1.1 describe the factors that affect health and well-being
1.2 describe the current national healthy eating
1.3 state the current national physical activity
1.4 identify the health benefits of physical activity
1.5 describe how technology can be used to support the customer experience
1.6 describe how to communicate healthy lifestyle choices to clients
1.7 identify evidence-based/reputable sources of health and well-being advice
The potential to increase fitness is influenced by a number of modifiable and unmodifiable factors. Everybody can have the potential to increase fitness potential if exercise or activity is consistent, progressive in the training load and supported by healthy eating plan.
Factors affecting fitness potential:
1: Genetics (unmodifiable) – Individuals often cite poor genetics as a reason for a lack of performance or inability to get a response from training. A person’s genetics does describe the naturally occurring genetic differences among individuals within a population. Through the lens of evolution this does make perfect sense as variation within a species permits flexibility and survival of a population in the face of changing environmental circumstances.
Genetics may explain the differences between individuals who follow the exact same training programme, one may end up stronger or faster than the other. However, the normal difference between individuals who are fitter is not down having good parents but to the commitment and motivation to regular training and you cannot blame your genes for that.
2: Gender (unmodifiable) – There are obvious performance differences between male and female at elite level sport differences in performance. These can be explained by differences in anatomy and physiology.
Although the above may explain the differences in performance between males and females it is training and hard work that counts. Females can get very strong, run very fast and reach very high levels of performance which far outstrips males that do not do the same.
3: Age (unmodifiable) – over the age of 30 there a natural decline in all physical systems thus making it harder to do the things that could once be done easily when younger. In general, the effects of ageing include:
Regular exercise, however, has been proven to slow down the aging process allowing levels of strength and aerobic fitness to be maintained at good levels past the age of 50. Physically active elderly people have greater function capacity, independence, and a better quality of life.
4: Somatotype – Somatotype means ‘body type’ or the shape of your body. Developed by William Sheldon in 1954, somatotyping is a scoring system used to ascertain an individual’s body-type and psychological traits in relation to three set categories. Sheldon proposed three basic body types.
Ectomorph
Endomorph
Mesomorph
In recent year’s science researchers and exercise professionals have debated whether somatotypes actual exist as the original research by Sheldon considered psychological traits and body type. The fitness industry took it upon itself to rekindle the theory but without the psychological component. Today many people use their body type to justify why they are carting more fat or find it hard to gain muscle. Nothing beats hard training or effort, and everyone can change their appearance or fitness level.
5: Lifestyle factors (modifiable) – Negative lifestyle habits such as smoking, alcohol and drug use, consuming high processed foods and sedentary behaviour affect a person’s health and fitness. Smoking damages, the lungs, hardens the arterial walls of the heart and affects general circulation, alcohol causes damage to the heart, pancreas, and liver. The use of recreational drugs causes damage to brain cells and affects mood, body coordination and memory. A lack of exercise and poor diet causes obesity, heart disease and type 2 diabetes. All the above factors are modifiable given the right circumstances and level of motivation.
6: Nutritional (modifiable) – Nutritional fitness is related to the quality of foods consumed over a period of time. Poor nutrition can have a negative effect on our health and performance as you cannot be healthier than the food you eat. You need carbohydrates to give the body its energy source to exercise and protein to repair and recovery muscles after a hard session. Nutrition also needs to be properly timed to allow a) The energy to exercise in the first-place b) to aid a quick recovery and repair tissue after exercise has stopped.
Feeling tired and lethargic is not a good recipe for success and normally affects your level of motivation. If you are not motivated because you feel tired and lethargic you are less likely to want to work out and if you do work out, then the level expected and the ability to recover after exercise will not be sufficient
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7: Recovery (modifiable) – includes all factors that allow you to recover from exercise such as rest, sleep, nutrition, and hydration. Exercise is good for you but too much exercise with not enough recovery can affect your progress to the point that at best you lose motivation, and at worst you get injured. Recovery is important for growth and repair of tissues after exercise. Repeated exercise sessions without enough time to recovery can be profoundly serious as the lack of recovery eventually leads to a condition called ‘overtraining’. Symptoms include a loss of motivation, frequent colds, chronic fatigue, poor physical performance, and high injured tissues. Overtraining is normally associated with long distance athletes due the high volume of exercise needed to improve performance. Recovery from ‘overtraining’ can take months so it is not to be taken lightly. Although most clients are not athletes and therefore less likely a candidate for overtraining, proper sleep and good nutrition can make a significant difference to training and therefore progress.
8: Medical – Certain medical conditions will impair a person’s ability to gain higher levels of fitness. Examples include high blood pressure, obesity, and diabetes type 2. Physical impairments such as amputees will also affect the type of activities that can be undertaken. Medical and physical conditions do not stop a person from exercises, but fitness instructors must take note of current exercise guidelines for each condition.
9: Motivation (modifiable) – Arguably the biggest and most profound effect on health and fitness potential in both men and women is their level of motivation. The most motivated people on the planet are elite sports people. They strive and make sacrifices to train and live a life to reach their performance potential. No matter how good a person’s genes, it does not matter if you cannot dedicate with some level of consistency to getting fitter. A lack of motivation may be for many reasons and it is a major role of the fitness instructor or personal trainers explore and discover in client’s their likes/dislikes and find activities they enjoy that they can stick to and make a habitual.
10: Time (Modifiable) – In the fast paced 21st century time is at a premium and for most people the daily grind with families and work commitments can have a serious effect of a person’s fitness. Improving fitness level will be slow progress if you do not make the time to do it. Your body responds to stress and exercise (or any other physical activity for that matter) progressively over time resulting in your body’s physiological systems adapting. You cannot modify time, but you can choose what you want to do with it. From the fitness instructor’s point of view ask questions to explore whether the client’s lack of time is real or perceived? Use a time diary allowing the client to record what they do with their time. It is often the case that people are not good at managing their own health or do not have the motivation.
11: Supportive relationships (friends, family, professionals, improved self-esteem and self-worth). Having caring relationships is important to an individual’s emotional well-being. The way to develop supportive relationships is to be supportive to others. Spending time as much time as possible with people who have the qualities that support you and spending time away from individuals who do not have those qualities is the best route to developing supportive relationships.
Supportive relationships help reduce stress and improve an individual’s general health and well-being. The more people in an individual’s life it is more likely that they will have a supportive relationship with one of them. It is important to make time to develop and reinforce relationships by meeting up with them by going out and having fun with them.
12: Sleep, relaxation, and rest. Sleep, relaxation, and rest has a positive impact on well-being. Relaxation (e.g. through hobbies and sports) has an important role in developing a healthy lifestyle.
13: Stress –Chronic stress can hinder brain development and ability to learn or concentrate.
Stress releases stress hormones which trigger the ‘fight or flight’ response which keeps the body in a perpetual level of tension. Stress can cause the following health and well-being problems:
Physical
Intellectual
Emotional
Social
Behaviour
14: Substance misuse (prescribed, legal and illegal, solvents,tobacco, excessive alcohol intake) (cancer, high blood pressure, heart disease, obesity, cirrhosis of the liver, death)
There are health risks to individuals who take illegal drugs as they are not supervised by health professionals. There is also the danger of drug addiction which leads to long term damage to the individual’s body and the risk of being poisoned.
Misuse of any substance legal or illegal can have serious effects on an individual’s health and well – being and can lead to death.
15: Psoture. Studies from Harvard University also back up the link between posture and mental health. Preliminary findings indicate that keeping an upright posture can improve symptoms of depression, stress, and anxiety.
Posture can chronically impact your physical health and the thing is, it can get worse over time. Good posture is important for balance, and for maintaining correct form while exercising. When we have poor posture, it impacts form, which leads to more injuries. An injured muscle or limb can lead to us over-compensating somewhere else in the body, leading to further injury.
Sitting with poor posture (including having your legs crossed) impedes blood and oxygen flow through the body. This can fatigue you and make it more difficult to think and can also lead to issues such as spider veins.
We live in an age where information on any topic can be found at a ‘click’ of a ‘button’ or a swipe of a page. When asked therefore, most people will have some idea on what foods when regularly consumed lead to better health. Data from a recent UK Government National Food survey (2016) however, has revealed that the UK’s eating habits in the 21st century have changed markedly over the last 40 years.
The survey gathered information from around 150,000 households who took part in the survey from 1974-2000 and indicated that shoppers are now more aware of where their food comes from than ever before and the internet has brought quality produce to our doorsteps at the click of a button.
The change in eating habits means that fitness instructors must be fully aware of the driving factors, motivations, and lifestyle circumstances that their clients live their lives by to offer effective strategies in basic healthy eating advice.
The main changes to eating habits from the survey are summarised in the table below.
1: An advance in technology
2: Greater convenience
3: Spending habits
4: Health consciousness
Good nutrition is the basis of overall health and a dietary intake that is devoid of nutrition such as high alcohol, sugar, salt, and process food intake, increases the risk of a number of diseases and conditions.
These include:
Nutrients are essential for the maintenance of life and for growth. There are two main types of nutrients:
1: Macronutrients – three main categories of macronutrients include carbohydrate, protein, and fat and are needed by the body in large amounts
2: Micronutrients – needed in smaller amounts they are vitamins and minerals, and these are needed by cells to make.
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The Government recommends that all individuals should consume a diet that contains:
The ‘Eatwell Plate’ is an easy-to-understand pictorial representation of the proportion that different food groups should make to the diet. A typical man needs around 2,500kcal a day to maintain his weight. For a woman, that figure is around 2,000kcal a day. These values can vary depending on age, metabolism, and levels of physical activity.
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Introduction
Regular physical activity provides a range of physical and mental health benefits. These include reducing the risk of disease, managing existing conditions, and developing and maintaining physical and mental function.
In September 2019, the four Chief Medical Officers (CMOs) of England, Scotland, Wales, and Northern Ireland presents an update to the 2011 physical activity guidelines. The UK CMOs draw upon global evidence to present guidelines for different age groups, covering the volume, duration, frequency, and type of physical activity required across the life course to achieve health benefits.
The report underlines the importance of all age groups participating in a range of different activities. Considering the importance of strength for physical function, particularly later in life.
These new guidelines have been presented, following a life course approach with a separate chapter for the age groups covered in the report: Under-5s, Children and Young people (5-18 years), Adults (19-64 years), and Older Adults (65+). Each chapter includes an introduction, sets out the guidelines for that age group, summarises the evidence to support the new guidelines, and outlines any changes made since 2011.
Under-5s
The Under-5s age group encompasses a very wide range of developmental stages and physical capabilities. These new guidelines for the Under 5s follow the approach taken in the 2011 guidelines of considering three distinct developmental stages and age groups: infants (less than 1 year); toddlers (1-2 years); and pre-schoolers (3-4 years).
The evidence-based on physical activity in the Under-5s has expanded substantially since the development of the previous set of guidelines. There is now a large body of evidence that the amount of physical activity in the Under-5 period influences a wide range of both short-term and long-term health and developmental outcomes. For example, low levels of physical activity have been recognised as a contributor to increasing rates of child obesity in this age group (15, 16). It has become very clear that higher levels of physical activity are better for health, and lower levels worse, and that there are benefits to increasing levels of physical activity across the distribution of starting physical activity level.
Physical activity guidelines for Under-5s
Infants (less than 1 year):
NB: Tummy time may be unfamiliar to babies at first, but can be increased gradually, starting from a minute or two at a time as the baby becomes used to it. Babies should not sleep on their tummies
Toddlers (1-2 years):
Pre-schoolers (3-4 years):
Physical activity, in the Under 5s should not be viewed in isolation, but more as a continuum into older childhood and adolescence. There is increasing evidence for the benefits of adequate physical activity and sleep and the risks of some sedentary behaviour in school-age children and adolescents.
Levels of these behaviours in the pre-school period are closely related to later levels in school-age children and sedentary behaviour increases from the age of school entry which then displaces physical activity and/or sleep.
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Children and Young People
The physical activity guidelines for children and young people are relevant to those aged from 5 to 18 years. Physical activity is associated with better physiological, psychological, and psychosocial health among children and young people (23, 24). Global and UK-specific evidence has shown that boys are more active than girls at all ages and that physical activity levels decline through childhood into adolescence. There is also some evidence to suggest that physical activity levels track from childhood into adulthood. As such, ensuring that all children are as active as possible throughout childhood is important for current and future population health.
Physical activity guidelines for Children and young people (5-18 years of age):
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Adults (aged 19-65)
Regular physical activity is associated with decreased mortality and lower morbidity from several non-communicable diseases (34). Adults who are physically active report more positive mental and physical health. The new guidelines and infographics developed for disabled adults and for pregnant and post-partum women within this age group. This can be found in the link provided.
Physical activity guidelines for Adults (aged 19-65)
Muscle strengthening activities should be done twice a week, but any strengthening activity is better than none.
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Older Adults (65+ years)
Regular physical activity contributes to the key determinants of healthy ageing: good physical and mental function; opportunities for social interaction; a sense of control over, and responsibility for one’s own health and well-being; and managing or coping with disease symptoms and functional limitations (51, 52). There is now also emerging evidence that increasing physical activity contributes to improving social functioning and reducing loneliness and social isolation.
Although age alone does not determine physical condition or capacity, older age (65 years and over) is associated with a greater risk and prevalence of many health conditions including coronary heart disease, stroke, type 2 diabetes, cancer, and obesity, as well as depression and dementia. Older adults are also at greater risk of falling, often resulting in the avoidance of activity, and consequent fractures and impairments.
There is strong evidence that physical activity contributes to increased physical function, reduced impairment, independent living, and improved quality of life in both healthy and frail older adults. Physical activity in later life can help treat and offset the symptoms of a range of chronic conditions (e.g., depression, CVD, Parkinson’s disease).
Physical activity guidelines for Older Adults
These could be combined with sessions involving moderate aerobic activity or could be additional sessions aimed at these components of fitness.
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The health benefits of physical activity
Physical activity was recognised as early as the 4th and 5th centuries BC (By the Greek Physicians) to benefit heath. Over the last 150 years however, physical activity levels have been decreasing, which parallels the rise in technology and automation. Sedentary jobs have increased 83% since 1950 and physically active jobs now make up less than 20% of our workforce.
Rising levels of physical inactivity have been without cost, the affect has been on our society health with a rise in chronic diseases such as heart disease, obesity, osteoporosis, cancer, and type 2 diabetes. What is alarming being that over the last twenty years the obesity and type 2 diabetes has skyrocketed in childhood.
People who are physically active are at lower risk of cardiovascular disease (CVD). To produce the maximum benefit, exercise needs to be regular and aerobic. This should involve the use of the major large muscle groups steadily and rhythmically, so that heart rate and breathing increase significantly.
Physical Activity Statistics 2015 report, British Heart Foundation.
It has been proven that regular physical activity using large muscle groups, such as walking, running, or swimming, produces cardiovascular adaptations that increase exercise capacity, endurance, and skeletal muscle strength. Habitual physical activity has many positive health benefits to include:
1: Reduced all-cause mortality – All of the deaths that occur in a population, regardless of the cause.
2: Weight management – regular physical activity and exercise will elevate basal metabolic rate (burn energy/calories more efficiently) helping to maintain a normal bodyweight thus reducing the risk of obesity and type 2 diabetes.
3: Improved blood cholesterol levels – More HDL (high density lipoprotein), which help to prevent LDL (low density lipoprotein accumulating on the artery walls (atherosclerosis) reducing the risk of Coronary Heart Disease (heart attacks, angina).
4: Normalised blood pressure – Stronger heart muscle, which is able to pump more blood (stroke volume and cardiac output) with less effort (lower heart rate) thus reducing resistance in arteries so that blood can flow more freely reducing the likelihood of hypertension
5: Improved stress management – stress has a negative effect on health. Exercise can have a positive effect on the hormones associated with stress. Exercise all releases feel good chemicals called endorphins.
6: Management of blood sugar levels – exercise makes your body more sensitive to insulin and can lower blood, consequently there is a reduced risk of type 2 diabetes.
7: Reduced risk of osteoporosis – Weight bearing cardiovascular activities such as running will also promote strong and healthy bones.
8: Improved brain function and mental health – Regular physical activity has a positive effect on brain development and function. It stimulates the development of new brain cells and releases feel good chemicals called endorphins thus improving your mood and how you feel about yourself. Exercise has been proven to positively affect people suffering from depression.
9: Prevents some types of cancer – there is lots of evidence that it can also reduce the risk of developing breast, bowel, and womb cancer. Keeping active could help to prevent around 3,400 cases of cancer every year in the UK.
Inactivity is an independent risk factor for CHD meaning that it increases a person’s risk regardless of other risk factors such as smoking and BMI.
According to the World Health Organisation ‘health’ can be defined as
‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’.
The fitness technology market is a growing industry, investing into the everyday lives of users. This growth has seen the introduction of devices that can be used in develop fitness, health, and well-being programmes.
Fitness technology includes everything from digital scales that can check your body fat, lean muscle, weight-loss apps, wearables, footwear with built-in running sensors etc
The benefits of the use of technology within fitness industry for supporting the customer experience include:
Some of these fitness tech devices will help you come up with a good plan for your regular fitness program. With the fitness watch, you can set aside the number of calories you intend to burn on a particular date. You can also set targets with other devices like the step counter. Coming up with the right plan is essential in ensuring you meet your daily goals.
Technology can contribute to the motivation needed to carry on with an exercise programme or routine. Looking at these devices during the workout sessions gives the user the desire to carry on so that you may achieve their target creating consistency.
You can keep track of the condition of your health with some of these devices. Keeping track of your body status will help you work hard to ensure you are fit all the time. You should take immediate measures after using such devices.
Technology is playing a more significant part in peoples fitness routines. A recent industry stated than more than three-quarters (77 per cent) of 18-24-year-olds use technology as part of their fitness routine’.
As the health and fitness industry continues to embrace new technologies, the convenience that technology can offer is incomparable. Personal trainers must get on board or fall behind.
According to the Statista Research Department, the estimated market growth of health apps and wearable devices in the United Kingdom (UK) in 2020 is worth approximately 460 million British pounds by the end of 2020.
Wearables are simply defined as “electronic technologies or computers that are incorporated into items of clothing and accessories which can comfortably be worn on the body.
Providing you with real-time data, wearable fitness trackers are able to track and monitor your daily progress, be it heart rate, calories burnt, pace and distance of your run, all types of data will be a beneficial piece of information. Information that gives meaningful insight into your current and past performance and helps guiding your workouts in the right way.
Today, wearable trackers are all-in-one devices designed to be worn throughout the day and usually synched with a computer and smartphone. Its significant benefit of wearables is they can motivate people to get more active by recording real-time data.
Typically, wearable technology includes the following features:
A relatively recent review on this issue reported that use of pedometers is associated with significant increases in physical activity (Bravata et al., 2007). Moreover, it was found that using a pedometer was linked to decreases in body mass index and blood pressure. Nevertheless, it was noted in this review that whether these favourable health changes persist long-term remains unknown.
Heart-rate monitors can be used to estimate energy expenditure because of the significant relationship that exists between the two. Accordingly, these devices can predict the energy expenditure associated with various durations, intensities, and frequencies of physical activity.
The future is particularly exciting for exercise professionals embracing modern technology and work practices and adapting to different training environments, changing social behaviours or broader global events, such as the 2020 Coronavirus pandemic.
To keep clients motivated and on track, it is useful to schedule occasional check-ins. Check-ins can take place over text, email, and phone call. However, it’s essential to be personable to maintain the trainer and client relationship, so use video conferencing services like ZOOM, Facetime or Skype.
Check-ins allows the trainer to discuss the client’s progress, any difficulties experienced by the client and offer tips and advice to improve. The client can ask their trainer questions about their workouts, exercise techniques or nutrition program.
Post consultation trainers can use the information provided by the client to develop a personalised plan. The next questions are how long the fitness plan should last? Typical online fitness plans can vary from a couple of weeks to 12 months. However, trainers should continuously be changing aspect of a fitness plan as clients progress. The client’s fitness plan can take the form of the following three options:
Client’s must have a method to log their workouts to track progress. Tracking progress is essential to help trainers adapt the current fitness plan or develop the next program. The benefit to the client is that they decide on the level of interaction.
Website-calorie and nutritional interventions and trackers have been shown to be effective in that they provide a solution to many of the traditional barriers to nutrition and exercise, including lack of time, knowledge, or money.
MyFitnessPal is a smartphone app and website that tracks diet and exercise. The app uses gamification elements to motivate users. To track nutrients, users can either scan the barcodes of various food items or manually find them in the app’s large pre-existing database.
Clients can log on to online classes and sessions in the comforts of their own homes using different platforms like Zoom, Skype and even YouTube, where live workouts can be undertaken.
Services like Peloton, Gaia and Class Pass have made it possible to enjoy almost everything that comes with a group workout in the comfort of your home. These virtual workout class services allow you to either join in for a live class or stream on-demand.
These services are making studio workout classes more widely accessible, increasing the efficiency and effectiveness of your workouts as they are instructor-led. Their lower cost, time, and location convenience, leads to an increased audience creating a positive impact on your motivation focus. As a result of being virtually surrounded by people, you will push harder than on your own.
Finally, the subscription model of these streaming services might also increase your motivation to train more frequently. Simply because more workouts mean lower costs per class, which should sound like a good deal to everyone.
The app store today, is loaded with various health fitness and wellness tools, changing our attitude towards different services in the health & fitness, making them more accessible and affordable for everyone.
But with the introduction of mobile apps that specialize in virtual training, you can train with an instructor whenever and wherever you want to completely free of charge.
The main advantage of these fitness apps is the overcoming of barriers of traditional personal training services. Applications now offer workouts with video and audio coaching by professional instructors.
And even the ones that are not free only ask for a small fraction of what a personal trainer would normally cost you. So, on one hand, these apps make personal training accessible for those who could not afford it previously and on the other, the usage of the app does not have any time or location constraints.
This means that you no longer have to spend time trying to sync yours and your trainer’s schedules. Or sit an hour in traffic travelling back and forth from the gym. Hence, these applications also make personal training more accessible for the time-poor audience.
Besides accessibility, there is also a positive influence on training frequency and precision.
Health and Fitness video games such as the Wii Fit, Zumba Burn It Up, Fitness Boxing etc allows for its players to physically interact whole-body movements with images onscreen in a variety of activities and sports, including boxing, dancing, tennis, skiing, soccer and walking.
Research has focused on how these types of health and fitness video games can be used to increase energy expenditure and improve various components of fitness.
In general, studies have shown that active video games can be employed to increase daily energy expenditure levels (Primack et al., 2012). One study of middle-age and older adults concluded that playing Wii Fit video games is a feasible alternative to more traditional aerobic exercise, and that doing so meets industry guidelines for improving and maintaining cardiorespiratory fitness (Guderian et al., 2010).
Research in children has also been shown to positively modify body composition (Foley and Maddison, 2010), and it has also been reported that Wii Fit video games can be used to safely improve balance in older adults (Agmon et al., 2011).
Smart fitness equipment can be used for various workouts and adjust to meet the level of intensity you need in a specific exercise. They provide a real time analysis into workouts and updates on the status of the machines is the type of cutting-edge technology this trend can provide your gym.
For a fitness facility, this can increase your client retention rates boosting their profile within the community. For the member, this provides a motivational tool, allowing them to track their progress set new goals, working harder, and staying consistent with the fitness routine.
Social media channels have now developed into social support systems, providing both gym and non-gym users with a community, where everyone is able to motivate and inspire one another. By posting picture and videos of their progress online, the community can support and encourage one another building confidence and staying committed and motivated towards achieving their fitness goals.
Sharing important insights and experiences from their fitness journey allows them to interact with like-minded people. Social media community also enables gym owners to connect to clients, other fitness professionals and communities.
Unhealthy lifestyle choices such as drinking, smoking and poor diet are significant and preventable causes of long-term conditions.
Low physical activity is the most prevalent risk factor for long-term conditions, with 95% of the adult population not meeting the recommended minimum 30 minutes of moderate-intensity physical activity five or more days a week (Troiano et al, 2008).
Physical inactivity is the 4th leading risk factor for global mortality accounting for 6% of deaths globally. People who have a physically active lifestyle have a 20-35% lower risk of cardiovascular disease, coronary heart disease and stroke compared to those who have a sedentary lifestyle.
Fitness professionals are well placed to encourage and support clients to make healthy lifestyle choices. Through good communication, collaboration and goal setting, behaviour change is possible to the development of health behaviours.
In a client -centred model, the client has an equal voice in the planning of their care and the client’s opinions are respected. The same approach should also be taken by fitness instructors to ensure the needs of the client are met and service delivery is successful. The foundation to a client-centred model is forming an effective relationship with patients.
There are four core principles of the client -centred approach:
A client -centred approach increases exercise participation as services are built on the needs and preferences of the patient rather than the service providers.
Adopting a client -centred approach has been shown to improve a range of factors, including:
The client-centred approach into practice
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Behaviour can be defined as the way in which a person behaves in response to a particular situation or stimulus. The term ‘health’ is a state of being free from illness or injury. It stands to reason that to be free from disease, illness or injury, people must engage in activities that have a positive effect on health.
Health behaviour can therefore be defined as behaving and actions an individual takes in a manner to be free from disease, illness, and injury.
Health behaviours include:
In the UK, a large majority of the population are still adopting unhealthy behaviours, even in the face of non-communicable diseases such as heart disease and diabetes. What determines behaviour and more importantly, unhealthy behaviour? The roots of a person’s behaviour could include:
Lifestyle choices can be influenced by advertising (e.g., magazines and billboards prompting specific ‘diets’ or ‘food choices’) and experiences of the individual (e.g., an individual may start using a behaviour such as comfort eating or using alcohol, with the belief that this will help them to cope and manage).
Behaviour change refers to the transformation of a person’s conduct and activities. In the context of health and fitness, the focus is on people’s behaviour change in relation to exercise or physical activity and healthy eating.
The fitness instructor has an important role to play by using techniques or interventions that have been specifically designed to change behaviour. There are many models of behavioural change that practitioners use to try and understand the process of current behaviour and how an individual changes from one behavioural state to another. Some of the most common models are:
The transtheoretical model, perhaps better known as the “stages of change” model, suggests that individuals modify their behaviour through a series of five distinct stages from pre-contemplation to maintenance (Prochaska et al, 1992). Some people move through the stages, but most will relapse and return to earlier stages. This pattern is repeated until behaviour change attempts are successful or unsuccessful.
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The diagram below shows each stage of change:
According to the transtheoretical model, effective behaviour change interventions need to be tailored to the stage of the individual. Action-oriented interventions are unlikely to produce successful outcomes in people who are in the pre-contemplation stage and have not yet acknowledged the need to change.
The goal for the fitness instructor is to provide the information and support needed to facilitate informed decision-making around health-related behaviours. Helping clients to recognise the need to change will increase self-motivation and the likelihood of sustained change.
Motivational interviewing (MI) is a therapeutic modality that has its origins in counselling for alcohol abuse. Motivational interviewing is a non-confrontational way of raising the topic of lifestyle, so overcomes at least one of the potential barriers to such discussions.
MI can also be used in behaviour change for obese or inactive clients. MI is a person-centred, goal-directed approach that works through the client’s intrinsic motivation for committing to behaviour change. It involves working through the client’s hesitancy towards behaviour change.
The fitness instructor is in a prime position to have a meaningful and motivating conversation about client-specific goals. MI is a client-centred approach with the following core principles:
Empathic and reflective listening are central to MI. The acronym ‘OARS’ describes core elements of MI:
O – Ask open questions
A – Affirm the client’s perspective
R – Reflect what was heard to ensure understanding
S – Summarise shared understanding to set specific goals
The underlying principle is that clients are the experts on their own lives and are generally better persuaded by their own reasons for changing behaviour than by others’.
This technique identifies how important the change is and the discrepancy between clients’ current situation and where they want to be. Highlighting this discrepancy is at the core of motivating people to change.
STEP 1: USE “CHANGE TALK”
Sample questions: On a scale from zero to 10, how important is it for you to lose weight? Where would you be on this scale? Why are you at ____ and not zero? What would it take for you to go from ____ to (a higher number)?
STEP 2: BUILD CONFIDENCE IN THE ABILITY TO CHANGE
Sample questions: On a scale from zero to 10, how confident are you that you can increase the number of days you exercise? Where would you be on this scale? Why are you at ____ and not 10? What would it take for you to go from ___ to (a higher number)?
STEP 3: CHOOSE A CHANGE PLAN TOGETHER
Sample summary statement: It sounds like you do not want things to stay the same. We need to answer these questions:
Source: Hall, Gibbie & Lubman 2012.
When clients are motivated and ready to change an unhealthy behaviour, evidence-based techniques can be used to help them to achieve their desired outcome. Of primary concern should be the client’s self-efficacy (Bandura, 1989), as this can influence both the initiation and maintenance of behaviour change.
Self-efficacy refers to confidence in one’s ability to achieve the desired behaviour change. Evidence suggests that individuals high in self-efficacy are more resilient when confronted by barriers or relapse. Someone with low self-efficacy, on the other hand, is more likely to give up after a setback.
Goal setting is the most effective method of working towards increased self-efficacy (Knols et al, 2010). Importantly, goals need to be realistic and achievable, as well as set by the client, not the instructor.
Fitness instructors can, however, guide the process by promoting achievable goals, such as moderate rather than vigorous physical activity, or 10 minutes of exercise three times throughout the day when 20 minutes in one go may seem too much. Realistic goal setting is particularly important at the beginning of an attempt to change behaviour as this is when failure is more likely to reduce motivation.
According to Bandura (1989), self-efficacy can be enhanced in four ways:
Ashford et al (2010) suggest three strategies to enhance patient self-efficacy through goal setting and achievement:
These strategies can be combined so that clients are helped to set realistic goals that can be achieved via a written action plan with time limits, instructions, and a reward system. It is important that goals are measurable, so that it is clear when they have been achieved.
An example of a measurable goal is to achieve 20 minutes of walking three days a week. Efforts to achieve this goal could be rewarded with words of encouragement, while achieving the goal could be self-rewarded with, for example, a new dress or a meal out with friends.
Regular physical activity is also associated with a reduced risk of diabetes, obesity, osteoporosis, and colon/breast cancer and with improved mental health. In older adults’ physical activity is associated with increased functional capacities.
Regular physical activity provides a range of physical and mental health, and social benefits, many of which are increasing issues for individuals, communities, and society. These include:
Regular exercise and physical activity may:
Regular physical activity offers numerous physical and mental benefits for older adults, including slowing the aging process, promoting psychological and cognitive well-being, managing many chronic diseases, reducing the risk of physical disability, increasing longevity and greater functional independence.
Health and fitness professionals can play an essential role in helping older adults minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy. Ideally, exercise programs for older adults should include aerobic exercise, muscle-strengthening exercises, and flexibility exercises.
Individuals who struggle with mobility impairment or are at risk for falling should perform specific exercises to improve balance in addition to the other components of health-related physical fitness. The important thing to remember is that it is possible to improve the ability to exercise at any age.
Physical activity is also an opportunity for social engagement, especially for the elderly. Therefore, unless programs also attempt to increase socialisation and enjoyment, it is unlikely that older people will continue to participate in what should be a regular part of their lifestyles. Additionally, health and fitness professionals working with older adults should emphasize that the process of being active is more important than the product of being fit.
Antenatal – Just because you are pregnant does not usually mean that you should stop any physical activity. Equally, it does not usually mean that you cannot start physical activity. For most women, it is important to do some regular physical activity during pregnancy as part of living a healthy lifestyle.
In most cases, moderate physical activity during pregnancy is safe. It can have benefits for both mother and baby and should not harm either of you. However, you do need to be sensible about what type of physical activity you do.
The aim of physical activity during pregnancy is that you can maintain a good fitness level throughout your pregnancy, rather than aiming for your peak fitness.
The benefits of physical activity during pregnancy include:
Post Natal– Regular physical activity after your baby is born can have a number of benefits. Regular physical activity in the postpartum period (up to one year) include:
Advise physical activity and a healthy lifestyle for antenatal and postnatal clients
Antenatal and Postnatal clients should aim, to do a mixture of both aerobic physical activity and muscle-strengthening physical activity.
Postnatal clients If you are breast-feeding should continue doing moderate exercise (the 30 minutes of moderate-intensity exercise as described above), this should not reduce the quantity or the quality of your breast milk or have any knock-on effects on your baby.
It is generally advised to start walking, doing pelvic floor exercises, and stretching immediately after birth provided that you have had a normal vaginal delivery with no complications.
Postnatal clients should gradually increase your physical activity to build up to their re-pregnancy levels. If you have had a caesarean section, you should ask your doctor or midwife to advise you about when it is safe for you to start physical activity. In general, it is not usually recommended to start until after your postnatal check at 6-8 weeks.
Daily active play and physical activity have traditionally been an important part of life for children and adolescents. Today, computers and social media have decreased the need and desire for children to move and play. This is the requirement of all instructors in the delivery of effective sessions with young people.
Participation in physical activity decreases with age, and the decline is greater in girls than boys. The challenges associated with getting kids active every day should be met with age-appropriate physical activities, enthusiastic leadership, and support from family and friends.
Regular participation in different types of physical activity is essential for healthy growth and development. Evidence shows that physical activity can have a beneficial effect on body composition, cholesterol, blood pressure, blood sugar, aerobic fitness, muscular strength, movement skills, and bone health. Regular physical activity can also improve academic performance and promote feelings of wellbeing.
The positive lifestyle behaviours such as participating in daily physical activity that begin during childhood and adolescence tend to carry over into adulthood. In the long run, daily participation in outdoor games, fitness activities and recreational sports will help to improve the health and well-being of all children and adolescents.
Activities for children and adolescents should be varied, developmentally appropriate, and enjoyable. Examples of aerobic activities include cycling or bike riding, walking, running, field games (football, basketball, volleyball, hockey, rugby), roller blading, dancing, and swimming. Note that there is little need for healthy children and adolescents to monitor their heart rate during the activity period.
Children and adolescents should also participate in activities that promote muscle strength on two or three days per week. Examples of activities for young children include climbing, jumping, tumbling and gymnastics, and a variety of games.
Older children and adolescents can participate in supervised strength training programs provided the focus is on developing proper exercise technique. Good form and mechanics should be stressed. Examples of appropriate activities include body weight calisthenics (i.e., push-ups, pull-ups), rock wall climbing, obstacle courses and strength exercises with dumbbells, medicine balls and resistance bands.
Traditional games and fitness activities that require participants to run fast, jump high, change direction, or maintain balance can develop and reinforce needed movement skills. Jumping rope, animal races, trail running, scavenger hunts and hop-scotch can get youth moving in fun activities. Participation in more than one sport or activity provides the child with skills that can be applied to others.
Sedentary activity is a strong contributor to overweight and low physical fitness. Sedentary activities such as television viewing, computer and telephone use, and inactive video games should be limited to < 2 hours per day.
You can access excellent information to improve your knowledge online, but make sure the source is credible. Examples include:
PTontheNet – PTontheNet is the most comprehensive resource for fitness professional education and development providing unlimited education alongside low cost/high quality CECs.
The National Strength and Conditioning Association (NSCA) – Founded in 1978, The National Strength and Conditioning Association (NSCA) is a non-profit association dedicated to advancing the strength and conditioning and related sport science professions around the world.
The NSCA exists to empower a community of professionals to maximize their impact through disseminating evidence-based knowledge and its practical application by offering industry-leading certifications, research journals, career development services, networking opportunities, and continuing education. The NSCA community is composed of more than 60,000 members and certified professionals throughout the world who further industry standards as researchers, educators, strength and conditioning coaches, performance and sport scientists, personal trainers, tactical professionals, and other related roles.
National Institute of Health and Care Excellence (NICE) – We provide national guidance and advice to improve health and social care.
The (NICE) guidance, advice, quality standards and information services for health, public health and social care. Contains resources to help maximise use of evidence and guidance.
NHS website – is the UK’s biggest health website, with more than 50 million visits every month. The NHS website is taking an active role in making data available to the public and those interested in improving the NHS. We are committed to ensuring relevant datasets are made available for further use and analysis once they have been published on the site.
Google Scholar: Google Scholar is a freely accessible web search enginethat indexes the full text or metadataof scholarly literature across an array of publishing formats and disciplines. Released in beta in November 2004, the Google Scholar index includes most peer-reviewed online academic journals and books, conference papers, theses and dissertations, preprints, abstracts, technical reports, and other scholarly literature, including court opinions and patents.
Journals can be accessed online and provide expert insight into specific areas of study. Always make sure the source is reputable ‒ some examples include:
American College of Sports Medicine (ACSM) – The American College of Sports Medicine advances and integrates scientific research to provide educational and practical applications of exercise science and sports medicine.
With more than 50,000 members and certified professionals strong from 90 countries around the globe. Representing 70 occupations within the sports medicine field, ACSM is the only organization that offers a 360-degree view of the profession.
From academicians to students and from personal trainers to physicians, our association of sports medicine, exercise science, and health and fitness professionals is dedicated to helping people worldwide live longer, healthier lives.
The Nutrition Society – The Nutrition Society was established in 1941 and is dedicated to delivering its mission of advancing the scientific study of nutrition and its application to the maintenance of human and animal health.
Highly regarded by the scientific community, the Society is one of the largest learned societies for nutrition in the world. Membership is worldwide with a majority of members living in UK and Europe.
Nutrition Journal: publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered.
British Journal of Sports Medicine: (BJSM) is a multimedia portal for authoritative original research, systematic reviews, consensus statements and debate in sport and exercise medicine (SEM). The BJSM are ranked number 1 in the field of sports sciences, affiliated with 25 sports medicine and physiotherapy societies globally, including the American Medical Society for Sports Medicine and the Canadian Academy of Sport and Exercise Medicine.
International Journal of Sport Nutrition and Exercise Metabolism: publishes original scientific investigations and scholarly reviews offering new insights into sport nutrition and exercise metabolism, as well as articles focusing on the application of the principles of biochemistry, physiology, and nutrition to sport and exercise. The journal also offers editorials, digests of related articles from other fields, research notes, and reviews of books, videos, and other media releases.
International Journal of Obesity: The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical, and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological, and epidemiological aspects of obesity and related disorders.
They publish a range of content types including original research articles, technical reports, reviews, correspondence, and brief communications that elaborate on significant advances in the field and cover topical issues.
Medicine & Science in Sports & Exercise– Medicine & Science in Sports & Exercise is a monthly peer-reviewed medical journal covering research in sports and exercise science. It was established in 1969 and is published by Lippincott Williams & Wilkins on behalf of the American College of Sports Medicine.