Association. As of May 2021, that’s 20 lbs. The results were gathered by monitoring smart scale users with Bluetooth technology. Subjects were male and female smart scale owners with a mean age of 51.

What Happened? 

Shelter in place (SIP) orders combined with stockpiles of pantry items, ample take-out and door-to-door delivery. Additionally, many found themselves with either a household of varied food wants and needs, serving up a daily meal dilemma, or in isolation lending to depression and anxiety. Neither scenario made it easy to adopt or stick to routine healthy dietary habits.

Researcher Suggestions

From the results, researchers suggest a need to mitigate our present post-pandemic conditions with dietary interventions and physical activity.

As aforementioned, the study included both men and women. Women at age 51, however, have another challenge. Women reach menopause at the average age of 51.3. During the latter stages of perimenopause and early postmenopause, there is an accelerated rate of loss of both muscle and bone. The loss is experienced when there is a sharp decline of estrogen and a corresponding increase of cortisol.

Show Me the Muscle

While average weight gain was the reported data in this study, changes in body composition weren’t included. This author suggests we may safely assume this was fat weight and not muscle. There is a need for both exercise and nutrition interventions.

There is also a potential need to identify solutions to sleep disruption and stress (as cortisol can have a negative impact on fat storage and muscle breakdown). Sleep disruption is common for women in menopause and often accompanies stress or anxiety, of which the pandemic provided an abundance.

Hormonal Contributing Factors

Testosterone and growth hormone also decline with age and levels will suffer more in women who experience unresolved insomnia during menopause. These two hormones are produced in the greatest amounts during deep sleep cycles, which menopausal women may reach with less frequency or for shorter durations. 

Women who were in late-stage perimenopause, early-stage post menopause window during the pandemic have the greatest potential for devastating disability. This is especially true if they weren’t strength training with adequate intensity. We may see these effects in a decade if losses of muscle and bone are not mitigated. 

Sarcopenia, a significant loss of muscle and strength, is experienced by 42% of women by the time they reach 65. This is true in normal times, without a 14+ month decrease in adequate exercise stimulus. Sarcopenia results in frailty, greater risk of falls, and with bone loss also occurring at accelerated rates during menopause, fracture risk is higher. 

Compounding Problems

Pre-existing obesity or that stemming from weight gain during the pandemic coupled with sarcopenia provides an even more severe condition known as sarcopenic obesity. Both obesity and sarcopenia are independent risks for disability. In adults diagnosed with both, there is a 2.5-fold increased risk of disability. 

Inadequate Stimulus

When hormone levels offered a stimulus for muscle decline, there must be some other stimulus to replace it. 

Remember the shortage of dumbbells early in the pandemic? While Peleton sales skyrocketed and walking increased for many, access to the type of anaerobic strength training that has the biggest pro-aging benefits for women in midlife required creativity. For those not familiar with strength training, or not online due to connectivity or comfort, muscle and bone loss awareness and solutions are warranted.

The Perfect Storm for Fitness Professionals

For personal trainers and fitness pros, this truly is a perfect storm. It’s an opportunity for a legacy of impact on a female demographic that touches three generations. Her young adult children, friends and life partners, and parents & in-laws. Household decisions and health habits are influenced most by her. No one else has as much influence on health as she does. 

The unnecessary devastating disability that could result for those who’ve gained and sustained significant weight during the pandemic can be avoided. Fitness pros who take proactive measures to educate, publicize, and offer positive solutions for behavior change can be a part of reversing this significant health risk.


Debra Atkinson is the #youstillgotitgirl who is flipping 50 and changing the way thousands of women think about their second half. She’s the host of the Flipping 50 TV Show and the Flipping 50 podcast. As a master personal trainer, strength and wellness coach with over 30 years fitness industry experience, she works with women who are pro-aging with vitality and energy. She serves on the MedFit Education Foundation Advisory Board, is an international fitness presenter, and author of hundreds of articles and multiple books. Visit her website, flippingfifty.com

References

  • Lin AL, Vittinghoff E, Olgin JE, Pletcher MJ, Marcus GM. Body Weight Changes During Pandemic-Related Shelter-in-Place in a Longitudinal Cohort Study. JAMA Netw Open. 2021;4(3):e212536. doi:10.1001/jamanetworkopen.2021.2536
  • Front. Endocrinol., 21 May 2020 | https://doi.org/10.3389/fendo.2020.00332
Stroke-Brain-MRI

Is Your Brain Really “Plastic”? – The Key to Stroke Recovery

Neuroplasticity is the brain’s ability to reorganize itself by forming new neural connections. This occurs through the changing of neurons, the organization of their networks, and their function via new experiences. Neuroplasticity is also called neural plasticity, brain plasticity, cortical plasticity, or cortical re-mapping.

You are experiencing neuroplasticity every time you learn something new, such as how to use a new computer program, a new line of music, a new app on your phone, or a new exercise in your workouts. Learning is neuroplasticity.

For brain injuries such as stroke, neuroplasticity takes on an even greater importance. Because the injury literally damaged or even destroyed neurons, we must harness neuroplasticity to build new neural connections to do regain or improve upon the resulting dysfunction. The cool thing is that other areas of the brain, those not normally associated with a given action, can assist if the stimulus is strong enough.

Why neuroplasticity matters for all brain injury survivors

The concept of neuroplasticity is very important and if you work with stroke survivors it is a concept you will want to explain at some level. Here are some points of why neuroplasticity is so important:

  • Neuroplasticity provides hope – Despite the fact that the concept of neuroplasticity has been around for several decades, it is still not widely understood in the public arena. When we explain neuroplasticity to our pain and brain injury clients, they often reply that knowing this gives them hope. Hope is especially important for a stroke survivor, in which the loss of a major motor function occurs so swiftly that it can seem to be a very daunting process to recover from.
  • We can target neuroplastic change – The great thing about learning a neuro-centric approach to training and exercise therapy is that the nervous system is very orderly and so we can be very targeted in our training to regain or improve dysfunctions.
  • Neurons that wire together, fire together – Understanding some basic neuroanatomy can go a long way. The bottom line is that areas of the brain that live close to one another can affect one another. Here is an easy example:

    • In the picture above, we see the sensory (purple) and motor (blue) cortices of the brain; if we had an issue with knee articulation, we could stimulate that area by moving the hip and/or ankle, which would “fire” into the knee area just by their proximity.
    • Here is a less obvious example: Also, notice how close the eyes and the hands are in the sensory and motor maps; you can help motor control of the hands by doing eye exercises.
  • You have lots of “backup disks” in the brain – A stroke can damage whole neuronal areas beyond repair. While this sounds daunting, it is still possible to regain function. One aspect of neuroplasticity is that other areas of the brain can actually take over to learn and perform tasks they are not normally associated with, given the right kind and amount of stimulus.

The concept of neuroplasticity and how to harness it is not only for stroke recovery, but also for general fitness, performance, and pain clients! Begin learning a neuro-centric approach to medical fitness and how to work with stroke survivors with our Stroke Recovery Fitness Specialist online course, available through the MedFit Classroom!


Dr. Grove Higgins is a chiropractor, rehabilitationist, soft tissue injury expert, researcher, anatomy instructor, biomechanist, human performance expert, speaker, and corporate health consultant. In 2015, Dr. Higgins cofounded Neuroathlete with Coach Patrick Marques (LTC, US Army Ret.) and Peter Hoversten. Neuroathlete’s goal is to more broadly deliver neurological training to a global audience.

Master Trainer Pat Marques served in the Active Duty Army for 20 years in the Infantry and Special Forces, including combat tours in Iraq. Upon retiring Pat decided to try and combine his two passions – soldiers and fitness. He was able to work with soldiers through adaptive physical training, helping them deal with amputations, chronic pain, PTS, and traumatic brain injury. Pat has completed over 600 hours of neurological training, becoming a Z-Health Master Trainer. 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 athletes. 

senior-man-lifting-weights

What Is an Anabolic Window?

If you’re trying to build muscle, strength training is the best way to do it. Strength training damages the muscles, which causes them to repair and grow. The result is bigger, stronger muscles. Bigger, stronger muscles to someone like us with MS means the strength to move those muscles once we create the brain to muscle reconnection. However, optimal muscle growth goes beyond your actual workout. It also relies on post-workout nutrition. Your muscles need enough protein and carbohydrates to effectively recover.

Seniors with trainer in gym at sport lifting barbell

Set Yourself Apart: Facing the increasing challenge of competing with underqualified trainers

As a personal trainer, you may find it increasingly difficult to compete in an industry that has no licensure and very little in the way of requirements. As an industry, we let anyone willing to take a two-, four-, six- or eight-hour online course become a personal trainer. This may explain the lack of expertise that is witnessed in so many trainers at gyms across the country. You may find yourself watching them from the sidelines, cringing as you notice the client performing deadlifts with an arched-back; squats with their knees caving in; or any other combination or poor supervision, direction and form.

It’s unfortunate, but the average person has no idea what to look for in a trainer. They don’t know the questions to ask, the accredited certifications and whether or not that trainer is able to work with any pre-existing conditions that they may have. As gyms hire underqualified trainers, underselling those of you who are worth your fee, clients continue to get injured. The client goes to a physical or occupational therapist and tells them they’ve been working with a trainer at X gym. The therapist rolls their eyes, having heard the story time and time again, discrediting personal trainers and the fitness industry as a whole.

If you have put your time in — getting your degree, obtaining every accredited certification you could get your hands on and starting at the bottom of the food chain, scraping your way to the top, you may be feeling frustrated and perhaps a little defeated.

Data from the U.S. Census Bureau shows that there are 76.4 million baby boomers. There were actually a total of 76 million births in the United States from 1946 to 1964, the 19 years usually called the “baby boom.” Based on these staggering numbers, many nationally certifying bodies are realizing the need for medical fitness professionals. They are looking to change the industry, set standards for our fitness professionals, and require advanced education in order to work with any special population. In the next few years, we are going to see the pendulum swing in the fitness industry. There is a movement towards medical fitness and you can get in at the ground level, setting yourself apart from the low-level trainers. You will be able to create a niche market that will open doors in the medical community, increase referrals and increase revenue.

Perhaps you or someone you love has been touched by cancer; there were an estimated 18 million cancer cases around the world in 2018!

  • One-quarter of new cancer cases are diagnosed in people aged 65 to 74
  • Median age at diagnosis is 61 years for breast cancer, 68 years for colorectal cancer, 70 years for lung cancer and 66 years for prostate cancer

In 2018, there were approximately 43.8 million cancer survivors diagnosed within the previous five years. By 2040, the global burden is expected to grow to 27.5 million new cancer cases. During the COVID-19 pandemic we are seeing that cancer patients, as well as others with compromised immune systems, are more alone and isolated than ever. This provides an unprecedented opportunity for you to provide a necessary and life-changing service to those in treatment or recovering from cancer. The Cancer Exercise Training Institute offers an online university fast-track program that also includes business coaching and training to take your business online. In five weeks, you can sit for the exam and, with at least an 80% passing grade, become a Cancer Exercise Specialist.

To some of you, working with what would appear to be an aging or sick population may not be of interest. You need to decide if you want to be like every other trainer, creating beach bodies and six-packs, or if you want to really make a difference in someone’s quality of life, and your success as a trainer. Think outside the box. Beyond the baby boomers, we have athletes and adolescents who have diabetes, who suffer with obesity, have asthma, cancer and so much more. This is a relatively untapped market.

For those of you who are up for a challenge, willing to step outside of your comfort zone and explore a new and exciting avenue in fitness, this offers a tremendous opportunity. There will always be those who want to lose weight, get toned, get ripped and improve sports performance, but after a while you can do that in your sleep. When you have clients that can’t get out of bed, can’t get up and down from a chair or can’t even perform self-care, and you are able to help them to take control of their life and their body in a way they never imagined was possible, it is truly the most meaningful and rewarding part of your career.

As we change the standards in the fitness industry, specialized training will be a requirement and you will be one step ahead of the game. By setting up meetings with nurses, doctors, patient navigators and support groups, you exponentially increase your potential client base. The unqualified trainer will not even be able to get in the door. The medical community will not accept a trainer without appropriate credentials.

As a highly credentialed trainer, you can establish yourself as a blog writer, magazine contributor and speaker. Opportunities may range from speaking to a support group at a local hospital to becoming a keynote speaker at a huge event. You can even conduct local or destination retreats for specific groups (i.e.; breast cancer, diabetes, juvenile diabetes, active aging etc.). The doors will also open up to you at medical fitness facilities and possibly hospitals that are looking for highly credentialed medical fitness professionals.

There are certainly other ways that you can make your mark and create unique marketing opportunities, but many of those will come and go with various trends and fads in fitness. Sadly, we live in a country that believes that “bigger is better” and wants “more for their money.” This has led to an epidemic of cancer, heart disease and diabetes, among other things. People will continue to age and whether it’s through the natural aging process or poor self-care, this is a market that is here to stay.


This article was featured in MedFit Professional Magazine. 

Andrea Leonard is the Founder and President of the Cancer Exercise Training Institute. She is a certified as a corrective exercise specialist by The National Academy of Sports Medicine (NASM), as a personal trainer by The American College of Sports Medicine (ACSM), the National Academy of Sports Medicine (NASM), the American Council on Exercise (ACE), and as a Special Populations Expert by The Cooper Institute. She is also a continuing education provider for the National Academy of Sports Medicine and The American Council on Exercise.

med-fit-client-doctor-exercise

Healthcare Through Fitness

A discussion of medical fitness is rooted in an understanding of the health benefits of fitness and exercise. The documented benefits are endless and include management of chronic disease, management and prevention of osteoporosis, improved mood and sleep disorders, stress relief, management and prevention of obesity.

Health agencies across the spectrum of public health and disease-specific organizations recognize and promote exercise and fitness as an integral part of the management of chronic disease; diseases that include diabetes, cardiovascular disease, Parkinson’s, depression, multiple sclerosis, and arthritis, among others.

If fitness and exercise are well accepted as part of the management strategy for multiple diseases, why is it that access to organized exercise plans, and fitness professionals who can help implement those plans, are not a standard part of the medical treatment paradigm? Why is it not a standard benefit covered by common medical insurance policies?

The reasons are multifactorial and a reflection of the overall healthcare conundrum in our country today. Let’s focus, however, on how to make a change. We need to focus on how to integrate fitness professionals into the medical paradigm. A perfect model for this is an integrative medical fitness center.

What is a medical fitness center? It is a fitness facility with a multidisciplinary staffing approach and has the following characteristics:

  • Regular medical oversight by a medical director
  • Practitioners with nationally-recognized certifications and training in the care of chronic disease
  • Comprehensive health assessments and exercise prescription
  • Exercise classes geared toward specific medical conditions

These centers bring together credentialed staff in a collaborative way to provide exercise prescription plans specific to the needs of an individual with chronic disease.

The concept of the medical fitness center is not new; many currently exist in communities throughout the United States. However, an understanding of their importance in the context of the current healthcare environment has grown. The idea of creating “medical homes” that are collaborative across disciplines and provide a comprehensive healthcare approach is now being recognized to provide a high standard of care while simultaneously decreasing overall healthcare costs. This is true specifically for high-risk individuals who suffer from chronic disease.

Further integration of medical fitness centers, and broad access to exercise and fitness resources, will hopefully become standard of care and widely accessible to all individuals, especially those with chronic disease. This integration will inherently bring fitness professionals into the paradigm of healthcare and promote healthcare through fitness.


This article was featured in MedFit Professional Magazine. 

Dr. David Kruse attended medical school at UC San Diego, after graduating from UC Berkeley. He holds board certifications in family and sports medicine. He practices sports medicine with the Orthopaedic Specialty Institute, in Orange, CA. Dr. Kruse is the Chief Medical Officer for the MedFit Network and on the Medical Advisory Board for the MedFit Education Foundation. He is currently a Team Physician for USA Gymnastics, Orange County Soccer Club, and Biola University. Visit his website, krusesportsmd.com

seniors-biking-in-gym-group

How to Turn Your Fitness Facility into a Health and Wellness Facility and WHY!

2020 came and went with a pandemic and the resulting crash of our fitness industry as we knew. It seemed like time stopped. Fitness facility doors closed. Staff were furloughed and separated. Fitness delivery models changed overnight – hybrid models of live streaming and on-demand services. Business plans were re-done for a budget year that evaporated.  

The OPPORTUNITY… there has been an increased awareness of the value of good health and the importance of exercise. Much of the research shared post-COVID clearly demonstrated that the sickest were at the highest risk with COVID and that those who were mostly healthy fared much better when diagnosed with COVID.

CDC reported that obesity worsens outcomes from COVID-19. Obesity increases the risk of severe illness, tripled the likelihood of being hospitalized, and is linked to impaired immune function, decreased lung capacity and many other risks. Obesity is forecasted to exceed 50% in Americans by 2030.

How do we go forward as business owners to capitalize on a perfect storm of individuals now realizing and valuing their health as an asset? How do we go forward to create environments in which our facilities feel like a home away from home for new exercisers, de-conditioned, COVID recoveries, overweight, out of shape and scared individuals who now wish to exercise?

American Psychological Association reported recently that Americans’ Physical Health has taken a back seat since the start of the pandemic. It was reported that 47% delayed or canceled healthcare services and that 53% have been less active than they wanted.

How do we fill the gap to provide services and welcome all ages, stages, shapes, sizes into our facilities to capitalize the business opportunity and to support those who need us most to get healthier?

  1. Bring communities together by offering health and wellness programs to non-members that teach good health and prevention. Some examples:
    • Post-hab COVID health program: 30 days to reset your health
    • 8-week weight loss programs/challenges, 8-week pre-diabetes classes, 8-week cardiovascular health and wellness programs.
    • Any program that can target a COVID risk factor that targets a certain element of health: cardiovascular, flexibility, strength, stress management, sleep, etc… or certain disease states such as asthma, obesity, diabetes, hypertension etc. all can be made into health and wellness programs for potential new members.
  2. Consider offering these health and wellness programs (with a nominal registration fee) without requiring a membership to your facility. So, include a membership to your facility for the duration of the program, offer a discounted sign-up fee to convert them to members at the completion of the program, and perhaps a friends and family rate to enroll. Leave a trail of financial incentive crumbs with some skin in the game to get them to value your facility and programs to stay long-term. Show them the value-added they experience by having you at your facility. Let them “try before they buy” — but in the wellness space first.  Not “gym and swim” first…that is too much for some.
  3. Offer intro level and disease-specific type group classes that may group like-minded individuals with common goals. Example: Beginner cardio class, where you clearly accommodate beginners, new exercisers, those who are low-level fitness and who need a shorter duration of work. 
  4. Offer personal training programs that clearly measure pre and post-health metrics to show improvement to give individuals confidence in their improving health and an appreciation of the value of the services they pay for. This also allows for your trainers and your facility to connect their improved health outcomes to their primary care providers so you can get future referrals as a credible source for a patient who needs exercise.
  5. Offer healthier food choices and nutrition education as part of your centers’ offerings. Consider adding a Dietitian to your team.
  6. Partner with local health departments, health care systems to host health checks to promote good health awareness and to get more foot traffic into your center.

THINK “A GYM without WALLS” and offer wellness to all – become the health hub of your community!! It makes good business sense for all!


Debbie Bellenger is a skilled presenter, public speaker, TRX Master Trainer and Reebok Master Trainer.  Over the past 30 years, Debbie has been developing and delivering medical wellness programs in an integrated continuum of care model with providers using EPIC as a platform of referrals and communications back and forth. She also successfully developed a new service line for CaroMont Regional Medical Center called Employer Wellness services which sold over $500,000 of corporate wellness programs with coordinators to local companies.

Debbie is the 2014 Medical Fitness Association Corporate Wellness Director of the Year – Employee Wellness. She is the 2017 IDEA Program Director of the Year Award recipient, which recognizes a Director who develops and delivers health, fitness and wellness programs for employees, participants and patients that have successfully changed behaviors and demonstrated positive outcomes of improved health.