The Important Role Diet & Nutrition Play at Your Gym

Respecting ‘scope of practice’ protects and pays dividends for your staff and your members.

Within the health club setting, the members of a loosely organized, but mission-related team—personal trainers, life coaches, and dietitians or nutritionists—all have valuable expertise to share on physical fitness and sound eating habits.

But how should a health club tackle these two vast topics and give the best advice? Should a club include nutrition when planning out an exercise program for a member?

“I think it’s important to address both together,” says Alexandra Black Larcom, a registered dietitian and IHRSA’s senior manager of health promotion and health policy.

“If done correctly and incrementally, I fully agree that doing both at the same time can produce more impactful results,” says Ashley Varol, who oversees employee wellness at the University of Cincinnati, in Cincinnati, OH. “I’ve witnessed this with clients.”

“Exercise and diet should absolutely be viewed and dealt with as one—it’s not a ‘one-sided’ coin,” says Mark Cuatt, the managing partner at All Sport Health and Fitness in Fishkill, NY.

“Exercise and diet should absolutely be viewed and dealt with as one—it’s not a ‘one-sided’ coin.”

Mark Cuatt, Managing Partner

All Sport Health and Fitness - Fishkill, NY

And: “In my experience working with clients, combining proper nutrition with safe and effective exercise programming ... proved to be more beneficial and yielded better results,” says Makeba Edwards, who manages a corporate fitness site in Tampa, FL, for EXOS, a human-performance company based in Phoenix, AZ.

Edwards also is a master trainer and subject matter expert for the American Council on Exercise (ACE), in San Diego.

Diet & Exercise: A Perfectly Compatible Duo

Their shared conviction proceeds from personal experience, but it’s predicated on a growing body of research. Larcom points to a seminal study, conducted by the Stanford University School of Medicine, in Stanford, CA, that was published in the Annals of Behavioral Medicine in 2013.

“In this study, the subjects who tackled diet and exercise together did best at meeting three healthy lifestyle goals—exercising for 150 minutes a week, eating five to nine servings of fruits and vegetables per day, and limiting saturated fat to 10% of calorie intake—than those who didn’t,” she says.

The members of two other control groups, who didn’t address diet and exercise simultaneously, failed to do nearly as well in achieving those goals.

“Studies have shown that changing exercise habits, but not nutrition, produces poorer results,” Larcom explains. “In most weight loss studies that compare all three factors, the hierarchy is this: Exercise and nutrition is better than nutrition alone, and is better than exercise alone.”

The National Weight Control Registry (NWCR), a research organization based in Providence, RI, which has been tracking data since 1984, has produced a number of studies that have reached a similar conclusion: Exercise is effective in helping dieters shed pounds and maintain weight loss.

Finding the Right Point Person for Nutrition Questions

Personal training dietitian fruits stock column

All of the individuals involved in a member’s pursuit of overall health and fitness have important roles to play, but, in many cases, the point person in a club—the one closest to the action—is the personal trainer. They’re clearly qualified to devise and oversee a program of physical activity for clients and, because they see them regularly, may become aware of other needs or be asked for advice on matters such as diet.

But is it appropriate for them to dispense such information? Yes ... with distinct and well-defined clarifications.

“Nutrition education—the sharing and reinforcement of basic or essential knowledge—is both appropriate and beneficial,” says Larcom. “It may be a good entry to the topic for clients and add extra value to workouts.”

At the same time, she adds, “Trainers need to be clear about what their role is.”

The critical commandment, the Golden Rule, when offering nutrition advice is: Be conscious of your scope of practice. It’s an admonition with both practical and legal implications.

A trainer with a basic understanding of nutrition can share basic, common-sense sorts of information. For instance: “A balanced diet of macronutrients—carbohydrates, proteins, and fats—and essential micronutrients enable the body to carry out its necessary functions,” says Edwards.

“The critical commandment, the Golden Rule, when offering nutrition advice is: Be conscious of your scope of practice.”

Or ... “Every healthy eating pattern has a strong foundation composed of a combination of vegetables, fruit, whole grains, nuts, seeds, some type of high-quality protein ... and healthy unsaturated fat,” says Rachele Pojednic, an assistant professor of nutrition at Simmons University in Boston. “Using that base, it’s possible to suggest a plan that works for an individual, their body, and activity level.

“I call it ‘the spectrum of healthy eating.’”

Trainers also are free to share simple tips, recipes, or personal experiences, and direct clients to authoritative, evidence-based resources, such as the U.S. Food and Drug Administration; Academy of Nutrition and Dietetics; U.S. Department of Agriculture; and Centers for Disease Control and Prevention.

Club-based nutrition, cooking, or healthy-shopping courses are other viable and valuable assets.

A helpful rule of thumb trainers can utilize is to distinguish between general and specific forms of advice. “A trainer can certainly provide clients with nutrition information,” says Pete McCall, an author, trainer, and the host of the All About Fitness podcast. “The role is to educate them about the types of choices that can move them closer to their individual goals.

“However, we need to adhere to scope of practice, which dictates that, while we can talk about general needs—such as number of calories to support daily activity, and how to make healthy decisions when eating—we shouldn’t be prescribing specifics. That crosses the scope of practice.”

Personal training NASM column

“There’s a line when it comes to making highly specific recommendations, or, for example, when offering medical nutrition therapy (MNT), which is the use of a nutrition diagnosis, therapy, and counseling to manage disease,” says Larcom. “By law, MNT is provided by a registered dietitian or nutrition professional.”

“Personal trainers should concentrate on the dynamics of movement and exercise,” says Cuatt. “However, part of their role is to educate clients about the types of foods that can help move them toward their individual goals. They can offer information and insights—as opposed to specific directions—about what to do.”

Varol echoes Cuatt’s observations: “Certified trainers have the knowledge to talk broadly about nutrition—for instance, what constitutes a sound diet, and healthy vs. less healthy options. They also can explain how nutrition informs and complements exercise.”

Out-of-scope practices—prohibited by law in most states and numerous countries—include such things as stipulating calorie intake, recommending specialty diets, assessing a client’s diet to develop meal plans for nutritional needs, and prescribing supplements.

“For healthy clients, a trainer should not recommend a specific diet. Under most state laws, they can’t make specific recommendations,” Larcom says. “It’s the difference between ‘You should’ and ‘I recommend’ vs. ‘You could try,’ or ‘I find it helpful to,’ or ‘This source says ...’”

When the red line that Larcom describes begins to materialize, it’s time to refer.

Healthy Choices Is a Collaborative Effort

“Trainers can steer clients toward making choices that create lasting changes in behavior and yield a healthier lifestyle,” says Edwards, “but there are instances that warrant a consultation with a dietitian, such as when someone requires a specific diet plan because of a medical condition or diagnosis.”

Referrals should be made, she says, when a client wants a prescriptive, step-by-step, ingredient-by-ingredient plan to follow, or one that’s goal- or condition-specific.

A good example, Larcom says, is a person with hypertension or prehypertension. “A dietitian can recommend the DASH (Dietary Approaches to Stop Hypertension) diet, working with them to understand the components of the diet and set specific calorie, macronutrient, and sodium goals. They also can recommend that the client follow a specific DASH meal plan.”

Trainers, she says, should refer to dietitians for specific plans or when issues need to be addressed. “They can walk a client over to the registered dietitian if the club has one, make an introduction, and do a personal handoff. It can be a seamless transition.”

Health coaches—another player in the extended, member-centric team—also can contribute in a meaningful way to successful and lasting results.

“Coaches focus on an overall balanced approach to well-being, incorporating activity, nutrition, mindfulness, and recovery,” says Cuatt.

“Coaches have a bigger lens to peer through, and engage the client in conversations that may touch upon their mental health and well-being, work/life balance, and motivation,” says Varol.

“Health coaches—another player in the extended, member-centric team—also can contribute in a meaningful way to successful and lasting results.”

“Their job is to identify the behaviors an individual wants to improve, whether it concerns exercise, nutrition, or stress reduction, and, then, help them develop their own course of action to get there.” Many fitness professionals recognize and endorse the merits of a multi-disciplinary approach to personal training and health coaching.

“My job as a trainer is to know how exercise affects the body and how to design and implement exercise programs that can produce the desired changes,” says McCall. “Other components, such as nutrition, mental health, sleep, soft-tissue injuries, etc., are all equally important, but require different types of training and skills to help clients make changes successfully.”

The holistic approach—which recognizes the unique skills and inherent limitations of trainers, dietitians, health coaches, and other health and fitness professionals—layers one body of expertise upon another, upon another, upon another ... to the ultimate benefit of the client.

“Staying in our own lane protects both ourselves, as the professional, but, most importantly, the client,” Varol says.

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