“What are your clients’ most profound nutrition challenges or areas of confusion?”

During my more than 35 years in the fitness industry, I have observed several recurring areas of confusion for clients concerning nutrition. Although not limited to these, the following are the most common that I have encountered:

And in more recent years:

My overall approach to health and fitness is to have a well‐balanced workout program and diet. I always try to respect the scope of practice of a personal trainer, thus I do not give specific advice about diets and nutrition. I encourage healthy eating, drinking lots of water and "everything in moderation." I back up my opinions with facts and references. I occasionally share personal experiences, approaches and strategies that work for me, but I never impose them on anyone.

I collaborate with a small network of expert dietitians and nutritionists. I feel comfortable talking to my clients about basic nutrition and the benefits of a well‐balanced daily diet, but for anything that requires more precise information or a specific diet, weight loss program, trends, etc. (see list above), I always refer them to a professional who has the right expertise and know‐how.

Finally, as an American who has been living in Paris for the last 27 years and has worked in more than 50 countries, I have come to realize that the approach to nutrition may vary from country to country. Thus, what is recommended in one country or region may not work elsewhere. Or there may be certain foodstuffs or ingredients that are staples in some diets and not in others, making it trickier to advise clients. For example, it would be challenging to ask Italians to go on a "low‐carb" diet and cut out pasta, or ask the French to stop eating croissants! This leads me back to the notion that clients need a personalized exercise and nutritional plan specific to their needs, goals and life/work environment.

     Fred Hoffman, Med
     Owner, Fitness Resources Consulting Services
     Paris

As a personal trainer for more than 18 years, I have seen many clients struggle with topics like fear of fat or concerns about calories. Most clients are afraid of eating carbohydrates and not getting enough protein. Client confusion about carbohydrate consumption often stems from diet fads such as Atkins, South Beach or Paleo. When clients ask me what I eat, I let them know that I eat as many fruits and vegetables every day and as many whole foods as possible. I choose brown rice and quinoa over pasta and bread. When clients ask me how much protein they should eat, I direct them to the T. Colin Campbell Center for Nutrition Studies at http://nutritionstudies.org/t/protein/.

I encourage my clients to be intentional about the foods they eat and to not worry too much about calories and protein. If we are eating a well‐balanced,
plant‐based diet, we should meet our nutritional requirements. After all, the United States is not a malnourished country; we are an overfed country focused on convenience foods. Encouraging our clients to focus on eating more plants can help our planet and our waistlines.

     Kristen Horler, MS
     CEO and Founder, Baby Boot Camp and Inspiring Wellness LLC
     Sarasota, Florida

I could write a book about this topic! I have to say the most common area of confusion I observe in my clients (women in their 40s and 50s who want to lose weight and improve health and fitness) is around how much they actually eat. Many of them come to me as chronic undereaters, having followed an "exercise more, eat less" strategy for many years—despite its failure to help them lose weight. Additionally, the calories they do consume tend to come from poor‐quality food choices. Once I'm able to convince them to eat more, and we improve the food choices they're making, most are shocked by just how much they can eat in a day while losing weight.

     Tamara Grand, PhD
     Fitknitchick.com
     Port Moody, British Columbia

With all the information circulating in the world today, clients often access inaccurate information or latch onto the latest trend. As the owner of a Pilates studio for 20 years, I have found that clients' biggest areas of nutrition confusion are these: "What should I eat to lose weight; how many calories should I eat; and what is an actual portion size for each food group?" Clients generally do not know how much they actually eat and what a true portion size should look like.

To help clients combat this problem, we offer the services of a registered dietitian who works in a hospital and consults on the side. The RD designs meal plans tailored to individual clients to assist in weight loss and then shows the clients what they will need to eat to maintain that weight loss. After these consultations, the dietitian usually reports to me that the clients were unaware of how much they were consuming and how quickly the calories added up.

     Patricia Welter, PMA‐CPT
     Owner, Suncoast Pilates
     Palm Harbor, Florida

My clients have no idea what they "should" be eating to stay healthy and energized and to maintain a healthy weight. Many have tried various diets with little to no lasting success. Some have mentioned purchasing special foods sold by diet companies that promised results if you just ate their foods. Some had success with diet plans that prescribed a meal plan, but they found it boring and stopped after a few months. Then there is the "what diet works best" confusion. Should they eat low fat, no fat or all fat?

With all the information at their fingertips, our clients are more confused than ever. They don't know if a given approach is fact‐ or science‐based nutrition or just another false promise.

As a Precision Nutrition coach, I teach clients how to eat right and which foods will actually help them gain energy and stay healthy. I provide articles, blog posts and in‐depth conversations about how to choose the right nutrition. When the latest and greatest diets are mentioned in newspapers and magazines, we discuss why those diets don't work but sound nutrition does.

     Heike Yates
     CEO, Heike Yates Fitness
     Silver Spring, Maryland

Clients consistently come to me with misconceptions about nutrition, commonly driven by what they see and read through mainstream publications and/or TV shows. Many articles take small, statistically insignificant outcomes from a study and/or represent a correlation as causality, further muddying the waters for people seeking to find the healthy path. To add to the confusion, people often mistakenly read the packaging for indications of how "healthy" a product might be and are swayed by marketing terms—such as healthy, organic or gluten‐free—splashed across the containers. They also may intuitively think a small package of something is one serving when the marketing says "only 90 calories per serving." However, when examining the small print, they find that the container holds two servings.

For clients seeking a specific food plan and nutritional direction, I refer them to a registered dietitian and I offer support on the behavior side of implementing (often the biggest challenge) the plan. Many clients benefit from learning to ignore the packaging information and focus on the nutrition facts label. Once they understand how to read and understand the label, they realize that this simple step is often a game changer for them. Forgo the flash (splashy marketing on the front) and focus on the facts (FDA nutrition label on the back). The new FDA nutrition facts label guidelines announced last May made great strides by reflecting scientific information, including the link between diet and chronic diseases such as obesity and heart disease. Although the compliance date isn't until the summer of 2018, I have used this information (specifically the part added sugars play in negatively affecting health) to help my clients now.

I find that providing clients with information from http://www.health.gov is helpful. One example is a two‐page guideline on cutting down on added sugars: https://health.gov/dietaryguide
lines/2015/resources/DGA_Cut‐Down‐On‐Added‐Sugars.pdf.

I attended the 2016 IDEA® World Nutrition & Behavior Change Summit, where we had a day of hearing from highly acclaimed and respected educators and leaders regarding all aspects of nutrition and the associated principles of application (behavior change). I found this experience highly valuable. Many of my clients have benefited from reading some of the books authored by those leaders, such as The Diet Fix by Yoni Freedhoff, MD. I budget a portion of my revenue each year to invest in my further education across the domains of exercise science/application, nutrition and behavior change, which improves my ability to help my clients obtain the full, healthy lives they seek.

     Beth Jordan

     Personal Trainer and Owner, www.FullestLiving.com
     Jacksonville Beach, Florida n