Nutrition Advice, take it or leave it?

Nutrition Advice: Take It Or Leave It, But Should You Give It Out?
From NASM Newsletter

Key Points
Personal trainers help clients achieve their personal health, fitness, and performance goals via the implementation of exercise programs and suggestions in lifestyle modification, including nutritional recommendations.Prudence about scope of practice and providing useful referrals to dietetics professionals when appropriate is essential to responsible practice, and serving clients' needsAccording to a 2002 article in the Journal of the American Dietetic Association , food and
nutrition misinformation can be a serious barrier to public health.

With certifications, continuing education, and even university-based education, fitness professionals bring safe, science-based exercise
> programming to their clients and group class members. But what about dispensing nutrition advice? When a client asks, "what do you think of this supplement? or "what diet should I follow to reduce body fat, improve my mile time, or vertical leap?" What should the answer be?
Personal trainers help clients achieve their personal health, fitness, and performance goals via the implementation of exercise programs and suggestions in lifestyle modification, including nutritional recommendations.
The Issues
> Not many years ago, the fitness field lacked the standardization and
> professionalism it is beginning to enjoy. Today, consumers are
> becoming better informed about how to locate a certified personal
> trainer and trainers are becoming more knowledgeable about how to find
> qualified continuing education. Consequently, the profession is
> benefiting from standards that are producing safe and consistent
> results. However, questions remain about fitness professionals and
> nutrition counsel. Who should dispense nutrition recommendations? What
> are the prudent parameters of scope of practice with dietary advice
> and how can trainers learn to recognize and respect them? Before
> trying to answer these questions, it is important to define some of
> the terms and credentials in nutrition -- both qualified and
> questionable.

> Many accredited universities offer degrees in nutrition. A bachelor's
> degree (B.S.) in nutrition requires four years of full-time study that
> qualify a graduate for entry level positions in dietetics. These
> positions are extremely varied and might include work with a food
> company, a government agency such as the USDA, or a medical environment.
>
> The Registered Dietitian (R.D.) credential is available to individuals
> who obtain a bachelor's degree in nutrition, complete an American
> Dietetics Association (ADA) -approved dietetic internship, and pass a
> comprehensive written test. RDs must keep their credentials current,
> just as fitness professionals keep their fitness certifications
> current, with continuing professional education credits (CECs). RDs
> also have varied employment, including corporate wellness, community
> and public health settings, sports nutrition, universities, medical
> centers, research areas, and many others. Although completion of a
> master's degree and PhD is valuable to nutrition professionals, it is
> not required to become a Registered Dietitian.
>
> There are other credentials in the field of dietetics, some credible
> and many questionable. For example, active membership in the American
> Society for Nutritional Sciences (ASNS) -- formerly called the
> American Institute of Nutrition -- is open to those who have published
> meritorious research on some aspect of nutrition and are presently
> working in the field. The Certification Board for Nutritional
> Specialists was founded by the American College of Nutrition in 1993.
> It offers a Certified Nutrition Specialist (CNS) credential to
> professionals with an accredited master's or doctoral degree that also
> have clinical experience and pass an examination.
>
> However others, like the Certified Nutritional Consultant (CNC),
> issued by the Society of Certified Nutritionists, do not require the
> same rigorous study or clinical experience that an RD must
> successfully complete. Other questionable credentials include
> Certified Clinical Nutritionist (CCN) and Certified Nutritionist (CN).
> Because the titles "nutritionist" and "nutrition consultant" are
> unregulated in many states, they have been adopted by many individuals
> who lack accreditation and are unqualified to practice.
>
> Forty-one states have laws that regulate the profession of dietetics
> and nutrition. (Iowa is one of those)
>
> The regulations fall into the following categories:
>
> licensure
> statutory certification
> registration.
> This is a complicated legal environment. According to Craig Busey,
> legal counsel to the ADA, "The treatment of this issue varies greatly
> from state to state. Some states address the difference indirectly by
> delineating the difference between dietetics and other forms of
> nutrition counseling, while others equate dietetics to nutrition
> practice. This notable lack of uniformity adds to the confusion and
> makes a general answer all the more problematic."
>
> While the discussion can get bogged down in legal minutia, it is
> important for fitness professionals to realize why they got involved
> in fitness. For most, it was the desire to help people. Busey adds,
> "dietetic licensure laws generally do not limit the right of an
> individual to provide nutrition advice and information related to non-
> Medical Nutrition Therapy (MNT)."
>
> With as many as 70% of American deaths due to diet-related diseases
> and conditions(1) , there's plenty of need.

Did you know?
> Twenty-four percent of physical activity professionals believe they
> know enough to provide all the information their clients need on
> nutrition, compared with 14 percent of dietetics professionals who
> stated that they know enough to provide all the information their
> clients need on physical activity. (2) In fact, according to IDEA
> Fitness Journal (2002) 26 percent of personal trainers use nutritional
> analysis software, 70 percent provide nutritional assessment, and 75
> percent provide nutritional coaching - practices that should be
> reserved to the scope of practice of registered dieticians who have
> four years of specific nutrition education. (3)

> With most health professionals looking toward the combination of
> balanced nutrition and regular physical activity to help stem the
> rising tide of obesity, it makes sense that those professionals
> trained in nutrition and those trained in physical activity should
> collaborate to help consumers realize the potential benefits of these
> healthful lifestyle practices. In 1997, the American College of Sports
> Medicine (ACSM), the ADA, and the International Food Information
> Council (IFIC) retained the Gallup Organization to conduct telephone
> interviews of both ADA and ACSM members to determine attitudes on
> nutrition and physical activity. The poll indicated that physical
> activity professionals tended to be more confident in their ability to
> provide nutrition information than dietetics professionals were about
> their ability to provide physical activity information. Even dietetics
> professionals observe specific limits to their practice scope, called
> the Scope of Dietetics Practice Framework (SODPF). (4) In theory, an
> RD without an accredited fitness certification has no more authority
> to give out specific exercise advice than a certified fitness
> professional does to give out specific dietary instructions.
What's the harm?
> For fitness professionals, the dangers of giving advice outside of
> practice are significant. According to a 2002 article in the Journal
> of the American Dietetic Association , food and nutrition
> misinformation can be a serious barrier to public health. Misinformed
> consumers may not only have a false sense of security about their
> health and well-being, but they also may delay appropriate, effective
> healthcare or replace it with products, services, or behaviors that
> may be harmful to their health. (5)

> If a fitness professional does not hold a recognized nutrition
> credential, how should they proceed with nutrition advice? "Certified
> personal trainers can provide general, non-medical nutrition
> information," explains Cynthia Sass, MPH, MS, RD, and ADA
> spokesperson. "But, they should not perform individualized dietary
> assessments, prescribe individualized diets, or even individualized
> dietary advice." Sass adds, "General information can be very helpful
> and still provides a great deal of freedom to talk about nutrition in
> a general way such as educating clients about the difference between
> saturated and unsaturated fat; which foods are good sources of fiber,
> etc. However, the fitness professional should be 100 percent confident
that the information they are providing is accurate, up-to-date, and science-based."
This is a challenging question," adds Dr. Mike Clark, President of the National Academy of Sports Medicine. "Only because there is no easy 'yes' or 'no' answer. Like with exercise, we want our professionals to always provide the best service to their clients, all things considered. If a trainer can help a healthy individual improve their diet, they should, through delivering general guidance which is science-based and well supported by established health authorities.
However, if the individual seeks medical nutrition therapy, they should pursue a qualified professional, a Registered Dietician, to
deliver this support."

Dr. Clark also points out that most accredited fitness certifications, including NASM Certified Personal Trainer, do include some nutrition information as well. NASM and other accredited role and functions of the macronutrients (protein, carbohydrate, and fat) in performance and healthy weight achievement. They should understand the role and importance of water, fiber, and the micronutrients (vitamins and minerals) and the basic nutrition guidelines for altering body composition. Certified fitness professionals should also be aware of issues surrounding supplementation, including the legislative environment regulating
supplements, as well as the government's Dietary Reference Intakes for
healthy people.
How to know what to say when
> With this knowledge, how can fitness professionals determine if they are stepping outside their scope of practice? By asking themselves a few key questions. This will insure that they are giving out sound, science-based information, thereby protecting their liability, professional ethics, and their client's well-being.

When to Refer
If you are a fitness professional, without a qualified credential in nutrition, here are some questions to consider. If the answer is
"yes," the client should be referred to a dietetics professional.
1. Is there a possibility that the client has a disease or co-morbidity associated with their weight or with their health?
2. Would your advice be considered medical or in the context of
disease treatment?
3. Does your advice involve the interpretation of blood work or other clinical tests?
4. Is the client asking you for individualized dietary assessment?
5. Is the client asking you to prescribe an individualized diet or
dietary advice (versus general information like portion awareness or nutrient density)?
6. Are you recommending a supplement as part of your counsel?
7. Is your client trying to manage medical symptoms through diet?
8. Could your assessment or advice possibly cause a delay in treatment
or a misdiagnosis that may result in serious harm to your client?
9. Could your advice result in an unwanted interaction between
foods/drugs, foods/medical condition, supplement/drugs,
foods/supplements?
10. Did you neglect to access the authorities and academic research on the topic in question?

> "The ultimate success of these two groups working together," explains
> ADA spokesperson Cass, "is that it isn't about territorialism. It's
> about working together and respecting scope of practice which is in
> the best interest of the trainer and the client." The need for sound,
> science-based nutrition information is evident. Consumers are confused
> and have a hard time discerning fact from fiction and science from
> marketing. However, an examination of issues surrounding scope of
> practice reveals that the lines are not always clear and ongoing
> vigilance and evaluation are necessary to best serve clients' needs.
> The general consensus among wellness professionals is that
> science-based, general information about healthy nutrition, including
> nutrient density, portion awareness, and the potential dangers of
> supplements and fad diets, remain inside the fitness professionals'
> scope of practice. In all cases, fitness professionals should continue
> to enlighten themselves through qualified continuing education so they
> can always position themselves as their client's best advocate and
> resource.
>
>
> References
>
> (1) Nestle M. Food Politics: How the Food Industry Influences
> Nutrition and Health University of California Press; 2003.
> (2) Professionals' Opinions Concerning the Role of Nutrition in
> Physical Activity for a Healthy Lifestyle. Princeton, NJ: The Gallup
> Organization; 1997.
> (3) Ryan, P. Trendsetting. IDEA Fitness Journal 2004;16(5):S2-S14.
> (4) Understanding and Using the Scope of Dietetics Practice Framework:
> A Step-Wise Approach. J Amer Diet Assoc 2006;106:(3):459-463.
> (5) Ayoob KT, Duyff, RL, Quagliani, D. Position of the American
> Dietetic Association: Food and Nutrition Misinformation. J Amer Diet
> Assoc 2002;102:260-266.
> (6) American College of Sports Medicine; The American Dietetic
> Association; International Food Information Council. For a Healthful
> Lifestyle: Promoting Cooperation Among Nutrition Professionals and
Physical Activity Professionals. J Amer Diet Assoc 1999;99(8).

CROSSFIT DES MOINES
Saturday Sept 3rd 8:00. CFDM will be hosting a memorial WOD for the 31 souls who lost their lives on Aug 6th in helicopter crash. Please visit www.31heroes.comto register if you wish to donate and receive a t-shirt.

Until next time...
look good, feel good, do good
http://www.sarabconsulting.com/

Crossfit DSM on WHOtv at 5 pm

Be sure you tune in to WHOtv today, Wednesday, March 16 at 5:00 pm. They will be doing a segment on CrossFit Des Moines. The segment will highlight owner Mike Brown’s ties to Master Sergeant Mike Maltz and their First Annual Mike Maltz Challenge.

http://www.whotv.com/news/who-story-crossfit-20110316,0,2615539.story

Find out more about the Maltz Challenge.
CrossFit Des Moines
1st Annual
Maltz Challenge
Des Moines 2011
Saturday March 26, 2011
1:00p Registration Begins
CrossFit Des Moines
Urbandale, IA

Suggested $20 Donation to DEA Survivors Benefit Fund
The US Drug Enforcement Administration sponsors an annual physical fitness event called the “Maltz Challenge.” The workout is named after DEA Special Agent’s Brother, Master Sergeant Michael Maltz. MSGT Maltz, a US Air Force Pararescue Jumper, was killed in 2003, while at-tempting a rescue of injured and sick children in Afghanistan. The Maltz Challenge commemorates the lives of not only Michael Maltz, but all fallen military service members and law enforcement officers.
2011 will be the first year CrossFit Des Moines will officially host the event. CrossFit Des Moines is honored to host the event, as CrossFit Des Moines has very close ties with the Pararescue Community. All Proceeds will go the DEA Survivors Benefit Fund.

Until next time...

look good, feel good, do good

http://www.sarabconsulting.com/

Strong is the New Skinny

a great blog post from a fellow dietitian that I thought I would share:
"Strong is the New Skinny"
Nice shout outs to Crossfit!

Until next time...
look good, feel good, do good
www.sarabconsulting.com

Baby S Update - Week 38

Week 37

Baby Shower #1

A few weekends ago J and I's wonderful friends Ryan & Robin threw us a couple's baby shower at Cedar Ridge Winery

Robin has a great write up about it on her blog: Indulge

It was a very enjoyable time with a group of our Iowa City friends

almost too pretty to eat

a personalized "Baby S" bag

Baby Shower #2

With the help of my girlfriends and Mom, my sister Kelli threw me a great shower on Sunday
It was awesome to see so many fabulous friends and family in one place. I can't wait for them to all have a special part in Baby S's life.

family, college friends, high school friends, and childhood friends!

everyone took on the challenge of designing a personalized bib for Baby S

the winners: Morgan with her bib saying "a doctor or apple a day keeps the doctor away, "Jess with her perfect drawing of Elmo, and Heidi with her "no high fructose corn syrup, trans fats, saturated fats, sugar, enriched flour" bib

my pal Amy served up this adorable diaper cake

complete with washcloth cupcakes

of course we had plenty of "real" cupcakes to enjoy as well

Rachel dished up jello/ice cream cups...simply mix one packet of jello with hot water and combine with vanilla ice cream...easy and delish

funny story:

post party, Leigh and I decided to try our hand at Kinect (a remote free video game J brought home from work)

we were playing volleyball and apparently I was really getting into it and went up for a spike and BAM...hit the light, which fell to the floor and shattered....luckily no one was hurt and it turned out to be a good laugh

still doing what I can....

do squats bring on labor!?

Until next time....will two become three?!

look good, feel good, do good

http://www.sarabconsulting/

Crossfit Des Moines Chili Cook Off

Crossfit Des Moines held a chili cook-off at fellow crossfitters Susan's beautiful home Saturday.
The competition and the chili was hot hot hot!

Chili galore...white, red, vegetarian, bison, beef.....

here are a few of the wonderful recipes
Blue Ribbon Chili

by Kelly Heffron
Ingredients:
1 lb. lean ground beef
1 lb. sausage
¾ C. chopped onion
½ C. chopped green bell peppers
1 large garlic clove, pressed
2 – 14 ½ ounce cans stewed tomatoes
1 – 15 ½ ounce cans tomato sauce
1 tablespoons chili powder
1 teaspoons ground cumin
1 tablespoons dried parsley
2 teaspoons salt
1 teaspoons pepper
1 – 15 ounce can chili beans, undrained
Instructions:
Brown hamburger. Add onions, green peppers, and garlic; continue cooking until the meat is well-browned. Remove skillet from heat. When the skillet cools, slightly, add the stewed tomatoes and tomato sauce; stir until the skillet is deglazed. Add the chili powder, cumin, parsley, salt, and pepper; stir to combine. Cover and simmer the mixture slowly for 1 hour. Add the chili beans; simmer, uncovered, an additional ½ hour.

CHECKERBOARD CHILI
From: Sherry Ellingson

Ingredients:
8 skinless, boneless chicken, halved and cut into 1 inch pieces. (I pre-cooked in chicken in crock pot and then shred it)
1 red pepper, chopped
1 yellow onion, chopped
4 garlic cloves, minced
3 Tbsp olive oil
4 Tbsp chili powder
2 tsp salt
1 tsp ground cumin
1 tsp ground coriander
1 (15oz.) can black beans, rinsed and drained
1 (15 oz.) can white kidney beans, rinsed and drained
1 (28 oz.) can tomatoes, crushed
1 can beer
1 (10 oz.) bag of shredded cheddar cheese
Instructions:
Saute chicken, red pepper, onion, and garlic in oil in a soup pot about 5 minutes or until chicken is just cooked. Add chili powder, salt, cumin, and coriander; cook 3 minutes. Stir in beans, tomatoes with juice and beer. Bring to a boil. Simmer 45 minutes, uncovered, stirring frequently. Reduce heat to lowest setting. Stir in cheese. Serve when cheese is thoroughly melted. Serves 10 - 12.

all the fixins to make a mean chili dish

Katie Claeys Chili was quite the contender

from the kitchen of her dad, Roger Fiscus

Ingredients:
2 lbs burger
2 cans of kidney beans (I usually do one light and one dark; low sodium)
1 qt. of tomatoes (my parents always froze tomatoes growing up, so that's what he uses. I usually buy two cans of no-salt added diced tomatoes)
onion
1/2 green pepper
1/2 red pepper
1 c. ketchup
1 c. water
2 T. cumin
1/2 c. celery
2 T. lemon juice
1 T. brown sugar
1 T. Worcestershire
1 t. Accent
1/2 t. vinegar
1/2 t. dry mustard
2 T. chili powder
crushed red pepper (I'm pretty liberal with this and the chili powder)
Instructions:
Brown burger with diced up onion, red pepper, green pepper, and celery. Drain fat/juices. Add everything but beans. Let simmer; stir often. Add beans last hour. I've done it on the stove top and in a crock pot- both are fine. It freezes well!
White Chickin Chili

although I made this recipe, props go to my pal Robin

Ingredients:
1 pound Northern beans (canned - rinse until foam is gone)
1 large onion chopped
1 teaspoon garlic, finely chopped
1 Tablespoon dried oregano
1 Tablespoon chopped jalapeno pepper
dash cayenne pepper
2 teaspoons ground cumin
pinch ground cloves
5 cups of chicken broth
1 can Rotel tomatoes
1/2 cup lime juice
3 cups cooked chicken, diced (I use HyVee Rotisserie chicken - usually makes 4 cups - but go ahead and add it all)
1/2 cup chopped fresh cilantro
1/3 cup Parmesan cheese
salt and pepper to taste
Instructions:
Briefly saute onions and garlic on stove until fragrant and onions are translucent. Add to beans along with oregano, jalapeno pepper, cayenne, cumin, cloves and chicken broth. Add 3 cups of water. Bring to a boil. Reduce heat and simmer 30 minutes. Add Rotel, lime juice and chicken. Cook 30 minutes, simmering. (Add more water if soup is too thick) Sprinkle with Parmesan cheese and fresh cilantro to serve.

of course there were yummy desserts to share

picture from Paula Dean's site...thanks Paula!

Beverly enlightened our taste buds with this Paula Dean recipe:

Pumpkin Gooey Bars

enjoy this dessert while keeping in mind, "all things in moderation" :)

these almonds were so incredibly good....great way to add a little spice to your life

Black Peppered-Sugared Almonds
By Jill Oxberger

Ingredients:
1 lb raw almonds
1/4 c packed brown sugar
2 tsp minced garlic
2 tsp course ground black pepper
1 tsp sea salt
1 egg white
1 tsp water

Instructions:
Mix sugar and spices in a bowl large enough to hold the almonds and mixture. Whisk the egg white in a separate bowl large enough for the almonds too, then add the water to the whipped egg white then whip again until it's frothy. Coat the almonds in the egg white mixture then drain the excess if necessary. Dump the almonds into the sugar/spices mixture and stir them to coat evenly.
Line a large baking sheet or jelly roll pan with foil, then spray the foil with a non stick Pam type coating. Spread the almonds on the pan in a single layer. Bake at 250 degrees for an hour and you can stir them during that time, but I usually don't. Once out of the oven scrap them off the foil a bit to keep from sticking and let them cool.

Good times with good people!

Thanks for sharing your recipes everyone!

Have a Happy & Healthy Thanksgiving!

Until next time...
look good, feel good, do good

http://www.sarabconsulting.com/

Notre Dame

Coach Mike, Coach, Kelli, and I received our crossfit endurance certifications this weekend!
Check out www.crossfitdesmoines.com or Crossfit Endruance for more info (the pic is from HyVee tri!). Excited share what I learned with my track girls, endurance junkie friends, and DSM crossfitters.

Notre Dame

For Mike and Kelli's 1st Anniversary, Kelli surprised Mike (longtime Notre Dame fan) with tickets to the game on October 30th.....(for those who didn't know, paper is the 1st anniversary gift).

J and I tagged along for the ride as we had never been to South Bend and were looking forward to a football weekend there.

Mike (brother-in-law) and Kelli (sister)

the night before we left we watched Rudy which made seeing famous sights like "Touchdown Jesus" even more memorable

Very cool cancer memorial. Each colored ribbon is for a different type of cancer.

I failed to take any dining pictures except for this funny experience at a local pub....

we managed to break our table and chair while there. It wasn't our fault though and got a free round of drinks!

Our table literally collapse from under us....
you'll see on the picture that the table top should be about 2 feet off the barrel...ha

the campus is absolutely beautiful with the stadium smack dab in the middle

that's real gold up there...kinda like their football helmets

the Grotto, lit up with prayer requests

look at this campus!!!

we watched the players and coaches head into church service

Go Irish!

Good times with good people!

Sorry this wasn't a very (well really not at all) food related post, but had to share.

Until next time...

look good, feel good, do good

http://www.sarabconsulting.com/

Baby S Update - Week 22

Baby S Update!

So I officially look pregnant, no more of the beer belly or I'm really full look.

Week 22

I now feel a TON of movement.

I mean...this baby is in the aero position, pedaling away, ready to rock a triathlon!

J flipped the ultrasound image on the left and added an aero helmet and aero bars....pretty sure we'll be bringing the baby home in a "future Kona qualifier" onesie.

Sunday was the Des Moines 1/2 Marathon!

J and Mike sporting their Crossfit Des Moines gear.

"Sara N Baby"

Kelli and I cruisin though mile 10

Thanks to everyone who came out and supported the runners!

Until next time...

look good, feel good, do good

http://www.sarabconsulting.com/