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Issue Date: November-December 2008, Posted On: 11/24/2008


Your Scope of Practice

The dos and don'ts of nutritional counseling

By Christopher R. Mohr

Physicians are medical experts who sometimes dabble in the diet arena. Psychologists are behavior experts who sometimes give nutrition advice. Celebrities act like experts in a lot of areas, and they too often provide nutrition advice. But qualified personal trainers often feel like their hands are tied when it comes to giving nutrition advice because it is “outside their scope of practice.”

 

Nutrition happens to be one of those fields that everyone knows or thinks they know something about. If you have a friend on a low-carb diet who has lost weight, that friend is the expert; if a store clerk in a supplement store is wearing a lab coat, they become the expert. However, while personal trainers may be looked up to as the expert for exercise training, they often do not broach the subject of nutrition — the most important component of physical change — unless it is with a 10-foot pole.

 

Who Should the Public Rely on for Advice?

Should they turn to the local bookstore with thousands of books with conflicting opinions on nutrition or maybe the attractive celebrity who swears by a particular lifestyle? Or should they turn to you, their qualified personal trainer?

 

Maybe they consider hiring a registered dietitian, who out of all those listed, has the most educational background in nutrition but not necessarily in sports nutrition. Marjorie Geiser, RD, NSCA-CPT, of Meg Fitness, agrees, “Just because a person is a registered dietitian does not mean they are automatically qualified to provide sports nutrition information. With the proper education, trainers could very competently provide basic information on sports nutrition to their clients.”

 

Most of our clients are in need of some clarity related to eating to support their new active lifestyle. They’re integrating exercise as a means to lead a healthier lifestyle. Isn’t the combination of exercise and nutrition essentially what sports nutrition is all about?

 

Dispensing Nutrition Information

Since the law allows trainers to “discuss” nutrition, but their expertise may not be sufficient to dispense sound advice, we need an established protocol for trainers finding comfort in reaching out to complementary experts.

 

Should Trainers Provide Nutrition Information?

Qualified personal trainers possess a fundamental knowledge of the human body, physiology and anatomy. Many also understand the interactions between nutrition and physical performance. The fact of the matter is that nutrition and training are like the two wheels of a bicycle; you cannot ultimately be successful if only one wheel is spinning. Fortunately, it is within the scope of practice for personal trainers who possess fundamental nutrition knowledge to address questions and concerns their clients may have. There are programs available to provide that continuing education and background about nutrition. These don’t make you a registered dietitian, but they give a general overview of the foundations necessary to help your clients.

 

5 Nutrition Dos

Here are five things that are 100% in line with the current nutritional beliefs of the ADA and mainstream nutrition academia:

 

  1. Discuss how to read food labels with your clients.
  2. Suggest switching to whole grains and adding more fruits
     and vegetables to their diet.
  3. Reduce the intake of saturated fats and trans-fats, and replace
     them with healthier fats, such as omega-3 fats from nuts, fish
     and flax.
  4. Talk about including leaner proteins, such as chicken and
     turkey breasts and fish.
  5. Discuss the importance of hydration and the unparalleled
     benefits of water.

Learning about Sports Nutrition

Suppose, as a trainer, you want to go the next step, to become an expert in the area of sports nutrition? Does a weekend seminar make one an expert? Dr. Jose Antonio, CEO of the International Society of Sports Nutrition, suggests, “Sports nutrition is a multi-disciplinary field that requires both nutrition and exercise physiology training. At minimum, a bachelor’s degree in one of the major biological sciences is needed. Second, experience (both personal [you should partake in exercise itself] and with clients/athletes) working with individuals is a must. On the flip side, having no academic background may lead to the syndrome of ‘a little bit of knowledge is a dangerous thing.’”

 

What this means is that as a trainer who is trying to be the best they can be in helping their clients achieve their goals quickly and healthfully, it is best to continue your education. Many people, trainers, dietitians and physicians alike, consider themselves experts because they own a pair of running shoes and lift weights. This is not the case.

 

Antonio continues, “If you feel uncomfortable or are admittedly ignorant of sports nutrition, then by all means do not dispense suggestions or advice beyond your competence. However, if you do your due diligence and educate yourself constantly in the field, it would behoove you as a health professional to offer your best advice or suggestion to your clients. It is not a prescription, but merely a suggestion. Bottom line for everyone interested in sports nutrition: Read, read and read. Read as much scientific and lay literature as you can.”

 

And this advice goes for any trainer or sports nutritionist. Education does not stop with a mere certification or college degree, it really just begins. The term “registered dietitian” doesn’t necessarily equate to “expert in the sports nutrition arena.”

 

Sports Nutrition Certifications

There are a variety of certifications, an ample amount of reputable textbooks and an endless number of seminars by qualified professionals. Continuing education is crucial for learning about any aspect of health, including sports nutrition. Attend all the seminars you can, read all the reputable information available, and consider a certification that you believe is reputable.

 

Geiser adds, “I see that these programs can help educate trainers so that they are better able to answer clients’ questions, but it also sends the wrong message to trainers, making them think that they are now qualified to offer more than just general, basic advice. I believe that if a trainer is considering any of the certification programs that are available, the first criteria to consider is the education of the people involved in the program. They should primarily be those who are educated in nutrition and have an RD involved because then the trainer knows that that person has more than just a few nutrition courses within their core education.”

 

Quality certifications are created to enhance the base knowledge a qualified trainer or dietitian already possesses and can absolutely enhance the credibility and skills of the trainer. They demonstrate that the trainer is seeking additional education and knowledge in all aspects of health in order to further assist their clients.

 

Remember, though, it is crucial to consult with other health care professionals, such as registered dietitians, nurses, physical therapists, etc., who possess the appropriate background and knowledge to assist with complex medical issues. Moreover, establishing relationships with these professionals will enable trainers to expand their network and provide expertise regarding exercise prescription and conditioning and may even lead to additional referrals and clients. The ultimate health of a client sometimes requires collaboration across many health care providers, and each provider should understand and work within their limits.

 

Quality Nutrition Information

There are a number of resources that are considered reliable among professionals. Geiser recommends Sports, Cardiovascular and Wellness Nutrition (www.scandpg.org), the Australian Institute of Sport (www.ausport.gov.au/ais), IDEA Health & Fitness Association (www.ideafit.com) and the American Council on Exercise, or ACE (www.acefitness.org). Antonio also offers a variety of suggestions, including his organization, ISSN (www.theissn.org), NSCA (www.nsca-lift.org), ACSM (www.acsm.org) and IDEA.

 

“In terms of reading, look for books on sports nutrition that are written by sports dietitians because these are the professionals who hold the highest standards and generally do not have a ‘hidden agenda’ in providing their information,” Geiser adds, suggesting books by Stella Volpe, PhD, RD, Chris Mohr, PhD, RD, Ellen Coleman, MA, RD, Susan Kleiner, PhD, RD, and Nancy Clark, MS, RD. Antonio’s “short list” includes books by himself and Jeffrey Stout, PhD, RD, Melvin Williams, PhD, and Richard Kreider, PhD.

 

Trainers are able to make informed suggestions and help lead clients in the right direction. Keep in mind, though, that unless one is a registered dietitian, you are not legally able to diagnose any medical conditions, provide medical nutrition therapy (meaning nutritionally consult with individuals who have specific disease, such as diabetes, cancer, heart disease, etc.) or prescribe any particular diets.

 

What you can and should do is align yourself with a qualified sports nutritionist who can complement your area of expertise when a specific nutritional condition may arise with a client, so you are not working outside the scope of practice but rather aiding in client success. Geiser agrees, “Regardless of what our role is, we all need to understand our scope of knowledge and always keep the client’s best interest in mind. It seems that when ego of the trainer comes into play, then they start working outside their scope of knowledge and practice, and ultimately it is the client who suffers.”

 

Christopher R. Mohr completed his PhD in exercise physiology and is a registered dietitian. To learn more about Dr. Mohr and his company, Mohr Results, visit www.MohrResults.com.


Topic: Nutrition

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