Category: Related topics

Top Five Healthy Food Trends to Watch

CBD Candies Tout Wellness Benefits

We just returned from southern California where we attended Natural Products Expo West, the world’s largest natural and organic food show. We walked miles (literally about 7 miles per day) to see what’s hot and new in foods and beverages.

Here are our
top 5 trends from the show:

CBD Edibles Galore

Since hemp-derived CBD is legal in all 50 states, there were hundreds of brands touting their new hemp-derived CBD products for their wellness benefits.  We came home with bags of samples of CBD tinctures, soft gels and vitamins along with candy, honey, tea and  other products made with full spectrum CBD. CBD is generally hemp-derived so it doesn’t contain THC (the psychoactive compound in cannabis) and you won’t get a buzz from these tasty edibles.

Regenerative Replaces Sustainable

General Mills Exhibit

Some 75 percent of the foods we eat come from just 12 plants and 5 animals. To increase diversity, several food companies are embracing more diverse ingredients and crop biodiversity for a more “regenerative” agricultural system.

General Mills announced that it would be using regenerative ag techniques on a million acres of farmland by 2030. Both Unilever and Danone are multinational companies also looking for ways to promote regenerative agriculture. Look for smaller brands, like start-up Kuli Kuli’s moringa and Varietal crackers, that are investing in sustainability and the regenerative movement too.

Oh My Oats!

Bobo’s Oat Toasters

Oat-infused products were everywhere at this year’s Expo. Almond and soymilk are being pushed aside for oatmilks, which are proving to be the darling of the nondairy milk alternatives. Oatmilk is considered more sustainable and has a neutral flavor more similar to cow’s milk.

We liked Elmurst 1925 from New York and Mooala creamy coconut oatmilk. Some of our favorite oat-based snacks included Enjoylife’s Breakfast Ovals, Oats Overnight (just add your favorite milk), and Bobo’s oat bars, cookies and toaster “pastries”. They make oats more portable than ever.

‘Shroom Boom

Bacon Chips Made with Mushrooms

Love fungi? If so you’ll be thrilled to hear that there’s been a boom in all things mushroom. Mushrooms are being touted for their health and wellness benefits, including immune-boosting and anti-cancer properties.

With Outstanding Food’s Pig Out Plant-Based Chips, you’ll think you’re eating bacon, but actually they’re just mushrooms with amazing texture and flavor. Similarly, Pan’s Mushroom Jerky are vegan, soy-free, gluten-free and high in fiber and vitamin D. We also liked Applegate Farm’s Blend Burgers that reduce the amount of organic beef or turkey in a burger patty and fill it out with organic mushrooms. These tasty burgers make it easy to amp up the veggies in your diet. 

Mouth-Watering
Plant-Based Burgers…Finally

New, Tastier Plant-Based Cheeseburgers

Plant-based was another huge trend at the show, and new mouth-watering plant-based burgers were drawing big crowds.  We liked Morningstar Farms new Cheezeburger, a vegan quarter pound patty with plant-based cheddar “cheeze.” Delish.  We also liked Strong Roots’ hearty quinoa and kale burger, which provided great taste and texture.  And, for a burger that looks and cooks like real beef, you’ll want to try Sweet Earth Foods Awesome Burger, a soy-based meat alternative.

Top Five Healthy Food Trends to Watch is a post from: Appetite for Health

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5 Reasons to Go Bananas!

Lately I’ve been fielding a lot of questions about one of America’s most popular fruits: bananas. On average, Americans eat about 20 pounds of bananas per person each year. Yet many people aren’t quite sure if this convenient fruit is really a healthy choice. In recent years some diets have put bananas on their ‘banned’ lists and some online rumors insist that they are a cause of weight gain.

Here are 5 reasons to peel open this fantastic fruit:

1. They Won’t Make You Fat
That’s right, bananas are diet-friendly. With just 110 calories per medium-sized banana, you get 30 grams of healthy carbs and 3 grams fiber. In addition to filling fiber, bananas contain resistant starch, a type of carbohydrate you can’t digest, but helps you feel fuller longer. A banana can have 2-3 grams of resistant starch (the greener it is, the more resistant starch it contains). This makes them a great mid-afternoon snack, or a perfect pre-workout energy booster.

2. They May Help Lower Your Blood Pressure
You may already know that bananas are a high potassium food. But did you know that means they may help to lower your blood pressure? A medium banana has 422 mg potassium while being sodium-free. Research shows that having a diet rich in potassium reduces the likelihood of high blood pressure and stroke.

3. They’re a good source of Vitamin C
Usually citrus fruits like oranges and grapefruit come to mind when we think of Vitamin C. But don’t overlook bananas for this important nutrient: a medium banana provides about 17% of the daily requirement for vitamin C. Vitamin C is a powerful antioxidant that plays an important role in immune function. It also helps to give you a gorgeous glow, as it helps to build collagen that provides structure for our skin.

4. They’re nature’s perfect on-the-go snack
Need a quick energy boost that will also fill you up when you’re on the go? Don’t forget to bring a banana. With healthy carbs and fiber, bananas are the ideal pick-me-up that will help keep you satisfied between meals. Plus they come in one of nature’s most ‘mess-free’ packages, so you’ll never have to worry about sticky hands.

5. Just smelling one could quash your cravings
According to a study performed at the Smell and Taste Treatment and Research Foundation in Chicago, smelling certain foods when you are hungry can trick you brain into thinking that you’ve actually eaten them. One of those foods is bananas. If that’s not enough to convince you that you can enjoy bananas while losing weight, smell one next time you are hungry.

5 Reasons to Go Bananas! is a post from: Appetite for Health

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Higher egg and cholesterol consumption hikes heart disease and early death risk

Cancel the cheese omelet. A large, new study of nearly 30,000 people reports adults who ate more eggs and dietary cholesterol had a significantly higher risk of cardiovascular disease and death from any cause. People need to consume lower amounts of cholesterol to have a lower risk of heart disease, the study authors said…. Read More

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Here’s the Link between Osteoarthritis and Exercise

You may be able to control and even prevent this debilitating disorder by going it on your own—that is, without pharmaceutical or surgical intervention. How? Good ol’ physical activity. Let’s explore the well-established link between osteoarthritis and exercise.

Is It OA? What You Need to Know about This Joint Disorder

Osteoarthritis (OA) is the most prevalent form of arthritis and the most common joint disorder in the United States, affecting some 30.8 million American adults—that’s nearly one in every 10 of us. This number is only expected to increase as the population ages and more and more people live their lives overweight or obese. (1, 2, 3) If you’re carrying extra pounds, you put added stress on your joints, which increases your likelihood of developing the disease. Obesity may also lead to metabolic changes that bring about the disorder. In addition to age and weight, other risk factors for OA, some of which are modifiable and some not, include: (4, 5)

  • Joint injury and repetitive use: Any joint damage, whether from serious injury or being overworked, increases risk; if you’re an athlete or work a physically demanding job, you may be more susceptible to OA.
  • Gender: Women over the age of 45 are more likely to develop OA than their male peers.
  • Genetics: If you have a family member with OA, you’re more likely to develop it as well.
  • Race: Studies show that the risk of developing osteoarthritis by age 85 is higher in Caucasians than in African Americans (41 percent compared to 29 percent).
  • Muscle weakness and low bone density: These factors are thought to contribute to the development and progression of OA.

If you’re concerned about developing osteoarthritis or you’re already experiencing joint pain, exercise may help. Check out this article to find out which workouts can help with OA. #healthylifestyle #wellness #chriskresser

Normally, cartilage cushions the ends of bones in your joints, allowing your joints to glide smoothly during motion. With OA, the cartilage breaks down and the smooth gliding surface becomes rough. As OA worsens over time, the underlying bone begins to change. Although these changes usually develop slowly, the cartilage can wear away completely, leaving bone to rub directly on bone. The results?

  • Pain
  • Swelling
  • Stiffness
  • Cracking or grinding sounds when moving
  • A loss of range of motion (flexibility) and function; OA is a leading cause of disability
The chronic condition can affect any joint, but it occurs most often in knees, hips, hands, big toes, and the spine, including the lower back and neck. Although there is no cure, the above symptoms can be managed.

The Connection between Osteoarthritis and Exercise: Managing Risk and Preventing Pain

Exercise, we now know, is a vital part of any OA prevention or treatment plan. In fact, exercise is typically recommended, even in conventional medical circles, as a first-line defense and management strategy before over-the-counter medicine or prescription drugs. Studies have shown comparable OA pain-relieving effects between physical activity and oral analgesics. (6, 7, 8)

Unfortunately, despite recommendations by physicians, clinicians, and health coaches to get moving, people with OA just aren’t exercising. It could be a holdover from previous generations, when doctors told their patients to rest and avoid movement that caused pain. Unfortunately, some elderly people with OA likely get worse as times goes by because they follow this outdated advice. Or perhaps some individuals are fearful that any discomfort means they’re causing joint damage. Whatever the reason, a national survey found that roughly 40 percent of those diagnosed with arthritis are inactive, meaning they don’t engage in any sustained periods of physical activity (10 minutes or longer) within an average week. (9, 10) I hope this article will help change that.

The research clearly shows that exercise is a must, whether you want to prevent OA or already have a diagnosis. Here’s why.

Exercise Keeps Your Joints Healthy and Pain Free

The adage “use it or lose it” applies here—regular moderate exercise keeps the body moving as it is designed to move, preventing joints from weakening and that all-important cartilage from breaking down. Animal studies even suggest that exercise can prevent further cartilage degradation in older or injured joints that have already suffered some loss. (11) Research in rats has also shown that exercise effectively relieves OA joint pain, including pain resistant to nonsteroidal anti-inflammatory drugs. (12)

It Helps You Lose Weight

You already know that obesity is a significant risk factor for OA. One meta-analysis of 47 previously published studies found a threefold increased risk for knee OA in overweight or obese individuals. (13) But here’s the good news: It’s also one of the most modifiable risk factors when it comes both to the development of OA and its progression. It’s been suggested that at least half of all cases of symptomatic knee OA could be prevented if the obesity epidemic were better controlled. The Framingham Study found that women who lost 11 pounds or more over 10 years reduced their risk of knee OA by 54 percent. (14, 15)

As previously shared, excess weight puts added stress on joints, particularly weight-bearing joints like the hips and knees, increasing the odds that cartilage will break down, the joint will fail, and OA will develop. Losing those extra pounds relieves that pressure. But that isn’t the only reason obesity and OA go hand in hand. Overweight individuals typically have inadequate muscle mass to properly support their weight, which can advance the onset of OA. They may also be less active, which only leads to further weight gain and muscular deficits and a further risk for the disease. (16) Evidence also suggests that added stress on joints leads to the release of arthritis-promoting pro-inflammatory cytokines, while weight loss reduces cytokine levels. (17, 18) And it appears that obesity brings on metabolic abnormalities, including excessively high levels of insulin, that are associated with OA. Not surprisingly, exercise may prevent or mitigate these changes. (19, 20, 21)

It Gets You out of Your Chair and off the Couch

A sedentary lifestyle can also cause metabolic shifts that may lead to OA, alterations that can be prevented through physical activity. (22, 23) After all, sitting six hours or more a day is far outside of the evolutionary norm for humans. Beyond the connection to metabolism, prolonged sitting is generally associated with an increased risk for OA and increased risk for pain and other complications from the disease. This may be because sedentary behavior degrades muscle strength and posture, impacting joints, especially in the spine. Sedentary individuals who spend significant time on smartphones and tablets further increase their risk of OA in hand joints. What’s more, lack of activity decreases pain tolerance and stiffens joints (24, 25). Conversely, physical activity appears to lubricate joints and strengthen cartilage. (26, 27)

Exercise Strengthens Your Muscles and Builds Bone

In one study, women who developed knee OA had quadriceps muscles that were 18 percent weaker than those without OA; the weakness predated the onset of the disease and was likely a contributor to its development. Weak quadriceps muscles cause the knee to become less stable, of special concern for athletes and others at increased risk for OA from joint injury or overuse. (28, 29) Treadmill exercise, in particular, has been found to block bone loss, which might help stabilize joints. (30) Of course, strength training is also a very effective way to build muscle as well as bone.

The Best Proven Exercises for Osteoarthritis

For overall health benefits, including OA prevention and treatment, experts recommend adults engage in around 150 minutes of at least moderate physical activity weekly.

Moderate activity three times or more per week has been shown to reduce the risk of arthritis-associated disability in study groups by an average of 47 percent. (31, 32, 33) That said, any activity is better than none, and every minute of movement is beneficial. Since joint injuries can cause or worsen OA, if you’re looking to prevent the condition or manage symptoms, choose moderate low-impact activities, such as:

  • Walking
  • Cycling
  • Swimming

These guidelines line up with the recommendations set by my colleague Dan Pardi, which I support, to occasionally push yourself as our ancestors did with bouts of relatively intense activity. (34, 35) In addition to the aerobic exercises mentioned above, we also encourage low-impact muscle-strengthening activities like lifting weights and yoga. Yoga also promotes flexibility to help maintain joint range of motion. Hatha yoga, or the practice of physical postures called asanas, has been found to provide marked improvements in pain and function in subjects with knee OA. (36)

Exercises that strengthen the quadriceps muscles in particular may be especially useful in the prevention and treatment of OA. As one study above highlighted, quadriceps have been shown to be weak in subjects who develop OA, suggesting it’s a risk factor. Research indicates that quadriceps-strengthening exercises can improve strength and function and reduce pain in those with knee OA. These include isometric exercises (in which a particular muscle is contracted without moving the affected joint) and isotonic resistance exercises (where both muscle and joint move, such as in weightlifting) when tolerated. (37, 38, 39)

Tai chi may also be beneficial: Its weight-bearing postures help improve strength while simultaneously promoting flexibility and balance. Studies show it may help relieve OA pain. (40, 41)

Can Exercise Actually Increase the Risk of OA?

It’s true that certain athletic injuries and extreme and excessive physical activity could set the stage for OA, but there isn’t any convincing evidence linking moderate or even vigorous low-impact exercise with an increased risk of OA or an accelerated progression of the disease. (42, 43, 44, 45, 46)

However, as you now know, there is a wealth of research showing that exercise has profound benefits for joint health. I hope you’ll get moving to stave off OA or help manage its symptoms, as well as improve your overall well-being.

Bonus: Another Great Way to Protect Your Joints

In addition to exercise, incorporate gelatin into your diet for extra joint (and bone) protection. Research shows it may be effective in treating osteoporosis and osteoarthritis, as it helps combat pain and inflammation and build stronger bones.

Do you plan on working more exercise into your daily life as a way to prevent OA? Or are you already experiencing symptoms of the condition? Leave a comment below and tell your story.

The post Here’s the Link between Osteoarthritis and Exercise appeared first on Chris Kresser.

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Friend Makin’ Mondays: Feeling Fruity!

Funny how that last post of “I’m going to post everyday for a month!” turned into “I’m not blogging for almost 10 months!”

There have been so many times I’ve thought about how I could “break back into” blogging after going radio silent. I attended Fitbloggin’ a month ago and while I loved seeing my friends and I *wanted* to blog again, I just had so many excuses about why I haven’t.

So what better way to make a return then doing a Friend Makin’ Monday by Sarah at Losing Weight and Having Fun.

This week’s topic is ‘Feeling Fruity’

1. What is your favorite fruit?
 Bananas! Or maybe Avocados….are those really considered fruit?

2. Is there a fruit that you really really don’t like?
Nope! I love all fruit!

3. If you could only drink one fruit juice for the rest of your life, what flavor would it be?
I don’t really like fruit juice, but a splash of Pomegranate juice is nice with sparkling water.<b… Read More

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Five Years of Evolutionary Psychiatry

Next month will mark the 5th year anniversary of this blog. Hard to believe I would still be at it after all this time. Back in the beginning, an interest in ancestral health felt like a very lonely endeavor. Since then I’ve met many online friends, physicians and otherwise, who share my interest, and that communication and support has made all the difference. I probably would have never met these people if not for the blog, and for that and the knowledge I’ve gained, all the thousands of hours and dollars spent have been worth it. Later this year I’ll even be going to New Zealand for the Ancestral Health Symposium there, which looks to be absolutely amazing. If your bucket list includes going to New Zealand, the conference is reasonably priced and is the perfect excuse to go.

Have my opinions changed over the years? Yes, I would say so. I’m more cognizant of the differences between people when it comes to diet and genetics instead of thinking of our species as a more homogenous whole. Just one specific example (not really psychiatry but…) I went from being taught about LDL cholesterol by Brown and Goldstein (who won the Nobel Prize for discovering the LDL receptor and basically ushered in the age of statin therapy) to being a cholesterol skeptic to landing somewhere on the skeptical side of the middle ground. I think statins can and do cause wide-ranging side effects, both physical and mental that for many, even most, people outweigh their benefits, but for folks with a personal history of heart disease or familial hypercholesterolemia, or a rotten cholesterol profile and a strong family history of relatives dropping dead from heart attacks at young ages, using a statin to up regulate the LDL receptor will help improve cholesterol particle recycling and might be worth taking. Since the awesome folks over that theNNTblog agree with me, I think I’m on pretty solid ground.

I’m also more friendly to beans and rice than I was at the beginning, but I’m still not a fan of peanuts or processed food. I have more reason to be suspicious of emulsifiers and artificial sweeteners. Due to my blog I’ve personally seen some very dramatic cases of serious mental illness that are under much better control via gluten-free diets…yes, beware the tyranny of the anecdote, but just keep an open mind about undiagnosed celiac disease that may not present with gastrointestinal symptoms.

I’ve also spoken with some folks with eating disorders who got a ton better and have remained in remission by restricting food to whole, real, minimally processed diets (which is not standard advice for eating disorders by any means, as restriction is a bad word), but I’ve also met anxious folks who had no eating disorders begin to worry about every mouthful and obsess about food all the time once they switched to a paleo-style diet. It’s so important to know yourself…95% of people in the develop world have to restrict diets somehow. We can’t just eat willy nilly whatever and whenever we want, or we will get sick and fat. Some people do much better and are perfectly happy counting calories and having three cadbury creme eggs every Friday night and go on a creme egg binge if they are trying to eat 100% “clean”, while other people find strict food quality rules and not thinking so much about calories makes life much easier and lessens eating obsessions. For health reasons I think we should push food quality over quantity rules in general, and far prefer Brazil’s food guidelines to the American nutty calculation crazy official rules.  

I’ve grown in my appreciation of the microbiome over the years, which is reflected in my most recent blog posts at Psychology Today. Modern chronic disease is all about chronic inflammation, and the microbiome is a huge part of our immune system. I think the first truly successful “diet pill” will be a modified probiotic of some kind (and if I’m being cynical will probably be terribly expensive and bankrupt the health care system). I also think the next breakthrough in pharmacology for mental health, particularly for depressive disorders and anxiety disorders (and maybe autistic spectrum disorders and other serious mental illness), will come from a better understanding and manipulation of the microbiome and the “old friends.”

I recently closed comments at this blog. Though a few thoughtful comments were being posted, some were at long ago posts I had no time to address, and the vast majority of comments coming through were spam or witch doctors advertising pregnancy and AIDS spells. It’s been nice not to have to deal with all that irritating spam email. I do keep comments open on my Psychology Today posts for a few weeks to a month or two.

I do have some new posts up elsewhere:

Improve Your Mental Health With Sleep Part 1
Improve Your Mental Health With Sleep Part II (will be live soon at the 9blog)

And at Psychology Today:
Junk Food, Gut, and Brain

Five Year Synthesis: Start Here Post

Still plugging away and finding *some* new things to write about from time to time. I appreciate all of you who have taken the time to come by, read my blog, and then think about psychiatry and human health maybe a little differently than before. I’ve even had researchers tell me that my articles helped them out. It’s exciting to think my little blog could do something to change the treatment of mental illness for the better.

Here’s to the next five years.

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Evidence-based coaching: Why some health and fitness pros are doing it all wrong.

Ask any health and fitness professional if they’re “evidence based,” and chances are good you’ll get a resounding, “Yes!” Perhaps even an indignant one. After all, everyone uses evidence… of some sort. But if you think evidence-based practice is only what “research says,” you’re doing it wrong. In this article, we’ll show you the right way to use evidence to inform and enhance your coaching—for more effective advice and better client results. 

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Here at Precision Nutrition, we love science.

In fact, no one loves science more than us!

But is it possible to rely too heavily on scientific literature? Can you actually science too much?

Maybe.

Ever see someone:

  • Dismiss a coach’s successful method solely because some element of it isn’t “research proven?”
  • Refuse to modify a nutrition plan—even though a client hates it—“because science?”
  • Call a respected health professional a “quack” because they cite years of clinical experience instead of a definitive clinical trial?

(If you haven’t, you probably don’t spend much time in Facebook comments.)

In each case, the person’s inflated reverence for research could be limiting their ability to learn, and evolve as a coach. They might also influence others to follow their narrow line of thinking, causing them to miss out, too. And this is often done in the name of “evidenced based practice.”

Now, evidence-based practice, or EBP, is all the rage in certain health and fitness circles, which is a great thing. We heart science, remember? Except there’s just one problem…

A lot of coaches, though well-meaning, are getting EBP wrong. Specifically, they’re over-emphasizing “what the research says” to the exclusion of other relevant information, like their professional experience and the personal preferences and values of the people they work with.

And that’s not good for clients, business, or the health and fitness industry.

To make sure you get EBP right, use this guide to understand what the method really is, why it matters, and how to implement it effectively in your own coaching practice.

Because when used correctly, EBP is a powerful tool that’ll make you a better coach—so you can help even more people achieve lasting change and deep health.

And that we love even more than science.

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What is “evidence”?

There’s “everyday life” evidence.

In our Precision Nutrition Coaching program and Certifications, we tell our clients and coaches to use outcome-based decision making (OBDM).

Very simply, that means you decide what to do next based on the data you got from what you just did.

Did your waist measurement go up after two weeks of vacation buffets? That’s data that says, “Welcome home, maybe dial it back a little.”

Did your blood pressure go down after four months of sticking to your exercise program? That’s data that says, “Keep up the good work!”

We tell our coaches and clients to use as many data points as they can, and look for progress everywhere, including:

  • body measurements
  • blood work and other medical tests
  • athletic performance, such as getting stronger or faster
  • photos
  • how clothes fit
  • recovery
  • sleep
  • mood and wellbeing
  • confidence
  • consistency

And so on. (Here are some more ideas.)

All of these data points, collectively, give us evidence that we can use to make informed choices.

Then there’s scientific evidence.

This includes clinical or case studies, experimental research, basic research (for instance, studying cells in culture), and more.

This evidence can vary widely in quality, who is studied, and how applicable the results are to you and your clients.

However, in general, scientific evidence is one of the best ways we have to know about the nature of reality.

And though it might be obvious, we’re compelled to say it anyway: You’re looking to glean these insights directly from reputable, peer-reviewed scientific papers—not random websites, articles in magazines, or pictures of sunsets with words on them.

Finally, there’s stuff you learn on the job.

We call this “expertise.” It’s the old coach’s intuition, the senior clinician’s knack for diagnosis, the way a master carpenter can tell you if something is a quarter inch off square just by looking.

After you’ve worked with over 100,000 clients, as we have, you start to build a database of collected wisdom. And often, there’s stuff that’s hard to explain or defend—you’ve just seen it enough times that you know it’s a thing.

When we bring together experience, research, and expertise, we have a pretty good set of working hypotheses about what is likely to be effective.

And that’s evidenced-based practice. So it’s not just about clinical research.

EBP is a systematic way of thinking and application that integrates scientific data with clinical experience and the individual needs and preferences of each client or patient.

Yes, that’s the official, eye-glazing definition, but you might find the Instagram-able version even more enlightening. (See the illustration below.)

All three parts are equally important.

That’s because:

1. You aren’t coaching research averages. You’re coaching people.

Most studies report the average results of an intervention. (This is especially true of their headlines.)

Yet, if we look at the actual data of most studies, we see that individual results tend to fall on a bell curve of some sort.

Take this example, noted by James Krieger and Bret Contreras.

A study on resistance training and muscle gain concluded the following:

“Previously untrained people who engaged in resistance training three times a week for 9 weeks increased their muscle mass by 6%.”

Based on that, you might expect a client to achieve similar results on your three-day-a-week program.

But if you look at the individual data within the study, muscle growth ranged from -2.5 to 20 percent. That’s right: minus 2.5 percent. As Krieger and Contreras point out, five of the 53 participants actually lost muscle!

That’s not to suggest the research results are misleading. In fact, most of the study participants experienced muscle mass gains between 5 and 10 percent, and some even more. However, it does show the overall findings may not to apply to every individual. So don’t expect them to.

Another example is broccoli. There’s a significant body of evidence supporting the health benefits of eating this nutrient-dense vegetable.

But if broccoli makes someone gaggy or gassy, it’s not the healthiest food for them, no matter what the research says about it lowering disease risk.

These kinds of patterns happen over and over: Some people get great results from applying the research, some get very little (or negative) results, and most get results somewhere in between.

This is reality.

Research can be incredibly useful for giving us a starting point for most people. But humans differ—often wildly—from one another.

They differ in terms of their habits, mindset, physiology, environment, and personal preferences. They also differ in their ability to follow a program in the first place. And even if they stick to a plan perfectly, they can differ in the results they get.

Coach for the unique human in front of you, not for an average.

Not only will this improve your client results (because you’ll be working with their particular, practical reality), it’ll also improve your client retention (because you’ll be actually listening to them and trying to understand them as individual people, not as data sets).

When a client is suffering, they probably don’t need you to search PubMed for more evidence.

They often need you to provide a solid, trusting coaching relationship and, of course, your coaching skills. This combination can help you ease client resistance, be creative and flexible when typical solutions don’t work, and be compassionate and supportive when a client struggles with dark stuff.

2. Your professional experience really matters.

If you’re a mindful, growth-oriented coach or practitioner, it’s impossible not to develop a certain degree of experience and expertise over time.

A lot of things go into your “expertise bucket”: courses and programs you’ve taken; books you’ve read; lectures you’ve attended; mentoring relationships you’ve had; and all the practical experience you’ve acquired from observing and coaching clients or patients.

The accumulation of knowledge and experience gives you a kind of “intuition” that can help you coach more effectively.

This “intuition” shows up when you see a client perform a wonky squat, quickly identify exactly what’s wrong, and make corrections to improve form.

It shows up when you perform a client intake, and based on their answers (Just had a baby! Prone to perfectionism!), you can anticipate what aspects of a program they might struggle with, and how you might help them.

Or it shows up when you do a postural assessment, and immediately know which exercises to avoid and which could be helpful.

Much of the time, this is knowledge you could have never learned simply from reading studies. It requires time working with people, and exposing yourself to new ideas and methods, including those that have yet to be studied.

But there’s a challenge here, too. The knowledge we gather from our experiences is very prone to human error: Our memories are unreliable, we see patterns that may not actually exist, and we discount information that doesn’t conform to what we already believe.

How can we reduce human error?

  • First, be aware that bias and error exist… yes, even for you.
  • Take notes during or after client sessions, and use a variety of validated measurement tools—such as weight, body measurements, pictures, mood scales, and sleep quality scales—to track the effectiveness of your advice.
  • Get mentorship and feedback on your practice. Coaches need coaches. Or, find a like-minded group of professionals with whom to collaborate. (That’s why we developed the Precision Nutrition Level 2 Certification.)

If you’re aware of the errors you’re likely to make, and take steps to moderate them, you might start to see some reliable, overarching patterns.

Like that very rigid meal plans don’t work for people in the long term. Or that people can only train so long and so hard before they burn out.

Or a thousand other possibilities experienced coaches notice, but perhaps haven’t been fully validated by published research.

If you’re just starting out and don’t have the experience gained from coaching many people over many years, you can “borrow” insight from mentors or other coaches with more reps under their belt.

Drawing on the wisdom of your (or a colleague’s) accumulated experience is an essential part of being a good practitioner.

3. Science will never have it all figured out.

The evidence is always evolving. Nutrition research in particular is a relatively new area, and there’s still a lot to be learned.

Plus, some things are really hard (or downright unethical) to test in a research setting, and so we may never have scientific evidence on it.

Even if it is possible to test, quality research takes a long time to gather. Usually, one study isn’t enough to “prove” something true or false. But waiting for multiple studies on a specific topic, or better yet, a meta-analyses (which is kind of like a poll of the research) may require a lot of patience. Maybe decades.

And yet, we still have to help our clients and patients make informed decisions. Like, now.

That’s where evidence-based practice comes in.

The RIGHT way to use EBP.

You can formally apply the EBP process to coaching decisions that feel especially important or uncertain.

EBP offers one of the best tools to help you reach a decision that’s most likely to be safe and effective, and that’ll also make sense in the context of your client’s life.

Follow these 6 steps to see EBP in action.

1. Assess the client.

Identify their unique abilities and needs.

  • What are their strengths?
  • Where might they need help from you?
  • What are their precise goals?
  • What are their identities, values, and beliefs?

Gather this information by asking questions, using intake forms, and taking measurements. This’ll help you create an initial plan of action and also provide a baseline against which to gauge progress.

Plus, as you collect data on many clients, you’ll be accruing practical evidence that can aid with decision making in the future.

Let’s use a hypothetical client to apply these steps.

Her name is Nora. Her goal is to lose fat, and she’s also interested in intermittent fasting. Through your initial assessment you learn that she’s begun to show signs of perimenopause, and her sleep isn’t great these days.

2. Find your research question.

Before you jump to a solution, get clear on the problem you’re trying to help your client with. 

Then, turn the problem into a question that’ll help you isolate the evidence you need for your recommendations. This question should incorporate the problem, as well as relevant factors about your client or patient.

Nora’s main goal is to lose fat, and she’s curious about intermittent fasting. Important factors to consider: Nora is a woman and she’s perimenopausal.

But you’re not sure if intermittent fasting is safe (or effective) for losing fat. And you’re definitely not sure if it’s safe (or effective) for a perimenopausal woman.

So your research question might be: “Is intermittent fasting safe and effective for fat loss in perimenopausal women?”

3. Gather the evidence.

Search for info using an online database like PubMed or Google Scholar. (If you don’t know how to use online research databases, here’s a PubMed tutorial.)

Using a research database will curate your hits so you’re only getting original, peer-reviewed research, rather than someone else’s (potentially biased) interpretation of it.

To find relevant research for Nora, a good keyword combination to type in a search box could be “intermittent fasting + fat loss + menopause”. These keywords contain the intervention you’re interested in learning more about, plus information about Nora’s unique goals and life stage.

To identify the best available scientific evidence on the research subject, use the “Hierarchy of Evidence” pyramid below. The higher up on the pyramid, the more trustworthy the information. So start your search from the top down.

In the case of Nora, prioritize finding a position stand, a meta-analysis, or a systematic review on using intermittent fasting for fat loss in menopausal women. This will give you a comprehensive overview of the current evidence. Basically, scientists and/or academics have already done the hard work—of reviewing, comparing, and analyzing the available scientific evidence—for you.

If that doesn’t exist, look for randomized control trials that compare appropriately chosen groups of people with a control group (such as a group that received no intervention, or a different intervention).

No luck there? You can expand your search to just “women” rather than “menopausal women.” Depending on what’s available, you may have to continue broadening your search and moving down the hierarchy of evidence.

Now, if you’re not well-versed in reading studies or interpreting research, that’s okay. Chances are, if you don’t find a meta-analysis or review, or—best of all—a position stand, the research further down the pyramid will be of limited use to you anyway.

If that’s the case—or you can’t find any scientific research on the topic—you might have to use opinions from other trusted experts, or develop an educated hypothesis based on your own knowledge of how physiology and nutrition work. This still counts as evidence, it’s just not as reliable, so temper your confidence in it accordingly.

All hail the position stand.

If you don’t feel equipped to navigate and interpret scientific literature, consider looking for best practice guidelines or position stands written by an authority in your field.

Position stands are official statements made by a governing body on topics related to a particular field, like nutrition, exercise physiology, dietetics, or medicine.

Here’s an example: The 2017 International Society of Sports Nutrition Position Stand on protein and exercise.

If you have a client who’s older and you’re wondering how to safely increase their training capacity (but don’t want to immerse yourself in a dark hole of research), simply look for the position stand on exercise and older adults.

To find the position stands in your field, consult the website of whatever governing body you belong to.

For example, if you’re a personal trainer certified through ACSM, NASM, ACE, or NSCA, consult the respective website for each organization. They should feature position stands on a variety of topics.

4. Appraise the evidence.

Through your search, you’ll probably find at least some evidence. This might be just a few small studies or some articles from trusted experts in the field.

Now, using the hierarchy of evidence, determine how valid and reliable those pieces of evidence are.

The more you have to broaden your question or move down the quality hierarchy, the less confident you might be about your recommendations.

With Nora, if all you find are some articles by an internet guru who’s never actually seen any real clients, you may want to present your findings as a mere idea, rather than as reliable advice.

On the other hand, if you find a handful of systematic reviews about intermittent fasting in menopausal women, you can go to Nora with more confidence about your recommendations. (Quick fact check, FYI: We couldn’t find any reputable systematic reviews on intermittent fasting in menopausal women.)

5. Create your recommendation.

Unless they ask for it, most clients don’t want to know all the complicated science stuff; they just want to know what to do.

This is where the science of coaching morphs into the art of coaching.

It’s time to see if you can actually apply the evidence you’ve found—along with your own professional experience—to the complex, real, live human standing in front of you.

Notice that the evidence by itself doesn’t make the decision. Nor does your experience, nor do the client’s preferences.

The three simply offer a more holistic perspective on a problem, to ensure you find the best possible solution for your client.

Rather than plunking down a stack of research in front of your client, combine the research with your expertise and your client’s unique circumstances to translate it into practical advice.

It could work like this: Through your research, you find that intermittent fasting is effective for fat loss. However, through your own professional experience, you’ve also noticed that most clients struggle to stick with intermittent fasting long-term. (Aligning nicely with your coaching experience, the research also shows a relatively high drop-out rate with intermittent fasting.)

You’ve also noticed that in some of your female clients, intermittent fasting seems to deregulate menstrual cycles and exacerbate menopausal symptoms.

Thinking about Nora’s unique values and preferences, you know that she wants to lose weight, but you also know that she’s had some trouble sleeping lately. In your experience with other clients, people who are sleep-deprived have an extra-hard time regulating appetite and losing weight.

So… intermittent fasting seems to be effective, but combined with your concerns about Nora’s hormonal health and sleep quality, plus the fact that intermittent fasting can be hard to maintain, you may decide not to recommend it to Nora.

After explaining to her your reasoning, explore with her what she’s comfortable trying. In the end, you may suggest some simple nutrition habits along with some short fasting experiments, plus some sleep tips.

These recommendations include what you’ve found from the best available research, your own coaching experience, and Nora’s unique preferences, goals, and challenges.

Nora’s just gotten some pretty wise, tailored-to-her advice, where you worked as collaborators to come up with her action plan.

That’s the art and science of coaching.

6. Monitor the results.

Once you’ve given your client a little time to practice what you came up with together, you can assess if those actions are working.

Consult those measurements you took in your initial assessments. Compare them to current measurements.

Are things moving in the right direction?

And talk to your client about how the plan is working.

Nora tells you although she’s applying and benefitting from the sleep tips, she’s struggling with fasting, even the shorter experiments. Turns out, it’s hard to fast when you’re having trouble falling asleep because of a grumbling tummy.

As you monitor progress, use what you find to re-evaluate goals and pinpoint where your client or patient needs more support.

Now Nora’s asking you about trying the Paleo diet instead. Looks like you have more research to do.

But keep in mind, over time, you’ll develop a solid grasp of the body of evidence on a number of topics. That’s the good part about science moving slowly: It’s not that hard to keep up.

What to do next.

Be empathetic, supportive, and flexible.

No matter what you believe is “right” or “true,” your first job is to work with your client, wherever they’re at.

Many practitioners intuitively know this, but the bond between coach and client (or patient) is extremely important and influential.

This bond is called the “therapeutic alliance,” and it refers to the level of trust and rapport between a practitioner and the person they’re helping.

Change is hard, and often scary. A strong therapeutic alliance can help a person feel supported and understood while surfing the tides of change.

In fact, some studies show the results a client or patient achieves in your care are up to 85 percent dependent on the therapeutic alliance. So, the stronger that relationship, the better the results.

If you’re constantly butting heads with your client, telling them, “But the research says!” or, “I know best!”, you can wave goodbye to a strong therapeutic alliance.

Many of the obstacles your clients will face are behavioral and emotional, rather than rational and theory-based. So more than facts, your clients often need compassion, support, and creativity to get them through the tough stuff.

Focus on the big rocks.

Given how complicated bodies and behavioral change are, it’s not surprising that science is still “trying to figure things out.”

Rather than using “cutting-edge” protocols like intermittent fasting or precise macronutrient ratios (which should really only be for more advanced clients anyway), focus on “big rocks” that offer the most bang for buck, like:

  • eating enough protein and vegetables
  • moving regularly
  • getting adequate sleep
  • managing stress
  • reducing smoking and/or excessive alcohol consumption

If that sounds boring or too obvious, we ask you this: How many people do you know who are consistently doing all five well? (In case you’re curious, it’s only about three to five percent of the population.)

Just managing those five things will keep most people plenty busy.

Be humble, throw out the rules, and keep learning.

The smartest people are often the ones who are most comfortable asking questions, saying “I don’t know,” and resting in uncertainty.

It’s a cliche but true: The more you know about something, the more you realize what you don’t know.

Be wary when others claim absolute certainty. It may be they don’t fully understand the complexity of the matter.

True expertise is about being comfortable with limited knowledge—while continuing to seek more and better information—and also accepting we may never have complete certainty.

Experiment wisely, and learn from both successes and failures.

Want to see how a theory works in practice? Test it out on yourself, and measure your experience as objectively as possible.

With clients, so long as there is no risk of harm, try out well-informed experiments (with their permission) that are either based on research or expert theory. Then, as always, track and measure their experiences and results to inform your next steps.

Know what you don’t know and work with other experts as needed.

Especially if you’re a beginner in your practice, it’s okay not to know stuff.

Focus on what you know best, whether that’s good lifting form, coming up with healthy meal ideas, or giving support during sticky coaching situations. But also know that some things will be out of your scope of practice.

So build a strong professional network—which could include family doctors, dietitians, massage therapists, naturopaths, chiropractors, and psychotherapists—and refer out whenever you encounter something you feel uncomfortable or especially inexperienced with.

Establishing a deep roster of experts will help clients get the support they need. And we’re pretty sure the evidence will show that’s good for everyone.

If you’re a coach, or you want to be…

Learning how to coach clients, patients, friends, or family members through healthy eating and lifestyle changes—in way that’s evidenced based and personalized for each individual’s lifestyle and preferences—is both an art and a science.

If you’d like to learn more about both, consider the Precision Nutrition Level 1 Certification. The next group kicks off shortly.

What’s it all about?

The Precision Nutrition Level 1 Certification is the world’s most respected nutrition education program. It gives you the knowledge, systems, and tools you need to really understand how food influences a person’s health and fitness. Plus the ability to turn that knowledge into a thriving coaching practice.

Developed over 15 years, and proven with over 100,000 clients and patients, the Level 1 curriculum stands alone as the authority on the science of nutrition and the art of coaching.

Whether you’re already mid-career, or just starting out, the Level 1 Certification is your springboard to a deeper understanding of nutrition, the authority to coach it, and the ability to turn what you know into results.

[Of course, if you’re already a student or graduate of the Level 1 Certification, check out our Level 2 Certification Master Class. It’s an exclusive, year-long mentorship designed for elite professionals looking to master the art of coaching and be part of the top 1% of health and fitness coaches in the world.]

Interested? Add your name to the presale list. You’ll save up to 33% and secure your spot 24 hours before everyone else.

We’ll be opening up spots in our next Precision Nutrition Level 1 Certification on Wednesday, April 3rd, 2019.

If you want to find out more, we’ve set up the following presale list, which gives you two advantages.

  • Pay less than everyone else. We like to reward people who are eager to boost their credentials and are ready to commit to getting the education they need. So we’re offering a discount of up to 33% off the general price when you sign up for the presale list.
  • Sign up 24 hours before the general public and increase your chances of getting a spot. We only open the certification program twice per year. Due to high demand, spots in the program are limited and have historically sold out in a matter of hours. But when you sign up for the presale list, we’ll give you the opportunity to register a full 24 hours before anyone else.

If you’re ready for a deeper understanding of nutrition, the authority to coach it, and the ability to turn what you know into results… this is your chance to see what the world’s top professional nutrition coaching system can do for you.

References

Click here to view the information sources referenced in this article.

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Baldwin, S.A., Wampold, B.E., & Imel, Z E. (2007). Untangling the alliance-outcome correlation: Exploring the relative importance of therapist and patient variability in the alliance. Journal of Consulting and Clinical Psychology, 75(6), 842–852.

Cabaniss, D. L. (2012, May 31) The Therapeutic Alliance: The Essential Ingredient for Psychotherapy. Retrieved from https://www.huffpost.com/entry/therapeutic-alliance_b_1554007?fbclid=IwAR1NDl7sNR60OSvNFWmpTUA-GqAV65fMtxsOrOFAQ9fLM5Z5eQlcRR4APbU

Duke University. (2018). Introduction to Evidence-Based Practice. Retrieved from https://guides.mclibrary.duke.edu/ebmtutorial/home

Erskine, R.M., Jones, D.A., Williams, A.G., Stewart, C.E. & Degens, H. (2010) Inter-individual variability in the adaptation of human muscle specific tension to progressive resistance training. European Journal of Applied Physiology, 110(6), 1117-25.

Evidence-Based Medicine Working Group. (1992) Evidence-Based Medicine: A New Approach to Teaching the Practice of Medicine. Journal of the American Medical Association, 268(17), 2420-5.

Frances, A.J. (2013, June 24) What Should Doctors Do When They Don’t Know What to Do? Retrieved from https://www.psychologytoday.com/us/blog/saving-normal/201306/what-should-doctors-do-when-they-dont-know-what-do?fbclid=IwAR3ce99uT-RDXcp_yvnJ0r2aTfBPWPpngqNUvkIc5a6PBZkyr5d-Z8sgy2Y

Joyce, A.S. & Piper, W.E. (1998) Expectancy, the Therapeutic Alliance, and Treatment Outcome in Short-Term Individual Psychotherapy. The Journal of Psychotherapy Practice and Research, 7(3), 236–248.

Löfgren, K. [Kent Löfgren]. (2013, February 25). What is epistemology? Introduction to the word and the concept [Video File]. Retrieved from https://www.youtube.com/watch?v=lI9-YgSzsEQ

Ludwig, J. (2018, April 16) Here’s what is going wrong with ‘evidence-based’ policies and practices in schools in Australia. Retrieved from https://www.aare.edu.au/blog/?p=2822

Schoenfeld, B.J., Contreras, B, Krieger, J., Grgic, J., Delcastillo, K., Belliard, R. & Alto, A. (2019) Resistance Training Volume Enhances Muscle Hypertrophy but Not Strength in Trained Men. Medicine & Science in Sports & Exercise, 51(1), 94-103.

Wampold, B. E. (2001). The great psychotherapy debate:Models, methods, and findings. Mahwah, NJ: Lawrence Erlbaum. NJ: Lawrence Erlbaum.

Evidence-Based Medicine Toolbox. (2017) Retrieved from https://ebm-tools.knowledgetranslation.net/

Evidence-based practice. (2018, November 19) Retrieved from https://en.wikipedia.org/wiki/Evidence-based_practice?fbclid=IwAR3ARk06zmx_lJYPIrTGA_chfBa9v_-NsW7HQbC7-rTHaq-Y7AYcSdLAk80

The well-built clinical question: a key to evidence-based decisions. (1995). Retrieved from https://mclibrary.duke.edu/sites/mclibrary.duke.edu/files/public/guides/richardson.pdf

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