Maria wants to lose weight. The 46-year-old mother of two never lost the “baby weight” she gained after having her second child 5 years ago, and the extra 40 pounds is compounding other challenges in her life.
She’s overworked, tired and stressed, and her doctor has warned her that she’s teetering on the edge of metabolic syndrome; if she doesn’t do something now to disrupt her negative health trajectory, the consequences could be serious. This new client is desperate, and she’s looking to youfor answers. How can you help her?
This Article Originally appeared in the Spring 2020 issue of American Fitness Magazine.
HOW YOU CAN HELP CLIENTS AS A NUTRITION COACH
How can you, as a personal trainer and health advocate, inspire and support change in clients like Maria? If exercise is essential but not enough on its own, and a multipronged approach is key, then education and awareness are paths to success.
To make a real difference, trainers must look at the bigger picture—at a client’s fitness, lifestyle and nutrition as a package. Client goals extend well beyond weight loss but, even for goals that have nothing to do with the scale, nutrition plays a pivotal role.
The food and drink a person ingests is a big piece of the puzzle. “As a rule of thumb, weight loss is generally 75% diet and 25% exercise,” according to Shawn M. Talbott, PhD, nutritional biochemist and former director of the University of Utah Nutrition Clinic. “An analysis of more than 700 weight loss studies found that people see the biggest short-term results when they eat smart” (Wexler 2017).
SUPPORTING POSITIVE BEHAVIOR CHANGE
To support positive behavior change that will persist long term, trainers must view their clients’ wellness as a larger entity with many moving parts—of which exercise and nutrition are only two (albeit two of the most powerful). “Fitness professionals should focus on helping clients make lasting lifestyle changes,” says NASM content development and production manager Brian Sutton, MS, MA, NASM-CPT, CES, PES, CNC.
“After all, achieving health- and fitness-related goals is not a quick fix or a one-time event, but rather a lifelong journey. Fitness professionals can provide their clients with the knowledge and skills needed to make positive behavior changes that last a lifetime.”
THE SCOPE OF PRACTICE FOR A NUTRITION COACH
For fitness professionals, no discussion about nutrition is complete without mentioning scope of practice. You’ve heard it before—you can’t out-train a bad diet—but how can you assist clients with nutrition without stepping outside your scope of practice? If Maria asks you to plan a diet for her based on her goals, that’s a no-no. So, what can you do? (See “Nutrition Coach Scope of Practice,” page 40, for more on this.)
Scope of practice includes actions, procedures and processes that a professional is allowed to undertake in keeping with the terms of a particular license or credential, and parameters vary from state to state. Above all, Sutton says, fitness professionals and even nutrition coaches “should not provide services that are reserved for medical professionals. Services such as [offering] nutritional therapy to treat disease, diagnosing or treating eating disorders, or prescribing specific meal plans are out of a fitness professional’s scope of practice.”
Although meal plans are off the table, there is still a lot you can do to educate your clients and provide support around nutrition, especially if you expand your education in this area. “In most states, [fitness professionals] can provide guidance, discuss supplements and coach clients to make the right choices through education and accountability,” says Mike Fantigrassi, MS, NASM-CPT, CNC, Master Instructor and senior director of product development.
Most of the laws blanket anyone without a registered dietitian title, so enhancing your nutrition knowledge may not drastically change your scope of practice. However, obtaining additional nutrition credentials will upgrade your knowledge and ability to help clients.
This is why some trainers, group fitness instructors and other fitness professionals are obtaining a nutrition coaching certificate. It is a good option for anyone who is not on the path to becoming a registered dietitian or a registered dietitian nutritionist, which requires a “bachelor’s degree from an accredited program in nutrition and dietetics, completion of an accredited supervised internship program, [a] passing score on a national registration exam, continuing education [and, in some states,] additional licensing,” says registered dietitian Mark Hedegore, RD, LD, owner of Live Fit Personal Training + Nutrition.
“In fact,” he says, “47 states, as well as several U.S. territories, have laws regulating the practice of dietetics and the use of certain titles such as ‘dietitian’ and ‘nutritionist.’”
While you can’t provide nutritional therapy to Maria, you can explain the pros and cons of diets and teach healthy portion sizes. In fact, there’s a lot you can do to help people like Maria make sound nutrition choices, and it’s all part and parcel of being a certified nutrition coach.
WHAT IS A NUTRITION COACH?
Since nutrition coaching has fewer barriers to entry than becoming an RD, coaching can be a viable option for many fitness professionals who are looking to advise clients on food choices. “[It] involves using coaching techniques to act as a guide,” says Fantigrassi. Personal trainers use a nutrition coaching certificate in the same way they use their personal training credentials—to educate and make suggestions within scope of practice and to guide clients to make their own decisions.
“There is no one way to eat that is right for everyone. Being a nutrition coach means being a partner in change [who] can provide answers when needed . . . or allowing the client to come to the right decision by asking the right questions.”
That’s a powerful statement. Examples of good questions you might ask Maria are “How do you typically walk through your grocery store?” and “What’s a normal portion size of protein per meal?” The answers to these questions are more than informative; they are foundational.
Again, nutrition is just a piece of the overall lifestyle puzzle. “To me, being a nutrition coach means that you serve clients in order to help them achieve health, fitness and weight loss goals by using nutrition as a tool to achieve those goals,” says Brad Dieter, PhD, chief operating officer for Macros Inc. and director of science for Harness Biotechnology.
“Nutrition coaches work with the general population to facilitate the inclusion of healthy eating behaviors and empower their clients to take responsibility for their own health,” says Sutton. “They are mentors and leaders who guide their clients toward a healthier lifestyle. To be a successful nutrition coach, individuals must possess knowledge of both nutritional science and behavior change strategies.” It is this knowledge of behavior change that makes personal trainers great candidates to become nutrition coaches.
With a nutrition coaching certification, Sutton says, fitness professionals can take their nutrition expertise to the next level. Practical applications include the ability to “perform dietary assessments and body composition testing; demystify nutrition myths and fallacies; discuss healthy cooking options; provide guidance regarding appropriate calorie consumption for safe weight loss; teach how to read food labels; demonstrate and clarify healthy portion sizes; and provide eating strategies for consuming adequate amounts of lean protein, vegetables, fruits, legumes and dairy to promote health (to name a few).”
WHAT CAN AN NASM-CERTIFIED NUTRITION COACH DO?
Refer to the following when determining what you can and can’t do as a nutrition coach.
What an NASM-certified nutrition coach can do:
- Calculate caloric needs.
- Teach healthy portion sizes.
- Teach how to read food labels.
- Calculate macronutrient ratios.
- Dispel nutrition myths and fallacies.
- Teach how to navigate grocery stores.
- Discuss the pros and cons of various diets.
- Use coaching and communication techniques.
- Teach the health benefits of various food groups.
- Evaluate eating plans and provide general
- Perform body composition testing and dietary assessments.
WHAT AN NASM-CERTIFIED NUTRITION COACH CANNOT DO:
- Provide exercise prescriptions.
- Promote or provide medication.
- Suggest drastic caloric restriction.
- Diagnose or treat an eating disorder.
- Create or prescribe specific meal plans.
- Conduct psychological counseling or therapy.
- Provide “nutritional therapy” to treat disease.
- Prescribe extreme practices (detoxes, colon cleanses).
- Go against recommendations of a healthcare professional.
PROVIDING A NUTRITIONAL AND EDUCATIONAL SUPPORT SYSTEM
Here’s how these strategies come into play: Most mornings, Maria eats a big bowl of granola for breakfast; she believes this is healthy. She doesn’t know about reading labels to check portion size or grams of added sugar. Proper education will empower her to make better choices.
Maria is not unusual. Many clients need nutritional support and advice and, with a little research, it can be clear exactly who can provide that support and advice.
But what are the elements of a solid nutrition program? Ask anyone who isn’t selling a particular program, and you’ll get some version of the same answer: The right program is the one that will work for your client. Hedegore says the sustainability of a program can make or break a client’s results.
“Most people [who] go on extreme fad diets gain all the weight back plus a few more pounds,” he says. “This yo-yo or roller coaster dieting is also proven to be extremely unhealthy. [It] is proven to increase the risk of metabolic syndrome, diabetes, heart disease and a variety of other unwanted medical conditions.” As many trainers know, a list of dangerous health concerns isn’t always enough to steer clients away from the allure of a quick fix, so you may have better luck educating them about the poor track records that extreme diets have.
Hedegore notes that “many [diets] are not giving active people the fuel they need to perform at their best and get the most out of their workouts.” He says a solid nutrition program will take a client’s workout regimen into consideration.
This can work in reverse as well. While it may be appropriate to alter nutrition to accommodate training, it may also be appropriate to adjust workouts to accommodate diet. “You have to know what a client is eating and tailor your training program to that,” says Fantigrassi. “For example, if a client comes to you eating a very low-calorie diet, it would not make sense to program very intense sessions that [he or she] would struggle to recover from.”
Practicality plays a central role when it comes to nutrition. Sutton says an appropriate nutrition program “considers the client’s food preferences, religion, family and work obligations, and culture and is customized and sustainable for the individual.”
Last but not least, Fantigrassi says, a quality nutrition program “has to lead to the goals a client has set.” One client may want to lose weight, but another may want to gain muscle mass. Nutrition is the key to unlocking results for both clients.
THE ART OF BEHAVIOR CHANGE
Speaking of goals, although the client-trainer relationship often starts off with a modicum of momentum, goals sometimes get lost along the way. Remember Maria’s fat loss goal? It’s about more than shedding those 40 pounds; it’s about shifting behaviors and possibly confronting many barriers to lasting change. This will call for precise program design.
“One of the most important things in helping clients reach their goal is to listen and truly understand what their goals are,” says Dieter. “Oftentimes we put our own ideas for what a client’s goals should be on the client, not letting the clients tell us themselves. There is a lot of conversation that should be held between a trainer/coach and the client about what it takes to actually achieve the goals set forth, ensuring both the client and the trainer are on the same page.”
Again, to meet most health, wellness and weight loss goals, trainers must look beyond exercise and even nutrition. Hedegore says it’s important to focus on habits in general. For example, he suggests that both fitness and nutrition professionals encourage clients to get more sleep, as this will help them “make more of the hormone that makes you feel full and less of the hormone that makes you feel hungry.”
He adds that lifestyle changes often work hand in hand, since “managing stress will often lead to decreased appetite, better sleep and more energy.” As an added bonus, with better sleep, more hormone consistency and regulation, and a smaller appetite, clients will likely have more willpower to make better food choices. Hedegore also suggests urging clients to reduce screen time, as this tends to result in more sleep, higher-quality sleep and less mindless eating.
It’s worth noting that there is a myriad of nutrition resources online, so clients need more than simple education. “Clients need accurate information combined with practical, real-world solutions that are individualized to their unique needs and goals,” says Sutton.
Sometimes, less is more, and trainers can often help by getting a client to focus. “Clients need someone to filter out the noise and to focus on what actually works for them,” says Dieter. “A large role of a nutrition coach is to help keep a client focused on the things that are important to them and not get overly distracted by new shiny toys (aka new diets or pills or programs).”
And while clients come to you with goals in mind, a trainer and/or nutrition coach can be very helpful when it comes to mapping out appropriate goals and addressing assumptions, especially regarding timelines. “Many people struggle with setting obtainable goals,” says Fantigrassi. “They are usually trying to do too much too soon, and they have unrealistic expectations of how fast, sustainable physical changes happen. Being a nutrition coach can help you provide guidance and accountability. You can help clients understand where they are and how to get to where they want to be.”
HOW TECHNOLOGY CAN HELP NUTRITION COACHES
Technology can provide a support system for clients, and when used properly, has been shown to produce results. “We are very fortunate that we live in a world with amazing tools and technology,” says Brad Dieter, PhD, chief operating officer for Macros Inc. and director of science for Harness Biotechnology. “There are countless apps for tracking food, as well as apps for calculating caloric needs.” Your clients likely have a phone on them at all times, so why not encourage them to use it to support their wellness journey?
With the number of apps available today, it’s easy to track meals, calories, nutrients and habits. “I would recommend any app that helps you log the food you eat,” says Mark Hedegore, RD, LD, CSCS, owner of Live Fit Personal Training and Nutrition. “People who log what they eat tend to lose more weight and keep
it off longer than people who don’t, and these apps
are also a great tool for keeping yourself accountable to yourself and others, if you wish to share your nutrition logs.” Apps that allow sharing make it easier for you to review client nutrition and habits, while also inspiring your clients to have a healthy relationship with technology.
NASM content development and production manager Brian Sutton, MA, MS, NASM-CPT, CES, PES, CNC, says the technology or gadget choice should fit into the client’s lifestyle and budget and be used only as a support tool (not the sole solution) while the client is working toward a health or weight loss goal.
Mike Fantigrassi, MS, NASM-CPT, CNC, Master Instructor and senior director of product development, agrees that apps and trackers can be very beneficial, but he adds: “The only caveat is [to make sure] the client does not become overwhelmed by using these tools.” Sometimes, technology can become a problem and encourage obsessive behavior. “If someone becomes too focused on hitting certain metrics like steps and does not reach that goal, it can make some people stressed and [they can] feel they are not doing enough. Losing weight generally has its ups and downs, and being consistent in the long term is what gets results.”
Whether clients are comfortable with technology or not, “there are very simple mental tools that people can use to help with nutrition,” says Dieter. “Being mindful about eating, paying attention to hunger cues and positive self-talk are also excellent tools.”
HELPFUL WELLNESS APPS FOR NUTRITION COACHES
- NASM Edge (personal training resources, workout routines and tracker, easy trainer-client communication)
- MyFitnessPal (diet tracker with extensive food database)
- Headspace (meditations and mindfulness around eating, exercise and lifestyle challenges)
- Lose It! (simple diet tracker)
- Mealime (meal planning)
- Nourishly (mindful eating–based diet tracker)
- Calm (meditation and sleep)
NASM. n.d. Nutrition coaching scope of practice. Accessed Apr. 7, 2020: https://www.nasm.org/docs/pdf/nutrition-coaching-scope-of-practice-slides.pdf?sfvrsn=ec3a63b3_2 .
Wexler, S.Z. 2017. Exercise vs. diet: The truth about weight loss. Accessed Apr. 7, 2020: