Wondering to what degree you can use nutrition with your clients as a PT?

Well, let's take a closer look at this issue and see just what you can and can't say, legally of course!

Most PTs will be familiar with the Fitness Australia stand that PTs can't really give dietary advice unless they have completed an approved nutrition course and are a nutritionist or dietitian or similar, which to a degree is true. However, it is the training package and its very specific wording which we need to take our lead from. Let's look at exactly what the units say.

When you started out you would have covered Cert III in Fitness and will have completed a unit SISFFIT306A 'Provide healthy eating information to clients in accordance with recommended guidelines'. This is a unit in the Fitness Training Package that the education authorities tell education providers they must cover in your training and you must complete successfully. Once you have completed all the units in this qualification (Cert III), then you are entitled to do as the Unit describes . In that case you can give healthy eating information to your clients as long as it sits within current guidelines (such as the Australian Dietary Guidelines).

I hear you sighing, thinking we have got your hopes up and then dashed them. But wait... there's more!! And even better news is that Cadence Health offers an approved nutrition course that allows you to have insurance cover to provide basic dietary advice. 


Be familiar with the detail in the training packages
If you 'unpackage' SISFFIT306A you will find a number of Elements are listed inside it, each of which has a number of units, called Performance Criteria within. It is these Elements and Units that really give you a clearer picture as to just what you can and can't do and say. With us... Ok, then let's take a look at the Elements and their Performance Criteria.


Element 1 'Explain the relationship between healthy eating, health and fitness to clients.' Specifically you are entitle to:
 1.1. Discuss with clients, the adverse effect of poor nutrition on health and identify common chronic diseases. 
 1.2. Briefly explain the general features of healthy eating to clients. 
 1.3. Convey the concept of a well balanced diet and regular exercise to promote good health when providing information to clients. 
 1.4. Explain the interaction between healthy eating options and physical activity and obtain information about current nutritional intake and physical activity levels of clients. 

The use of words such as 'provide' tend to suggest the information is sourced from somewhere else, where as 'describe', 'list', 'explain' tend to suggest this information is from you verbally or in written format for example. You can see above that you are entitle to give an explanation of what healthy diet is as well as how healthy eating options work with physical activity based on information you have gained about your clients diet and activity level.

Becoming clearer now...Get the picture... there is a reasonable scope here! Moving along to Unit 2!


Element 2 says 'Provide basic information to clients about the fundamental principles of healthy eating.'
2.1. Provide information to clients about the fundamental principles of healthy eating to improve overall health. 
 2.2. Apply knowledge of the general principles of healthy eating to provide basic information to clients about healthy eating options and requirements for exercising individuals. 
 2.3. Identify the advantages and disadvantages of current dietary trends appearing in the media with clients. 
 2.4. Observe the industry standards for giving healthy eating information to clients and refer clients with healthy eating or dietary concerns to suitably qualified accredited practising dieticians. 

Ok, here there is a little less scope for you to create healthy eating programs, clearly there is an erring towards the provision of information as apposed to explanations. Don't forget that is why our nutrition courses provide you with dozens and dozens of healthy eating booklets and fact sheets! WE HELP YOU PROVIDE INFORMATION! No need to look around or question what is accepted knowledge.


Element  3 states 'Provide healthy eating information to clients regarding body composition management.'
 3.1. Evaluate information collected in the fitness appraisal of clients about current body composition using relevant body composition measures. 
 3.2. Provide basic information about the relationship between diet and the management of body composition to clients. 
 3.3. Describe briefly the role of the body's energy systems in the storage and utilisation of energy substrates for energy production. 
 3.4. Refer clients requiring more extensive dietary information to a suitably qualified  accredited practising dietician.

We can see here there is a mix of both the provision of information and describing information (eg verbally or written from your own knowledge). 


Element  4 goes on to 'Support fitness clients with body image issues.'
 4.1. Implement strategies to promote body satisfaction when providing information about exercise, fitness testing and healthy eating options. 
 4.2. Provide information about healthy eating options that fosters a positive attitude towards food and eating. 
 4.3. Recognise indicators of poor body image and discuss body satisfaction with clients, providing referral to an appropriate medical or allied health professional, if required. 
 4.4. Show sensitivity to cultural and social differences.

The term implement in 4.1 does tend to leave the door open. After all to implement a strategy you are very likely to have had to work out a plan with a client, for example a healthy eating plan. This would then be supported by fact sheets and other information (websites, booklets etc) that will assist your client in meeting their goals. 


Element  5, 'Refer clients to medical or allied health professionals for further information or consultation.'
5.1. Recognise and acknowledge the current legal and ethical limitations of a fitness instructor in providing healthy eating information. 
5.2. Identify gastrointestinal disorders or other medical conditions, disclosed by the clients during a screening process, which may affect nutritional intake, and refer clients to a suitably qualified medical or allied health professional. 
5.3. Identify healthy eating or dietary concerns and refer clients to contact suitably a qualified accredited practising dietician or medical or allied health professional in accordance with organisational policies and procedures maintaining confidentiality of clients. 


Element  6 'Provide information about the structure and function of the digestive system.'
6.1. Use knowledge of the structure and function of the digestive system when providing information to 
clients. 
 6.2. Describe to clients the process of digestion and absorption, including the production and action of enzymes during the breakdown of foodstuffs for energy. 
6.3. Explain the process of energy metabolism in relation to muscle contraction. 

Again, we can see here that the use of the terms 'describe' and 'explain' allow you scope to guide your clients using your own knowledge.


The only courses that allow you to use nutrition professionally:

• If you hold a Certificate IV in Fitness and complete our Accredited Certificate of Nutrition you can gain insurance to use with nutrition with your clients.

How Cadence Health courses help fill the gap
We have been very aware of the frustration that many people in the fitness industry feel in regards to the scope of nutrition they are able to work with. As a result we have worked for many years in extending our courses to help fill this gap. Cadence Health and Nutrition Courses assists in 'providing nutrition information' by suppling you with:

• A full set of healthy eating fact sheets you can print and pass onto clients ranging from everything from caffeine to yoghurt.
  
• All students have access to our private Student Facility which holds the very latest national and global reports, including the Dietary Guidelines, WHO policy, OECD Obesity Reports and much much more, giving you access to the latest 'Guidelines' 24 / 7.
  
• Our courses are not only written at a tertiary level we offer you extended readings, webinars and research reports so that you are as up-to-date as we are.

 
Read more of the detail!
We recommend that you take a good look at the training package units on the Government Training site by simply typing in SISFFIT306A into the unit search area, or  download the package units. If you read over the document (they are quite brief but detailed), you will also find specific details determining just what is acceptable sources of information and so on. If you have trouble just flick Olga an email (admin@cadencehealth.com.au) and we can send it onto you.

Want to give nutrition and dietary advice legally?  

Personal Trainers - legally entitled to provide basic dietary advice
All Cadence Health PTs who hold Cert IV in Fitness and who complete Accredited Certificate of Nutrition course can be insured for the:
- Provision of basic dietary advice 
- Undertaking of meal analysis 
- Provision of meal plans

Details on the insurance package from Marsh Fitness, simply contact Marsh to ensure you have these options added onto your current insurance.


Note: We believe that SISFFIT306A will be updated this year in which case you are likely to see it represented at SISFFIT306B. We are hoping it will further extend the PTs options in nutrition. Fingers crossed

Well if you are finding the path to choosing where to study to become a nutritionist confusing you are not alone. As one of the most common questions we are asked we completely understand your confusion! 

Why is it so confusing?  
Currently in Australia and NZ there is no strict control over who can use the label 'nutritionist'. Having said that, one of the central reasons you must undertake a relevant course is so that at the end of it you are:
   a) Accepted by a reputable industry association and;
   b) You can then gain public liability and indemnity insurances so you can practice safely.

In essence anyone can call themselves a nutrition consultant, weight loss consultant, nutrition coach and so on and unless you check you won't necessarily know if they are accredited or registered or associated to an industry body who will have ensured a certain level of academic and clinical proficiency (current and ongoing); mental note to self to check these things...!


What is the minimum requirement?  
The simplest (and we are not judging it to be the easiest) way is via an Advanced Diploma of Nutrition Medicine. These are commonly offered by private colleges.

Most colleges offer the diploma via face-to-face, but also recognising that geography shouldn't be a limitation they also offer distance options. Now, it is important to make mention of two considerations:

1. That some industry bodies don't recognised diplomas that have been gained via correspondence only. It makes sense, you really need to see actual patients and have hands on in this industry! So if you opt for distance ensure you chat to your chosen college about how many hours and subjects you should do face-to-face and how best to go about it!
   
2. It is highly possible that in the future the minimum requirement to practice nutrition will step up to a degree. Almost all colleges offer an upgrade to a Bachelor of Health Science. Now, not only might this cover you in the future, but it also opens pathways to continue on to other levels of 'nutritionist' (more on this in a tick). We recommend you discuss how many and they type of extra subjects you may be required to complete, how long this might take and the total cost.
   

What do you mean by different type of 'nutritionists'?  
Good question. Well you will see nutritionists refer to themselves in the following ways:

• Accredited nutritionist/nutritionist - commonly diploma and/or degree qualified nutritionist who have registered with complimentary health bodies such as ATMS and ANTA.
  
• Associate nutritionist - Generally with an undergrad degree and at least a post graduate certificate in nutrition and is recognised by theNutrition Society of Australia (NSA) as an 'associate nutritionist'. 
  
• Registered nutritionist - Is the next step up from associate nutritionist with a minimum of a post graduate diploma in nutrition and three years experience and is registered with the NSA. Registered nutritionist are eligible for Medicare rebates. We like to point out that in some cases you can qualify as a registered nutritionist with little or no actual experience and only a post-graduate qualification up your sleeve (and even then there are some pretty weird and wonderful subject options out there).
  
• Accredited and practicing dietitian - Holding a minimum of a master in dietetics which requires over 200 clinic hours in a hospital, registration is with the Dietitians Association of Australia (DAA) . Dietitians are also eligible for Medicare rebates given they have a thorough knowledge of hospital based nutrition. Now this is an interesting one. While it might sound like the 'gold standard' in fact you can find that some practitioners have entered a dietetics masters program from all manner of backgrounds (not just health), and have had only clinical experience within a hospital.   

Our view
We have numerous nutritionists and dietitians who work with us, all with different expertise and backgrounds. And as you can see from the points above, there is no one type of 'nutritionist' that is necessarily better than the other. Instead, ensure a practitioner is registered with a body, has current insurance and try to find one who has long specialised in the area you require help with. Word-of-mouth is an excellent referral system and select a person you feel comfortable with. Don't be too swayed by the seemingly impressive long lists of qualifications someone tacks on their website or business card, you can find sometimes half of them are in fact only memberships... tricky!!!!


Don't forget the new Certificate IV in Food Coaching!
The only courses that allow you to use nutrition professionally apart from the ones above are:

• Certificate IV in Food Coaching - graduates as qualified food coaches are entitled to provide dietary based advice and meal plans. Cadence Health is the exclusive partner to the college offering this course. By enrolling with us you become a Cadence Health student and receive all the benefits our members are offered.
• If you hold a Certificate IV in Fitness and complete our Accredited Certificate of Nutrition you can apply to have nutrition added to your insurance so that you can provide basic dietary advice.

Career advice - not sales
Yes, we hear you! You have tried calling a few colleges and all you get is ill-informed reception staff whose main aim is to sell 'bums on seats'. If you are still stuck on where to start feel free to call us. While we believe our distance and online courses are the best, we also know they sell themselves. We promise to give you unbiased information to help you in what we know is a very big decision, no catches! 

Read more on our dedicated page about how to become a nutritionist!

How things can change in nutrition. Once we thought that eggs were to be feared, that they increase blood cholesterol and had way too much fat for good health. Not any more. It seems eggs are now one of nature’s nutrient-packed meals-in-a-shell and they don’t cost a fortune either. Cadence Health and Nutrition Courses and Sneakys director and nutritionist Leanne Cooper takes a look at the nutritional facts on eggs.

What’s in an egg?
 Eggs are packed with at least 11 different nutrients, they contain a good quality protein (in fact one of the most absorbable forms of protein) and have healthy fats such as omega-3s. Containing a number of nutrients that have unique health benefits, eggs certainly pack a punch; for example two eggs provide around two-thirds of our daily requirement for selenium (which is reputed to be a strong antioxidant). Another is choline, vital for foetal and infant development, as well as potentially keeping homocysteine production (linked to a number of disorders) in the body in check.

Eggs are a good source of a number of B vitamins, vitamin E, folate and iron. Plus they are a good source of vitamin D; important for healthy bodies. In fact iron, vitamin D, folate and several other nutrients found in eggs have been shown to be low in Australian diets, particularly in children and women.

For those nutrition lovers out there who want all the facts there is a full table of the nutritional breakdown of an egg at this link - http://eggs.org.au/health-and-nutrition/nutrition-table  

What about eggs and heart disease?
Current research points to very little association between the consumption of eggs and the risk of heart disease and stroke. We now know that dietary cholesterol (the form found in our foods) doesn’t appear to strongly affect blood cholesterol (unlike trans fats and excessive saturated fat in foods).

For those who have a risk of heart disease, for example those with diabetes or high cholesterol, current recommendations are as follows:
    “There is little research to guide recommendations for egg consumption for people at high risk of heart disease (e.g. with diabetes or high cholesterol). However, prudent advice is that the inclusion of eggs in the context of a diet low in saturated fat, and containing known cardio-protective foods, is not associated with increased risk.” The Eggs Network, Australia
 

How much?
So we know that eggs aren’t bad for us, but let’s just take a quick look at how much is enough. Using figures based on two eggs (which is one serving, just to make it confusing) this provides 581 kJ (139 calories) of which 10g is from fat (90 calories). Not so bad!

The Heart Foundation recommends “all Australians can consume up to six eggs a week, in a healthy, balanced diet low in saturated fat, without increasing their risk of Cardiovascular Disease (CVD).”
 

Good, better, best or just hype? Organic, free-range, omega-3, veg eggs… what next?
If you are mindful of animal welfare and prefer to purchase humanely laid eggs, or if you are health conscious and buy organic eggs to avoid nasties, or you just think organic tastes better you may need to do a little homework. The area of labelling of eggs appears to be somewhat wanting. Sadly, sometimes what you are buying isn’t as it seems.

Interestingly there are just three major egg producers in Australia (Nov, Pace Farm and Manning Valley); they represent over 50 per cent of free-range eggs sold in Australia (Choice, 2008). And a whopping 80 per cent or so of our eggs come from intensive battery farms (FREPA, 2010).

Free-range
Exactly what ‘free-range’ means depends on where you buy your eggs. Free-range eggs can come from small roaming flocks to large flocks of more than 100,000 birds; some roam outside, others never see the open space. I see a frown beginning to form!

The actual standards are quite lengthy and complex, and are currently voluntary. In a nutshell, the standards state: “When fully feathered, in accordance with the current edition of the appropriate State Animal Welfare Code, birds must have easy access to an area on which to range during daylight hours.” You can see from this that there is considerable flexibility in these standards. The United States has begun to adopt the term ‘barn-roaming’ to describe eggs that are laid by chickens who don’t roam freely outdoors, so keep an eye out for this term being used here.

If you are really keen and would like to read the standards visit Free Range Egg and Poultry Australia (FREPA) - http://www.frepa.com.au/standards/egg-standards/

Update: Sadly, the Australian Egg Corporation has proposed an increase of laying hens from 1,500 hens per hectare to 20,000 (yes, that’s a 750 per cent increase). Hens would be allowed to be kept in these conditions from 25 weeks, even though they begin laying at 18 weeks. In this event the good ole ‘free-range’ eggs would hardly live up to their name.

Be informed
If you want to know just what you are buying it’s worth checking out the Animal Welfare Labels site, which lists the brands and their hens’ egg-laying conditions; it’s eye-opening!

·       http://www.animalwelfarelabels.org.au/dev/index.php?option=com_zoo&task=category&category_id=7&Itemid=227 

Or if you wanted to stay up to date with industry changes or take action, you can read more and keep up with all the latest on the Animals Australia website - http://www.animalsaustralia.org/take_action/save-free-range-eggs/

Clearly there is a need for the egg industry to pay urgent attention to its labelling to assist consumers.

Organic eggs
This is the best way to ensure you get the whole egg and nothing but the egg; no antibiotics, nasties or inappropriate animal feed. It doesn’t necessarily say anything about the farming practices but generally organically produced eggs are laid under very humane conditions. It’s best to opt for brands that have an endorsement (look for organic certification logos), that way there is a good chance an independent body has checked out the farm.

So, remember variety is one of the most important keys to a good diet, so enjoy your eggs, along with other whole foods as nature intended!

Passionate about nutrition? Why not do a short nutrition course!
Accredited Certificate of Nutrition at Cadence Health and Nutrition courses! Go to www.cadencehealth.com.au or www.cadencehealth.co.nz. 

Caffeine was once considered a diuretic, which was believed to increase dehydration.  However, we now know that while caffeine does cause some fluid loss, where it is consumed as a liquid there is generally a net gain in fluid, caffeine also has its benefits in sports nutrition and is no longer a banned substance. Roughly 1.07 mg of fluid is lost from the body.  Given most drinks will provide about 200 mls of fluid this will still leave a net gain of about 150 mls of fluid entering the body.  

Caffeine facts  
Caffeine is found in the leaves and beans of the coffee tree, in tea leaves, guarana berries, and in small quantities in cocoa and the kola nut.  If you are a Rooibus tea drinker you will be pleased to learn that this tea comes from a different plant and contains no caffeine.   Caffeine can also turn up as an ingredient in cold medications, appetite suppressants, and pain relievers and can be helpful against some headaches and of course drowsiness.  Surprisingly, it's the leaves of the tea plant that contain the most caffeine, around 5% compared to 1 -2% for coffee beans.  The plant world uses caffeine cleverly for survival as it helps to repel many insects. As most of us know, caffeine is a stimulant to our central nervous system (CNS), helping to keep us alert and overcome feelings of drowsiness.   

What’s in a cuppa?  
Depending on what you read the amount of caffeine any in food will vary.  The caffeine content of an average 150 ml cup of tea varies from 30 - 100 mg, depending on how long the tea is made.  If you use milk, sugar, loose leaves or tea bags (strong loose-leaf tea provides the most caffeine)all create a different end result. Coffee beans come in two flavours, Robusta, which has more caffeine and Arabica. An instant coffee has 60–100mg per 150 ml, depending on the brand. An espresso comes in at around 90 mg per 150 ml1. Consuming a whole 200 g block of chocolate, would mean you would get the equivalent of about 550 mg of combined methylxathines (caffeine and other stimulants). A 30 g bar has between 20 to 60 mg caffeine. Given it’s our teenagers who consume the greatest quantity of soft drinks; caffeine intake is something worth keeping an eye on. A 375 ml cola drink contains around 40 mg of caffeine while a 250 ml energy drink contains around 80 to100 mg caffeine – about the same as a shot of espresso.

Caffeine is rapidly absorbed in less than an hour. After this, caffeine has a half-life (the time it takes for the total amount taken in to be reduced or cleared to half the original total) of 3 ½ hours to 6 hours2.
  
Athletes
Caffeine is a common aid in sport and hence why specific levels of caffeine derivatives in the urine were once banned in many sports.  However, recently the ban was lifted.    But remember there is a fine line between the benefit and cost of caffeine use in sports, for example, intake of 13 mg/kg and over greatly increases the risk of serious side effects including gastric distress, anxiety attacks, heart palpitations and headaches. The use of caffeine in sport varies according to intensity of the activity and the athlete’s body weight. One last major variable must be considered and that is the individuals ‘tolerance’ to caffeine, for example, habitual coffee drinks may require a period of abstinence from caffeine in order to gain beneficial effects from caffeine.
  
Caffeine’s effect on performance
Caffeine at intermediate dose levels of 5-mg/kg caffeine up to three to four hours before intensive exercise stimulates the oxidation of free fatty acids, as a glycogen sparing effect researchers suggest that this is limited only to the first 15 minutes of activity (Burke, 1998).  Other effects include increased blood flow to the central nervous system and consequently stimulation of the nervous system providing a feeling of alertness and acuity.  Increased release of adrenaline occurs at this dose also, stimulating muscle, improving performance and generally causing an excitatory effect on the nervous system.

Caffeine was once considered a diuretic, which was believed to increase dehydration.  However, we now know that while caffeine does cause some fluid loss, where it is consumed as a liquid there is generally a net gain in fluid. Roughly 1.07 mg of fluid is lost from the body.  Given most drinks will provide about 200 mls of fluid this will still leave a net gain of about 150 mls of fluid entering the body.


Download the full fact sheet. 

Yes we are getting bigger! As most of us know, many health professionals believe there is an ‘epidemic’ of overweightness in Australia and New Zealand and indeed in most developed countries. The body weight of the average Australian has been increasing, and around 20–25% of Australian children are either overweight or obese; so it’s little wonder that so many of us are looking for fast-track methods to reduce body fat. We need to be cautious about going too far in the opposite direction.  Becoming overly concerned with slimness can also lead to well-documented health problems. With reasonable certainty, we understand that society’s current weight issues are due to an interaction of one or more of the following:
  1.      Biological factors of weight gain
  2.      Environmental factors of weight gain
  3.      Behavioural issues of weight gain
 Most likely, it is a mix of all of the above that has lead to our increased weight.  Read the whole fact sheet on overweightness.