But beyond the fake fitness news, alternative nutrition facts, and stage-managed social image crafting, what IS an expert anyway?

A real expert who actually knows what they’re talking about. Who CAN you trust? Who SHOULD you trust?

In this guest post by Dr Dan Jolley, PhD, professional strength and conditioning coach and doctoral researcher studying the fitness industry, he discusses personal training qualifications, knowledge, and what it truly means to be an expert. 

Will the real fitness experts please stand up!

Over to you Dr Dan!
Bill

Before I start, I’ll preface my comments by saying that I come from a personal training background and by no means is this article a “hit job” on the entire industry or all personal trainers.

It is, however, a warning shot across the bow of those who, with a little knowledge, think they’re experts on everything.

Bad information promoted by the “experts” serves to undermine responsible public health messages, makes a joke of personal trainers, and further erodes the reputation of the fitness industry.

So the purpose of this article is to call bullsh*t on the “experts” and encourage you to use critical thinking when seeking out reliable health and fitness information.

—

The fitness industry in recent years has been changing at a breakneck pace.

Some of this change has been for the better – public parks have outdoor exercise equipment, group exercise options have increased, some gyms are now paying attention to the benefit of social support for exercise adherence, and the recent proliferation of barbells, lifting platforms, and free weights warms the heart of a grizzled old athlete and coach like myself.

But there have also been changes which have made things downright confusing for people looking for good quality information.

How Do We Find Reliable Information?

The internet opened the flood gates and democratised the flow of information and, though information is far more accessible now than it was only a decade ago, the quality of this information varies greatly.

In fact, much of the health, fitness, and nutrition information found online is simply not trustworthy.  

Most people tend to assess the quality of online information based on cognitive shortcuts known as “heuristics” (i.e., “hmm, this sounds intuitively logical to me, so therefore it must be true”), rather than a detailed examination of the quality of the information.

And fair enough, it’s hard to know better if you don’t have a relevant science qualification! So how can you know what to trust?

Many people will look for someone who can interpret this information for them (and if you’re reading this article then, congratulations, you’ve already found an excellent resource in this site!)

But for many truth seekers, a highly accessible source of information is their personal trainer, the big guy who’s always at the gym, or the attractive girl that posts about nutrition on Instagram.

Some of these people will even call themselves (or brand themselves) as “experts” or “gurus.”

We’ve Seen How This Goes Wrong!

So just how trustworthy ARE these self-proclaimed health “experts”? Some recent controversies offer some clues.

Famously, there was Belle Gibson, the health blogger with no science qualifications who made false claims about having multiple cancers and “treating” them through nutrition.

Her lies netted her a large amount of money which she has yet to repay despite a court order.

For a fascinating read on this case, I can recommend the book The Woman Who Fooled The World by Nick Toscano.

More recently, blogger Olivia Budgen made the news for insensitive claims about cancer, then was rightly criticised on this very site for her attempted apology (i.e., “sorry, not sorry”).

Olivia provides a great resource when she just sticks to posting recipe ideas. She has made an effort to improve the quality of her advice in recent times, providing references for her claims, and clear disclaimers in response to criticism from myself and others.

But Olivia does not appear to have any relevant health qualification (I’ve asked her about this in previous communication).

She cherry picks evidence to support her opinions about the proposed health benefits of certain foods then extrapolates these findings too far.

Sometimes bad “expert” advice has potential to cause harm or even death.

In 2015, Chef Pete Evans, despite having no tertiary health qualifications, drew widespread condemnation from public health professionals after releasing a cookbook for mums and babies with a DIY baby formula which contained 4.5 times the maximum vitamin A dose for a baby.

Be sure to check out Dr Tim Crowe’s excellent parody of dubious online health claims.

Fitness Gets It Wrong Too!

In the personal training world in the last 5 to 10 years, I’ve observed a trend of trainers programming and encouraging higher training intensities.

This may take the form of hard intervals with heavily loaded sleds, battle ropes, or high volumes of plyometric exercise (bounding, jumping, etc.).

And the assumption seems to be that everyone can benefit from this intensity regardless of whether they have a weight loss goal, a general fitness goal, or a more specific performance goal.

In fact, I’ve met trainers who are dismissive of steady state running (i.e. jogging) to assist in weight loss (or develop general fitness) despite the fact that the type of adaptation you receive from both resistance training and cardio training depends heavily on variables such as intensity and volume.

Research shows that short, very high intensity sessions may not achieve the best results for your needs, and tend to result in poorer exercise adherence.

These “experts” also seem to be unaware that a well-developed aerobic fitness base (yes, even with low intensity running) can in fact improve your ability to recover between high intensity efforts.

As I mentioned in my CrossFit review on this site, as a coach, I program very different training to achieve different adaptations for different people.

Furthermore, high intensity sessions may be contraindicated in those with multiple cardiac risk factors (which opens up a completely different discussion on the importance of pre-exercise risk stratification).

But My Trainer Seems To Know…

So there’s a lot of questionable, if not bad, information out there, especially online, but aren’t fitness professionals trustworthy sources of information?

Shouldn’t we be able to assume the personal trainer at your local gym is a helpful source of safe, effective advice?

Sometimes yes, but not always.

Over the last 15 years, a growing body of research has consistently demonstrated that personal trainers possess errors in their factual knowledge base (and sometimes serious errors in knowledge which I have discussed in a previous article). 

But even more concerning is the fact that, despite knowledge gaps, personal trainers tends to possess high levels of confidence in their knowledge.

Thorough interviews with personal trainers have shown that trainers tend to value on-the-job experience and mentoring from other professionals more than formal qualifications.

While these can certainly be valuable tools for professional development, recent Australian research showed that only about half of personal trainers used reliable sources of information (i.e., science journals, science text books).

So to summarise the research, we have a large proportion of personal trainers with:

• potentially poor knowledge;
• high levels of confidence;
• little appreciation for qualifications; and
• who rely on unreliable sources

What Qualifications Do Experts Have?

What qualifications do these “fitness experts” possess?

Some of the better ones may have a relevant health science university degree.

Many others will possess a personal training qualification (a Certificate IV in Fitness), which is the minimum entry level qualification required to gain accreditation with Fitness Australia.

And some will possess nothing more than a blindingly white smile and a few years banging weights around the gym.

I’m in my 22^nd year of study and/or work in the fitness industry and recently finished my third (and hopefully last) degree.

But if I relied on this experience as an argument for why my opinion should be accepted without question, I would be committing an appeal to authority fallacy. (i.e., “take my word for it because I have degrees”).

In fact, it is all my years of work experience and university study that have given me an immense respect and humble appreciation for established evidence (as opposed to “bro science”).

My education has taught me that, whilst I’ve learnt a lot along the way, there’s still so much MORE that I have yet to learn!

You will rarely see any of the advice I give to clients, students, or colleagues directly contradict the established science on a topic, and certainly not without copious amounts of high quality evidence to support my alternative claims.

Yes, science is always evolving and we must keep an open mind about new exercise and nutrition research, but not so open that our brains fall out and we become mouth pieces for pseudoscience and quackery.

We must demand evidence over opinions no matter who is spouting off the latest greatest exercise or nutrition “breakthrough.”

A Common Example

Many self-styled “experts” are quick to dismiss heavily researched exercise and nutrition guidelines, which may not be consistent with popular fitness and nutrition trends (i.e., “detoxes” and “superfoods”).

The argument is often this: “These nutrition guidelines have been around for a long time and yet people are getting fatter and fatter…therefore the guidelines are wrong.”

And they are partially correct, according to government statistics, obesity rates ARE on the rise.

But the assumption that obesity rates continue to increase because of these guidelines is flawed.

Assuming a cause and effect relationship from a mere association is a rookie mistake for any aspiring critical thinker.

In fact, the rising obesity rates are not because people are following these guidelines, but because they’re NOT following them. 

National Health Survey data shows us that very few people actually achieve the recommended amounts of fruits and vegetables in their diet, instead choosing more energy dense options (i.e., burgers, chips, and fizzy drinks).

On top of that, people are not meeting the physical activity recommendations, with just over 50% self-reporting sufficient exercise.

Some of these “experts” also attack these guidelines for encouraging diets high in refined sugars but, in fact, guideline #3 specifically mentions limiting added sugars in the diet.

But Criticism Is Welcome

I need to state this clearly here: NO ideas are beyond criticism.

We rightly SHOULD question exercise prescription and healthy eating guidelines. And we do, regularly.

In fact, in 2012 the physical activity recommendations in Australia were changed to increase the volume of recommended exercise, with specific mention of limiting screen time.

The Australian Dietary Guidelines were updated in 2013 to:

1. increase their focus on maintaining an appropriate energy balance; and
2. reflect changing evidence about risks, and benefits, associated with consumption certain foods.

These changes are informed by mountains of evidence.

Hundreds of scientific journal articles, each representing months or years of work by multiple scientists, are considered when these changes are made.

And each article is carefully read and criticised by other scientists, multiple times, until they are considered worthy of publication.

They are, in short, extraordinarily well-informed documents, designed to provide safe, effective advice to the majority of the population.

What Does Your “Expert” Think?

Now we get to the crux of the issue.

What does your exercise or nutrition “expert” think of something as fundamental as healthy eating or physical activity advice?

Do they dismiss these guidelines as irrelevant, out of date, or paid off by industry groups or “big pharma?”

There’s no doubt that we could find issues with individual pieces of evidence that inform these guidelines or even the motives of lobbyist groups, but to dismiss the whole body of research because of some cherry-picked examples that suit an argument is not rational.

That would be like throwing out everything we know about the effectiveness of vaccination because one piece of research by a now disgraced researcher with undisclosed conflicts of interest suggested vaccines were linked with autism… and as we know, that would never happen. Wait. Never mind.

There’s also no doubt that these recommendations do not apply to everyone.

They are designed to be general, and simple enough, to apply to the vast majority of the population.

Certainly if you have medical issues, cultural preferences, or performance requirements, your needs may differ, and you should seek more specific advice.

Is Your “Expert” An Actual Expert?

Does your “expert”:

1. Dismiss high quality research evidence, preferring their personal anecdotes, case studies, or one or two selected pieces of evidence? They are not an expert.
2. Make alternative claims and/or promote questionable products and services (i.e., detoxes, cleanses, fat burning supplements) without providing any compelling body of supporting evidence? They are not an expert.
3. Make judgements about the quality of scientific research, without holding a research qualification in a relevant field to be able to even read and understand the said research? They are not an expert.
4. Use unreliable sources of information such as blogs, social media sites/apps, and websites that do not have clear author and reference information? They are not an expert.

Christopher Hitchens once said “what can be asserted without evidence can be dismissed without evidence.”

So your fitness or nutrition “expert” making an extravagant or controversial claim is no more deserving to be taken seriously than a flat earth proponent, anti-vaccination campaigner, or notorious Hollywood woo peddler Gwyneth Paltrow.

Show this article to your trainer and pay attention to their response.

Are they dismissive of my support for established evidence?

Ask why and, specifically, which evidence informs their opinions.

Making a claim that contradicts established evidence carries quite a burden of proof!

Or do they claim that they are different because their years of experience mean they know more than younger trainers?

This is not a strong claim. In fact, it is the same appeal to authority I was careful to avoid earlier.

Early results from my doctoral research show that years of experience as a personal trainer have no impact on the knowledge personal trainers possess, but their level of education does.

To Sum It All Up

There is a growing body of evidence that many personal trainers use highly variable sources of information, and many also have inadequate knowledge about fundamental nutrition and exercise concepts.

So choose your trainer wisely.

Pick someone who operates within their scope of practice, is humble about their knowledge, is prepared to adjust their opinion in the face of changing evidence, and who recognises that a Certificate IV in Fitness alone does not make them a “guru” or “expert” in any field of knowledge.

Yes, a trainer can be a great person and an excellent, highly skilled practitioner, but that does not make him/her an “expert.”

And neither, for that matter, does a million Instagram followers.

The post Is Your Fitness “Expert” an Expert or Just Full of Sh*t? Here’s How to Tell appeared first on Dr Bill Sukala.

But is this criticism fair and warranted?

CrossFit helps a lot of people, so how can it be bad?

In this guest post by professional strength and conditioning coach Dan Jolley, PhD, he takes a step back and provides a level-headed and balanced rundown on CrossFit, the pros and cons, and those who might benefit most from it.

Over to you Dr Dan!  -Bill

There has been a massive change in gyms and group exercise over the last few years.

At the forefront of this has been one of the most polarising exercise modalities of recent years – CrossFit.

While nothing in a CrossFit workout is actually new (they use bars, weights, and equipment that has been around for decades), their workouts are put together in a novel – and in some circles, controversial – way.

Plenty has been written about CrossFit, most of it very polarising.

Therefore, the aim of this article is to take the view of an impartial observer.

I’ll assess the pros and cons of this form of exercise and examine what the evidence says about its claims.

Principles of CrossFit

To define CrossFit, it is useful to go to the source. According to the CrossFit website:

CrossFit is constantly varied functional movements performed at high intensity. All CrossFit workouts are based on functional movements, and these movements reflect the best aspects of gymnastics, weightlifting, running, rowing and more.

While this isn’t necessarily a novel approach, there are a couple of things worth noting. One is the use of the word “functional.”

What Does “Functional” Actually Mean?

“Functional” is a buzzword bandied about by the fitness industry in recent years and tends to be attached to the use of free weights, body weight exercises, and exercises that challenge stability. None of these are bad things.

In fact, as a strength & conditioning coach, these are all options I use daily.

You will always see plenty of free weights in a CrossFit gym, and this has influenced the broader fitness industry to provide this equipment too.

But when deciding whether or not a movement is functional, it’s worth considering whether that “function” is relevant to the person doing the training.

Personal trainers are generally taught to select exercises (and other variables) to suit the needs of the client.

This is good practice regardless of whether or not you consider your exercise “functional”.

There isn’t necessarily an agreed-upon industry standard definition of this term as it relates to exercise.

The key phrase from the Wikipedia definition, “movements based on real-world situational biomechanics” is a good place to start.

CrossFit has a slightly different take:

We scale load and intensity; we don’t change the program. The needs of Olympic athletes and our grandparents differ by degree, not kind.

What this suggests is that everyone walking into a CrossFit gym will do the same workout, in the same order, though the resistance applied will vary.

Exercise selection is generally seen as a fundamental part of exercise prescription that can be varied to suit the individual (a good summary of the research on resistance training prescription can be found here).

CrossFit suggests that everyone can benefit from the same program.

To a point this is true: beginners, especially, will benefit from any increase in exercise levels, regardless of the choice of movement.

This becomes less true with more training experience since the athlete is closer to his/her own physiological ceiling, but more on that later.

CrossFit and Exercise Intensity

The other variable that may be manipulated in a CrossFit workout is intensity:

The more work you do in less time, or the higher the power output, the more intense the effort. By employing a constantly varied approach to training, functional movements and intensity lead to dramatic gains in fitness.

In this case, the concept of power (i.e. a faster workout) is used synonymously with intensity.

But in other modes of exercise, intensity can be changed in other ways.

In resistance training, for example, intensity is often measured as a proportion of the maximal weight a person can lift (i.e. their one repetition maximum, or 1RM) that is used for an exercise.

When running, intensity could be the proportion of maximal speed or heart rate, depending on what can be measured at the time.

Further, if we look at intensity subjectively, a more intense effort could be anything that the exerciser thinks is harder (the concept of RPE – rate of perceived exertion).

This can be influenced not only by the difficulty of the workout, but other social and psychological factors, and their recovery from their previous workout.

We can also vary difficulty of a workout by using methods such as repetitions which are slower, or over a longer range of motion, or more repetitions at a lighter weight.

The speed of the movement is just one variable that a good trainer can manipulate.

In CrossFit however, the emphasis is on completing workouts faster.

Speed is characteristic of these workouts, rather than a variable to adjust.

How Can You Tell Which is a CrossFit Gym?

This can be harder than you think. CrossFit gyms are independently owned, not franchised.

As such, there is no common image or corporate branding. And while there are similarities in the types of equipment you will find, the size and layout of gyms will vary significantly.

Similarly, they tend to be operated by the owners, and there can be significant differences in the approach of the owners and the instructors they employ.

They have a few things in common though.

The word “CrossFit” will probably be in the title. When you go into a CrossFit gym you know what you are going to get in terms of exercise.

You will lift weights. The exercises will generally be big, compound (multiple joint, multiple muscle group) lifts. You will be challenged to lift heavy.

There will be an element of cardiovascular fitness in the workout.

And you will race against a clock, with your time being written up on a board.

Each gym will have their “workout of the day” or WOD.

In keeping with the principles of CrossFit, most people who attend the gym that day will complete this session.

Depending on the gym they may have other classes or sessions for different levels of ability.

The workout may take around 45 minutes, so fits pretty comfortably into a working day.

One of the major characteristics of CrossFit is the atmosphere of the gym.

Though (as mentioned earlier) there is significant variation in gyms, there is an element of teamwork and camaraderie that is missing from most commercial gyms.

You don’t see many people training on their own in a corner wearing headphones.

This is either a positive or a negative – depending on how you like to train – but it is obvious!

There is a genuine social element to attending one of these gyms.

Who Are CrossFit Coaches?

Again, this is a tough one to answer, as the coaches I’ve met come from a variety of backgrounds.

Some have come from a traditional gym or personal training background, some have sport science degrees, and others have come from sporting or Olympic weightlifting backgrounds.

And some have known nothing but CrossFit in their fitness careers.

Qualifications

CrossFit qualifications have been a point of discussion in the fitness industry for some time.

The basic qualification for a new instructor is a two-day course, which includes theory, practical components, and an assessment.

There are other courses an instructor can do to update their knowledge after that but these are not compulsory.

While this is better than nothing, it compares poorly to the rest of the industry.

In Australia, the Certificate III and IV qualifications for personal trainers, for example, have recently become much more demanding and can take up to 12 months to complete full time.

University qualified personal trainers and accredited exercise physiologists have 3 to 4 years of education.

And to work in sport in a professional or semi-professional capacity as a strength and conditioning coach, it’s pretty hard to even get a foot in the door without a Master’s degree or PhD, as well as practical coaching qualifications.

While not everyone needs such a highly qualified coach, it is clear that, in terms of education and depth of scientific understanding, basic CrossFit certifications compare poorly to the industry at large.

It’s always useful for the client to know what qualifications their trainer holds and whether they are up to date with ongoing education.

Is CrossFit Effective?

The short answer is: it depends on the individual and level of exercise experience.

One of the key tenets of CrossFit – the high effort the workouts consistently call for – means that even someone with a decent exercise history can stand to benefit from the increased effort.

All of us have been guilty of coasting in our workouts from time to time, so getting pushed harder can lead to real improvement.

The workouts are also conducted in group settings, against the clock, with the encouragement of trainers.

The psychological benefits of this environment are huge; most of us will work harder in these conditions.

If you have fairly general fitness needs, this could be a great environment for you.

For those with more specific needs, CrossFit might not be their best option.

Earlier in this article, I discussed the need for specificity when designing training programs.

For those with a long training history, or those who compete at higher levels of sport, generic programs are comparatively less effective.

For example, in my time as a strength and conditioning coach, I have worked at high levels within Australian Football and American Football (gridiron).

Both groups of athletes need a degree of aerobic fitness and repeat sprint ability. CrossFit would improve both groups of athletes if they were relatively untrained.

But the Australian Football players may need to run hard over relatively long distances with short rest between efforts.

The American Football athletes, on the other hand, need to be able to perform high intensity sprints, but get much longer recovery between efforts and cover much shorter distances.

I spend much more time developing the aerobic capacity of Australian Football players, whereas the gridiron guys have much more of a repeat sprint focus.

With CrossFit’s focus on generic programming and timed workouts, and speed as their major marker of intensity, the specific requirements of each sport may not be met.

Additionally, differences in the distances covered, types of change of direction and physical contact, and the different body positions in the sports mean the training programs of these players end up looking quite different.

And lastly, the needs of an individual may change over the course of a season.

Meeting these needs often involves an element of foresight and planning (called “periodisation”).

The WOD on any given day may not match these needs.

How Safe Is CrossFit

The answer to this is, it depends who you are (do you sense a trend here?). It is hard to label CrossFit as “safe” or “unsafe” due to the massive variation in gyms and clientele.

But regardless of the gym you are joining or the exercise program you are beginning, there are a few things that should be standard:

• Did the gym you joined ask you to complete a form outlining your medical and injury history?
• Did they ask follow up questions based on the answers you provided?
• If they identified you as a high risk client, did they request a medical clearance?

If they didn’t do any of these things, they are breaching their duty of care.

There is now an industry standard form and process endorsed by both Fitness Australia (which regulates personal trainers), and Exercise & Sports Science Australia (which regulates exercise physiologists).

This level of detail is a good start and clearly a step in the right direction.

• Did the trainers at this gym assess your ability to perform the exercises required? A movement screening of some sort (for example, the Functional Movement Screening), a fitness test, or a strength test, would provide relevant information here. If everyone is doing the same program, it’s worth making sure everyone is capable!
• Do they offer introductory courses? Despite the marketing, I know from firsthand experience that not everyone can do the same movements. In particular, CrossFit WODs may involves parts of (or even full) Olympic lifts, which are technically quite challenging. If they run beginner’s classes, sessions where they teach these lifts, or individually adjust the exercises to suit the individual participant’s ability, you can have some confidence that they are looking after their members.

There is an inherent risk to performing any exercise under high levels of fatigue, such as CrossFit may encourage.

As a general rule, injury rates in CrossFit are comparable to other sports.

A 2014 study of CrossFit participants found the injury rate to be 20%, though those with more trainer supervision had lower injury rates.

This may be a level of risk that someone wishing to compete in CrossFit may be willing to take on, but the recreational exerciser with general goals should make an informed decision about whether this exercise intensity (and risk) is appropriate for them.

CrossFit-induced Rhabdomyolysis?

One of the most well-publicised risks of participating in CrossFit is rhabdomyolysis (or “rhabdo”).

While this condition is not unique to CrossFit, there has been an upsurge in rhabdo cases with the increasing popularity of this type of exercise.

The CrossFit brand is also not helped by the casual way that rhabdo is treated by some of its proponents.

In an exercise setting, rhabdomyolysis occurs when skeletal muscle breaks down rapidly.

While some muscle damage is an essential part of our adaptation to exercise, a very high volume of demanding resistance exercise using large muscle groups (i.e. squats), can cause an extreme amount of muscle damage.

As a result, byproducts of muscle breakdown enter the bloodstream.

Very dark urine, and unusual swelling in the muscles are obvious signs.

Previously this was seen in athlete populations such as triathletes and ultramarathon runners, but those who are relatively untrained and doing CrossFit workouts have a higher risk than other modes of exercise.

The incidence of rhabdo in CrossFit is not well documented and the scientific literature to date mostly deals in case studies, so it’s hard to draw conclusion from such a small sample of cases.

On top of that, a competent and well-qualified trainer should be able to manage the progression of the client at a safe rate (as discussed above), rather than throwing them off the deep end straight into the full workout.

My Experience?

The aim of this article was to remain impartial and present the risks and benefits of CrossFit to someone without a pre-existing opinion, or a lot of exercise knowledge.

My own personal experience with CrossFit has been fairly limited, but unusual for someone writing an article about this mode of exercise, I am neither an advocate or a hater.

I have used CrossFit gyms for testing and training sessions when coaching teams which didn’t have access to gym facilities.

This is because they have the weights, lifting platforms, and other equipment we need that not all gyms have.

The trainers I’ve met as a result and been welcoming and helpful.

When holidaying in the US a couple of years ago, I was staying with some friends in Denver who train at a CrossFit gym.

I went along for a workout with them one morning and found it to be a reasonably enjoyable experience.

While it was not a session I would normally select for myself, I was happy to join in.

The instructors were degree qualified, did a movement screening with me before the session, and made sure I warmed up properly.

And I got a decent workout (I didn’t perform at my best though – I blame the altitude!). Overall, it was a professionally run operation.

I’m aware of other CrossFit trainers who are highly experienced and possess good qualifications beyond their CrossFit certifications.

Unfortunately, I am also aware of trainers who cut a lot of corners and operate outside their scope of practice (by purporting to be able to treat injuries or prescribe diet plans).

I’m also personally aware of one case of exercise-induced rhabdomyolysis from a CrossFit workout here in Perth.

This person was the typical higher risk candidate for the condition (having a poor training history to that point), but was put straight into the main workout by her trainer and ended up hospitalised.

Take Home Message on CrossFit

Like all exercise modalities, this CrossFit is not for everyone.

If you want a challenge, have a moderate level of fitness, and have lifted weights in the past, go for it.

If you want to compete in the sport of CrossFit, by all means go for it.

If you have a history of injuries or medical conditions that may affect your ability to exercise, then a group setting, or high intensity exercise, may not be the best choice for you. CrossFit is both of these!

If you have very specific needs (such as sports performance), then CrossFit may give you a bit of a boost to your training in the short term, but a more structured long term approach will provide a better benefit.

The post CrossFit: An Independent Unbiased Review appeared first on Dr Bill Sukala.

Who is best qualified to help you? Who will deliver excellent service in the most safe and effective way possible?

In this post-truth age of social media-driven misinformation like “alternative facts” and “fake news,” lots of maverick trainers out there literally make up whatever training or nutrition theories they want, with no research evidence to back it up, wrap a marketing campaign around it, and then demand critics “prove them wrong.”

To be clear up front, this is not a hit job or a scathing indictment against personal trainers.

Quite the contrary, there are excellent trainers out there who stick within their scope of practice and transform peoples’ lives.

And it’s sad that their good reputation is being sullied by the presence of maverick trainers who are in way over their heads in professing knowledge they don’t have.

In this guest post by professional strength and conditioning coach Dr Dan Jolley, he discusses the research around personal trainers’ knowledge and skills against the backdrop of their perceived level of knowledge and skills.

He’ll then provide practical tips you can use to find a qualified trainer best suited to help you meet your goals. Over to you Dr Dan! –Bill

Hiring a personal trainer: hasn’t this been covered before?

There are plenty of articles giving you good advice on how to find a personal trainer.

Some of the advice is excellent (check out these articles here and here if you want to read further), but it’s an evolving landscape out there and it’s not just a simple case anymore of “find someone who is registered or certified.”

There are about 20,000 registered personal trainers in Australia (and, unfortunately, plenty more that aren’t registered), so there’s plenty of choice.

But we’re going to take a slightly different angle on choosing a trainer.

Not just what the trainer knows, but what they think about what they know. In fact, this could be the most important thing you find out about your personal trainer.

But firstly, what recommendations are already out there?

Choosing your personal trainer

Here is a quick 7-point tick list for choosing a good trainer:

Are they qualified?

A Certificate IV in Fitness is the minimum standard for a personal trainer in Australia, though some have university exercise science degrees.

Are they a Registered Exercise Professional?

If the trainer turns up in Fitness Australia’s register, you can at least be sure they have the minimum qualifications.

You can also see what professional development they have done (though this is self-reported).

Do they have the appropriate insurance?

A minimum standard is professional indemnity and public liability insurance.

Do they outline fees & charges up front?

Standard advice in any industry. Make sure you know how much you are spending. Also ask about any refund or cancellation policy.

Are they capable to delivering the type of training you are after?

If you have specific requirements due to injury, age, or unusual needs (i.e., uncommon diseases), can the trainer meet these needs?

Some people may need a trainer with more advanced qualifications and specialty knowledge.

Do they perform a pre-exercise screening?

This is a limitation for many trainers.

This is not just a bit of paperwork, or a coffee and chat about what you want to achieve.

This should be an in-depth, documented discussion of your exercise, medical, and injury history.

Standard screening tests should be performed, as well as a movement screening, strength, or fitness testing as appropriate.

You should be referred to a general practitioner or allied health professional if necessary before you begin training.

Do they operate within their scope of practice?

If a trainer encourages the use of fat blaster nutritional supplements, plans highly restrictive diets, offers professional sports coaching, or claims to be able to diagnose or treat injury or illness, they are practising outside their scope of practice.

I address this issue in my previous article on spot reduction in which I tackle exercise misconceptions that refuse to die.

What else should you know about your trainer?

Something I would like to add to this list of recommendations, however, is “make sure your trainer is aware of his/her own limitations, and is not overly (arrogantly) confident.”

There is no shortage of personal trainers out there willing to tell you they are an “expert” in their field.

They may tell you they are up to date with the latest science of exercise and nutrition and are absolutely cutting edge. But are they?

It’s unlikely unless they have a postgraduate research qualification (i.e., honours, masters, or doctoral degree in a health science discipline) and are able to read/comprehend complex biochemistry and physiology, interpret statistics, and then put the results into practical context.

The information presented to students as part of a personal training qualification is often a distilled and simplified interpretation of large and complex bodies of evidence across multiple health science disciplines.

Personal trainers may pick up a lot of additional knowledge by attending professional development courses, but they are still relying on experts in their respective fields (such as physiotherapists, dietitians, exercise physiologists, psychologists, etc.) to interpret the information and provide the context and perspective relative to the personal training field.

How much does your personal trainer know?

There’s surprisingly little research about the knowledge of practicing personal trainers, so to answer this question we must rely on international studies.

Results from a small qualitative study in Switzerland (which does not require personal trainers to be registered) found 85% of personal trainers possessed the required qualifications (with 12% having a university degree), but many used poor practices, or operated outside their scope of practice (such as prescribing supplements when providing nutritional advice).

Furthermore, 73% of trainers did no follow up on the nutrition advice, which is unfortunate considering how unsuccessful the majority of weight loss attempts are.

While 62% did some ongoing reading or self-directed education, fewer than 20% attended a conference or course.

However, this doesn’t tell us about the quality of the information to which they are exposed.

A survey of 115 trainers in the US found that personal trainers with a bachelor’s degree in exercise science and certification by American College of Sports Medicine or the National Strength and Conditioning Association as opposed to other certifications were strong predictors of a personal trainer’s knowledge, whereas years of experience was not related to knowledge.

Another US study from 2015 found similar results, with personal trainers demonstrating poor knowledge of exercise prescription guidelines.

Neither study found that the length of practice of a personal trainer improved their knowledge.

This is important, as experience is often seen as a substitute for formal education in the fitness industry and is sometimes more highly regarded than education by many personal trainers I have met.

What has been shown to improve knowledge is the level of qualification the trainer possesses.

So maybe we can consider this when choosing our trainer.

Do they have, or are they in the process of completing, a university exercise science degree?

Following on from above, it’s worth mentioning that in the United States, no university degree or formal training is required by law to become a personal trainer.

For some certifications, you can read a book, memorise as much as you can, and then take the exam. If you pass, then you’re a personal trainer.

An alarming finding of the 2015 study was the unfounded confidence that most of the trainers surveyed possessed.

When asked to rate their knowledge after completing the test, only 7% of the trainers thought they knew less than half the answers.

This is despite an average score of 43% in this case!

More than half the trainers surveyed thought they knew “most of the answers”, though more confidence didn’t relate to better test scores!

The Dunning-Kruger Effect: the less you know, the more you think you know

In 1995, McArthur Wheeler robbed a Pittsburgh bank in broad daylight, in full view of security cameras, without an apparent disguise.

But when arrested later that day, he was shocked that he had been caught.

After all, he had rubbed lemon juice on his face. For some reason, Mr Wheeler thought that this would make his face invisible to security cameras!

While most of us would shake our heads at his stupidity, two Cornell University researchers were intrigued at how confident he had been in his (obviously flawed) knowledge.

They wrote a paper entitled Unskilled and Unaware of It: How Difficulties in Recognizing One’s Own Incompetence Lead to Inflated Self-Assessments.

The phenomenon they described became known as the Dunning-Kruger Effect, which suggests that a certain amount of knowledge is required for someone to be aware of their lack of knowledge.

For a personal trainer, a small amount of education could make someone confident that they are ready to go into the industry and represent themselves as a fitness expert.

But someone with more education may also develop an awareness of how much more there is to know, and how incredibly complex a system like the human body is.

And though they are more educated and informed, they often do not express as much confidence in their knowledge.

Where does this overconfidence come from?

If you have a trainer already, you may be thinking “surely you’re talking about those other trainers?

My trainer is on the ball!” You may be right, but all of us – you and I included – are affected by errors in thinking that influence our confidence.

One of the major ones is confirmation bias.

This is when we interpret information in a way that supports our pre-existing opinion.

There may be no problem here if our pre-existing opinion is correct, but this isn’t always the case.

When our knowledge of a topic is limited, it’s probably wrong, or incomplete at best. 

We then receive new information in a way that confirms our opinion and we become more convinced we are right.

This is how misconceptions form and strengthen over time, so you end up with people believing vaccines cause autism (they don’t), the earth is flat (it isn’t), or homeopathy works (it doesn’t).

Even armed with this knowledge of confirmation bias and how it affects your thinking, you are still prone to it.

Researchers have tried interventions to eliminate confirmation bias and none have been reliably successful to date.

The best we can hope for is to be aware of it, and examine our own thinking and attitudes for bias on a regular basis.

This also requires a willingness to admit our mistakes and be open to correction, which can be a challenge for many of us.

The attitude of your trainer is crucial

A study of personal trainers in the United Kingdom found that trainers would often behave in the fitness industry differently to how they were taught during their course.

They would do what their instructor required during the course then operate in whatever way they thought best once in the workplace.

While it is possible that these trainers were making better decisions than their instructors were, and interpreting information more accurately, this seems unlikely.

Admittedly, I’m relying on anecdotal evidence here – my eight years of lecturing in personal training courses makes me doubt the ability of these graduates.

More likely, they were overly confident in their knowledge and abilities for the reasons discussed above.

The same trainers saw on-the-job training and industry experience as important, but said cost would discourage them from attending formal professional development opportunities.

So the trainers prone to confirmation bias are not exposed to information that could lead them to correct their opinions.

And as has been shown in previous research studies here and here, industry experience is not always a reliable indication of the quality of your trainer. But even this finding may be rejected by trainers with a contrary opinion.

While years of experience may tell you how dedicated to their craft a trainer is, and qualifications may tell you how intelligent or well-read they are, it isn’t the whole story.

If your trainer is unwilling to accept that their opinions may be wrong, then it’s your health they may be putting at risk.

How to tell if your personal trainer is aware of their knowledge limits

A perfect opportunity to find out about your new trainer’s openness to evidence and change is the pre-exercise screening. If you have a medical or injury issue that will affect your training, what type of questions do they ask?

If your trainer wants to know which allied health professionals you have received treatment from, what remedial exercise, treatment, or medication was been prescribed, and what recommendations for ongoing management you have received, then you may have a good one.

If they ask you detailed questions about how you have managed your exercise until now, even better.

If they also want to discuss things further with other professionals, or do some extra reading, excellent! They get a gold star, and you have a trainer you can trust!

If, on the other hand, they don’t ask these questions, and are highly confident in their ability to treat or manage this issue, or are dismissive of the opinions of these qualified professionals, be sceptical.

Unless one of these professionals was a homeopath – their opinion can be dismissed immediately.

In closing, the moral of the story is make sure your trainer is well-qualified, aware of their own limitations, and not proudly standing on top of “Mount Stupid.”

The post How to Choose a Personal Trainer – Using Science! appeared first on Dr Bill Sukala.

During my many years as a personal trainer I quickly got used to hearing some of the same comments from clients, over and over.

Young men wanted to put on muscle, young women were scared of putting on too much muscle, and almost everyone wanted to lose body fat.

The latter was by far the most common, and it is this concern about body fat that has sprouted urban fitness myths that have survived and thrived for decades despite all attempts to correct them.

Almost every second client I started training would point to a specific part of their body (i.e., stomach, hips, thighs, arms, or butt) and tell me that was the area they needed to lose weight.

This idea is known as “spot reduction.”

The proposed mechanisms of spot reduction vary depending on who is selling the idea (or the product that purportedly promotes spot reduction), but the theme is consistent: exercise a specific part of your body, and you can lose weight from that part of the body.

Cycle for skinnier thighs, do arm exercises for skinnier arms, or hip movements for slimmer hips.

Edwin Checkley: The Godfather of Spot Reduction

The idea of spot reduction is nothing new. In fact, it’s old – really old.

In 1890 Edwin Checkley released a book called “A Natural Method of Physical Training.”

Chapter seven discusses obesity and makes what is possibly the first reference to spot reduction (though if you find an earlier one, let me know!).

Checkley makes the following claim:

“The dissipation of fat is local; that is to say, it disappears in localities in which muscles are active, and in proportion to their activity. Thus people will accumulate fat in accordance very largely with their personal habits. People who sit a great deal, yet have occasion to use their arms considerable, will be found with arms having proportionately more muscle and less fat than their legs.”

Intuitively this makes sense to us, which is why it has been such an enduring idea.

And until the advent of a rigorous scientific method and accurate body composition technologies, it was hard to disprove this.

But today we know a lot more about fat loss.

And tellingly, as our technology and measurement of body fat has improved, the evidence refuting this old theory has mounted up.

Body fat measurement techniques such as skinfolds (although early evidence was mixed), ultrasound, muscle biopsy, MRI, and the modern gold standard DEXA scans (and another reference for good measure here) have all shown that specific exercise does not result in site-specific fat loss. Somehow, the idea persists in spite of this mountain of evidence.

You only have to look at women’s magazines down at your local supermarket to see how the idea of spot reduction endures.

The covers are plastered with the promise of a flat stomach, lean butt, or toned arms.

The pages are loaded with series of exercises (probably low intensity body weight exercises) that work the body part in question.

And while it is entirely possible that this exercise program may work towards the desired effect, far more important are the dietary changes required for this desired weight loss effect (or the large amounts of energy expended during a cardio or heavy weights workout).

Yes, this sounds a lot harder. Yes, it takes longer. But it is unavoidable.

BioSignature Modulation and spot reduction

Given the scientific evidence against the existence of spot reduction, if it were to be taken seriously again, any new evidence would need to be overwhelming.

But a few years ago, a modern take on spot reduction idea emerged.

Unusual for this type of pseudoscience, it was from a far more reputable source than a women’s fitness magazine!

Charles Poliquin is a Canadian strength and conditioning coach, with a master’s degree in exercise physiology – much like myself (though not being a Canadian, I had to settle for marrying one!).

Poliquin used to be considered cutting edge. Some of his books and articles on resistance training were quite influential, as was his work on periodisation (here).

But I fear he may have “jumped the shark” a few years ago when he first promoted the idea of “Biosignature Modulation.”

He spent a lot of time promoting the concept and running workshops, before selling the brand in 2013 (now owned by the Poliquin Group).

Poliquin’s explanation of BioSignature Modulation begins with a description of his method of assessing body composition:

“There are 12 major body fat sites that can be quickly and accurately tested by a pair of quality skin calipers and a qualified technician… I believe that body fat testing with skin calipers is the best method to be used for Biosignature Modulation because it can determine precisely the amount of fat in each of the major fat-testing sites were [sic] other testing methods only tell you your percent body fat.”

Sounds great, but here’s the problem.

There are some pretty well-known issues with skinfold measurement, particularly in the fitness industry.

First, skinfold-thickness equations frequently used by clinicians and practitioners have been shown to underestimate percent body fat.

Second, skinfold testing may not be sensitive enough to detect small changes in body fat.

This means a person might think nothing’s happened from their diet and exercise when in fact there were positive changes in body composition.

Third, tester error is a common problem with skinfolds.

Trainers get very basic instruction in skinfold measurement as part of their Certificate III in Fitness course, and the variation in technique and measurement is far greater than what you would see in a specialised course (such as an ISAK Level 1 course).

Fourth, not all personal trainers may have access to top quality skinfold calipers, which may cost around $400-500 and must be calibrated every 12 months.

Even if skinfold measurements are done accurately, there are still issues in assessing obese clients – and visceral fat (deep fat inside the abdominal cavity) isn’t assessed at all.

Triceps skinfold measurements 

Once we’ve gathered skinfold measurements, then what happens?

Well, Poliquin says we need to interpret our results this way:

“Measurements from each site are then compared to the triceps reading and this identifies which areas of the body have excessive levels of fat relative to the other 11 body fat sites. Some people may have excessive fat in just one area, while others may have several problem areas.”

Hopefully you can see the problem here straight away.

Why are we comparing everything else to the triceps measurement? Poliquin does not explain this.

What happens if your triceps measurement is high? This impacts all our comparisons!

For example, if someone has a triceps measurement of 5 mm and a mid-thigh measurement of 25 mm, the ratio of these two measurements is 1:5.

For the sake of the argument, let’s say that 1:3 is an acceptable triceps to mid-thigh ratio.

If the triceps measurement was 10 mm and the mid-thigh was 28 mm then, relatively speaking, this person has an “acceptable” ratio of 1:2.8.

In the second example, the person with a higher skinfold total would appear to fare better in terms of ratio despite having more fat than in the first example.

I have no idea what the actual cut-offs for the numbers should be according to BioSignature Modulation, as I was not able to find any scientific validation, explanation, or justification for this.

Hormones and spot reduction

The next step is the most concerning for me. BioSignature Modulation suggests that specific hormones are responsible for body fat in certain sites and should be controlled through a combination of diet, exercise, and supplementation.

A screenshot of the summary (complete with the author’s spelling errors) is below:

I agree that a healthy lifestyle is important for controlling body fat.

But my concern with this table is that it’s an oversimplified explanation of the individual effects of hormones on regional body composition.

In reality, we know that bodies come in all sizes and shapes due to inter-individual variations in genetics, gender, diets, lifestyle habits, gut microbiota, hormone to hormone interactions, neurotransmitters, effects of medications, etc.

Trying to whittle it all down into a simple “this hormone equals this body shape” is naive and misinformed.

Here is a more thorough review on BioSignature Modulation, hormones, and the program’s limitations which you might find interesting.

Diagnosing clients’ hormonal imbalances?

The above table also calls scope of practice into question. According to the BioSignature website, Poliquin explicitly states:

“Let’s say that after being tested, it’s discovered that there is an excessive amount of fat on the lower thighs (again, relative to the other major fat sites). This indicates that there is a problem with the estrogen levels. If the problem area is the triceps, the issue is with the androgen levels. If the problem area is the shoulder blades or hip, the problem is with your insulin levels.”

If this isn’t diagnosing clients (i.e., practicing medicine without a license?) then I don’t know what you call it.

You can see for yourself that a trainer learning BioSignature Modulation might be inclined to make assumptions about a client’s hormone levels by relying on such information.

This can create unwarranted fear and anxiety in clients that may already be dealing with other physical or mental issues.

Understanding correlation vs cause and effect

Even a cursory look through the research will provide plenty of reading about a correlation between high levels of abdominal body fat (and specifically a high waist-to-hip ratio) and high insulin levels.

This is because higher body fat levels are associated with reduced insulin sensitivity and an increased risk of developing type 2 diabetes (further reading here)

Body fat in the trunk has been shown to have a greater effect on insulin sensitivity than fat in the extremities, but this refers to all body fat in the trunk, not just around the shoulder blade.

Poliquin then suggests that “controlling blood sugar levels of the body with more frequent meals, reduced daily carbohydrate and low GI [glycaemic index] food choices is critical.”

Low GI food choices do not influence weight loss anywhere near as much as energy restriction does, so it is implausible to suggest that this will lead to selective and preferential body fat reduction in the upper back.

Some may be fooled when their upper body skinfolds do, in fact, decrease.

But if there is a general decrease in body fat as a result of increased exercise and healthier eating, skinfolds will change all over the body.

It is not appropriate to assume that just because a person’s insulin levels decrease, and their skinfolds decrease, that there is a direct causal link between the two.

If you’re a trainer, memorise this: Correlation does NOT always mean cause and effect! Check out this site on spurious correlations and you’ll get a clear picture of what I mean.

BioSignature Modulation and supplementation

Poliquin also recommends supplements for spot reduction. He writes:

“For the fat stored around the shoulder blade… corosolic acid, alpha lipoic acid and fish oils may be prescribed to control insulin.”

We’ve already established that controlling insulin will not preferentially reduce body fat in the upper back.

But if it did, the evidence is preliminary at best.

Corosolic acid, for example, has been found to have an effect in mice, petri dishes, and some human trials, though many papers appear in alternative medicine journals, rather than more reputable titles.

And while early results in humans have shown some promise, with closer examination and better designed research, these early positive results tend to disappear.

In the meantime, though, you can very conveniently find a number of supplements in the Poliquin Group’s online store.

Scientific evidence for BioSignature Modulation?

So given the faulty logic and patchy evidence I’ve outlined so far, what is Poliquin’s evidence for his controversial spot reduction theory? In his own words:

“Biosignature Modulation is a scientific approach to [sic] spot reduction that I have developed over 20 years of performing blood, urine and saliva tests while working with world record holders, professional athletes in all the major sports, and Olympic medalists in sixteen different events.”

The problem with this is that research findings can only be reliably applied to the population upon which the testing was conducted.

So research conducted on elite level athletes can inform the training and nutrition of similar athletes, but not necessarily the rest of the population (i.e., your client trying to lose a few kilos of body fat).

Similarly, the differences between athletes and training methods of various sports and disciplines make it impossible to assume that research can be applied to all of them without a lot of follow-up research – research which, in this case, has not been done.

Another concern is that this type of evidence is generally described as “case studies.”

This is a nice way of saying “anecdote” – not the strongest form of research as you’ll see in the image below.

Evidence can come in many different forms, depending on what it is you are trying to test.

Case studies are generally considered pretty poor evidence, as it is impossible to control for other variables.

When someone loses weight, we need to consider not only diet and exercise factors, but also their psychological state, support from friends and family, the quality of their sleep, stress, and other factors that may change compliance to their healthy lifestyle habits.

Two case studies are not necessarily any better than one, because the factors influencing each may be completely different, meaning you can’t reliably compare the two.

Similarly, twenty case studies are not any better than two.

On the other hand, if you were to take these twenty people, put them on identical programs, and control other variables as much as you can, then we’re getting somewhere.

Poliquin didn’t do this though.

He tells us about a series of case studies on a unique population, doesn’t publicly provide the results, then applies his theory to the general population.

For BioSignature Modulation to have any scientific street cred, Poliquin would need to not only conduct strictly controlled studies but he would need to submit his results to reputable journals where they would undergo review by highly-qualified experts related to the subject matter (i.e., endocrinology).

After a series of revisions, a decision would be made on whether or not his research cut the mustard and is worthy of publication in a peer-reviewed medical journal.

Scope of Practice

All the aforementioned limitations of Poliquin’s ideas aside, there is another equally pressing concern: scope of practice.  

I know I addressed this briefly above, but it warrants further discussion here.

The BioSignature Modulation course required to become a practitioner of this method is marketed largely towards personal trainers.

And while there is a large variation in the experience and qualifications of different personal trainers, there is no doubt that the ability to assess a client’s hormone levels, and the interaction of these hormones with nutrition, sleep, stress, and exercise levels, is well outside their scope of practice.

This scope of practice is very clear on what a personal trainer is not qualified to deliver:

• Nutritional advice outside of basic health information and nationally endorsed nutritional standards and guidelines
• Therapeutic treatment or independent exercise prescription
• Independent exercise prescription for high risk clients
• Diagnostic tests or procedures
• Sports coaching
• Psychological counselling

Diagnostic assessments and prescribing nutritional supplements are outside the personal trainer’s scope of practice.

To operate outside this scope of practice is to risk being found legally liable for any injury or mishap that might occur as a result of your training or advice.

There are personal trainers with extra qualifications (such as exercise science degrees) who may be able to operate more broadly than this scope of practice, but any analysis of a person’s hormone levels needs to be performed by a licensed medical practitioner.

Not a personal trainer. Not a strength & conditioning coach. Not an exercise physiologist. Not a nutritionist. Not any number of professionals who may be concerned with the health and well-being of their clients.

An important part of any professional’s knowledge is the understanding of where the boundaries of this knowledge and expertise lie, and when they need to refer the client to a more appropriate health professional.

For this reason, I have largely avoided addressing the specific claims made about hormones and body fat distribution here, preferring to trust the opinions of those more qualified.

It’s important to note that if any of these claims turn out to be correct (that is, they repeatedly stand up to the scrutiny of the scientific community), it would be a game changer!

Take home message

You probably can lose fat from your trouble spots, but it may not happen in the order that you hoped!

There are no shortcuts, and it doesn’t look like any will emerge in the near future.

I would love to be able to tell a client: “yes, you CAN reduce body fat from the exact areas you want. It’s easy!” But I can’t.

Unfortunately, there are no shortcuts. It probably took years to accumulate that extra body fat and it may take months or years to lose it. Sorry!

The post BioSignature Modulation For Spot Reduction? Fat Chance appeared first on Dr Bill Sukala.