Ready to Start Your Career as a Health Coach? 

Are you ready to begin your career as a Health Coach? Would you like assistance with choosing the online Health Coach Certification that’s the best fit for you? 

In this article, we will do just that along with:

• The reasons why NOW is the best time to become a Certified Health Coach.
• How much time it takes to become certified as a Health Coach.
• How much it costs to get certified in Health Coaching.
• What to expect from a Health Coaching Program.
• What to look for in a Health Coaching Program
• A Free preview of the Health Coach Collaboratives Nutrition Coach Certification

Why Become a Certified Health Coach?

This is the perfect time to become a Certified Health Coach! 

Now more than ever, people are becoming more health conscious. The world is changing and so is the health industry. This career is for you if you want to help clients build healthier habits and behaviours that can dramatically improve their well-being. And get well-paid to do just that!

Health Coaches have an array of employment and career opportunities available to them. This includes building a consulting practice and working collaboratively with other healthcare practitioners or fitness facility practitioners.

Health Coaches can work one-on-one or with groups of people to help them make lasting health-related lifestyle changes. They help their clients to identify areas of concern and assist with goal setting, while also providing motivation and encouragement along the way. Research shows health coaching can help clients lower their risk of developing preventable diseases. This includes diseases like type 2 diabetes and heart disease. In addition, some Health Coaches are trained in specific areas like behavioural health or nutrition. Ongoing studies are proving the effectiveness of Health Coaching for:

For example, a study published in 2022 found that Lifestyle Coaching was more effective in helping subjects improve blood pressure. Coaching also helped with hypertension rather than increasing medication. Another study found that lifestyle coaching can reduce depressive symptoms and improve workability.

The Best Health Coach Certification of 2023 – HCC (healthcoachcollaborative.net)

How Long Does it Take to Complete a Health Coach Certification?

The great news is that Health Coach training tends to be pretty flexible and there are various styles of coaching to choose from as well. With our top ten recommendations for Health Coach Certifications, you’re sure to find one that suits your goals and requirements.

Many of these programs are now available online and are designed for adult learners who have busy schedules and full-time jobs. Some are self-directed which means you have the flexibility to work on the courses whenever you want and have the time. 

Our recommended Health Coach Certification Programs vary in the length of time they take to complete. There are programs that run from 3 months in length to others which may take up to 2 years to finish. Discovering which program is right for you depends on what you need from a program.

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How Much Does it Cost to Get Certified in Health Coaching?

Starting a new career as a Health Coach requires both an investment financially and of your time. 

A review of the ten different health coaching programs that we recommend found that the costs ranged from $999.00 to over $7,000, with most offering convenient payment plan options.

Depending on the program cost, you may see a return on your investment after just coaching a few clients! When you take into account the career opportunities available to health coaches, it is a reasonable investment.

We’ve put together a list of the best health coach programs. This will help you compare and contrast various options in your search for a program that’s right for you.

What to Expect from a Health Coaching Program

A Health Coach certification program should equip you with up-to-date health information and coaching skillsets. This will ensure that you are able to guide clients effectively and safely to a healthier lifestyle.

To become a Health Coach, you’ll want training from a trusted certification program. Some programs focus on a particular area like nutrition. Others may offer a broad curriculum designed to cover several health-related concerns. It is important to do your research and find a program that fits with your philosophy and learning style. For example, if you’re interested in nutrition and whole-body wellness, the Natural Nutrition Coach certification is a great start!

What Can I Do With a Health Coach Certification?

A Health Coach Certification will allow you to guide clients in achieving and sustaining habits. These changes can include:

• Healthy Eating
• Exercising
• Practicing Stress Management
• Getting adequate and good quality sleep
• Wellness plans
• Meal planning and more!

The Best Online Health Coach Certifications 2023

These are the top ten picks:

• Best for Holistic Nutrition and Health Focus: Health Coach Collaborative
• Best for Integrative Health: Institute for Integrative Nutrition
• Best for Business Support: Health Coach Institute
• Best for Fitness Professionals: American Council on Exercise
• Best for the Sport Nutrition-Focused: Precision Nutrition Level 1
• Best for Academics: Emory University
• Best for Practicum Opportunities: Humber College
• Best as an Accessory for Licensed Professionals: National Society of Health Coaches
• Best for Weight Loss-Focus: Fit Chicks Academy
• Best With No Prerequisites: Dr. Sears Wellness Institute

HEALTH COACH COLLABORATIVE

OVERVIEW

If you are interested in holistic nutrition and whole-body health, this program is for you!

The Health Coach Collaborative courses include information about; nutrition, health coaching, and whole-body wellness. The students use this information to help clients in the pursuit of health and the prevention of chronic disease.

Each nutrition course is based on the four pillars of health:

• Nutrition with a focus on digestive health
• Stress Management
• Sleep
• Movement

The Natural Nutrition Coach Certificate Program

The Health Coach Collaborative’s Natural Nutrition Coach Program takes a holistic and evidence-based approach to health. In-depth teaching of how the body systems (immune, nervous, digestive, etc.) are integrated into the program. Coaches learn how the body systems are connected. As well as how to recognize imbalances within each system. The program wouldn’t be complete without learning how those imbalances relate to nutrition, stress, sleep, and movement. Students will understand common risk factors for chronic diseases. This includes topics such as:

• Cardiovascular disease
• Diabetes and prediabetes
• Obesity
• Kidney disease, adrenal, and thyroid conditions
• Osteoporosis
• Health indicators (e.g., fasting blood glucose, A1C, blood pressure, cholesterol -HDL and LDL, etc.)
• And more!

The Natural Nutrition Coach Program combines nutrition theory, live coaching practice sessions, and business-building tools. The program weaves all three components together – nutrition, coaching, and business. Graduates can easily and quickly build a highly successful and profitable career in nutrition and health coaching.

Program Length

The 260+ hour, 14-course Natural Nutrition Coach Program combines textbook reading, videos, and activities. The program also includes a comprehensive 4-course module on how to effectively coach clients. The last module in the program includes nutrition business and strategy to ensure the success of their graduates. Mandatory nutrition and coaching case studies and a comprehensive final exam are included. The courses are self-paced, but HCC prides itself on support from its instructors throughout the whole program.

All graduates of the 260-hour Natural Nutrition Coach Certification Program are automatically approved to join the Health Coach Alliance where they will be awarded the HCA Registered Health Coach title. To qualify for the RHC designation, students must successfully complete the full 260-hour Natural Nutrition Coach Program. 

This program is for you if: You are passionate about holistic nutrition and whole-body health.

This program is not for you if: You want to become a Health Coach in less than 6 months

• Cost: $2799
• Payment plan available: Yes
• Format: Online, 260-plus hours

INSTITUTE FOR INTEGRATIVE NUTRITION

OVERVIEW

The Institute for Integrative Nutrition (IIN) was founded by Joshua Rosenthal. It has grown into one of the larger health coaching certifications with more than 100,000 graduates to date. 

The curriculum focuses largely on what IIN calls “primary foods, relationships, finances, stress, social life, and how they affect our health. To IIN, actual food is secondary to all of those factors. There is some general instruction about nutrition, physiology, and anatomy. These lessons stick to the basics (think: how carbs, protein, and fat affect the body differently). 

This program is for you if: You want to focus on lifestyle management. Expect to dedicate a minimum of 10 hours per week to this program. 

This program is not for you if: You want to spend less than six months on a certification or want to dive deeper into the nuances of nutrition.

• Cost: $3,000—$7,500 depending on the program
• Payment plan available: Yes
• Format: Online or in-app courses, 6 or 12 months

HEALTH COACH INSTITUTE

OVERVIEW

The Health Coach Institute (HCI) offers two programs: Become a Health Coach (their base-level certification) and Coach Mastery. The Health Coach Institute focuses on many of the same objectives: behaviour change, nutrition, exercise, stress, lifestyle, etc. 

To take it one step further, however, the graduate course focuses entirely on building your health coaching business. The Coach Mastery course is best for people who already have experience with health coaching.

This program is for you if: You want a health coach certification with a business coaching component to refine your health coaching career. If you already have a health coaching certification and want to better your business with the graduate-level program. 

This program is not for you if: You don’t have an interest in or need to learn business-building practices. 

• Cost: $5,450
• Payment plan available: Yes
• Format: Online, 6 months

AMERICAN COUNCIL ON EXERCISE

OVERVIEW

The American Council on Exercise (ACE) is best known for its personal training certifications. It has a vast selection of specialization programs. The ACE Health Coach certification is a great accessory for those who are already personal trainers. Even though you don’t necessarily have to be a certified personal trainer, you do need some sort of health credential or experience as a prerequisite. 

To enroll with ACE, you must have one of the following prerequisites:

• Current NCCA-accredited certification in fitness, nutrition, healthcare, wellness, human resources, or a related field
• An associate degree or higher from an accredited college or university in fitness, exercise science, nutrition, healthcare, wellness, or a related field
• A completed health coach training and education program approved by the National Board for Health and Wellness Coaches (NBHWC);
• A minimum of two years of documented work experience in coaching, leading, designing, implementing or facilitating behaviour or lifestyle changes.

The Health Coach Advanced Study Program is accredited by the National Commission for Certifying Agencies (NCCA). It is also approved by the National Board for Health and Wellness Coaching (NBHWC).

This program is for you if: You have or are working toward one of the necessary prerequisites, and plan on using your health coaching knowledge in addition to your current specialty (e.g., a certified personal trainer who can also provide nutrition coaching). 

This program is not for you if: You don’t have a prerequisite health or fitness credential.

• Cost: $1,299—$2,299 Health Coach Study Program to $3999 Health Coach Advanced Study Program
• Payment plan available: Yes
• Format: Online (self-paced), 3 to 6 months for the base program to one year for the advanced program

PRECISION NUTRITION

OVERVIEW

The Precision Nutrition program dives deep into nutrition science. If you want to deep dive into human anatomy and physiology, this program is ideal for you. Precision Nutrition is available to anyone—no prerequisites are required. Although the course attempts to put things in lay terms, you can’t expect to entirely avoid medical terminology. All of the course materials are in textbooks or on-demand online seminars. This is a self-paced program.

This program is for you if: You want an online course developed by a nutrition expert (John Berardi, Ph.D.), that you can do at your own pace and you want to focus on nutrition only. 

This program is not for you if: You want hands-on field learning on a structured schedule or want to learn about more aspects of health coaching, other than just nutrition.

• Cost:  $999
• Payment plan available: Yes
• Format: Textbooks, exams, and online seminars for 12 months

EMORY UNIVERSITY

OVERVIEW

Emory University’s Health Coach Certificate Program is approved by the National Board for Health and Wellness Coaching (NBHWC). This program is geared towards those who are looking for continuing education. This means it’s suitable for students who have already earned a bachelor’s degree or higher.

Emory’s Health Coach Certificate Program is a 20-week Online Health and Wellness Coaching Certificate Program. It is a hybrid program that combines live online and a self-paced curriculum. Weekly coaching practice sessions and mentored coaching practicums are included. Students can expect to spend a minimum of 8 hours each week on coursework. 100% attendance is mandatory for the live classes and the practice coaching sessions.

Emphasis is placed on the foundational knowledge and practical skills of the coaching standards and competencies NBHWC. 

This program is for you if: You love academia and want a challenging, university-level health coaching program, as well as a nationally recognized title. 

This program is not for you if: You haven’t earned a bachelor’s degree or higher and/or can’t attend the in-person weekend courses.

• Cost: $4,995
• Payment plan available: Yes
• Format: Online, hybrid live and self-guided training, 20 weeks 

HUMBER COLLEGE

OVERVIEW

Humber’s Wellness Coaching graduate certificate program prepares the graduate to work in the field of health and wellness coaching. Students have an opportunity to engage with clients in experiential learning opportunities within Humber’s innovative Centre for Healthy Living. There are also field placements within a variety of organizational settings. Students also receive a  Mental Health First Aid Certification and undergo the WellCoaches Core Training program as part of the coursework. The program is also approved by the Health Coach Alliance.

Courses are scheduled over two 14-week semesters and offer a blend of self-directed online modules and evening synchronous remote classes. Placement occurs in Semester 2 and offers both in-person and virtual options. This work placement consists of 210 hours. Currently, this program is only available to Canadian students.  

This program is for you if: You are interested in having practicum experience and plenty of it with 210 hours of work placement.

This program is not for you if: You don’t have the minimum academic prerequisites: a bachelor’s degree, advanced diploma, or diploma, or if you do not reside in Canada. Currently, international students are not accepted. As well, the work placement is 210 hours–a significant amount of time for many.

• Cost: $5624 CND
• Payment plans available: Yes, through the college
• Format: A blend of self-directed online modules and synchronous remote classes that take place in the evenings. Two semesters of 14 weeks each, and 210 hours of work placement.

NATIONAL SOCIETY OF HEALTH COACHES

OVERVIEW

The National Society of Health Coaches (NSHC) spearheaded the first clinical, evidence-based health coaching program. The course uses Motivational interviewing as its core coaching tactic. It’s a rigorous program that prepares students for anything and everything in the health coaching industry. The caveat? The NSHC is only available to licensed healthcare professionals. 

The NSHC certification is designed to be used in conjunction with a medical license. This means the program is ideal for: doctors, registered nurses, licensed dentists, naturopathic doctors, or other degrees in healthcare. Other health professionals not on the list of acceptable prerequisites can take the course for a “certificate of completion”. This means they won’t earn the actual “health coach certification” credential.  

This program is for you if: You are a licensed health or medical professional and want to earn an additional credential or use this program as a continuing education opportunity. 

This program is not for you if: You do not have one of the accepted health or medical licenses to enroll and earn the NSHC certification.

• Cost: $875
• Payment plan available: Yes, through PayPal financing
• Format: Online, 85 hours (on average)

FIT CHICKS ACADEMY

OVERVIEW

The Fit Chicks Academy is a female-focused company founded by fitness gurus Laura Jackson & Amanda Quinn. Fit Chicks offer several certifications including the Holistic Nutrition Weight Loss Coach Certification (HNWLC). The three-phase HNWLC program consists of 8 modules. The classes are a mix of audio and video classes with a focus on weight loss and habits coaching. Provided in the materials are done-for-you programs to use with clients. According to the website, students can complete the program in as little as 60 days.

The program is available in two offerings, the base HNWLC program, and HNWLC Plus. Both programs include a license for the exclusive use of all the coaching and teaching materials in the Fit Chicks resource portal and a 4-week Mastermind program for business. The HNWLC is recognized by NASM and AFAA and approved by the Health Coach Alliance.  

This program is for you if: You want to focus on weight loss and become a Health Coach in 60 days.

This program is not for you if: You are looking for a program with less focus on weight loss.

• Cost: Level 1 HNWLC -$1997 and the HNWLC Plus – $2997
• Payment plan available: Yes
• Format: Online, 60 days

DR SEARS WELLNESS INSTITUTE

OVERVIEW

The Dr. Sears programs are very well-rounded and follow Dr. Sears’ personal philosophy in lifestyle, attitude, nutrition, and exercise. These four items are also the four pillars of the health coaching coursework. Also, Dr. Sears Wellness Institute is approved by more than 10 leading agencies in the health and fitness industry. This includes the NBHWC and the American College of Sports Medicine (ACSM). 

This program is for you if: You want a well-rounded, information-rich program that requires no prerequisites to enroll; you want online-only learning; and you want a program you can complete in as little as six weeks (or up to 36 weeks, depending on the course you choose).

This program is not for you if: You don’t want mandatory live lectures (online); or you don’t want to choose one of the Dr. Sears coaching specializations (adults and seniors, pregnancy, or families) and would rather have an overarching certification.  

• Cost:  $945-$3875 depending on the program
• Payments plan available: Yes
• Format: Online, 6, 9, or 12 weeks

 

Natural Nutrition Coach Preview

Want to find out more about the Health Coach Collaborative’s Natural Nutrition Certificate Program? Click the image above to go to the Preview!

Watch the replay HERE

Interested in adding stress management protocols to your fitness or health/wellness business? To learn more about our programs click on the courses below.

Mind Body Medicine Specialist

Holistic Group Fitness Instructor

Holistic Stress Management Consultant

As a health and fitness professional, you have an unprecedented opportunity to help millions who need guidance with exercise and create a niche market for yourself. MedeXN fitness INSTITUTE provides online Advanced Qualifications and Specialty Courses in the growing field of Medical Fitness Exercise and Nutrition. Our courses are intended for Fitness, Nutrition & Health Professionals who wish to further their knowledge and education to better help their clients. To find out more visit: www.medexn.com

Meal preparation is relentless. You eat every single day, multiple times a day. There is no reprieve from the numerous steps involved in preparing food—washing, chopping, slicing, mixing, heating—and the clean up afterwards. It’s no surprise that meal kit delivery services and Uber Eats have flourished. In 2020, the global meal kit market was valued at $10.26 billion and the industry is expected to see a 13% compound annual growth rate between now and 2028.[1]

The modern approach to meal preparation is in striking contrast to our early human ancestors, for whom foraging, growing, and hunting food was their most important priority. Skipping ahead to 1965, when cooking was still largely a woman’s responsibility, about 2 hours a day was spent in the kitchen.[2]

Nowadays, the average person spends a grand total of 37 minutes a day on food preparation and cleanup.[3]

With all the conveniences available to us, there isn’t a need to invest hours of time making meals, but a 2014 study published in the American Journal of Preventive Medicine found that people who spent more time on home food preparation ate a better quality diet, with a significantly higher intake of vegetables, salads, and fruits than those who relied on convenience foods.[4] The study also found that those who spent less time on food preparation spent considerably more money on fast food restaurants.

Excluding breakfast, which is typically straightforward to prepare, mainly because the options are limited, you eat 14 meals each week (seven lunches and seven dinners). But that doesn’t mean that you have to prepare 14 separate meals. A few simple time-saving strategies can help you get organized and prioritize healthy eating.

Keep a running list of your favourite meals.

Coming up with what to make for dinner after a long workday can be a more onerous task than the cooking process itself, especially when you’re low on ingredients. A handy list of your favourite go-to meals, recipes you’ve prepared and enjoyed, or recipes you would like to try will save you time and frustration and help you with weekly meal planning. Divide your list for easy reference: plant-based, kid-friendly, holiday meals, etc., and add to the list whenever you come across a new recipe you might like to try.

Keep your list within reach—on your mobile device, home computer, or if you prefer, store your list and recipes in a decorative box in the kitchen. Include a link to online recipes or record the recipe right onto your list to avoid wasting time looking for it. Some recipe manager apps to check out include Paprika and The Recipe Manager.

Plan a menu for the week

This important step saves time, money, and food waste, since you can make use of leftovers for the next day’s meal. Preparing a weekly meal plan also means you’re less likely to stop for take-out.

On the weekend or a quiet weeknight, brainstorm lunches and dinners for the upcoming week. If you don’t know where to start, consider weekly themes. Choose two three themes to repeat each week for the next month and select others from the list when you need inspiration.

A variety of printable menu planning templates like this one can be found on Pinterest, or try a meal planning app like Mealime.

Prepare a grocery list from your weekly menu. A list reduces visits to the supermarket and unnecessary spending. Record the list on your mobile device to ensure it goes to the grocery store with you, or use a shopping list app like Listonic. If you’d rather do things the old-fashioned way and prefer to keep a written list on your fridge, don’t forget to snap a photo before heading out for groceries.

When pressed for time, shop online. Another option is to join an organic food co-op that delivers a box of locally grown organic groceries right to your door.

Prep on weekends. Spend some time on Sunday afternoon preparing base ingredients for the upcoming week. Chop raw vegetables, cook a large pot of quinoa or brown rice, steam sweet potatoes, boil a carton of eggs, and make a large bean salad to eat throughout the week. Opening your fridge to find containers of prepared ingredients that you can easily combine to make a layered salad or stir-fry will save a lot of time and stop you from ordering in.

Keep meals simple.

Centre your dish around protein, aiming for 20 grams per meal, colourful vegetables or a large salad, and a small amount of fibre-rich starchy carbs if desired (like sweet potatoes or quinoa). Instead of spending time slicing 6 different types of vegetables, add nutrients to meals by sprinkling some raw nuts, mineral-packed sea vegetables, hemp hearts, or dried fruit onto your main dish or vegetables. The probiotics in just a forkful of kimchi, sauerkraut or another fermented vegetable are beneficial to your microbiome and will do more for your health than a side of overcooked green beans.

This should go without saying, but there is no need to make every dinner Instagram worthy.

Cook to have leftovers and containerize. Make double batches of each recipe and containerize the extra food for another day. Freezing entire meals in freezer-safe containers will give you a few nights off from cooking.

This recipe freezes well. Divide the finished soup into two batches, one for now and one to enjoy later.

BETA-CAROTENE BLAST SOUP

½ lb. carrots, chopped

½ large (or 1 small) sweet potato, chopped

½ butternut squash, chopped*

1 clove garlic, minced

1 small onion, chopped

4 cups water, vegetable stock or bone broth

2 cups coconut milk or almond milk

½ tsp. nutmeg

¼ tsp. cloves

¼ tsp. sea salt

1. In a large pot, boil the water or stock on high heat.
2. Add the carrots, potato, squash*, garlic, and onion. Cook until tender.
3. Using a ladle, pour about 3 ladle’s-full of the vegetable mix with some of the stock into a blender. Add ½ cup of coconut or almond milk. Purée until well blended.
4. Pour contents of blender into a large container.
5. Continue this same process with the rest of the pot contents until all of the vegetables have been blended. Much of the water will remain in the pot. You can put this into a container and use it as vegetable stock in another recipe.
6. When all of the soup has been puréed and is in a container, sprinkle in the spices and sea salt and mix with a spoon.

Serve hot or cold.

*Roast the butternut squash ahead of time to soften before cutting. To roast, poke holes in the squash with a sharp knife and bake on a baking sheet at 400F until tender.

Are you interested in more natural solutions for your health? Our Natural Nutrition Coach Program was designed for “Coaching” a natural foods diet in the pursuit of health and the prevention of chronic disease”

As a Natural Nutrition Coach, you can help to transform lives… even your own!

For more information on the Natural Nutrition Coach Program click HERE.

Lisa Tsakos, R.H.N. is a nationally recognized holistic nutritionist, educator and author specializing in weight management and corporate nutrition programs. Lisa is a co-author of the Natural Nutrition Coach® program.

[1] https://trulyexperiences.com/blog/meal-kits-industry-statistics/#What-is-a-Meal-Kit

[2] https://theflag.org/trivia/time-women-spend-cooking/

[3] https://www.ers.usda.gov/amber-waves/2016/november/americans-spend-an-average-of-37-minutes-a-day-preparing-and-serving-food-and-cleaning-up/

[4] https://www.sciencedirect.com/science/article/pii/S0749379714004000

Exercise is considered the “gold standard” in the management of clients with low back-related pain and disability. However, not all core exercises are created equal. Traditional core exercises, which involve creating motion about the spine (i.e., crunches, side bends), may worsen your client’s condition because of excessive spine loads created in combination with repetitive segmental spinal motion. However, spine-sparing core exercises which impose minimal spine loads and motion (i.e., McGill’s “Big 3”) have been shown to be safe and effective for patients^1,2. Before rehabilitation occurs, the patient’s functional goals (activity requirements) and functional deficits (relevant impairments) should be identified. This provides a start and end for the exercise prescription, with the ability to progress challenge based on their functional goals. This article will go over the science and anatomy of the ‘core’ muscles, rationale of certain core exercises over others, and how to coach a few basic but highly effective exercises.

Core exercises—defined as exercises that challenge the core musculature (muscles of the torso proximal to the ball and socket joints that help stabilize the spine)—are a staple among athletically trained individuals and clinical populations because of the exercises’ ability to strengthen musculature,^3,4 improve muscular endurance,⁵ reduce low back pain (LBP),^6-8 and improve sport performance.^9-11 The mechanism of how these exercises stabilize the spine is thought to be from enhancing stiffness of the core muscles.^12,13 Greater core stiffness enhances performance through three mechanisms.

As explained by world renowned spine biomechanist, Dr. Stuart McGill:

(a) briefly stiffening the torso proximal to the shoulders and hips transfers the full force and movement of muscles to the distal side of these ball and socket joints, resulting in greater limb strength and speed;
(b) muscularly stiffening the spinal column enhances its load bearing capacity, preventing buckling; and
(c) the muscular turgor associated with stiffness creates an armor over vital structures (i.e., internal organs) enhancing resilience during contact sports.¹⁰

The reason core stiffness is such an important concept is because it creates spinal stability. Without accounting for stability, almost all human activities could not be successfully performed. Three major tenets with regard to stiffness and stability exist for human function¹⁷:

1. Sufficient stiffness allows for the body and spine to bear load.
2. Stiffness and stability are related through muscular mechanisms, creating a guy wire system for the spine.
3. Proximal stiffness may allow for distal mobility

In the context of the spine, mechanical engineer and biomechanist Anders Bergmark, described the stability–stiffness continuum using a spring-mass system: the stability of a system (spine) is dependent on the stiffness of the springs that attach to it (the “core” muscles, i.e., rectus abdominis, quadratus lumborum, internal and external obliques) (Fig. 1).¹⁸

How Muscles Stabilize the Spine

The concepts of stability and stiffness are benchmarks for all human motion, including spine function. Unlike the muscles of your limbs, the core musculature is composed of numerous layers of short, thick muscles designed to stabilize the spine and prevent excessive motions.

Figure 2: Comparing the core muscles to a barrel

When we look at the architecture of the torso these muscles act in a way like how hoops around a barrel generate ‘hoop stresses’ to keep the barrel from falling apart when filled.

External perturbation (i.e., externally applied loads or movements) can potentially disrupt the equilibrium of the system, like strong winds perturbing a radio tower. To maintain static equilibrium (ensuring the spine experiences no unwanted motion), the core muscles must generate sufficient stiffness. This is akin to how the rigging on a ship stabilizes its mast (Fig. 2). The stiffness of the “guy wires” provides stability to the mast to ensure it stays upright against external forces such as the wind or rocking of the ship. Similarly, stiffness generated by the core muscles helps to “anchor” the spine, enhancing its ability to resist external perturbation. Insufficient stiffness of the guy wires may cause the mast to fall over or buckle if excessive perturbations are applied. Similarly, insufficient core stiffness will cause the system to mechanically buckle, resulting in an involuntary bending of the spine when trying to resist external perturbation (i.e., yielding during a heavy deadlift).

Figure 3: The same core muscles stabilize the spine like how guy wires stabilize the mast of a ship

Exercise Selection

Now that we better understand how the core muscles work, how do we go about training them? Going back to our barrel example, to optimally train the core muscles, it would make sense to not train like them like your limb muscles (i.e. biceps, hamstrings) by taking them through a long range of motion, but instead to challenge them in stabilizing the torso (prevent your spine from bending) under load or awkward postures.

For those of you reading who enjoy videogaming, I think of exercise selection is an action roleplaying game – before I can start doing any jumps or weighted carries or anything else fancy, I first have to devote my EXP points into mastering basic skills. Here are is the start point of ANY core-focused program: three exercises that will train isometric/static core stability:

Plank

Figure 4: Plank demo

The plank challenges primarily the anterior core muscles (rectus abdominis) to prevent the spine from hyperextending. When the body is held in an extended posture like this, the rectus abdominis (aka your ab muscles) work like a Roman arch to support your spine.

Figure 5: Roman arches supporting a bridge. Your core muscles work like the arches to support the bridge that is your torso

To perform the plank, simply lie face down and balance on your toes and forearms. Keep your back straight resisting the urge to hike your hips into the air or let them sag to the floor.

Without the core muscles working, gravity would pull your hips down to the floor creating hyperextension of the low back, which can be a mechanism of pain for some types of clients. During the plank you can get extra activation by:

• Actively bracing your abdominals (imagine stiffening them like someone is going to punch you in your stomach)
• Squeezing your glute muscles (like you’re trying to hold a one hundred dollar bill between them)
• Squeezing your fists
• Statically pulling your elbows toward your waist

Start with performing multiple 10 second holds (i.e. 5 x 10 sec). If this is easy, add a second set of 4 x 10 sec holds, then a third set of 3 x 10 sec holds, etc.

Side Bridge

Figure 6: Side bridge from the knees demo

The side bridge challenges the lateral core and glute musculature to hold your body in place when balanced on your side.

Begin on your side resting on your knees with your hips bent and bottom forearm supporting you. To initiate the side bridge, simply drive your hips forward so that your torso is off the floor and hips are completely straight.

Similar to the plank, these muscles work like a Roman arch to prevent your hips from sagging to the ground and spine laterally bending. You can use the exact same cues from your plank to get more activation out of your muscles with the same set/rep scheme. This doing this from the knees is easy, progress to your feet with your top leg in front of your bottom leg.

Figure 7: Foot placement for the side bridge from the feet

Bird Dog

Figure 8: Bird Dog demo

The bird dog is a rotational core stability exercise. It challenges the muscles of your back (upper back, low back, glutes) to prevent the body from rotating as you hold the outstretched position.

Begin the bird dog on your hands and knees. Ensure your spine is neutral without excessive rounding or arching. From here, use a light core brace and then drive the opposite arm and leg out in front and behind you, respectively. Hold this outstretched position without losing balance.

During the bird dog you can get extra activation by:

• Actively bracing your abdominals (imagine stiffening them like someone is going to punch you in your stomach)
• Squeezing your extended leg’s glute muscle while driving out your heel/pulling your toes toward your knee
• Squeezing your fist

About the Author:

Benjamin Lee is a formally trained Mechanical Engineer (BASc ’09, University of Waterloo) whose passion for fitness and athletics led him to pursue a master’s degree in Biomechanics (MSc. ’13, University of Waterloo). His research on the assessment and prescription of exercise for low back injury prevention/rehabilitation was supervised by the world-renowned professor, Dr. Stuart McGill. Ben has published numerous ground-breaking academic papers and textbook chapters on this topic, lectured to thousands of healthcare professionals, and has worked with a variety of clients ranging from office workers to elite professional athletes. Ben applies his knowledge as Chief Scientific Officer of Fortius Labs, developing revolutionary artificial intelligence software to help health & fitness professionals objectively assess their clients’ training needs and develop data-driven corrective exercise programs.

References

1. McGill SM. Low back exercises: evidence for improving exercise regimens. Phys Ther. 1998;78(7):754-765.
2. McGill SM. Low back stability: from formal description to issues for performance and rehabilitation. Exerc Sport Sci Rev. 2001;29(1):26-31.
3. Norris CM. Abdominal muscle training in sport. Br J Sports Med. 1993;27(1):19-27.
4. Willett GM, Hyde JE, Uhrlaub MB, Wendel CL, Karst GM. Relative activity of abdominal muscles during commonly prescribed strengthening exercises. J Strength Cond Res. 2001;15(4):480-485.
5. McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehabil. 1998;80(8):941-944.
6. Gardner-Morse MG, Stokes IA. The effects of abdominal muscle coactivation on lumbar spine stability. Spine. 1998;23:86-92.
7. Morgan D. Concepts in functional training and postural stabilization for the low-back-injured. Top Acute Care Trauma Rehabil. 1988;2:8-17.
8. O’Sullivan P, Twomey L, Allison G. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997;24:2959-2967.
9. Hedrick A. Using uncommon implements in the training programs of athletes. Strength Cond J. 2003;25(4):18-22.
10. McGill SM. Ultimate Back Fitness and Performance. 5th ed. Waterloo, Canada: Backfitpro Inc; 2014.
11. Willardson JM. Core stability training: applications to sports conditioning programs. J Strength Cond Res. 2007;21(3):979.
12. Lee BC, McGill SM. Effect of long-term isometric training on core/torso stiffness. J Strength Cond Res. 2015;29:1515-1526.
13. Lee B, McGill S. The effect of short-term isometric training on core/torso stiffness. J Sports Sci. 2017;35:1724-1733.
14. McGill SM. Low Back Disorders. 3rd ed. Champaign, IL: Human Kinetics; 2015:56.
15. Bergmark A. Stability of the lumbar spine: a study in mechanical engineering. Acta Orthop Scand. 1989;60:1-54.

Understanding The Seven Stages of Grief and Chronic Disease

Article by: Robyn Kade, B.A., MBMS

It is essential to understand the Seven Stages of Grief and chronic disease if you plan to work with clients living with a chronic disease. Many individuals have heard of the five stages of grief created by Elizabeth Kubler – Ross in 1969. This model is used to explain the stages of grief over the loss of a loved one. There has been an updated model called the Seven Stages of Grief for Chronic Pain and Chronic Illness by Dr. Jennifer Martin, PsyD of imaginelifetherapy.com.

According to imaginelifetherapy.com, there are seven stages of grief for chronic disease: denial, pleading, bargaining and desperation, anger, anxiety and depression, loss of self and confusion, and acceptance. Clients can go from one stage to another until finally reaching acceptance. An individual, for example, can go from denial to anger and back to denial. Everyone will go through the stages on their own timing. There is no set time for anyone to reach acceptance of their situation. If your client can see positive changes after working with you, their outlook will be more positive. As they become stronger and learn more skills, clients will become more ambulatory and be able to move more over time.

Many times, clients will be experiencing their symptoms (chronic disease symptom cycle) and the stages of grief simultaneously. We usually think of grief with respect to the loss of a loved one. With chronic disease, your client may be grieving the life they used to live. Knowing that their lives may change because of an illness is very stressful. In addition, the individual may be thinking about the future and how their health will be ten years from now. As a Health – Fitness Professional, you need to help your client to be present and in the moment. The work that your client does today will influence how mobile they are ten years from now. If they are discouraged by the big picture, it will be harder for them to stay focused.

Each stage of grief has its own parameters and can give you insight as to which stage the client is currently in. Empathy and support are a critical part of helping a client to get through the stages of grief. Tailor exercise programming to what your client can handle each time they train. If Someone is having a rough day, you can offer the client a guided meditation session or aromatherapy with relaxing stretches instead of a training session. This trade-off will allow the client to participate even if they are not mentally ready for a regular training session, bringing benefits for the client, such as lowering stress, and saving a missed session for you!

To know which stage of grief a client may be in, you must have a firm understanding of what each stage is. Denial is the first stage in which the individual was just diagnosed and is in shock. They cannot believe that they are diagnosed with a chronic disease. They start to wonder how they will make changes and live a good life. Shock can help the person to decide to move on to the next stage and start working through the stages. It may also backfire if the individual who has the condition thinks that it will eventually go away or be okay.

The next stage is pleading, bargaining, and desperation, where the client tries really hard to bargain or plead to not have a chronic illness. The individual also wishes really hard that they could go back to the life that they had. They may feel guilty and blame themselves for becoming sick and wondering if they could have done more to prevent their illness. Guilt usually comes with bargaining as the person blames themselves for their situation.

Anger is a crucial stage for individuals to begin the healing process. There is no specific timeline for the client to get through the anger stage. Please note that a client may come in angry some days when training, but they are not angry with you. Try to remain empathetic and patient as the individual goes through this stage. Keep in mind that everyone on the healthcare team often sees anger from the newly diagnosed individual who has a chronic illness. It is normal for the client to be angry at their doctor, caregiver, family, friends, and even you, their trainer. However, they will most likely apologize after showing you that they are visibly angry. This stage comes later in the process when the disease progresses, and the individual realizes that life will change.

Anxiety and depression will set in next as life changes are solidified. The feelings of depression can be substantial and seem to the client like they will never go away. If a client starts to withdraw, offer meditation instead of a training session to keep the client on track. Try to also be understanding about their condition and how they are feeling. If they must cancel with you, ask that they do so within a certain amount of time as your time is valuable as well. There may be anxiety about the future and the unknown as the person wonders what will happen to them.

The loss of self and confusion is very real for individuals with a chronic illness. In this stage, life has changed so much for this individual that they do not recognize themselves. As a result, they cannot do what they used to and have to redefine themselves and decide how to do that. This stage may happen at the same time as anxiety and depression or separately.

In the stage of re-evaluation of Life, Roles, and Goals, the client will be thinking about how they can move forward as a wife, mother, husband, father, sibling, and friend. They are forced to re-evaluate how they fit into the picture and what that means in daily life, figuring out how to go about daily activities and what work will look like for them.

The final stage is acceptance, in which the client accepts his or her new reality. The client is not usually happy with it, but they learn how to deal with their new norm. They strive to learn new skills to make life better and discover new things that bring joy into their lives. In this stage, the client will be most accepting of trying new exercises and stress relief modalities in their training sessions.

References:

Adapted from: Pratt, Amanda. “7 Stages of Grief for Chronic Pain and Chronic Illness: St. Petersburg Therapist.” Chronic Illness Therapy, 3 Aug. 2018, imaginelifetherapy.com/7-stages-of-grief-for-chronic-pain-and-illness/.

Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 20 years of experience in medical-based fitness. For more information on the our mind/body programs and supporting clients through stress management click HERE

Other Blog posts by Robyn:

Osteoporosis and STRESS – MedeXN

Choosing Appropriate Music for Mind/Body Classes – MedeXN

At the beach this summer, I was surprised to see my friend’s fair-skinned red-headed daughter romp around in a regular swimsuit. Last summer, and every summer before, Audrey couldn’t leave the house without a hat, long sleeves and a thick layer of sunblock without risking a sunburn. This year, however, along with sunscreen, she was getting added sun protection from the inside out with astaxanthin supplements.

One of the most potent antioxidants found in nature, astaxanthin (pronounced as-ta-ZAN-thin) is sometimes called “sunscreen in a pill”. The carotenoid protects skin cells by neutralizing free radicals produced from sun exposure. Free radicals cause DNA damage and the inflammation (redness, pain and warmth—or burning) known as sunburn.[1] In animal studies, astaxanthin derived from diet or supplements reached both the dermis and the epidermis, accumulating in the skin and preventing the effects of ultraviolet (UV) radiation exposure.[2]

As an antioxidant, astaxanthin has been shown to be more potent than other antioxidant in neutralizing free radicals and protecting cell membranes,[3] including vitamin C, vitamin E, coenzyme Q10, lipoic acid and other carotenoids.[4]

Its antioxidant properties, combined with its anti-inflammatory effects, play an important role in boosting overall skin health, even offering protection against skin cancer.[5] In the skin care industry, astaxanthin’s popularity is gaining momentum as an anti-aging treatment as it can slow the aging process by combatting dryness, skin irritation, and reducing wrinkle formation by improving skin elasticity within a matter of a few weeks.[6]

Astaxanthin shows promise in other areas of health as well, including age-related macular degeneration, which can cause vision loss, heart health, joint health, and other conditions associated with inflammation or oxidative stress.

Astaxanthin is found naturally in salmon (sockeye salmon has more than Atlantic farmed salmon) trout, shrimp, krill, crab, lobster and flamingos. In fact, marine animals get their pink hue from eating a microalgae rich in the reddish carotenoid. While including these foods in your diet will offer some protection, for astaxanthin’s sun-protective and anti-inflammatory effects, a dietary supplement of 1 mg taken twice daily will provide the defense you need. Because astaxanthin accumulates in skin, for sun protection, take it consistently for at least 2 weeks to build up protection. As with all nutritional supplements, it’s best to start with a low dose and gradually increase the amount to assess your tolerance.

Are you interested in more natural solutions for your health? Our Natural Nutrition Coach Program was designed for “Coaching a natural foods diet in the pursuit of health and the prevention of chronic disease”

As a Natural Nutrition Coach you can help to transform lives… even your own!

For more information on the Natural Nutrition Coach Program click HERE.

Lisa Tsakos, R.H.N. is a nationally recognized holistic nutritionist, educator and author specializing in weight management and corporate nutrition programs. Lisa is a co-author of the Natural Nutrition Coach® program.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946307/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295690/

[3] https://pubmed.ncbi.nlm.nih.gov/10775364/

[4] https://www.ijstr.org/paper-references.php?ref=IJSTR-1119-24690

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946307/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946307/

Article by Robyn Kade, B.A. MBMS, cpt

When creating mind/body fitness classes, we are never told which type of music is most useful or how to appropriately choose our music. An instructor will usually choose music for the sound that is pleasing to them. There is nothing wrong with this, and in fact, music is very subjective to everyone. Not everyone will like the same music that is chosen for the class. Some class participants may ask where you purchased your music, but you cannot please everyone with the music selection. You may be wondering how the brain picks up these frequencies and synchronizes them with its brainwaves. The brain can differentiate each sound frequency as it enters the brain through the ear. You may not know, however, that each frequency has its own specific purpose. For example, white noise is commonly used for helping individuals to get to sleep as well as calm the sound of Tinnitus (a ringing in the ears). Once you understand how frequencies work you can choose music that will produce a certain outcome. (National Institutes of Health, 2018)

Music and Stress

According to the University of Nevada, music can be a powerful stress reliever as well as help the mind to be more focused. Choosing the right type of music for each class is critical in helping you to achieve the objective of somatic movement classes. It is known, for example, that faster music can make participants feel upbeat and be better able to concentrate. A slower beat can help you to quiet the mind and your class participant to de-stress. The University of Nevada says that music that is 60 beats per minute can cause the brain to synchronize with the beat, causing alpha brain waves to initiate. This relates to sound frequencies that are 8-14 hertz or cycles per second. Alpha brainwaves are present when we are relaxed and conscious. Delta brainwaves are dominant at 5 hertz. Stanford University found that certain sounds tend to relax us more; they are Native American, Celtic, Indian stringed instruments, drums, and flutes. There is a song called “Weightless” by Marconi Union, which is said to be the most relaxing song in the world. They ask that you not listen to it while driving in the car. The specific purpose of the song is to help lower the heart rate, reduce blood pressure, and reduce levels of the hormone cortisol. You can play the song on YouTube for a thoroughly relaxing experience and then record how you felt in your journal. It is noted that individuals should listen to this type of music for at least 45 minutes to obtain full benefits. (University of Nevada, 2020)

Psych Central says that nature sounds are very beneficial in decreasing stress levels because of the external focus it provides. When playing nature sounds for somatic movement classes, you want to use real sounds of nature. Artificial sounds draw the participant into themselves and can have the opposite effect. Listening to nature for 30 to 40 minutes three times a week can profoundly decrease stress and cortisol levels. (Collingwood, 2020) When choosing music for the Mindful Stretch or NeuRoll Calm class, we ask that you use primarily natural sounds mixed with soft music. Isochronic tones can be used as well, depending on the goal of the class you are instructing. (Kade, 2020)

Nature sounds help you to focus internally

Nature and soundscapes are widely used for meditation, but the question is which sounds are best for our group exercise class or small group training sessions. As the instructor, you are setting the objective for each class, and you can choose the music accordingly. Both of these types of music have frequencies or noise colors, and each color can be used to elicit specific meditative responses. The colors are white noise, pink noise, blue noise, grey noise, violet noise, red noise, green noise, and black noise. According to audiology.com, the most common noise colors used in meditation are white noise, pink noise, and brown noise. You can tell the difference in the noises by listening to them one at a time. White noise has a higher frequency and is perceived to be louder than it is; think of a water fountain. Pink noise has a more resonant sound than white noise and has more of a balanced sound; an example would be a calm ocean, and brown noise sounds like a soft rumble like thunder or a rough ocean. (Gulf, 2016)

White noise is a collective frequency of all noise and can block out or mask other sounds. Some individuals use a fan, for example, to help them fall asleep at night. White noise is the go-to sound for masking sounds that come from within. Tinnitus sufferers use white noise to mask the constant sounds in their ears. Tinnitus can sound like a heartbeat, swooshing noise, or many other sounds within the ear. Other benefits of white noise are improved concentration and sleep promotion. (Gulf, 2016)  Example of White Noise

Pink noise is a popular alternative to white noise, and some individuals prefer it because of the more gentle, relaxing sound it makes. We recommend changing up the music because not everyone will always like the music you choose. Like white noise, pink noise also includes the whole sound spectrum, but it has a less harsh sound. An example of pink noise is rushing water or heavy rain. Pink noise is also used to block out other sounds and help with improved focus, alleviating headaches, and promoting sleep. (Gulf, 2016) Example of Pink Noise

Brown noise was actually discovered by Robert Brown, a botanist in the 1800s, who calls this Brownian Motion. Brown takes the low frequency of pink noise lower, so it sounds like a buzz. Brown noise sounds like rushing water with a low roar. Brown noise is used to help with relaxation or meditation, improved focus, and reading comprehension, as well as sleep promotion. This is also known as Brown noise because the change in sound signal is random. (Gulf, 2016) Example of Brown Noise

Adapted from:  Gulf Coast Audiology. “White, Pink or Brown: Which Noise Helps You Sleep Better? – Hearing Aids Hearing Loss: Pascagoula: Biloxi, Mississippi: Gulf Coast Audiology.” Hearing Aids Hearing Loss | Pascagoula | Biloxi, Mississippi | Gulf Coast Audiology, 10 Feb. 2016, www.gulfcoasthearingaids.com/2016/02/10/white-pink-or-brown-which-noise-helps-you-sleep-better/.

Binaural Beats

Binaural beats are another type of music that can be used by clients at home or whenever they feel stressed. The sound produced is relaxing as long as the hertz or cycles per second are within the right cycle per sound. Individuals usually listen to binaural beats through earphones to achieve the best outcome. Each ear typically has a different frequency than the brain is listening to. The frequency should be no more than 30 hertz apart for the brain to synchronize the soundwave. The only known side effect of binaural beats, when listened to through headphones, is seizures. If anyone chooses to listen to binaural beats on their own with headphones, it is recommended to consult with their physician first. If you are using binaural beats in class, it does not have the same effect. It is relaxing, but the brain can only synchronize the sound and pick up brainwaves through earphones. For now, we know that binaural beats can help with anxiety, memory, mood, creativity, and attention. The different brain waves are Delta, Theta, Alpha, Beta, and Gamma. Delta brainwaves are synchronized with a hertz of 0.1 to 4, Theta brainwaves are noticed at 4 to 8 hertz, Alpha is 8 to 13 hertz, Beta is 13 to 30 hertz, and Gamma is 30 hertz and higher. (Booth, 2019)

Psychology Today says that individuals have decreased cortisol, increases in melatonin, and decreases in DHEA when listening to binaural beats. This therapy is also being looked into as a possible treatment for anxiety and pain reduction. It is essential to stay within the hertz ranges that are provided below. If you go higher than the recommended Herz range, the individual could end up with the opposite effect of what the goal for the class originally was. For example, someone who is looking for stress relief could become anxious instead. Music that pre-mixed already follows these guidelines. (Booth, 2019)

Isochronic Tones                                   

Isochronic tones are single notes of tones that are spaced evenly to create a rhythmic beat type of sound. You do not need to wear earphones for Isochronic tones to be useful as they are a singular beat, and the brainwaves produced can be measured by an EEG test. Many Isochronic tones are mixed with soft music or nature sounds. According to Healthline, Isochronic tones may promote better quality sleep, focus, and attention, decrease pain, help with declining memory, meditation, and a more positive mood. Isochronic tones follow the same brainwaves as Binaural Beats. It is recommended to use isochronic tones when instructing mind/body classes. (Booth, 2019)                                                                                 

     Binaural Beats and Isochronic Tone Brain Waves Chart

Adapted from: Booth, Stephanie. “Brain Health With Binaural Beats.” Healthline, Healthline Media, 14 May 2019, www.healthline.com/health-news/your-brain-on-binaural-beats.

The music for class should be either natural soundscapes with soothing music blended with it or Isochronic Tones-based; you can find an example online. Isochronic tones can be sold as a full album or a single song. We suggest starting the music before class to help calm class participants and prepare them for Mindful Stretch.  The instructor should also use a natural voice and no microphone. A natural voice helps to elicit the relaxation response and enables participants to connect with you. Keep in mind that breathing from the diaphragm helps instructors not to strain their vocal cords. The volume of the music being played is essential as well. It should be just loud enough that everyone can hear but soft enough that you can safely talk over the music. If you feel that you are straining your voice, lower the music to a level that is comfortable for you. (Kade, 2020).

For more information on stress management techniques including breath work, download the free eBook by Robyn Kade, Mind/Body Medicine in the Fitness Industry.

Learn more about Robyn’s courses HERE, 

• Mind Body Medicine Specialist
• Holistic Group Fitness Instructor
• Holistic Stress Management Consultant

Robyn Kade is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 20 years of experience in medical-based fitness. 

References:

Booth, Stephanie. “Brain Health With Binaural Beats.” Healthline, Healthline Media, 14 May 2019, www.healthline.com/health-news/your-brain-on-binaural-beats.

Gulf Coast Audiology. “White, Pink or Brown: Which Noise Helps You Sleep Better? – Hearing Aids Hearing Loss: Pascagoula: Biloxi, Mississippi: Gulf Coast Audiology.” Hearing Aids Hearing Loss | Pascagoula | Biloxi, Mississippi | Gulf Coast Audiology, 10 Feb. 2016, www.gulfcoasthearingaids.com/2016/02/10/white-pink-or-brown-which-noise-helps-you-sleep-better/.

Kade, Robyn. Mind/Body Medicine Specialist Manual. 4th ed. / USA, Stress Management Institute for Health and Fitness Professionals, 2020.

Medical Fitness Exercise is the bridge between Medical Management and Regular Exercise; it takes into consideration what stage the client is at, in that moment (for every session), and the limitations that may result from the client’s surgery and/or treatment. It is designed to help the client move safely and effectively along the fitness continuum, post rehab, helping them to reach their desired fitness goals and beyond! This is where a Specially trained Fitness Professional comes into focus!

What can a Fitness Professional who Specializes within a Medical Fitness Exercise field do?

A Fitness Professional, who Specializes in one or more fields within the Medical Fitness Exercise space, helps their client to make the transition from medical management and/or physical therapy or rehab, to a regular physical activity program following a surgery, an injury, a medical diagnosis, or exacerbation of a pre-existing condition.

They will understand contraindications for different types of exercise, the effects of certain treatments and medications and when to refer their client out for additional support or for a diagnosis. They have an elevated level of knowledge and skills that will help them to make a huge difference in the life of someone who is in need of specialized support for exercising with medical concerns such as obesity, metabolic syndrome, diabetes, hypertension, neuromuscular disorders, heart disease, osteoporosis, orthopedic injury, cancer, Alzheimer’s, arthritis, Parkinson’s, multiple sclerosis, and stress caused disorders, and can Specialize in one or more Medical Fitness Exercise fields of practice such as Cancer Exercise, Diabetes Exercise, Brain Health, Functional Aging, Clinical Exercise, Multiple Sclerosis, Stress Management, Mind/Body Medicine, Natural Nutrition and/or support people in Stroke Recovery, with Joint Issues etc..

These Specialized Fitness Professionals can help clients improve their client’s fitness level and decrease their risk factors for disease. They can help clients to regain strength, endurance, and functional movement during and following rehabilitation for diseases, disorders, surgeries, and ailments. They can work in complement with the clients’ health care team, providing metrics and results updates via technology such as GoGet.Fit and Trainer Plus App.

They have the knowledge and skills for designing, implementing, and modifying exercise programs for their client. They understand the roles of various healthcare professionals and will work with them to enhance their clients exercise program. Specialists can work with individual clients or in group sessions and can incorporate their specialty into existing classes, for example, Pilates or Yoga for Cancer Survivors, or Pre or Post Natal exercise classes for participants with Prediabetes or Diabetes.

We know that lifestyle factors can influence the development of many diseases, doesn’t it make sense that they can also influence the management of these same diseases? Studies certainly support that.

And while Personal Training and many of the Group classes that are offered at many facilities such as Spin, Barre, Zumba, HIIT and other currently popular activities, we know to be beneficial for a generally healthy participant, many of the health compromised individuals are unable to participate. Nor should they in some cases, as often these classes would involve activities that may be contraindicated for them. But we want to encourage these individuals to participate in physical activity, we all just want to make sure it’s activity that will support their recovery and help them to reach their goals safely and effectively. Imagine a client is coming to your facility who is a cancer survivor, a stroke survivor, or who is prediabetic or diabetic, may have a chronic condition such as arthritis or is in cognitive decline, and there is a Personal Trainer or Group Trainer on staff who is Specially trained to work with individuals that have that health concern.  Imagine that Specially trained Fitness Professional as a resource that can help other trainers make adaptations for their group participants or Personal Training clients so that they have the best outcome. Imagine how those individuals will feel that they can now participate and be included?

That is what a Specialized Fitness Professional can do for their clients!

The Opportunity: Why Should Trainers and Gym Facilities Consider Specializing?

The need is growing for Fitness Professionals and Gym facilities to Specialize. Why is that? A huge factor is the aging population. Let’s use Canada as an example.

• Similar to other Western countries, the Canadian population is aging, the median age is 42. That means half the country is over the age of 42 and one in six Canadians are 65 years of age and over.
• That number is projected to rise by 2024 to be one in five, and by 2030 one in four.
• With that aging population comes increased numbers of chronic conditions including heart problems, cancer, diabetes, obesity, arthritis, joint issues etc.
• Many of these health concerns and risks can be mitigated with lifestyle modifications including exercise.
• Cancer rates are rising; there were over 220,000 diagnoses in 2018 and more than 3 million cancer survivors in Canada.
• 90% of cancers are diagnosed in the 50 plus age group
• 63% of Canadians are considered overweight or obese.
• And while 11% of Canadians over 20 years of age have been diagnosed with diabetes, twice as many, another 22% of the over 20 population, is considered to be prediabetic, bringing the total to nearly one third of all Canadians over the age of 20 to be either prediabetic or diabetic.
• 73% of working adults aged 20-64 report some level of stress, and according to Stats Canada, 30% of those aged between 35 and 54 are extremely stressed!
• Stress is a known factor for the development of many chronic illnesses and issues with mental health.

There is much less Competition in the Medical Fitness Exercise Space!

Not only will you be providing a much-needed service, but in this Medical Fitness Exercise space, there is less competition. And many of these clients can utilize your existing facility and use much of your existing equipment. The return on investment is immediate for many of these Specialist programs, even with one client! You will have the opportunity to reach a portion of the population that may never have considered joining your gym or to come for training. And because this is mostly an older demographic that has the time and resources to spend on programs that will help them to obtain better health outcomes and mitigate their health risks, they typically stay with the facility or trainer for a longer period of time. They aren’t looking for immediate results, and typically their goal isn’t centered on physical appearance; they are looking for wellness, longevity and functional movement to help them in their activities of daily living, to remain independent and to just feel better! So, their goal is living LIFE to the fullest!

Many of these Specialties can be taken as part of your professional development, providing you with meaningful CECs/CEUs that will enhance your skill set and open the door to a new segment of the population that you may not have had access to before.

What to look for in a Specialty program:

• Is the course developed by people knowledgeable and recognized in their field of practice?
• Is the course recognized by certifying organizations?
• Does it fit in with your professional development plan?
• Is it a field of practice that you’re interested in/ you can see yourself in?
• Will it provide you with additional knowledge that you can use?
• Will it bring in new clients and expand your practice?

Whether you are someone new to the fitness profession, or have been in fitness for years, creating your niche in the Medical Fitness Exercise space will provide new opportunities for your fitness business for years to come!

MedeXN provides Certifications and Courses for the ongoing professional development of Fitness and Allied Health Professionals looking for meaningful continuing education in the field of Medical Fitness Exercise. For more information visit www.medexn.com

“Exercise Your Knowledge to Elevate Above.”

Many Fitness Professionals will look to the American College of Sport Medicine (ACSM) and the Canadian Society for Exercise Physiology (CSEP) and their recommendations for what to include in an EPAP: a minimum of 150 minutes of cardio, resistance exercise at least twice a week and making sure to include flexibility and balance training, especially for older individuals. But should we also consider recommending at least 120 minutes of weekly nature exposure and include outdoor activities in the plan for even better overall health and wellbeing? There are studies that now support this!

Research into this area began nearly 40 years ago in Japan, with their practice of shinrin-yoku, literally translated as ‘forest bathing’. A body of evidence is growing that spending time in nature is responsible for many positive measurable changes in the body.

What happens when we spend time in a natural setting surrounded by trees and plants? A Professor at the Nippon Medical school in Tokyo, Dr. Qing Li, found that trees and plants emit aromatic compounds called phytoncides, that when inhaled, spurs a response in the body similar to the affects of aromatherapy. Li has shown, through multiple studies, that when people walk through or stay overnight in forests, they often exhibit changes in the blood that are associated with protection against cancer, better immunity, and lower blood pressure. Additional recent studies have also linked nature to symptom relief for health issues such as heart disease, depression, anxiety, attention disorders and technostress.

Phytoncides have been shown to increase natural killer cells (NK), which is a type of white blood cell that supports the immune system and is associated with a lower risk of cancer. NK cells are also thought to have a role in combatting infections and lowering inflammation. Systemic inflammation has been associated with many long-term chronic illnesses including heart disease, cancer, and diabetes.

A simple long walk in a forested park area, for two hours in the morning and the afternoon, was shown in a study to increase the number of NK cells and NK cell activity as well as to increase levels of anti-cancer proteins, and that the effects lasted for at least 7 days afterwards.

Li also found in a study, that infusing people’s hotel room with phytoncides had some of the same anti-cancer-cell effects as those seen amongst the forest walkers.

So, what is the mechanism that triggers these NK cells to increase? University of Illinois Environment and Behavior Researcher Ming Kuo believes the answer lies in nature’s ability to enhance the functioning of the body’s immune system.

One way to understand this relationship between nature, health, and the immune system, Kuo explains, is that exposure to nature switches the body into “rest and digest” mode, which is the opposite of the “fight or flight” mode. When the body is in “fight or flight” mode, it shuts down everything that is immediately nonessential, including the immune system.

“When we feel completely safe, our body devotes resources to long-term investments that lead to good health outcomes–growing, reproducing, and building the immune system,” Kuo said. “When we are in nature in that relaxed state, and our body knows that it’s safe, it invests resources toward the immune system.

Another recent study , conducted in Europe, examined the association between recreational nature contact and self reported health and well being for a period of 7 days. Almost 20,000 participants, weighted to be nationally representative, were asked to do the survey. The results: Compared to no contact with nature during the week, the likelihood of reporting good health or high well being became significantly greater with ≥120mins. Positive associations peaked between 200 to 300 minutes per week with no additional gain. Researchers found that the pattern was consistent, even amongst older adults with long term health issues. The affects were cumulative, it didn’t matter how the 120 mins of contact with nature was achieved, for example benefits were seen with one long exposure and with several shorter visits / exposures per week. The research suggest that additional studies may be the next critical step in developing weekly nature exposure guideline comparable to those for physical activity.

As you’re creating an EPAP (Exercise and Physical Activity Plans) for your clients, perhaps you should also consider time for them to spend in nature as well. Can they do some of their activities in a natural environment? Based on recent studies, including at least 120 minutes of activities involving nature exposure, will help to provide them a better overall health and wellness outcome.

By Lisa Tsakos RHN

One of the joys of summer is cooking on the grill or over an open fire. Before your next backyard cookout, be aware of potential health concerns associated with grilling and the charring of meat.

Two cancer-causing by-products are associated with the grilling of beef, poultry, lamb, pork, and fish. The first involves a well-known group of carcinogens called heterocyclic amines, or HCAs.

HCAs form when creatinine, a waste product of muscle metabolism, amino acids and sugars react at high temperatures.[1] HCAs begin forming at approximately 300°F, whether meat is cooked on an outdoor grill or in a frying pan indoors. Cooking at higher temperatures and for longer periods of time increases the HCAs produced.

The second carcinogen associated with grilling, particularly charcoal grilling, is polycyclic aromatic hydrocarbons (PAHs).[2]^,[3] PAHs are formed when fat from meat drips onto coal or a hot surface, creating chemicals in smoke that are carried back to the meat. PAHs can also form directly on the food when it is charred. These substances are endocrine disruptors that can affect hormones and health.[4]

Fortunately, meat can be grilled safely with a few preventative measures:

• Marinate the meat. A marinade containing vinegar, olive oil or citrus juices can protect meat and reduce the formation of harmful chemicals. Marinating meat from 30 minutes to two hours has been shown to reduce carcinogen formation during grilling by as much as 99 percent.[5]

• Prepare a dry rub with black pepper and herbs. Black pepper greatly reduces the formation of HCAs on the surface of meat. Blending black pepper with the herbs rosemary, oregano, basil, thyme, or sage eliminates nearly 100 percent of HCAs. The effect is likely due to the antioxidants carnosic acid, carnosol, and rosmarinic acid, found in these herbs.[6]

• Avoid eating burned or blackened parts. HCAs are three to four times more prevalent on meat that is burned compared to meat that is cooked without burning.[7] Flip meat frequently to prevent overcooking or charring on one side. Discard charred pieces of meat or vegetables.

• Trim off excess fat. Fats dripping onto the grill produce PAHs. Choose leaner cuts of meat (like tenderloin, round steaks or loin chops)[8] and trim off visible fat on other cuts of meat.

• Use a drip pan. This keeps fat from dripping onto coals and causing flare-ups. Avoid stabbing meat with a fork as it causes fat to drip onto the coals. Wrapping meat in foil before grilling helps to keep food from burning, fat from dripping, and keeps smoke away from the meat.

• Sear without fear. Briefly sear meat on the outside leaving the inside lightly cooked. If you’re concerned the meat is undercooked, pre-cook it in the oven first, and finish on the grill. This can eliminate up to 90 percent of carcinogens.[9] Use a thermometer to assess the internal temperature. The USDA Recommended Safe Minimum Internal Temperatures[10] are:
  • Steaks & roasts – 145°F
  • Fish – 145°F
  • Fresh Pork – 145°F
  • Ground beef – 160°F
  • Poultry – 165°F

• Cook smaller portions of grilled meats. Avoid well-done meat as shorter cooking time produces fewer HCAs. Smaller or thinner cuts of meat cook quickly. Cut meat into kebob-sized cubes to thread onto skewers.

• Keep your grill clean. The build-up from the bottom of the grill can be a source of cancer-causing agents. To clean the grill, turn the heat to high with the lid closed for about 10 minutes.

• Eat more veggies and fruit. Vegetables and fruit don’t form HCAs when they’re grilled,[11] and they have cancer-fighting abilities that can counteract the harmful effects of grilling. At the next family barbecue, fill your plate with grilled vegetables, green salad, mixed berries and watermelon and make meat a side dish, or enjoy a veggie burger instead.

Happy BBQing!

Lisa Tsakos, R.H.N. is a nationally recognized holistic nutritionist, educator and author specializing in weight management and corporate nutrition programs. Lisa is a co-author of the Natural Nutrition Coach® program.

[1] https://www.cancer.gov/about-cancer/causes-prevention/risk/diet/cooked-meats-fact-sheet

[2] https://www.medicinenet.com/polycyclic_aromatic_hydrocarbon/definition.htm

[3] https://pubmed.ncbi.nlm.nih.gov/26785749/

[4] https://pubmed.ncbi.nlm.nih.gov/30137621/

[5] https://medcan.com/medcan-insights/health-tips-advice/5-tips-for-safer-grilling/

[6] https://www.k-state.edu/media/newsreleases/2017-05/grilling51617.html

[7] https://www.k-state.edu/media/newsreleases/2017-05/grilling51617.html

[8] https://fightcolorectalcancer.org/blog/bbq-and-colorectal-cancer-whats-the-connection/

[9] https://medcan.com/medcan-insights/health-tips-advice/5-tips-for-safer-grilling/

[10] https://www.foodsafety.gov/food-safety-charts/safe-minimum-cooking-temperature

[11] https://medcan.com/medcan-insights/health-tips-advice/5-tips-for-safer-grilling/