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Fitness Forum

Your feedback, concerns and insights.

Digital IDEA Fitness

I noticed your
article on medical fitness (December digital IDEA Fitness Journal) in the “best of” list. You did an excellent
job, and I still believe that it is the wave of the future. Years ago, medical
nutrition was not part of medical school, but now it is. We are now offering a
specialty qualification in nutrition and exercise for our medical students,
after a number of them completed internships with me last summer. Recently I
spoke to our residents at the [Veterans Administration] hospital and, although
they are hospitalists, they enjoyed hearing about articles from [The Journal of the American Medical
on physical activity and health, and we exercised using a “fit
it in” approach—so it was fun. Next, I’ll speak to our primary care doctors, as
I think they’ll have the greatest impact. The sticking point is billing, since
fitness professionals are not licensed—and there is concern over who is
qualified and what that entails. There are lots of barriers to overcome, but
with ACSM’s Exercise as Medicine and IDEA’s [and other group’s] promotions,
hopefully the field will emerge.

Mary E. Sanders, PhD, FACSM
Associate Professor, Division of Medical Nutrition
University of Nevada, Reno

I have just finished reading the article
“Going From Foodie to RD” (December digital IDEA
Fitness Journal
). The article was very informative about how a fitness
expert could further her career with education to become a [Registered Di­etitian
(RD) Technologist] or an RD. A huge gap exists between the degreed nutrition
professional and the general population requiring services, and the nutrition
science industry has yet to address this growing need.

From a grass-roots level, we
see new businesses addressing obesity issues and the publishing industry
advancing new books that essentially rehash the basic food principles. As
personal trainers, we seek to augment our education to enhance our services to
our clientele and remain personal
trainers. It’s foolish to suggest we require a 4-year degree to achieve that.
The stringent qualifications of the RD are comparable to those for physical
therapists. Yet within the fitness area we have exercise science—and those
graduates are strongly encouraged to become certified by the same certifying
bodies that the nondegreed have access to. Over the past 25 years, a fledging
concept has developed into a billion-dollar industry with our own high
standards. If nutrition certifications aren’t acceptable to the nutrition
industry, how is that being addressed?

Fitness and nutrition go
hand-in-hand toward good health. Personal trainers cannot ignore nutrition, as
it is the fuel source for activity. Conversely, nutritionists could ignore the
fitness aspect (although we hope they would not!).

Our obesity epidemic grows.
Our national hunger for sensible, solid nutrition advice grows. The fitness and
nutrition industries need to jointly address the lack of acceptable
certifications and lack of personnel who can deliver services, professionally
and within the scope of practice, to the general population.

Becki Bottoms
Carmel, Indiana

Diabetic Clients

I am so
grateful for the article “Working With Diabetic Clients” (November–December,
page 54). I have my first “confessed” diabetic client, and this article is just
what I need. Sometimes clients don’t let you know up-front about this medical
issue—even when you’ve tried to do a thorough check on their personal needs
assessment. I now keep little apple juice boxes handy just in case some
[clients] are less than forthcoming. Thank you!

Sarah Booker
Santa Maria, California

Certification? Licensure? What’s on PFTs’ Minds?

I read the
article “Certification Standards? Licensure? What’s on People’s Minds?” in the
January issue (p. 51), and I think the points raised are extremely pertinent
and crucial to our longevity and integrity as fitness professionals. As a
small-business owner who focuses on cardiovascular risk-factor modification and
chronic disease management, I must say that a measurable and attainable
standard for our profession is needed in the very near future. As you know, we
are embarking on a time in our communities during which our clients are getting
older, more health conscious and more likely to need some type of risk-factor
management strategies built into their training programs. Whether it is
hypertension, diabetes or more serious medical concerns, personal trainers over
the next 10 years must become equipped to deal with such issues.

I sit on a national personal
trainer certification
committee, which recently met for our semiannual meeting.
Issues related to industry standards and certification credentials were a very
“hot” topic. I think it is up to very visible and credible organizations such
as IDEA and ACSM to set the standards and lead the exercise and fitness
industry into the next phase. Gone are the days when personal trainers should
be musclebound power lifters; instead, they should be health-conscious fitness
experts. More people are seeking the advice of companies like mine for
strategies to make a difference in their health profile, rather than their
repetition maximum on a bench press.

What is the next step?
Restricting the number of NCCA-accredited agencies for certified personal
trainers (CPTs) will be a start because as more become NCCA-accredited, the
more diluted the standard for CPTs becomes, which puts us back in the same
predicament as [we were in] before accreditation in our industry began. A CPT
license accessible to professionals with certain credentials would be a huge
step for our industry. We need to find a way to maintain and develop industry
standards that everybody must adhere to in order to call themselves personal
fitness trainers, or any variation thereof.

I have four specific roles in
the industry: I am an exercise physiologist in a clinical rehabilitation
setting; I am a certified personal trainer with a limited number of clients; I
am a small-business owner/
manager with six trainers to keep busy; and I am an exercise science instructor
at a local college. I see students with no experience and I work with very
seasoned professionals. I think there is more need now than ever to address
these issues from several aspects, including those that I am directly involved

Thank you for your time and
dedication to our careers!

Tom Spring, MS, CES, CPT
Huntington Woods, Michigan

I’ve been
through some pretty nasty wrangles with club owners who didn’t see the harm in
misleading their members about their staff’s certifications. I most definitely
agree there ought to be more stringent guidelines in place than a weekend
workshop coupled with “I’ve-worked-out-for-years-so-I-know-what-to-do”
experience. I still cringe at what I see going on in gyms that I visit, and I
find myself wondering if the staff truly carries the credentials claimed.
Unfortunately, most of the public simply don’t consider that when choosing
their instructor/trainer.

As wellness professionals, we
should be more concerned about the whole package during assessments and not
just how lean and mean we can get [clients] in as little time as possible. With
more stringent education/practical experience/qualifications in place, that
would likely weed out the “work ’em till they puke, mirror-muscle trainers” so
many flock to.

It would also be beneficial to
have some protection in place for those unfortunates who blow the whistle on
unscrupulous owners. In Washington State, none is offered unless [the
whistleblower] works for the state or the medical profession. Harassment and discrimination
can be carried out with impunity unless you have oodles of money to file a
lawsuit within the court systems.

I agree with the experts who
voiced their opinions in the certification and licensure article. People put
their wellness in our hands, and we should be held to some pretty high
standards so that the flashiest drill sergeants in the industry aren’t the gold
standard that the easily seduced are drawn to.

Nancy L. Jerominski
SeaTac, Washington

Teen Girls and Yoga

As a mother of
a teenage daughter and a yoga practitioner for the past two decades, I loved
Beverly Blair Harzog’s article “Image Conscious: Why Teenage Girls Need Yoga”
(January, page 92). From an early age, girls are bombarded with unrealistic
media images and poor Hollywood role models. In addition, the competitive
environment of sports, school and social situations can create additional
stress. Along with an international communications expert, I have been leading
Mother and Daughter Yoga Retreats to help girls learn how to create positive
and healthy thoughts and emotions and release feelings of judgment, criticism
and competitiveness through yoga. Study after study proves that a healthy
relationship between mothers and daughters leads to both the mother and
daughter enjoying increased happiness, success and longevity.

Stacy McCarthy, RYT
Rancho Santa Fe, California

Study Design on Low-Fat Dairy Consumption Flawed?

I really
appreciate your sending me a copy of the September issue with our whey advertorial.
However, I was disappointed to look further into the journal and see a piece on
a study by J.E. Chavarro and others published in [the May 2007 issue of] Human Reproduction and titled, “A
Prospective Study of Dairy Foods Intake and Anovulatory Infertility.” The
high­­light of your report, titled “Get milk? Get pregnant?” [Food for Thought,
p. 79] sum­marized [Chavarro’s] findings, which concluded that consuming
high-fat dairy foods decreased the risk of anovulatory infertility, and
consuming low-fat dairy foods increased its risk. While we understand the
importance of IDEA to communicate current research findings and their
implications to the public, we would like to bring to light several critical
weaknesses of this study and emphasize the potential negative implication this
study may have on nutrient intake among women, a population that already
consumes significantly lower amounts of recommended nutrients such as calcium that
are found in dairy foods.

The Chavarro study evaluated
the association between dairy foods and anovulatory infertility in over 18,000
women and found that the fat content of the dairy foods determined women’s risk
for the infertility. While the researchers controlled for several factors that
may influence infertility (including age, exercise and smoking), they failed to
control for other factors (including socio­economic status) and dietary
patterns (including total fat and energy­ intake) that may have influenced the
results. The authors themselves state that after adjustments for other
variables, “. . . only dairy fat intake was associated with a lower risk of
anovulatory infertility. The intakes of lactose and phosphorus were not associated with anovulatory
infertility in any of the models.”

Since most dairy foods contain
lactose and phosphorus, and lactose particularly is a direct indicator of dairy
food intake, this study essentially concludes that there is no association
between dairy food consumption and anovulatory infertility. The only association
found between anovulatory infertility and dairy foods resulted from the fat
content of dairy foods. Because total calories, total fat intake and total
nutrient intake were not accounted for in this study, it could very well be
hypothesized that women consuming high-fat dairy foods may also consume
significantly different amounts of calories, fat and/or nutrients compared with
the low-fat dairy food consuming group. One or more of these variables may
actually be accountable for the observed differences in fertility.

Last, the authors of the study
admit that very little research had been conducted to determine the effect of
dairy foods on fertility, and the results of those studies have been directly

On a final note, this study
was purely observational and did not measure any type of cause and effect
regarding anovulatory infertility. Therefore, the conclusions and implications
of the study need to be determined extremely cautiously. Unfortunately,
highlighting a study that is purely observational and does not account for
critical variables may be interpreted falsely by the general population and in
this case may have a negative effect on essential nutrient intake for women.
The IDEA summary piece does acknowledge the contradictory data available on the
subject and reminds women that the current study is not an endorsement for
whole milk for those wishing to become pregnant. Unfortunately, the summary
piece does not remind its consumers of the 2005 Dietary Guidelines
recommendations encouraging individuals to consume three servings of low-fat and fat-free milk or milk-equivalent products since these foods provide
three of the five “nutrients of concern” for Americans: calcium, potassium and
magnesium. Reiterating to consumers the importance of consuming adequate levels
of foods and nutrients, as recommended by the science-based 2005 Dietary
Guidelines and other leading health professionals, for overall health is
critical, particularly if the results of observational, highly inconclusive
research are to be reported.

Marlene Schmidt, MS, RD
Vice President, Nutrition Affairs
National Dairy Council
Rosemont, Illinois

Next Stop: Mount Everest!

Thank you for
covering the story about my quest to Inspire the World to Fitness® [by climbing
the world’s highest mountains]. (See “Seeking the Summit,” January, page 24.).
I am so proud to be a part of such a wonderful organization, which I feel has
brought so much to my professional life. I will always continue to do my best
to Inspire the World to Fitness.

Nancy Norris
Grand Blanc, Michigan

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