You can't always do things alone! Sometimes it takes a team of experts to affect positive, dynamic change! As personal fitness medical professionals, we want the best for our clients, and reduce their risks of disease and help them make long-lasting lifestyle changes. However, too often we are bogged down with time constraints, limited knowledge in nutrition, exercise or medical treatment plans. We just can't do it all or know it all!

            That's how I felt as more clients with high medical risks came through the door of my personal training studio. Our fitness professionals could provide motivation, challenge and encouragement, however they could not provide sufficient nutritional or medical support and testing. That's why an integrated approach works! Let me give you a case study in progress.


The Patient

            Carl, a 53 year-old male, telephoned me with the intent of improving his health. His long-term goal was to lose 54 pounds, learn to eat healthier and start an exercise program. In speaking with him further, he described himself as a former college athlete who was completely out of shape. He told me he was on medication for high blood pressure, cholesterol and thyroid. He was an unattached professor at a college where he worked both mornings and evenings teaching. He listed his three biggest sources of stress: his schedule, workload and travel. He had tried diets and exercise in the past and failed.

            Realizing that he had several "red medical flags" that needed monitoring and evaluation, I decided he was an excellent candidate for our "Wellness Answer." I discussed our comprehensive, integrated program that combined medical, nutritional and fitness matters with Carl. He knew he needed constant communication and support because he knew he couldn't do it alone.


The Medical Evaluation

            Carl was referred to one of our physicians for a complete medical evaluation since his last exam was approximately a year and half ago.

            During his physical exam in August of 2005 Carl's past medical history was discussed which includes: chronic problems with asthma, hyperlipoproteinaemia, testosterone deficiency, recurrent sinusitis, chronic allergic rhinitis, obesity, bunions and signet cell adenocarcinoma colon. He had surgery and chemotherapy for colon cancer treatment, which ended in 2003. Carl's medical exam included an electrocardiogram, which was within normal limits. The diabetes related labs were outside the normal range of 65-109, registering at 120. The results of Carl's lipids panel put him at high risk for cardiovascular disease. Carl's HDL, the healthy form of cholesterol, was only 47. The normal range for HDL is 45-100, the higher the number the better. In addition, Carl's triglycerides level, the fats, was 245. After Carl's medical review with his physician, Carl was instructed to: achieve a goal of fasting glucose level of 80-110 at all times, and achieve a goal of LDL less than 100, a goal of HDL greater than 45 and a triglycerides goal less  than 100. His physician recommended behavioral and lifestyle changes especially diet and exercise as a way for Carl to reach his medical goals. 

            This preliminary stage, medical testing and evaluation, is an important step in understanding the patient/client as a whole.


Fitness Evaluation    

            The second phase of this wellness model is the fitness evaluation performed by our chiropractic physician. It was during this evaluation that Carl was also tested for cardio respiratory fitness, muscular strength and endurance, core strength, flexibility and balance. Carl evidenced great strength during his muscular assessment, but his cardio respiratory fitness was low. He had difficulty breathing with weight-oriented and balance exercises. Carl also demonstrated weak core muscles.


The Fitness Plan

            As a result of the medical findings and the fitness assessment, our chiropractic physician recommended the following fitness plan:


  • Weight Loss


  • Walk on treadmill for five minute intervals at a fast pace and recover and repeat


  • Client should maintain a heart rate of 60% to 80% throughout the entire workout


  • Keep weights light, not building muscle mass on top of fat


  • Focus on training entire body through compound exercises and functional training


  • Work on core exercises


  • Encourage Carl to walk on his own several times a week


    Nutritional Component

                The next phase of the program is the nutritional  component. Carl met with our nutritionist, Kelly, for an initial consultation. Kelly concluded due to his teaching schedule, in addition with the fact that he has to prepare his own meals, Carl did not know how to plan ahead or make better food choices. Kelly made several suggestions: Carl needed to monitor his blood sugar levels on a daily basis, include fruits and vegetables, fiber and whole grains in his diet, and needed to eat more frequently throughout the day. Carl's caloric intake is pretty low, by his choice. Carl maintained a simple meal plan so he could "stick with it."  Kelly decided to keep him on this program for a short period of time, and then introduce more protein and healthy carbohydrates. 

                In conjunction with the nutritional program, Carl began his fitness program. Lindsay, his fitness professional, has written an exercise "prescription," which combines core strength, balance, flexibility and cardio respiratory. According to Carl, Lindsay "puts a good deal of thought into the design of each session. No two sessions are exactly alike. We may target similar things, but because it is never exactly the same routine I am never bored and always feel challenged. What I have is someone who is constantly assessing my progress and building upon that progress to take me to the next level."

                Carl could not do this program alone. With the support of this amazing team, Carl is reaping tremendous health benefits. In one month, Carl has experienced the wonders of a dynamic team of professionals who know they can't do it alone. With Carl's commitment, we can make a difference in the health of individuals.


                Marilyn Gansel is the founder and owner of Fitness Matters Inc. For more information, visit