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
Portrait of smiling women wearing pink for breast cancer in parkland

Training Cancer Survivors

/30 July 2018/ All MFN blog/

Once a virtual death sentence, cancer today is a curable disease for many and a chronic illness for most. With continued advances in strategies to detect cancer early and treat it effectively along with the aging of the population, the number of individuals living years beyond a cancer diagnosis can be expected to continue to increase.

Approximately 15.5 million Americans in the United States are cancer survivors. By 2026 that number is expected to reach 20 million. Anyone who has been diagnosed with cancer, from the time of diagnosis through the rest of his or her life is considered a cancer survivor.  And while not all cancer survivors are older adults, many are simply because of the cumulative effect of years of lifestyle issues that are risk factors for their disease. Survivors less than or equal to 19 years old comprise 1% of the cancer survivor population, 6% of survivors are aged 20–39 years, 33% are aged 40–64 years and 60% (more than half) are aged greater than or equal to 65 years.

Breast cancer survivors are the largest constituent group within the overall population of cancer survivors (22%), followed by prostate cancer survivors (19%) and colorectal cancer survivors (11%) (3). Gynecological and other genitourinary cancers each account for 9% of cancer survivors, followed by hematological cancers and lymphoma (7%) and lung cancer (4%). Other cancer sites account for much smaller percentages and together are responsible for 19% of the total number of survivors. In terms of stratification by gender, more than two thirds (69%) of all female cancer survivors have a history of breast (41%), gynecological (17%) or colorectal (11%) cancer. For male survivors, two thirds (66%) have a history of prostate (39%), other genitourinary (such as testicular or renal) (14%) or colorectal (13%) cancer.

Not surprisingly, cancer survivors are often highly motivated to learn more about things like nutrition, supplements and herbal remedies, and exercise that might improve treatment outcomes and ultimately their survival and quality of life. For many of the most important nutrition and physical activity questions faced by cancer survivors, the scientific evidence comes only from observational and laboratory animal data, or unreliable reports from poorly designed clinical studies. Moreover, the findings from these studies are often contradictory. Very few controlled clinical trials have been done to test the impact of diet, nutritional supplements or nutritional complementary methods on cancer outcomes among cancer survivors.

In an effort to identify and evaluate the scientific evidence related to optimal nutrition and physical activity after the diagnosis of cancer, the American Cancer Society (ACS) convened a group of experts in nutrition, physical activity and cancer. The findings of this group guide healthcare providers, cancer survivors and their families through the mass of information and help them make informed choices related to diet and exercise.  The Expert Committee reviewed all of the scientific evidence and best clinical practices for different types of cancer and “graded” both the quality and certainty of the scientific evidence for factors affecting the most common cancers. As was already mentioned, there are few clear answers to many questions, a wide range of sources and often conflicting information. But, these experts agree that even when the scientific evidence is incomplete, reasonable conclusions can be made that can help to guide choices in the areas of nutrition and physical activity.

Physical activity may help cancer patients build up their physical condition; decrease the number of comorbid conditions (like heart disease and diabetes); reduce drug interactions; help cancer patients cope with treatment; restore good health; improve quality of life during and after treatment; and help cancer patients and survivors maintain independence as long as possible

Physical rehabilitation programs similar to those for cardiac rehabilitation may be effective in managing, controlling or preventing adverse medical and psychosocial outcomes manifested during cancer survivorship. For example, exercise programs are being developed as interventions to improve the physical functioning of persons who have problems with mobility as a result of therapy and are also being shown to be efficacious for weight control after breast cancer treatment, lessen the effects of chronic fatigue, improve quality of life, prevent or control osteoporosis as a result of premature menopause and prevent or control future or concurrent comorbidities.

Diet, weight and physical activity interventions carry tremendous potential to affect length and quality of survival in a positive manner and prevent or control morbidity associated with cancer or its treatment.

General Physical Activity Guidelines for Cancer Survivors

In general, physical activity is likely to be beneficial for most cancer survivors. Recommendations on the type, frequency, duration and intensity of exercise should be individualized to the survivor’s age, previous fitness activities, type of cancer, stage of treatment, type of therapy, and comorbid conditions.

Particular issues for cancer survivors may affect or contraindicate their ability to exercise. Effects of their cancer treatment may also promote the risk for exercise-related injuries and other adverse effects.

The following specific precautions are from the American Cancer Society:

  • Survivors with severe anemia should delay exercise, other than activities of daily living, until the anemia is improved.
  • Survivors with compromised immune function should avoid public gyms and other public places until their white blood cell counts return to safe levels.
  • Survivors who have completed a bone marrow transplant are usually advised to avoid exposure to public places with risk for microbial contamination, such as gyms, for 1 year after transplantation.
  • Survivors suffering from severe fatigue from their therapy may not feel up to an exercise program, so they may be encouraged to do 10 minutes of stretching exercises daily.
  • Survivors undergoing radiation should avoid chlorine exposure to irradiated skin (e.g., swimming pools and whirlpools).
  • Survivors with indwelling catheters should avoid water or other microbial exposures that may result in infections, as well as resistance training of muscles in the area of the catheter to avoid dislodgment.
  • Survivors with significant peripheral neuropathies may have a reduced ability to perform exercises that use the affected limbs because of weakness or loss of balance. They may do better with a stationary reclining bicycle, for example, than walking outdoors.

For the general population, the ACS and other health organizations recommend at least 30 minutes of moderate physical activity at least 5 days per week to reduce the risk for cancer, cardiovascular disease and diabetes. These levels of activity have not been studied or tested specifically in cancer survivors, however. For the general population and for cancer survivors, any movement is likely beneficial. Therefore, although daily and regular activity may be preferred and may be a goal, any steps that are taken to move from a sedentary to an active lifestyle should be encouraged. For survivors wanting maximum benefit, the message should be that the health benefits of exercise are generally linear, with benefit related to higher intensity and duration, although extremely high levels of exercise might increase the risk for infections.

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.

park-walk-biking

Heart-brain connection: Fitness now protects your brain in your 70s and 80s

/18 July 2018/ All MFN blog/

Stay fit today; avoid dementia tomorrow

It’s well-known exercise plays a vital role in your physical health, and now studies propose staying fit in midlife may protect your brain as well, avoiding mental deterioration in later years.

A new study, published in Neurology, that followed Swedish women for more than 40 years,  suggests one’s level of physical fitness predicts the amount of protection from dementia decades later.1

Swedish dementia/exercise study began 50 years ago

At the onset of the study in 1968, 191 Swedish women ranging in age from 38 to 60 took part in a vigorous stationary cycling test to measure their exercise work capacity. Based on work capacity, women were split into low, medium, and high fitness categories. The women were followed from 1968 to 2012, and dementia diagnoses were recorded.

The measurement of exercise capacity is an important aspect of the strength of this study –  it was based on the participants’ actual performance rather than relying on participants’ subjective reports of how much, how vigorously, and how often they exercised.

Strong association between fitness and likelihood of dementia decades later

Dementia incidence correlated with fitness level, the greater the fitness level, the less the dementia: 32 percent, 25 percent, and 5 percent of women developed dementia in the low, medium, and high fitness groups, respectively.1 This particular study is one of the longest, following participants for up to 44 years, but shorter studies have come to similar conclusions.2-4

Another very interesting finding: in the subset of women whose initial exercise tests had to be stopped because of issues such as excessively high blood pressure, chest pain, or an abnormal EKG change, almost half (nine out of twenty women) developed dementia. Fit women who did develop dementia did so much later in life. Among the five percent of fit women who eventually developed dementia, the average age of development of dementia was eleven years later compared to the medium fitness group – age 90 vs. 79 – an extra eleven years of dementia-free life.

Midlife fitness also linked to brain volume 19 years later

In another study, the effects of midlife physical fitness on the brain were visualized with MRI. Participants at an average age of 40 performed a treadmill test to determine their exercise capacity. Lower exercise capacity at midlife was associated with smaller total cerebral brain volume 19 years later, suggesting having a higher fitness level helps prevent brain shrinkage with age.5

Diet determines your propensity for fitness

Important to note, one’s fitness level is strongly linked to what you eat.  People who are overweight  as well as those who don’t eat healthfully, do  not have the will, energy or capacity for regular exercise.  When you eat right, you’re more likely to get fit; when you don’t eat right it is very difficult to get fit.

A nutrient-dense, plant-rich diet (Nutritarian) is the most critical determinant influencing whether one gets dementia or not.  When you eat right you automatically crave exercise and it becomes pleasurable to do so.

This study also demonstrates the wide variety of health benefits, including reduced risk of cardiovascular disease and several cancers when you get fit. Mixing together nutritional excellence and exercise is when the magic happens to protect yourself from the common diseases of aging.  Exercise offers additional benefits to cardiovascular health and insulin sensitivity, as well as some direct effects in the brain, such as the release of protective compounds called neurotrophins.6,7

At any age, fitness is vital for your present and future brain health.

It is never too late to start exercising and you are never too old. Studies have documented cognitive benefits from exercise (strength training and aerobic training) in all age groups, from children to the elderly.6-9  Today is the day to make sure you do both; eat right and get fit.

Originally printed on DrFuhrman.com. Reprinted with permission.

Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
 
For over 25 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.

References

  1. Horder H, Johansson L, Guo X, et al. Midlife cardiovascular fitness and dementia: A 44-year longitudinal population study in women. Neurology 2018.
  2. Defina LF, Willis BL, Radford NB, et al. The association between midlife cardiorespiratory fitness levels and later-life dementia: a cohort study. Ann Intern Med 2013, 158:162-168.
  3. Liu R, Sui X, Laditka JN, et al. Cardiorespiratory fitness as a predictor of dementia mortality in men and women. Med Sci Sports Exerc 2012, 44:253-259.
  4. Willis BL, Gao A, Leonard D, et al. Midlife fitness and the development of chronic conditions in later life. Arch Intern Med 2012, 172:1333-1340.
  5. Spartano NL, Himali JJ, Beiser AS, et al. Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later. Neurology 2016, 86:1313-1319.
  6. Kandola A, Hendrikse J, Lucassen PJ, Yucel M. Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment. Front Hum Neurosci 2016, 10:373.
  7. Kirk-Sanchez NJ, McGough EL. Physical exercise and cognitive performance in the elderly: current perspectives. Clin Interv Aging 2014, 9:51-62.
  8. Fiatarone Singh MA, Gates N, Saigal N, et al. The Study of Mental and Resistance Training (SMART) study-resistance training and/or cognitive training in mild cognitive impairment: a randomized, double-blind, double-sham controlled trial. J Am Med Dir Assoc 2014, 15:873-880.
  9. Mavros Y, Gates N, Wilson GC, et al. Mediation of Cognitive Function Improvements by Strength Gains After Resistance Training in Older Adults with Mild Cognitive Impairment: Outcomes of the Study of Mental and Resistance Training. J Am Geriatr Soc 2016.
boomers-biking

The Biggest Population in US History

/16 July 2018/ All MFN blog/

Did you know the Baby Boomers were the biggest population in US history?
Well, that was until their kids, the millennials, came along. Baby boomers were born from 1946-1964 and were 79 million strong. We are now down to about 76 million boomers and 10,000 are turning 65 or 70 every day! The millennials only outpaced them by 81 million, but for some reason the entire fitness industry is competing for their business and their attention and completely ignoring the largest, wealthiest, longest living generation in US history!

The leading Boomers are 63-72 and they are becoming “seniors” in a completely new way. In fact programs like Silver Sneakers, and other “senior” fitness programs, they are not attending, because as they would put it, those are for “old people ”….maybe for my mom or dad, but not me! This entire generation is breaking the mold on aging and is looking for something new, something cutting edge, something to give them a competitive advantage on their next 20-30 years. They want to give the grand kids a run for their money and they are only just beginning to take on new adventures. So they need personal trainers, group fitness instructors and fitness programming to be the best it can be.

If you want to stand out and dominate this market, then you need expertise and credentials that set you apart, because they are not going to just train with anyone.

In 2014 we set out to change the fitness industry introducing the first ever Specialist program based on decades of research and over 2,000 clients. We knew the industry didn’t need just another “senior fitness ” lite exercise course, but rather, one grounded in the science of human function and longevity…..and one that believed people could be vibrant, healthy and fit at any age….up until their very last breath!  We believe there will be hundreds more like Dr. Charles Eugster who decided to take up sprinting and wakeboarding in his 90s…..because it simply looked like a “hell of a lot of fun”!

If you want to be part of the functional aging movement I encourage you to check out the Functional Aging Specialist certification, and join the growing ranks. Save $100 on the certification with code 100OFFMFN. Click here for course details. 30% of proceeds from this FAI purchase is donated to the MedFit Education Foundation!

Dan Ritchie, PhD, has a broad background in the fitness industry including training and management in commercial and university/hospital-based fitness, for-profit, notfor-profit and educational facilities. His primary areas of expertise are in personal training for special populations: athletes, pregnancy, blind, stroke recovery, Parkinsons, multiple sclerosis, cerebral palsy, Fibromyalgia, Alzheimers, etc.

This article was reprinted with permission from the Functional Aging Institute.

nordic walking picture

Active Living for Seniors and Nordic Walking

/23 June 2018/ All MFN blog/

Healthcare professionals working with older adults are routinely prescribing walking, as part of rehabilitation and overall health and wellness programs. There are over 100 research studies identifying health benefits of adding specialized poles to any walking routine. Due to the improved balance, posture, reduce impact off painful joints and improved mood and confidence health, this accessible and affordable activity, urban poling, and especially the use of Urban Poling‘s unique ACTIVATOR™ poles, has become a popular choice for persons requiring help with stability and balance, as well as for older or perhaps less active adults. The ACTIVATOR™ poles are the only ones like it available on the market which have been co-designed by an occupational therapist for maximum safety, comfort and effectiveness, as well as reducing the factors related to falls. —Dr. Agnes Coutinho

Research Benefits

Evidence based research relating to older adults clearly identify poling, with the proper training, as a healthy activity suited for improving quality of life. Proven benefits include:

  • Increase balance & stability
  • Increase in mobility
  • Improve posture
  • Reduce impact off lower extremity joints
  • Improve gait speed
  • Improve strength (poling can engage up to 90% of your muscles)
  • Increase confidence

Short-term and long-term effects of Nordic Walking training on balance, functional mobility, muscle strength and aerobic endurance among Hungarian community-living older people: a feasibility study. Balance, functional mobility and aerobic endurance significantly improved in the Nordic walking group.  This study showed that Nordic Walking is a simple, well–tolerated and effective physical activity for older people in Hungary.1

Effect Of Walking Poles On Dynamic Gait Stability on the Elderly. Texas Women’s University study, which concluded that walking poles provided increased gait stability at both preferred and fast speed.2

Effects of Nordic walking compared to conventional walking and band-based resistance exercise on fitness in older adults. While all modes of exercise improved various components of fitness, Nordic walking provided the best well-rounded benefits by improving upper-body strength, cardiovascular endurance, and flexibility. Therefore, Nordic walking is recommended as an effective and efficient mode of concurrent exercise to improve overall functional fitness in older adults.3

The effects of pole walking on health in adults: A systematic Review. The effects of pole walking (PW) on cardiorespiratory fitness were most extensively studied. The most frequently examined psychosocial measure was quality of life. All studies reported at least one beneficial effect of PW compared with the control group. The results of this systematic review indicate that PW  programs have some beneficial effects on both physical and psychosocial health in adults with and without clinical conditions.4

Diana Oliver is a dynamic business professional with a extensive background in marketing, sales and fitness. She has a passion for promoting the many health benefits of Urban Poling, which stems from her personal experience. Diana combined Urban Poling with other positive lifestyle choices to regain a healthy weight and improve her cardiovascular health following two strenuous pregnancies. Her positive recovery has instilled a drive to help change the face of health care in Canada.  In 2012, she became a certified urban poling instructor and taught classes in her own Pilates business.  In 2014, became a partner in Urban Poling Inc.

References

(1) Viraq et al., 2014

(2) Kwon, Silver, Ryu, Yoon, Newton & Shim, 2006 (unpublished)

(3) Takeshima et al., 2013

(4) Fritschi et al., 2012.

The information in this article is not intended to replace existing rehabilitation programs. The testimonials are those of independent therapists and are not a guarantee of results. The consumer should not rely solely on this publication but should also consult their physician or therapist. Urban Poling Inc. and its employees and representatives do not accept any liability for the information contained in this publication or any damages.

urban poling image 2

Getting Active at Every Age and Stage: Benefits of Nordic Walking

/14 June 2018/ All MFN blog/

With a shocking 70% of children leaving organized sports by the age of 13 and obesity rates on the rise, we know that we need to be introducing our children to activities that they can do across a lifespan, whether they are 5 or 95 years of age!

Join Urban Poling for a free webinar that will walk through some of the most important and challenging stages of life. Learn why Nordic Walking can be beneficial for each age group to ensure longevity and exercise adherence across a lifetime!

Webinar Overview:

  • Shocking Stats & a look into the Sport-Lifecycle Trends
  • What is Nordic Walking?
  • Research supporting Nordic Walking for All Ages and Stages
    • Childhood (3-11 Years)
    • Adolescence (12-18 Years)
    • Adulthood (Pre/Post Natal, Weight Management & Disease Prevention, Pre/Post Hip/Knee)
    • Seniors & Mitigating Falls

This webinar will be presented by Gabriella De Nino, Registered Kinesiologist, CSEP-CPT & NCCP Certified Soccer Coach.

June 26, 12:00-12:45 EST
Webinar Registration ►

Diana Oliver is a dynamic business professional with a extensive background in marketing, sales and fitness. She has a passion for promoting the many health benefits of Urban Poling, which stems from her personal experience. Diana combined Urban Poling with other positive lifestyle choices to regain a healthy weight and improve her cardiovascular health following two strenuous pregnancies. Her positive recovery has instilled a drive to help change the face of health care in Canada.  In 2012, she became a certified urban poling instructor and taught classes in her own Pilates business.  In 2014, became a partner in Urban Poling Inc.

ed-concept-signs

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

/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

trainer client squat

Squats: Five Things to Consider

/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”.

Personal trainer and her client with dumbbells

Metabolic Syndrome: A New Focus for Lifestyle Modification

/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

  1. 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.
  2. 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.
  3. 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.
  4. Huang, Paul L. “A Comprehensive Definition for Metabolic Syndrome.” Disease Models & Mechanisms5-6 (2009): 231–237. PMC. Web. 16 Apr. 2018.
plank 2 elbows 2

The Power of Plank

/10 May 2018/ All MFN blog/

Many people will go to the gym in hopes of “looking” better. Although we all want to be our best selves, working out for a “look” vs. overall strength and well-being can lead to imbalanced muscles, as well as other injuries. This can be especially true for those looking for a “flat stomach” or “washboard abs”. However, the true importance of abdominals is to strengthen and contain the organs in our central region, as well as support the spine, especially the lumbar region.

In Pilates, as well as in Yoga, our main focus is the Transverse Abdominus. A way to think of this: the saran wrap, or casing of a vegan sausage, that wraps all the way around, and holds everything together.

For this reason, many exercises are done in neutral spine, vs. merely moving one’s head up and down. In fact, many people injure their necks because they “pull on their heads”, and don’t even come up high enough to achieve enough forward flexion to have the desired result of abdominal contraction.

I have also encountered students who have had neck and spinal injuries that prevent them from curling up. Does that mean that abdominal strengthening is off the table? The answer is quite the opposite.

Plank is such a wonderful and functional exercise. Learning how to maintain one’s body in neutral spine plays into everything that a person does in daily life activities: from simple sitting and walking, to running and spinning. And you would NEVER want to lift a box in a rounded spine, so it is important to learn to TRAIN the body for real life.

When working with beginners, I will often use a raised box or platform to take the edge off, as having the chest inclined upward will help a new person ease into the idea of eventually having a horizontal line. However, remember that this is not a FLAT line by any means! The spine has 3 curves: the cervical spine (at the neck) has a concave curve, the thoracic spine (back of the rib cage) has a convex curve, and the lumbar spine (lower back) has a concave curve. And if you want to add a 4th, the pelvis/sacrum has a convex curve as well. Together, this “S” shape is what keeps a body “straight”.

To get started: Find and all fours position where you can feel “the suspender” action: when the base of your ribs and your pelvic bone will feel like they are aligned in the front. All your curves in your spine will be present. Your arms will be directly under the line of your shoulders.

At this point I will cue, “Elbow, elbow, leg, leg”. Place one elbow on the mat or on the bench (if modifying), then the other, then walk one leg back straight, followed by the second. The elbows will still be right under the line of the shoulders. The Head will remain elongated (never hung, and DEFINITELY not hanging into one’s hands, hoping for it to be over). The chest is expanded, not rounded, as if you have a great necklace or t-shirt you want everyone to see. The feet are parallel, not spread apart. And although a strong plank will lead to a strong downdog, the BUTT is NOT above the chest. The opposite can be true, especially for a beginner on a box, or when doing the plank on straight arms, but sticking the butt up in the air takes away from the abdominals, and will eventually hurt one’s back and shoulders. Same is true for pelvic tucking/back rounding. The trick is to find and enjoy the neutral spine alignment.

As you progress, some fun variations on plank are:

  1. Gently lifting one foot off the floor a few inches, and placing back down. Doing 8-16 reps alternating legs.
  2. On straight arms (if on the mat), or on bent elbows (on a platform that is 2-4 risers high), gently bend one knee to 90 degrees, hold for a second, place back to parallel on the floor, and switch sides. Doing 8-16 reps alternating legs. This is NOT to be done as a run, as many people will lift their butt/hang their head/round their back. This is meant to be done in a slow and controlled manner for the most pain, I mean FUN!
  3. More advanced, you will see me do a plant on straight arms with my feet on a foam roller. Without changing out of neutral spine, I will gently roll the roller with my feet toward my midline, (about a 90 degree angle), and then extend back to the original plank, without letting my center sag. I do not do this on a ball as that would lift my butt. Again, it is better to have the chest higher than the hips, rather than the reverse.

Of course, plank does involve a bit of strength. Therefore, new students could simply go to an all fours and practice finding neutral spine. Or, to modify further, sit at the edge of a hard backed chair, and practice aligning one’s ribs and hips, and then containing the abdominals. Hold for a count of 5, and release.

In closing, abdominal strength is so much more than flat stomachs and washboard abs. Using the power of the plank, one can achieve true abdominal strength that will help with all sports and daily life activities.

Kama Linden has been teaching fitness for over 2 decades. She has taught strength, step, pilates, vinyasa yoga, senior fitness, and has worked with clients and students of all ages and fitness levels. She is certified by AFAA Group Exercise and NASM CPT, as well as 200 hour Yoga. She has a BFA in Dance from University of the ARTS.  Her newest book is titled, “Healthy Things You Can Do In Front of the TV”.  Visit her website, bodyfriendlyoga.com