Start Your Successful Career as a NESTA Certified Personal Fitness Trainer by John Keats

emotions

CHRISTA PEPPER

125lb

PUBLISHED BY

transformation

INTRODUCTION PUBLISHING TEAM

NESTA and Spencer Institute Scott Gaines Mark Teahan Michelle Adams Suzan Askins Elizabeth Carter Aishwarya Kumbhojkar

Contact: nestanews@nestacertified.com

Personal Trainer Magazine was created with you in mind. You love fitness. You feel rewarded when you help your clients reach their goals. You love the active lifestyle. And, you realize you can and deserve to make a great living while helping people add value to their lives. For these reasons, PTM brings you the perfect combination of science, application, business and personal development skills. Regardless of your niche in the fitness industry, you will find effective and easy-to-understand methods for enhancing the lives of others while you are personally fulfilled.

We welcome your comments, questions and critique of PTM. This is your magazine. If you want to see something featured, please let us know. If you’d like to contribute, our editorial department would like to hear from you.

CONTENT CONTENT

4-5 The Proper Mindset for Weight Loss

6-7 Coaching Clients with Misaligned Weight Goals 9-12 Christa Pepper 16-18 Why the Gut Microbiome is Crucial for Our Health 20-22 Where Do I Start? What You Need to Consider When Working With overweight Clients 24-25 The Benefits of Journaling for Your Health and Wellness 26-31 The Impact of Obesity on the Cardiovascular System 32-33 Eating Evolution: How We Came to Eat as We Do 35-37 The Connection Between Weight and Diabetes 38-40 Gout: Knowing the Signs and Prevention 41-43 Why Your Mental Health Matters: How Your Emotions are impacting your Weightloss 44-45 When to Refer Clients

THE PROPER MINDSET FOR WEIGHT LOSS By Scott Gaines

In my 25 years as a fitness professional, I’ve seen plenty of theories, plans, guidelines, and overall “solutions” for weight loss. I’m guessing that if you’re reading this article, you’ve seen much of the same. Whether the focus is on exercise or diet or some combination of both, these so-called solutions can usually be grouped into two categories. 1. QUANTITY: The first category is the “calories-in/caloriesout” model, which proposes that if you simply burn more calories than you take in, either by increasing your caloric expenditure through exercise and/or decreasing your caloric intake through diet, you will lose weight. This model comes down to simple math (caloric expenditure - caloric intake = caloric deficit). One will typically find this to be the dominant model in most cookie-cutter diet and exercise plans. It is simple and easy to understand (but not necessarily easy to follow). 2. QUALITY: The second category sees the first as being overly simplistic. Advocates in the second category typically admit you must burn more calories than you take in, but in their eyes, it is much more complicated than that. In this model, you also worry about the type of calories you are taking in. For those who are old enough to remember, at one time, the dominant view was to decrease fat and increase carbohydrates. Then, seemingly overnight, it switched, and carbohydrates were “bad.” Of course, in this category, you can throw in all the typical diet trends (e.g., keto, paleo, Mediterranean diet, intermittent fasting, etc.). Again, advocates of diets in this category see the first model as too simple and point out that we need to worry NOMADIC

about the individual’s overall metabolism. In this view, rather than just being concerned about calories, we need to focus on how diet affects overall health and performance. In many ways, I see the value in both viewpoints. I agree with many fitness professionals who fall into the second category because we need to be concerned with the quality of food we take in. However, I also have seen how it can be easy to get “lost in the details” and forget that if you want to lose weight, you have to burn off more calories than you take in. So, which is it? Should we stress quality or quantity with our clients? Well, the answer might be both AND neither. As a fitness professional, you need to be well-educated in the most up-to-date scientific theories on weight loss. More importantly, you need to communicate it successfully with your clients so that they can implement these changes into their lifestyles. However, while the plan's structure is essential, its success primarily depends on the client's proper mindset. The REAL Reason for Wanting to Lose Weight If an individual wants to lose weight, there is obviously a reason for this goal. In an initial assessment, trainers will often ask clients their fitness goals, with the common response of “I want to lose weight.” If the trainer stops the inquiry there, they do the client a disservice. Good trainers will ask questions to dig a bit deeper. The client might respond they may simply want to feel better about themselves or get in shape for a particular event coming up (e.g., a wedding, vacation, etc.). These details are essential for the trainer, especially if there is a time limit to meet their goal. However, I would argue that we need to go deeper than that. The underlying reason people often want to lose weight is often accompanied by an unsatisfied desire that has plagued them. While it is essential to stay within our professional boundaries (we are fitness professionals, not psychiatrists, psychologists, counselors, etc.), in order to help the client make lifestyle changes, we need to be able to get the client to acknowledge why losing weight is important to them. WHY is feeling better important to them? WHY is it important that they lose weight before vacation. Consider the following exchange: Trainer: “Why do you want to workout? What is your main goal?” Client: "I want to lose weight." *NOTE: As mentioned above, many fitness professionals will

stop here and, in doing so, do themselves AND their clients a disservice. Trainer: “Why do you want to lose weight?” Client: “I have a reunion coming up.” *NOTE: This is much better. The trainer now has more information, including the fact that there will be a certain time limit to meet the client’s goal. That said, the question still remains, “WHY is this important to the client?” Trainer: “Please let me know why this is important to you.” Client: “I want to be seen well by my former classmates.” Notice that the trainer is now getting closer to the underlying, implicit goals of the client. Having the client verbalize and share these goals not only informs the trainer but also forces the client to organize and clearly articulate what had previously been unconscious thoughts. This process helps clients better understand their own goals and allows them to place value on that goal mentally. The Proper Mindset for Positive Lifestyle Changes There are 168 hours in a week. A trainer will work with a client only a handful of times in that timespan. Why a client may workout with their trainer an hour- 5 days a week, the trainer must remember that they are still their client the other 163 hours of the week. The trainer must be able to tap into the client’s implicit goals to encourage them to make positive lifestyle changes. Lifestyle changes are often difficult and unpleasant, requiring continuous effort. The process is not about perfection; it is about progress. Both the client and the trainer need to remember that.

Scott Gaines, Ph.D, Senior Vice President, and NESTA ECB Liaison

COACHING CLIENTS WITH MISALIGNED WEIGHT GOALS By Mark Teahan

With time and experience coaching, I have learned that the initial step in the coaching process is to establish a trusting relationship with the client, so they can freely and openly discuss their hopes and dreams. We use this vital early coaching session time with our client to build rapport, and make them feel a sense of safety to explore new thinking and behaviors. How do we do this if we have a reluctant or resistant client? What if our client is angry or frustrated with their life, but they feel they really don’t want to make the changes being put out for consideration. Lose weight, sleep better, and eat better. Getting our client to turn away from what the OUGHT-SELF would do. This list is endless. But how can we let our client proceed to make changes if they are undertaken for someone else? How would we even know if this was the case? Our client may say things like “Well, I know I really should lose some weight, my wife thinks I’m too heavy”. It sounds like a plausible situation. But is this client losing for him or his wife? Weight is probably the number one “ought-self” behavior.

But there are others. How about the coach that pressures a teenaged athlete to control her weight to a point where the participant (your client), is not motivated and has a lot of ambivalence regarding changes to eating for better performance. Is the athlete/client trying to manage her weight for herself, her coach, or her game? It can get convoluted! The best practice here is to ensure two things to prevent an “oughtself” intervention:

1. Client self-esteem and confidence must be assessed and addressed if needed. It is vital for your client to have a healthy opinion and perspective of themselves. Clients need to believe that, with improved self-esteem and confidence, goals can be reached. This should serve as a protective factor for those focusing more on the “ought-self” (I ought to lose weight for my coach/game/my own happiness and health) 2. The client’s goals are always stated by the client, never the coach. This way, the client owns the goals and is not able to ever say that they did something at the coach’s suggestion or urging. So, we dig tirelessly, we fish for information and we get really curious in a non-invasive manner with our client. It sounds a little different than how we are off the clock but maybe not so far off…

are tasked with bringing clients to have the self-motivation and a focus orientation toward the future to reach their desired outcomes. Watch for clients who think they are pursuing an ideal self, but are instead pursuing an “ought self- an ideal and vision self-imposed on ourselves by others, or sometimes, by an internal desire to please others. It can represent who we think others think we should be or whom we think we should be, rather than who we really want to be. These external expectations can easily mask one’s ideal self. It’s like losing our inner compass and deciding to follow the suggestions coming from someone externally. This often happens because the client may believe that being compliant with the external world can make them - and the people that care about them happier.

Coaching With Compassion Coaching with a healthy dose of compassion is a process that aims to further the clients’ development by focusing on their Ideal Self and strengths. Although Appreciative Inquiry will direct mine for strengths, the “ideal-self” and the “ought-self” need to be sorted. With great coaching, your clients can experience positive emotions and become more open to new possibilities, growth, and renew themselves. The guiding principle of this coaching style is to focus on the client’s strengths, more than their weaknesses. The emotional support we provide as a coach does not change. Only our strategy does, in this case. Because humans are an evolutionary process in action, maybe the most important ability to have is adapting to different circumstances. The human experience is a process of change, through which we change our bodies, environment, beliefs and perspectives. Spanning broadly across these different levels of change is our core identity. This helps inform our personal values, aspirations and even our professional choices.

At one point, our clients might experience a wake-up call and find that they feel disappointed, frustrated, or even angry. The main reason is often that time and energy have been spent pursuing something not wanted. Helping a client who feels trapped in the ought self can be fairly obvious to an experienced coach; these are clients living life engaged in a process of conformity adopted to accomplish the external social requirements. Getting clients in touch with their ideal self will require a personal vision. This is a cornerstone of coaching as vision is often required for the motivational force needed for a meaningful change or goal. The development of a clear vision is a process through which we teach our clients how to learn to know themselves, their abilities, talents, and aspirations. Constructing a personal vision is the best way to face change; this is considered targeted, focused work, as every unknown circumstance, or moment of indecision are less risky by making sure your client has a solid vision to lead them.

Some behavior change theories state that sustained, desired change occurs in a dynamic, non-linear process. This is also known to be impacted by the following: Ideal Self: Who do we want to be? Real Self: Who are you? Strengths emerge when the Ideal Self and Real Self are similar. Gaps are found where Ideal Self and Real Self are different. Formulation of a learning agenda: building on my strengths while reducing gaps. Practice and experiment with new behaviors. This is best done with a competent and experienced coach. The support of resonant and fulfilling relationships. Coaches will normally wind up spending more time on the first discovery: the ideal self, namely one’s passion, purpose, and core values since this will set the direction to follow in the early stages of the coaching process. Try using components of the Ideal self, along with a vision or desired image of the future. This will directly help a client to define their identity. These elements support your ability to walk your client through their vision while supporting a sense of hope. This hope – turns out to be a huge catalyst for change! The ideal self is centered on self-motivation: what a person wants to do. Coaches

Mark Teahan, Director of the Spencer Institute

"The best thing we can do to help others along their journey is to encourage them to simply be 1% better than who they were yesterday. "

Christa walked towards her departing flight with anxiety and dread in every step. Just shy of having a panic attack, she felt like the mortified embodiment of Eminem’s lyrics with her sweaty palms, weak knees, and heavy arms. It wasn’t a fear of flying or the plane crashing, her undeniable, no longer avoidable reality was one question: “Will I fit?!” The onslaught of nervous thoughts and stress-induced adrenaline were compiling into mental and physical claustrophobia. “Will I be able to walk down the aisle without my body brushing up against someone? How will I put my luggage up without my belly being pushed into someone’s face? When I squeeze into the seat, will my body be too wide and push up against my neighbor, intruding on their space?”

When Tuesday morning’s alarm sounded off, the hesitation started to creep in as she succumbed to the snooze button. A half-assed workout, egg whites, and some veggies later, a sore and exhausted Christa survived another day despite the nearly unbearable urge to hide in her bathroom with some chips, as the chaos of the kids played exceptionally loud in the background after a long and tiring day. Then Wednesday came along and Christa immediately thought, “Nope, not today, I did two days in a row, I need a rest day…I’m too tired… I’m too sore….” By the time lunch came around, it was “More rubbery meal-prepped chicken? Forget that, what’s on the takeout menu?” Christa’s willpower was depleted, her motivation and excitement gone, just as quick as her french fries disappeared.

The questions kept spiraling, with every step moving her closer to face her situation. “Will the seat belt fit? Will I need a seatbelt extension? How do I discreetly ask for one without drawing attention and embarrassing myself?”

This became Christa’s life on repeat for some time. Until, eventually, the insanity of attempt after unsuccessful attempt led her to decide that rather than purchase one more program, one more shake, one more pill, she would invest in herself in a different way- in her education. After all, in her fitter high school years, she had aspired to be a Personal Trainer.

The overwhelming possibilities of all the ensuing embarrassing situations were enough for her. She knew she couldn’t continue living life this way anymore, she knew she needed to make changes. So, Christa did what most reasonable people looking to lose weight do; she bought every late night infomercial product along with their promises that things would be different come Monday.

Christa began the process of becoming a Certified Personal Trainer and pursued her education with vigor, earning multiple certifications including her NESTA Lifestyle Weight Loss Management certification, all while working on herself. She applied the skills and knowledge gained through her education to help herself toward her own health and wellness goals. She became her own Client Zero, she was the experiment.

“If Susie can do it, so can I.” She threw out all the “bad, unapproved foods” and went grocery shopping. She prepped all her meals and scheduled all six workouts for the week. Monday came painfully at 5am, but Christa was committed, so she showed up and did the work. She got that first workout in, just as her “Never Miss a Monday” Tshirt commanded. She followed up by carefully eating her prepped meal, chicken, broccoli, and rice, and chugging down water the whole day. By dinner, she was silently praying that the chocolate cravings would subside with just a little more willpower. But she survived it, Day 1 was done.

Through the journey of trying to lose weight, Christa decided to pursue the Physique and Figure Training Specialist certification. She knew how to exist in her oversized body, but wanted to know how others on the spectrum of fitness and weight loss navigate their headspace. She felt that, maybe, if she understood various perspectives and mindsets, she might be able to help people who are trying to achieve the best version of themselves but don’t know how to get there.

The goal of losing 100 pounds was not as simple as calories in vs. calories out.

As she continued through the grind of weight loss, Christa realized that the goal of losing 100 pounds was not as simple as calories in vs. calories out. It wasn’t about hitting her calorie goal for the day or how many hours she spent working out for the week. It wasn’t the reps counted, weights lifted, meals prepped, or the calorie deficit created. It even seemed like the harder she tried, the harder the journey became- from birthdays and barbecues to solitary moments of weakness and vulnerability. The self-doubt would often overcome her: “Maybe, this is just who I am meant to be… maybe I just need to accept being fat and unhappy….maybe I am unworthy of the life I want…” As she studied and learned more, using herself to collect data and test out methods, she began honing in on her mindset.

She already knew the fundamentals of weight loss and what the industry was selling- eat your veggies, move your body, create a deficit. But there seemed to be a crucial core to the puzzle that was missing. How did she get to this point in the first place? Was it simply habits that had been established over the years that she needed to re-wire? Was it unhealthy coping mechanisms for trauma and abuse throughout her life? What were the tapes playing in the background, the limiting beliefs, the default mode imprinted into her mind, subconsciously accepted as a truth she could never change?

Christa finally saw what she hadn’t seen, and the realization flooded her eyes. The wall keeping her from herself was crumbling before her. It wasn’t the meal prep and workouts. It was the undeniable truth that you can never hate yourself into being healthy. No

matter what size she was wearing, no matter what the number on the scale read, if she didn’t begin to love herself now, she would never love her body. A deep process of healing began, journaling through her thoughts and becoming aware of her internal dialogue. She was finally working through trauma with therapists and finding support through coaching. It was learning what weight was hers to carry in life and what weight was not, physically and subconsciously. It was unlearning so many things she had internalized. As she began losing the mental weight of all the things she was holding onto, she began to lose the weight physically. The physical barrier she had created to protect herself slowly came down. With this new path forward came a whole new set of situations for Christa to navigate. As her body changed,

You can never hate yourself into being healthy.

respiring pound by pound, her movement and balance started to transform accordingly. Just as she reached to grab her ankle behind her to do a standing quad stretch for the first time, her balance quickly shifted, causing the celebratory accomplishment to turn into a new moment of awkward frustration. She even noticed significant muscle imbalances she needed to overcome now. Spending time with her kids shed new light on the mind-body connection for Christa, as well. One time, out hiking with the kids, she recalls having an internal conversation regarding mindful movement, “I wondered if I step that high, will my knee be able to hold my weight? Will I have the strength in my legs to actually push myself up to that step?” Along with the physical challenges, her new learning process involved working through body dysmorphia issues as well. Playing with her kids at the park, an innocent request from her son to slide down with him would stop her in her tracks, “...I don’t know if I can fit in that slide.” Progress didn’t mean her newfound confidence was impenetrable, but each moment of self-doubt became a chance for Christa to fight for herself, and let love win. Christa’s journey has taken her years of trial and error, learning on the job, pursuing ongoing education, and guidance from mentors and coaches. But the lessons learned have proven to be priceless when it comes to helping others along their own journeys. Because of her own path, she has learned how to meet people where they are, and ask the harder questions to show her clients the most vital, vulnerable parts in the journey of selfimprovement. It has provided Christa an additional level of empathy and wisdom to understand that what really goes on underneath the weight factors into the process of becoming the healthiest version of oneself. And that sometimes as the Coach, showing up with a hug and a smile is more productive than showing up with an assessment and a workout. The best thing we can do to help others along their journey is to encourage them to simply be 1% better than who they were yesterday.

Christa is a Certified Personal Trainer specializing in behavioral change and habit based nutrition. After battling her own weight issues for years, and I do mean battling; it was as if unhealthy food and an unhealthy mindset attacked at every corner of her existence. Christa took it upon herself to deep dive into education and fitness. Join Christa and learn more about becoming a Certified Personal Fitness Trainer, a Lifestyle and Weight Management Specialist , and a Physique and Figure Training Specialist.

WHY THE GUT MICROBIOME IS CRUCIAL FOR OUR HEALTH EXCERPT FROM THE CERTIFIED INTEGRATIVE HEALTH COACH COURSE

The human body is full of bacteria, viruses, and fungi. They are collectively known as the microbiome, and their totals are impressive, numbering in the trillions. While some bacteria are associated with disease, others are extremely important for your immune system, heart, weight, and many other aspects of health. What is the Gut Microbiome? Bacteria, viruses, fungi, and other microscopic living things are referred to as microorganisms, or microbes, for short. Trillions of these microbes exist mainly inside your intestines, with some also known to be on the skin. It is here that most of the microbes in the intestines are found, in a “pouch” at the junction of the small and large intestine called the cecum. The microbes found in the cecum are generally referred to as the gut microbiome. For various reasons, bacteria are widely studied even though many different types of microbes exist inside us. The human body also relies on mucosal tissues to store microbes in some environments.

Some of the strongest studies have looked to understand NOMADIC | 24 the interface for host-microbiota interactions and the

intestinal mucosa. This highly specialized feature of the intestinal immune system can establish immune tolerance towards an enormous and constantly changing wealth of harmless microorganisms, while concomitantly preserving immune responses against pathogenic infection or commensal intrusion into our sterile bodies. In a healthy state, the host’s immune response to the intestinal microbiota is strictly compartmentalized to the mucosal surface. A single layer of epithelium separates the intestinal lumen from underlying tissues. Many mechanisms are employed to achieve microbiota compartmentalization. A dense mucus layer separates the intestinal epithelium from resident microbes. The mucus barrier is organized around the hyperglycosylated mucin (MUC2). However, MUC2 not only offers protection by static shielding but also constrains the immune properties of intestinal antigens by imprinting enteric dendritic cells (DCs) towards an anti-inflammatory state.

of the host and their ability to maintain the appropriate immune tolerance/response.

Mucus is somewhat colonized by a vast number of microorganisms that we also include in the use of the term microbiome. The collective genomes of bacteria and other microorganisms in this ecosystem have been increasingly investigated during the past two decades, due to the rapid development of culture-independent genomics, techniques, and the convenience of athome testing. Recent advances in microbiome research revealed that the gut microbiome is not just a passive bystander, but actively impacts multiple host functions, including circadian rhythmicity, nutritional responses, metabolism, and immunity.

Such an intimate relationship requires the proper functioning of host immunity to prevent commensals from over-exploitation of host resources while maintaining immune tolerance to innocuous stimuli. However, perturbation of the gut microbiome by environmental incursions (such as antibiotic use, diet, or changes in geography), impairment of host-microbiome interfaces, or alterations of the immune system can result in systemic dissemination of commensal microorganism, susceptibility to pathogenic invasion, and aberrant immune responses. In

We also need to realize the impact and function of the gutbrain axis (GBA). It consists of bidirectional communication between the central and the enteric nervous system, linking emotional and cognitive centers of the brain with peripheral intestinal functions. Recent advances in research have described the importance of gut microbiota in influencing these interactions. This interaction between microbiota and GBA appears to be bidirectional, namely through signaling from gut-microbiota to brain and from brain to gutmicrobiota using neural, endocrine, immune, and humoral links. Some practitioners also believe that a malfunctioning microbiome in the gut can send signals akin to cravings using the GBA. This is a powerful connection and again, is another way our brain protects how our gut tube interacts with the environment we are in.

In humans, the immune system encompasses a complex network of innate and adaptive components in all tissues, playing a vital role in host defense against various potentially harmful external agents and endogenous perturbations of homeostasis. From an ecological perspective, mammals and their commensal microorganisms co-evolved toward mutualism and hemostasis. Such an intimate relationship requires a healthy gut microbiome. It also requires the proper function

Still, there are more bacterial cells in our bodies than human cells (there are about 40 trillion bacterial cells vs 30 trillion human cells in the body. That means we are more bacteria than anything else. There are believed to be up to 1,000 species of bacteria in the human gut microbiome, and each of them plays a different role within the body. Most of them are extremely important for overall health and yet others are known to cause some diseases. Altogether, these microbes may weigh as much as 2–5 pounds (1–2 kg), which is roughly the weight of your brain. Together, they function as an extra organ in your body and play a huge role in our general health.

For example, obesity, inflammatory bowel disease, alcoholic and nonalcoholic fatty liver disease, and hepatocellular carcinoma all have been linked to the microbiome in human beings, and changes in the microbiome have been shown to induce or modify these diseases in animal models. The human gut is home to a variety of microbes, including bacteria, archaea (single-celled organisms without nuclei that are related more closely to eukaryotes than to bacteria), fungi (mostly yeasts), microbial eukaryotes (usually Blastocystis in the United States, but a variety of pathogenic and nonpathogenic taxa in developing countries), and viruses/phages. This collection of microbes is called the microbiota; their genes are called the microbiome. However, the term microbiome has come into popular use to refer to the microbes themselves. Whether the microbiome includes the virome (the repertoire of viral genes) is open to debate. Because of the technical ease and widespread utility of approaches that just read the bacteria (see later), many people assume that the microbiome refers only to the bacteria, but this is not correct. Rather, if a difference is shown in the bacterial compartment of the microbiome between cases and controls, it is necessarily true that the microbiome is different; however, if no difference in the bacteria is found,

there still might be a difference in other kinds of microbes (eg, yeast or viruses). Until recently, a frequently repeated slogan was that the human microbiome contained 10 times as many cells as the human body. This figure was based on a rough calculation 40 years ago, and the correct claim was that the true figure was somewhere between 1:10 and 10:1, but could be as much as 10:1. Since then, errors on the estimates of the number of human cells and microbial cells have narrowed considerably, with the true figure being much closer to 1:1, with the balance slightly in favor of the microbes. However, since it is part of our triad model of Coach training, we will explore ways to increase good bacteria in the gut.

Drug Administration estimates that 80 percent of antibiotics are used in animal agriculture.

PLANNING

In a general sense, we will assess the current intake of fiber and recommend intake based on current values in client food logs. If, in fact, fiber is an ongoing concern or if it is a specific goal, we look at CHO intake and examine the quality of the intake for each food log entry. If food logs are not being generated on a consistent basis, what might this indicate? A lack of readiness to change dietary habits A gap in understanding macronutrient intake General indifference to the suggest on behalf of the client (in other words, client is non-compliant) High-fiber foods feed healthy bacteria that improve immune function, reduce inflammation and chronic disease, and even help regulate mood. In the GM, prebiotics feed healthy bacteria. Good sources of prebiotics include artichokes, chicory root, raw dandelion greens, leeks, onions, garlic, asparagus, whole wheat, spinach, beans, bananas, oats, and soybeans. Probiotic foods are those with live bacteria or yeasts found in fermented foods that, when consumed, take up residence in the gut and improve health. Healthy sources include sauerkraut, miso, tempeh, kimchi, and water kefir. By avoiding red meat, high-fat dairy products, and fried foods, clients should receive coach guidance to consider plant-based alternatives. The intake of these foods reduces the growth of healthy bacteria and enhances the growth of “bad” bacteria. Better still if we can wean our client from excessive fried foods, especially important if your client is diabetic (or prediabetes). Another pro in the list of plant-based diets: most plant foods are naturally low in fat.

The overuse of antibiotics is a widespread problem. Sure, we need them at times for our very survival, but overuse of antibiotics can kill off healthy bacteria. The U.S. Food and

In general, the CIHC is called upon to lead clients toward healthy outcomes. There are no alternative ways to be healthy. The tried and true techniques of proper nutrition, exercise, getting enough sleep, and managing stress can all have a positive impact on your gut microbes.

WHERE DO I START? WHAT YOU NEED TO CONSIDER WHEN WORKING WITH OVERWEIGHT CLIENTS

Being a fitness trainer, the clients you will often work with are carrying around extra weight, some of which would medically be categorized as obese. When they come to you to ask for your help to maintain a healthy and balanced weight, you must guide them well as obesity is the mother of diseases. It comes with many underlying conditions like high cholesterol levels, high triglyceride levels, a higher risk of developing cardiovascular diseases, and an overly increased risk of developing Type 2 diabetes. To help your clients battling with their body fats, you must know the medical considerations they might have along with obesity. Adopting a true lifestyle at the right time is necessary to fight obesity and all the related conditions. While encountering obese patients, your prime goal should be to help them control their caloric intake without letting them fall into the trap of nutritional deficiencies. When you ask them to maintain their diet, they usually stop eating, and the ultimate result is the deficiency of multiple vitamins and minerals.

In addition to a low caloric diet, exercise is a must to control the fat deposition in the body. Let’s see which health considerations are highly associated N O M A D I Cwith | obesity 24 and how they should be treated.

Special Health Considerations Linked with Obesity:

Cancers Some cancers like esophageal adenocarcinoma, liver cancer, kidneys cancer, pancreatic cancer, colorectal cancer, ovarian cancer, etc., are also linked with obesity.

PLANNING

Multiple health considerations are linked with obesity. Being overweight can be a consequence of certain diseases and also be a cause of some lethal diseases. So, it is important to recognize the underlying conditions to know the cause. The following are the diseases that appear as a consequence of obesity. Type 2 Diabetes Type 2 Diabetes occurs when the levels of glucose rise in the blood. And obesity increases the chances of elevated blood glucose levels. Obesity is the major cause of type 2 diabetes, and losing 5 to 7 percent of body weight can help reduce the risk of type 2 diabetes if someone is on the verge of developing it. Heart Diseases Heart diseases denominate a broad category. All the heartrelated problems that affect the heart come under this category, including heart failure, heart attack, angina, sudden cardiac death, and abnormal heart rhythm. All of these conditions have a direct link with obesity. Excessive body fat accumulated on or around different body organs, including the liver and kidneys, increases the risk of developing heart-related problems.

Metabolic Syndrome Metabolic syndrome is a condition in which different metabolic conditions occur simultaneously. These conditions include stroke, type 2 diabetes, and heart diseases, interlinked with excessive accumulation of body fat around the waist. Ultimately, the levels of cholesterol and triglycerides also increase, putting the individual’s life at risk. Stroke A stroke happens when the blood flow from the heart to the brain stops due to underlying conditions. One of the underlying causes is the excessive accumulation of fat in the body. Fatty Liver and Gall-bladder Diseases Fatty liver disease is a condition in which fatty acids get accumulated in the liver resulting in non-alcoholic fatty liver diseases and non-alcoholic steatohepatitis. These diseases, if untreated for a long time, can cause cirrhosis. Pregnancy Problems Issues like gestational diabetes, cesarean section, and preeclampsia appear in pregnancy due to obesity. An overweight pregnant woman has double the chances of developing these obesity-linked pregnancy issues.

Kidney Diseases Obesity increases the risk of developing kidney diseases as obesity causes diabetes and high blood pressure, directly linked to kidney diseases. However, obesity alone enhances the risk and quickens the progress of kidney diseases. As a trainer, it is important to know all the complications linked with obesity. Knowing them can help you design a better-customized training schedule for your obese clients. Here is what can help you make your obese clients lose fat more healthily! Physical Activity and Calorie Deficit Diet There is no doubt that a calorie deficit diet is the first line of defense against obesity. But physical activity also plays an important role. As a trainer, you must know the complete health concerns of the clients coming to you. After knowing the details, your goal should be to design a diet plan. The diet plan must be calorie deficit fulfilling all the nutritional requirements. For example, if your obese client also has cancer, you must include anti-oxidants in his diet that can help in reducing his body’s oxidative stress. Once the therapeutic diet shows its effects, it becomes easier to adapt. Sticking to a calorie deficit diet is important. But calorie deficit doesn’t mean starving. Make sure your clients don’t starve to lose extra body fat! Enhanced physical activity helps fasten the metabolism, but strenuous physical activity can be lethal in some obesityrelated diseases such as heart diseases. To avoid such dangerous incidents, you must know the client's medical history to help him prevent activities harmful to him. Obesity and Societal Pressure Obese people go through a lot of trauma. Along with multiple interlinked disorders, they also go through mental states like depression and stress. So, these people need more moral support along with physical support. As a fitness trainer, you must know the client's weaknesses to help them recover as early as possible. Obesity might result in lifelong conditions if not taken into account earlier. In women, depression, and obesity, can both result in PCOS which itself can ruin the hormonal balance of the body resulting in issues in reproduction.

As a Trainer… To treat your clients well, you must know all the hidden reasons and the interlinked consequences of obesity. With sound knowledge about the complications and special health concerns linked with obesity, you can help your clients prevent falling into the trap of life-threatening conditions. It would be best to make your clients aware that fatty tissues do not disappear with starving. A balanced, healthy, and therapeutic diet along with perfectly scheduled physical activity can fight obesity only. Your goal should be to make them adapt to a healthier and happier lifestyle to avoid getting tired of the changes. Rather they enjoy the lifestyle modifications and prefer a healthy routine over a sedentary one!

THE BENEFITS OF JOURNALING FOR YOUR HEALTH AND WELLNESS

Did you know that journaling has been shown to help you destress, eat healthier, boost self-confidence, and help you solve your own problems? Journaling is a good way to help us to stop, take a step back, and reflect on ourselves. We can self-reflect on gratitude or what we did today and write it in our diary. Daily reflection can also be done at night before bed. We can look back at our life in a journal and think about how we’ve changed and what we can do to improve ourselves. Journaling is a vehicle of emotional exploration, a way to channel difficult feelings into healthy and creative outcomes. It is a form of free self-expression that leads to exploration and personal growth. By writing down your thoughts and feelings, you are forced to slow down and pay attention to everything that is going on in your life. Reduce Depression and Anxiety

Writing down your feelings helps you to “brain-dump” your anxieties, frustrations, and pains in a journal. This can help you to reduce and release any stress which you have accumulated over time. A good way to relieve NOMADIC

stress is to write in the stream of consciousness style first thing in the morning.

with a positive, holistic view of themselves is less prone to things like depression and anxiety, both of which can cause a variety of physical health problems.

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Both depression and anxiety are often accompanied by negative thoughts. Journaling allows you to get these thoughts down on paper, process them in a more analytical, non-emotional way, and then respond appropriately to them.

Many studies have shown that journaling can reduce overall levels of depression. Studies have also shown that writing in a journal can be as effective as cognitive-behavioral therapy when it comes to reducing the risk of depression in young adults. Instead of simply letting negative thoughts run rampant in your mind, journaling allows you to engage with your thoughts and determine whether they are true or false. Keeping a Journal can Improve Memory Function It shouldn’t come as any surprise that journaling can also improve overall memory function. When you journal, you are both recording and processing the events of a particular time period. As you do this, you are remembering and reflecting upon the details of the events, which then helps you retain those memories for a significantly longer amount of time. Your brain is likely to store information that you have written down in a journal. Your brain will make stronger connections with the information you have learned after you write them down in a diary, making it easier for you to recall in the future. Additionally, journaling allows you to analyze past events for patterns. As you look at your journal over time, you may begin to see particular patterns emerge, whether in your own behavior or in the behavior of others. Once you spot these patterns, you can respond appropriately. Journal Writing Can Help Boost Immune Function This may come as a surprise, but journaling has also been proven to improve overall immune function and decrease your risk of illness including fewer stress-related visits to the doctor, improved immune system functioning, reduced blood pressure, and improved lung and liver function. Journaling allows a person to take the events they experience and integrate them into their overall perspective on life and enables a person to think more positively about their lives and create a more holistic picture of themselves in relation to the rest of the world. It follows that a person

Journaling Can Help With Recovery From Trauma It has also been shown that journaling can help a person recover more quickly from traumatic events. Writing things down allows you to process what has occurred and see the good side of life, even when things are difficult. Journaling also allows you to directly confront the things you’ve experienced instead of avoiding them and not taking the time to process them. How to Start Journaling For someone who has never journaled, used a diary, or done any sort of personal writing, Journaling can feel awkward and even uncomfortable at first. But, there are many different approaches you or your clients can take when first dipping your toes into journaling. Track Your Mood: The easiest way to start journaling is by using a bullet journaling mood tracker. There are many ways you can implement mood tracking in your journal. You can write your overall mood for the day. If you’re journaling throughout the day or covering key events, mention your specific mood at the time. If you’re wanting to write about specific topics, people, or events then you can also write your immediate emotional response. Tracking Gratitude: If you’re journaling to gain a positive outlook, one of the best journaling techniques can be simply listing what you’re thankful for. It’s one of the best things to do on a daily basis. The most common approach is to list a few things that happened each day that you’re thankful for. It can be anything that you appreciated, no matter how big or small. Dreams: Our dreams and personal well-being have long been connected. Recording your dreams is a great journaling technique for both beginner and veteran journalers. This would be best done at the start of the day. You might not have vivid dreams every night — we’re all a little different in our dreaming intensity or frequency — but making it a ritual to record what you remember each morning will help ensure you get as much of it as possible down. Inspiration and Goals: Each day, write the goals that you want to achieve (if you journal in the morning, do it for the day ahead; and if you journal at night, do it for tomorrow) and make a note of what you did the day before. Ticking off completed tasks is mentally and emotionally rewarding, and it’ll help drive you forward!

THE IMPACT OF OBESITY ON THE CARDIOVASCULAR SYSTEM

Being a fitness trainer, clients you come across with the most are obese. When they come to you to ask for your help to maintain a healthy and balanced weight, you must guide them well as obesity is the mother of diseases. It comes with many underlying conditions like high cholesterol levels, high triglyceride levels, a higher risk of developing cardiovascular diseases, and an overly increased risk of developing Type 2 diabetes. To help your clients battling with their body fats, you must know the medical considerations they might have along with obesity. Adopting a true lifestyle at the right time is necessary to fight obesity and all the related conditions. While encountering obese patients, your prime goal should be to help them control their caloric intake without letting them fall into the trap of nutritional deficiencies. When you ask them to maintain their diet, they usually stop eating, and the ultimate result is the deficiency of multiple vitamins and minerals.

In addition to a low caloric diet, exercise is a must to control the fat deposition in the body. Let’s see which health considerations are highly associated with obesity and how they should be treated. NOMADIC

factors. Other than this, if the mother consumes alcohol, smokes, is diabetic, or has a rubella virus attack, the risk of developing congenital heart diseases increases.

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Let’s look at some widely prevalent diseases related to the heart and know them in-depth. The Most Common Type of Heart Disease Coronary artery disease or coronary heart disease is the most common type of heart disease. The risk of developing this type of heart disease is common for many reasons, including high consumption of alcohol, soft drinks, and saturated fats. Causes In this disease, a plaque is formed in the coronary artery, causing narrowing of the artery-blocking the supply of blood to the heart. The plaque is made up of cholesterol and reduces oxygen and nutrients supplied to the heart. The muscles of the heart weaken. When the plaque blocks the artery, it is called Atherosclerosis. Symptoms The symptoms of coronary heart disease are severe. They include the following signs and come as soon as the plaque is formed. Angina (chest pain or discomfort) Cold sweat Nausea (feeling sick to the stomach) Pain in left arm or shoulder Shortness of breath Treatment The following treatments can be used against coronary heart diseases if medications fail to treat them. Coronary angioplasty is done by a balloon catheter, which helps relieve the narrowing of the artery, improving the blood flow to the heart. Coronary artery bypass graft Heart transplant Heart Defects by Birth Some heart defects are present in babies by birth, known as Congenital Heart Defects. These defects include atypical heart valves (heart valves don’t open properly or they cause leakage of blood through them), septal defects (a hole present in the wall of either the lower chamber of the heart of the upper chamber), and atresia (missing heart valve).

Causes The major cause of congenital heart defects is genetic

Heart diseases are numerous. All the abnormal conditions related to the heart come under this category. These diseases vary from mild to severe. Some of them are easily treatable, while some are not even diagnosable. But most of the diseases share common causes, such as obesity and hypertension. Let’s look at some widely prevalent diseases related to the heart and know them in-depth. The Most Common Type of Heart Disease Coronary artery disease or coronary heart disease is the most common type of heart disease. The risk of developing this type of heart disease is common for many reasons, including high consumption of alcohol, soft drinks, and saturated fats. Causes In this disease, a plaque is formed in the coronary artery, causing narrowing of the artery-blocking the supply of blood to the heart. The plaque is made up of cholesterol and reduces oxygen and nutrients supplied to the heart. The muscles of the heart weaken. When the plaque blocks the artery, it is called Atherosclerosis. Symptoms The symptoms of coronary heart disease are severe. They include the following signs and come as soon as the plaque is formed. Other than this, if the mother consumes alcohol, smokes, is diabetic, or has a rubella virus attack, the risk of developing congenital heart diseases increases. Symptoms Signs and symptoms of congenital heart diseases include: Cyanosis (bluish skin and lips) Swelling of legs and tummy, and around the eyes Tachycardia (increased heartbeats) Rapid breathing (also while feeding) Severe fatigue and tiredness Treatment Treatments of congenital heart disease depend upon the cause. Other factors like the type of defect, age of the child, the severity of the disorder, and overall health of the baby are also prime determinants of the treatment of congenital heart diseases. But the following are the treatment options available for defects.

Medications Catheter procedures Surgery Heart transplant

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Irregular Heartbeats The heart disease that causes irregular heartbeat is known as Arrhythmias. The following are the types of irregular heartbeats. Tachycardia (rapid heartbeat) Bradycardia (slower heartbeat) Atrial Fibrillation (irregular heartbeat) Premature contractions (early heartbeat) Causes Irregular heartbeats occur when the electrical impulses do not coordinate with the heartbeats correctly. And the causes of these disrupted electrical signals can be: Sudden exertion or stress Imbalance in the blood Prolonged use of medicines, especially antibiotics Symptoms A sudden change in pulse Fatigue Dizziness and lightheadedness Syncope (fainting or about to faint) Treatments Medications are used to treat irregular heartbeats. But if they don’t improve through medications, the following treatment methods are used: Catheter ablation Pacemaker Implantable cardioverter-defibrillator Maze procedure Coronary bypass surgery Dilated Chambers of Heart Cardiomyopathy is the disease of the heart in which the chambers of the heart become dilated. In this condition, the muscles of the heart stretch and become thinner. Causes The most common causes of cardiomyopathy are past heart attacks, irregular heartbeats (arrhythmias), certain toxins. The genetic factor is also involved in developing this disease of the heart.

Breathlessness while performing any activity or even at rest Swelling, especially in legs, feet, and anklets Coughing and difficulty in lying down Chest pressure and fatigue

Symptoms The following can be the signs and symptoms of cardiomyopathy:

Treatments Lifestyle changes and dietary modifications play an important role in treating cardiomyopathy. Limiting alcohol, fat consumption, and smoking can relieve its symptoms. Other than these, the following can be the treatment options: Drugs (beta-blockers, diuretics, anticoagulants, etc.) Removal of extra heart tissues to lessen the thickness (ablation) Surgically implanted device to help maintain a proper rhythm Heart transplant Heart Attack Heart attack is known as myocardial infarction. It occurs due to insufficient blood supply to the heart due to any interruption. Treatments Medications are used to treat irregular heartbeats. But if they don’t improve through medications, the following treatment methods are used: Catheter ablation Pacemaker Implantable cardioverter-defibrillator Maze procedure Coronary bypass surgery Causes The most prevalent cause of heart attack is coronary artery disease. The plaque formed in the coronary artery interrupts the heart's blood flow, resulting in a heart attack. Symptoms The following are the signs and symptoms of a heart attack. Severe pain in the chest with tightness causing aches in the upper body, including jaw and back Sweating and anxiety Syncope (feeling like fainting) Shortness of breath Vomiting and Nausea Treatment The most beneficial treatment of myocardial infarction is Aspirin, an anti-platelet drug that helps dissolve the blockage.

Mitral Valve Issues Mitral valve prolapse and mitral valve regurgitation are the two conditions related to the heart valve. In mitral valve regurgitation, the valve does not close tightly, allowing blood's back and forth flow. While in mitral valve prolapse, the valve does not completely close, making the blood throw in bulge form to the left atrium.

Obesity and cardiovascular disorders:

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Causes Congenital heart defects are a big cause of mitral valve issues. Other than these, the following can be the causes of mitral valve abnormalities. Endocarditis Rheumatic fever Myocardial infarction Cardiomyopathy Damaged tissue cords Radiation therapy Symptoms The following are the symptoms of mitral valve problem: Shortness of breath (on exertion and while lying) Tiredness and fatigue Lower capability to exercise Palpitations Treatments Beta-blockers, diuretics, aspirin, and blood thinners are used to treat mitral valve issues. Otherwise, surgeries are performed to fix, rebuild or fix the valve's flaps to open or close the valve. Heart at Risk: Congestive heart failure is when the heart is still working but not as it should work. Heart failure occurs due to abnormal contraction and relaxation of the heart. Causes All the other heart diseases that, if untreated or given no proper attention and cure, can fail the heart. High blood pressure is a big contributor to heart failure. Symptoms All the symptoms that arise in other heart conditions come from heart failure. From feeling like fainting to having severe pain in the chest, signs are noticeable. Treatment As the name sounds, heart failure can be a life-threatening condition, but if it’s cured earlier, a life can be saved. The treatment of heart failure is surgery because medications don’t work well at this stage. The treatment of choice is heart valve surgery

Obesity is the excessive accumulation of fats and adipose tissue in the body. It is the mother of all diseases which impairs body health. Obesity has become a major problem in today's world, and it is the second most modifiable risk factor of death. There is an association between obesity and cardiovascular disorders. Research studies suggest that one in every three American individuals is obese. What does obesity do to your body? In obesity, there is increased fat deposition in our bodies. There is an increase in body mass index (BMI). Persons whose BMI range is >25 and<30 kg/m² are categorized as overweight, while persons having BMI >30kg/m² are classified as obese. Excessive fat deposits cause weight gain. Fat is deposited in the adipose tissues. When there is excessive fat deposition, fat deposition also occurs in other tissues of our body. There is an increased level of triglycerides, cholesterol, increased LDL cholesterol, glycerol, and free fats in our body; increased levels of these fats lead to several diseases. In obesity, apart from an increase in cholesterol, LDL, triglycerides, there is a deposition of epicardial and pericardial fats. Pericardial fat is located in pericardial sacs below the superior extent of left and right coronary arteries. Pericardial fat is increased in obesity. It increases the risk of atherosclerotic cardiovascular disorders and heart failure. To improve this condition, there is a need for exercise, weight reduction, and certain medication, including VAT, along with weight reduction. What vascular changes occur in obesity? In obesity, there is an accumulation of fats in vessels, these fats are later converted to fatty streaks. These fatty streaks are converted to atherosclerotic plaques. Obesity promotes inflammation, which oxidizes LDL, risk of atherosclerosis is increased further. These plaques can also cause thrombus formation and embolism. How does obesity cause ischemia? Obesity causes increased adiposity in coronary vessels. It leads to obstruction in blood flow in the vessels which results in ischemia. An increase in BMI by one unit increases the risk of ischemia by 4 percent. Obesity and coronary artery diseases: Obesity causes an increase in coronary artery diseases. Central obesity increases this risk. It is also associated with hypertension and dyslipidemia. Weight gain of 10kg increases the risk of coronary artery disease by 12 percent.

Myocardial infarction:

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Obesity increases the risk of non-ST segment elevation myocardial infarction. It's also associated with ST-segment elevation myocardial infarction. When there is thrombus formation, there is occlusion of vessels, which leads to ischemia. There is reduced or impaired blood supply to the heart. As a result, the death of myocardial cells occurs; that's called a myocardial infarction. Sudden death can also occur due to myocardial infarction. Obesity and Heart failure: Obesity increases the risk of heart failure. According to the Framingham Heart Study, an increase in BMI by one unit increases the risk of heart failure by 5 percent in men and 7 percent in women. About 32-49 percent of heart patients are obese, and 31_40 percent are overweight. Obesity causes increased blood pressure, hemodynamic changes, and a rise in cardiac output. There is the activation of the sympathetic nervous system and the renin-angiotensin system. An increase in blood flow increases venous return preload, increasing fiber tension and ventricular dilation ultimately. Hypertension and myocardial damage:

Obesity leads to hypertension. Hypertension increases afterload. As a result, myocardial hypertrophy occurs due to myocardial remodeling. Inflammatory cytokines like TNF alpha, IL2, IL6, IL8, etc., increase the risk of cardiovascular disorders. They cause myocardial fibrosis, and myocardial stiffening occurs as a result. Necrosis of cardiomyocytes: In obese people, triglycerides increase in heart cells, they are metabolized, and their toxic products like ceramide cause necrosis of cardiomyocytes and cardiomyopathy. Obesity and arrhythmias: Obesity increases the risk of cardiac arrhythmias, particularly atrial fibrillation. The risk of sudden death is greater in obese people. Atrial fibrillation affects one to two percent of the young population. About six million Europeans suffer from atrial fibrillation. One unit rise in BMI increases the risk of atrial fibrillation by four percent. It also worsens health, increases hospitalization, and impairs life quality. Obesity and sudden death:

Obesity increases the risk of sudden death. It causes arrhythmias, infarction, ventricular tachyarrhythmias, systolic and diastolic ventricular dysfunction, and left ventricular hypertrophy. As a result, there is a strong association between obesity and sudden death. Obesity and stroke: An increase in BMI increases the risk of stroke. Obese young adults have 73 percent greater risk of stroke as compared to healthy people. Obesity increases our blood pressure, which leads to stroke; it also increases triglycerides, cholesterol, etc. It increases the risk of thrombus formation clot formation. A clot is formed in vessels and reaches the brain. As a result, stroke occurs. Cardiovascular deaths: Statics show there is an increased incidence of cardiovascular deaths nowadays. The number of deaths due to atherosclerosis in Spain reached more than 1.35 thousand in 2019. In 2019, a number of deaths due to stroke in the UK was 19.3 percent due to bad diets. In 2021, the leading cause of death was cardiovascular disorders. Heart diseases risk in the US between 2000 and 2018 for 65 years of age was 39 Percent in 2000 and 28.5 percent in 2017_18. Hypertension: Obesity increases fatty acids, particularly triglycerides, cholesterol, and free fats. It causes an increase in blood pressure and hypertension as a result. Hypertension further leads to various disorders, including cardiovascular disorders, cardiomyopathy, and other problems. How to prevent cardiovascular disorders due to obesity? Improving lifestyle Hiking Swimming Jogging Avoid fizzy drinks Avoid too many carbohydrates Avoid fatty foods Dietary restrictions Avoid smoking Proper sleep Workout Walking regularly Minimize screen time and prefer a walk, exercise, etc

Brisk walk Work out Avoid too much fatty food Don't adopt a sedentary lifestyle Improve diet Try to add fibers to your diet Don't eat foods containing margarine

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Cardiovascular disorders have increased the number of deaths at a young age. They are a major risk factor for the population. One of the major causes of cardiovascular diseases is obesity. These disorders include stroke, hypertension, myocardial infarction, thrombosis, thromboembolism, arrhythmias, atrial fibrillation, flutter, etc. It's the need of the hour to treat cardiovascular disorders as well as maintain a healthy weight. One of the major steps to be taken is to change our lifestyle. A sedentary lifestyle is a gateway to a lot of diseases. So, we have to change our lifestyle.

EATING EVOLUTION: WHY DO WE EAT LIKE THIS? EXCERPT FROM THE CERTIFIED HOLISTIC NUTRITION COACH COURSE

Throughout history, people have eaten food essentially as nature produced it. People ate whole and unprocessed vegetables, fruit, grains and beans and chicken, fish, and other animal foods. Small amounts of sugar and honey or some wine and beer in the diet were balanced by regular physical labor, from sunrise to sunset, for every member of the family. They had no cars, planes, trains, or bicycles for transportation. Life was active. Our ancestors would not recognize the food in today’s supermarket. In the last 100 years or so, large-scale food processing has become the norm. Bread and other baked goods that were once made of whole-grain flour are now made from processed, white, bleached flour that is far less nutritious. American consumers have developed a taste for processed foods like pastries, cookies, crackers, chips, and other foods that are far removed from their origins. Many people don’t realize that processing food strips them of many nutrients. Think of the difference between white bread and wheat bread. Both come from wheat. But wheat bread uses the entire grain, while white bread is made by removing the bran and the germ (parts of the grain) during the milling process. NOMADIC

Manufacturers remove these parts to create lighter, fluffier bread and to extend its shelf life. The germ, specifically, contains natural oils that could make bread go rancid. White bread can sit on the shelf for about 21 days before it loses its moisture and gets hard, while bakeries typically sell their fresh-baked bread within 24 hours.

stuffed with a white filling, made with cream, which comes from cow’s milk and contains added sugar, this is not healthy. Many different machines are involved in both the production and the packaging of processed foods like this one.

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In addition to leaving out or removing essential nutrients, processing foods generally involves adding sweeteners, colors, flavors, and preservatives. Manufacturers now add sugar to everything from ketchup to toothpaste. Supermarket shelves are filled with highly chemicalized foods, including soft drinks, packaged snacks, frozen dinners, boxed desserts, and condiments. Nearly all of these items contain artificial ingredients, rather than fresh, natural ingredients. Sometimes manufacturers try to reintroduce nutrients to foods by a process called enrichment. But a laboratory can’t possibly reintroduce all the vitamins, minerals, carotenoids, phytochemicals, and fiber that the original plant source contains. A single tomato contains more than 10,000 phytochemicals. (Scientists believe phytochemicals may protect cells from the damaging effects of toxic substances that can result in cancer and heart disease). When you see the word “enriched” on bread labels, such as “enriched white flour” or “enriched wheat flour,” it means they took out the best part in the processing and tried to put some of it back in another form. A similar process occurs with fortified cereals, which typically feature highly processed grains and sweeteners, enriched with a few vitamins. A simple way to think about enriched foods is to imagine you have $100 in your wallet. If someone stole the $100 but then decided to put back $20, would you feel enriched? Most people would feel like they’re still missing some cash! The fact that we have to inject nutrients back into our food demonstrates how strange our eating habits have become. Not that long ago, we ate what was fresh and available. Now we eat foods that are cheap, fast, and convenient with little thought about whether they give our bodies the nutrients we need to get us through our day. What we buy in the grocery store may look like food, and it may taste like food, but it’s not the food our greatgrandmothers ate. We encourage clients to eat foods in their whole, natural states as much as possible. Before buying products at the store or ordering at a restaurant, think about the processing the food went through to get to the table. For example, at a Mexican restaurant, the corn tortillas are probably made from processed cornflour and a mix of preservatives. Not that your client would, but buying Twinkies from the store – we only need to think of how they were created. With highly processed flour and sugar and

Many people are disconnected from real, whole foods and have lost touch with the reality that our food comes from the earth. Simple eating celebrates the richness of whole foods. Think of the juiciness of a ripe piece of fruit, the crunchiness of a whole carrot, or the creaminess of mashing an avocado. We always encourage clients to find simple pleasures in the foods eaten.

THE CONNECTION BETWEEN WEIGHT AND DIABETES

Obesity is one of the major problems in the world nowadays. Gone are the days when nutrient deprivation was one of the major causes of cell injury and death. Now, apart from nutrient deprivation in some parts of the world, obesity is the major cause of cell injury and the gateway to a lot of diseases. The major complication of obesity is diabetes mellitus. According to advanced research studies, about 90% of diabetics are obese. Obesity causes Type 2 diabetes mellitus or Non-Insulin Dependent Diabetes Mellitus (NIDDM). Obesity affects the way our body uses glucose and ultimately leads to Type 2 diabetes mellitus. Which hormone is related to diabetes in obese persons? Insulin is a hormone that's involved in diabetes-related to obesity. Insulin resistance, as well as impaired insulin secretion, are causes of diabetes in obese people. Reduced insulin secretion is a late phenomenon; there is insulin resistance at first. How does obesity impair the function of Beta cells?

Obesity leads to a decline in the function of beta cells. It affects the function of Beta cells in the pancreas. Normally, NOMADIC | 24 Beta cells can cope with insulin resistance by an adoptive

mechanism. But in obese people, Beta cells are damaged, and they can't cope with insulin resistance. Moreover, there is impaired insulin secretion as well. There is decreased glycolysis, increased gluconeogenesis, and elevated glucose levels. Elevated glucose has Glucotoxic effects on beta cells, further impairing Beta cells' function.

What is the treatment of diabetes mellitus?

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Moreover, there is an elevation of NEFA levels in diabetes. Continuous elevation of NEFA leads to Beta cells failure and insulin resistance. What changes occur at the cellular level in obesity that leads to diabetes mellitus? Increased Body mass index leads to diabetes. In obesity, there is an excess of fat in our body which causes deposition of excess of fat in the adipose tissues. Excess of fat in adipose tissue leads to inflammation which is one of the causes of insulin resistance. It also causes expanding of fats in other tissues such as liver and skeletal muscles, which increases insulin resistance. In such a condition, Beta cells of pancreas produce normal insulin, but it can't act on cells. Elevated levels of glycerol, free fatty acids, cytokines, proinflammatory markers in obese people also cause insulin resistance. Moreover, when there is an excess of Plasma free fatty acids, muscles utilize Fatty acids, and there is decreased utilization of glucose, and hence, insulin resistance occurs. At first, there is a compensatory insulin increase, but later, there is diminished insulin secretion.

Common medications for diabetes mellitus include Sulfonylureas, Insulin secretagogues, Beguinides, Acarbose, GLP analogues, Oxazolidinones, etc. Initially, along with weight reduction, Beguinides, i.e., Metformin is prescribed. It increases insulin sensitivity and decreases insulin resistance. It enhances carbohydrates metabolism, decreases glycolysis, increases lipolysis and decreases glucose levels. Its advantage is that it doesn't increase weight like other drugs because it doesn't increase insulin secretion. So, it is the drug of choice for diabetes in obese persons. After some time, there is need to add other classes of drugs because of decreased insulin secretion by Beta cells. These include a combination of short-acting and long-acting drugs. Incretin analogues and DPP4 inhibitors are used for diabetes related to obesity. Incretin analogues produce glucagon-like peptide, which provides a feeling of satiety by delaying gastric absorption of glucose, decreasing glucagon secretion, stimulate insulin secretion, stimulate carbohydrate utilization and decrease glucose levels. DDP4 inhibitors increase the levels of GLP, GIP, increase insulin secretion, decrease gastric emptying and also decrease glucose utilization. Dietary restrictions and requirements:

Insulin resistance also depends on fat distribution; individuals with peripheral fat distribution have more insulin sensitivity than individuals with central fat distribution. Omental adipocytes produce more adiponectin than peripheral adipocytes. What are common strategies for the treatment of diabetes mellitus? For Type 2 diabetes mellitus or NIDDM, there are the following remedies: Weight reduction Dietary restrictions of excess glucose Medication Role of weight reduction in diabetes: Weight reduction is an important step for controlling type 2 diabetes mellitus. Weight reduction decreases insulin resistance. Insulin increases glycolysis and decreases gluconeogenesis. There is reduction in blood glucose levels. Weight loss has been shown to control the onset of diabetes in prediabetic individuals. Weight reduction also improves glycemic control.

For diabetes, you have to avoid foods like pasta, white rice, sweets, candies, juices, soda drinks, fried foods, etc. The diet should include the following groups: Vegetables like broccoli, pepper, tomatoes, potatoes, corn, etc. Fruits like bananas, apples, grapes, melons, etc. Whole grains like wheat, rice, beans, etc Proteins including lean meat, chicken, fish, eggs, nuts, etc What's the importance of fiber in diabetes? Fiber is an important component of a balanced diet with many advantages. Fiber is particularly important in controlling and managing diabetes. It's the carbohydrate found in grains, fruits, vegetables, legumes, etc. Fiber is important in maintaining blood sugar levels because it can't be digested or absorbed. So, it can't raise our blood glucose level as other carbohydrates do. They also provide a feeling of satiety. It moves slowly through our stomach, provides a feeling of fullness and food intake is limited. So, fiber is an important component of diets with minimum calories. Such diets are helpful for weight loss.

What is the role of physical activity and exercise in diabetes?

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Regular exercise and physical activities are important for diabetics, as they also cause weight reduction, which is important for diabetics. Exercise has the following advantages: Burns extra calories Burns extra fats Lowers glucose levels Lowers blood pressure Helps in weight reduction

Some of the common exercises we can suggest to people with diabetes include: Regular walk Walk briskly Hiking Dancing Swimming Cycling Jogging Torso twists Overhead arm stretches Leg lifts or extensions Side lunges Desk chair swivel Walk while talking to someone instead of watching TV Climb stairs instead of elevator Go to some park, walk, run Go for picnic Obesity, a major problem today, is a gateway to a number of diseases. One of these diseases is diabetes mellitus. Obesity leads to Type 2 or Non-Insulin Dependent Diabetes Mellitus (NIDDM). It occurs due to increased insulin resistance and impaired insulin secretion. At first, our body produces normal insulin, but it can't be utilized, and there is a rise in blood glucose levels. Later, there is reduced insulin secretion. Our lifestyle has contributed to obesity, diabetes mellitus, and other diseases as a result. There is a dire need to control obesity and diabetes by lifestyle modifications, calories restriction, exercise, and medications. Medications for diabetes include Metformin, incretins, and others.

GOUT: KNOWING THE SIGNS AND PREVENTION

Wondering the reason behind Gout? Several experts claim that Gout is the result of excess body fat. Gout occurs typically when a person has an excess of uric acid in the body. Although uric acid can increase due to various reasons, fat is the most prominent. Individuals who remain obese throughout their adult life have a higher risk of being affected by Gout. People who maintain stable weight at their adult age have a lower ratio of being affected by Gout. Obesity is regarded as one of the most significant factors contributing to Gout; we would explore this. Relationship Between Gout and Obesity Gout is an inflammatory form of arthritis known for causing extreme pain in the big toe. Although Various factors can cause Gout, obesity plays a more significant role. The connection of Gout with obesity is the reason it is was known as the disease of kings; The reason for calling Gout by this name was that only wealthy people were affected by this in the past. As affluent people can afford to eat more and drink alcohol, that was probably the reason they were more affected by it.

Various researches indicate that people who gain a lot of weight are more prone to developing Gout. Research N Othroughout M A D I C | their 2 4 life suggests people who remain obese

have more chances of developing Gout. Whereas people who are obese but lose weight are less likely to be affected by Gout.

changing diet and increasing physical activity. The second one deals with medication that experts suggest should be taken regarding specific conditions. Here we would look at both scenarios.

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The primary reason for developing Gout in obese people is a higher uric acid level. As healthy people have a greater concentration of uric acid in their bodies, they can build Gout. What is Gout? Gout is a painful form of arthritis resulting from excessive uric acid in the body. A person suffering from Gout develops crystals containing uric acids in the person's joints. These crystals are responsible for swelling and inflammation of joints, resulting in intense pain. At an initial level, Gout affects only one joint, which is mostly the big toe joint. But after some time, it starts spreading towards other joints, resulting in reddishness and swallowing of the joints. What Causes Gout? As we have mentioned before, Gout occurs due to excess uric acid in the blood. The human body produces uric acid when it breaks down purines, found in the food we eat. Some popular foods containing purines include beer, shellfish, and red meat. Although our kidneys eliminate uric acid in the body, it becomes difficult to break down when obese. Therefore an obese person's kidney would find it challenging to eliminate uric acid, resulting in higher risks of developing Gout. Moreover, many experts suggest that an overweight person would get Gout sooner than a healthy person. A person may have visceral fat, which is belly fat and doesn't constitute obesity. But still, that person is likely to develop Gout; the reason is that belly fat produces inflammatory chemicals that may contribute to developing Gout. Symptoms of Gout: Normally signs and symptoms of Gout may develop in a few days or even early, like overnight. These symptoms include the following: Limited range of motion Redness and inflammation Extreme joint pain Prolonged Discomfort How to Treat Gout?

When it comes to treating Gout, there are two main ways. One is by considering a person's lifestyle, including

Changing Your Lifestyle to Prevent Gout Although some people believe that only changing diet would help eliminate Gout, as we have mentioned before, Gout results from higher uric acid concentrations. And higher uric acid is the result of consuming a lower quantity of purine foods. So to simplify the treatment, one may say that consuming more elevated amounts of purine-rich foods could help eliminate Gout. Some purine-rich foods that are good for removing Gout include red meat, seafood, and alcoholic beverages. Although one of the studies suggests, Broccoli can be a great food to add to the diet to eliminate Gout and enjoy a healthy life. Apart from food, it is also essential to look at the overall lifestyle for better outcomes. Your kidneys eliminate uric acid, but it doesn't effectively work for an obese person. Therefore it's essential to embed physical activity and exercise to lose weight. Losing weight would help reduce uric acid in the body and hence would eliminate Gout. In fact, in many cases exercising daily and striving to lose weight can produce better results than consuming a purine-rich diet. Medications for Gout Maintenance Prevention Gout's good news is that it can also be eliminated with Medicines. Medicines help in two ways. Firstly the medication would help in reducing the intense pain. Secondly, medication can help reduce uric acid build-up, which eventually leads to Gout in the first place. But when it comes to taking medication to treat Gout, there are two schools of thought. One school of thought suggests that patients suffering from Gout should take medications under certain conditions. These conditions include patients having kidney stones, uric acid deposits, or gout attacks; experts of this school of thought believe only a person should consume the uric acidlowering medication in such situations. On the other hand, another school of opinion exists, which states that any gout person should take medication. How to Prevent Gout? After discussing the two popular ways of eliminating the development of Gout, it's essential to look for prevention in the first place. Although we have stressed this point before, it's worth emphasizing. Maintaining a healthy lifestyle is the

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best way to go when it comes to avoiding Gout. There is a positive relationship between obesity and Gout; it's essential to take the necessary measures to maintain a healthy weight. Exercising daily and eating healthy food would eventually help avoid Gout and other harmful diseases. Avoid overeating sugar, excessive alcohol intake, and eat a balanced diet. To conclude, Gout is a severe inflammatory disease that causes intense pain. If not treated properly, it may develop further and cause more harm. Therefore it's essential to prevent it before it occurs.

WHY YOUR MENTAL HEALTH MATTERS:

The physical consequences of excess weight are well known, ranging from type 2 diabetes to increased risk of falls, heart issues, and osteoarthritis. Yet not quite as much spotlight is given to its impact on our mental and emotional health.

HOW YOUR EMOTIONS ARE IMPACTING YOUR WEIGHTLOSS

What Mental Health Challenges Do Adults with Obesity Face? In addition to their physical challenges, people living with obesity often struggle with mood and anxiety disorders. Other research has linked being overweight with significant increases in major depression, bipolar disorder, and panic disorder or agoraphobia. How Obesity Causes Mental Health Problems There are a variety of practical and societal factors that can lead to mental health issues for patients living with obesity.

Men and women who carry significant extra weight often face problems related to physical and occupational functioning, both due to their size and NOMADIC

chronic ailments. Being physically unable to do the things they love—such as attend fun events, travel, or visit with friends and family—can lead to social isolation, loneliness, and more difficulty coping with life’s hardships. Chronic pain on its own has been linked to depression.

those comfortable habits when times get tough. These habits relieve discomfort—at least in the short term.

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One of the biggest challenges for those struggling with weight issues is society’s negative perspectives on obesity. Weight bias refers to the stereotypes and attitudes that define people with obesity as unattractive, lazy, and undisciplined. These unfavorable misperceptions can be widespread within families, among peers, in the workplace, and in medical settings by healthcare providers. They can lead to discriminatory behavior that affects a person’s selfesteem, employment opportunities, and even the quality of healthcare they receive. Weight bias and poor body image tend to go hand-in-hand. Patients may internalize society’s stigma against obesity, which causes them to feel embarrassed about their weight and dissatisfied with their appearance. People who struggle with excess weight may also experience anxiety over being judged for how they look. There are also obesity-related health factors that can negatively influence mental health. Research suggests that excess body fat and poor eating habits increase inflammatory markers. This heightened inflammation can lead to a higher risk of developing depression and also plays a role in immune system health. If you've tried every diet and exercise plan and can't slim down, there may be a psychological block in your way. Weight loss is an uphill battle for anyone, but those dealing with emotional struggles may have a harder time reaching their goal. The first step to a healthy resolution is identifying the issue. You may find that there is more than one roadblock to address. The good news is, however, that these hurdles are surmountable.

What's worse, is that you likely have strong rationalization skills to support the continuation of unhealthy habits. After all, why would you discontinue a practice that provides relief and comfort? In the case of food habits, it is particularly difficult to change our habits. Our bodies are designed to eat and we need food to survive. We also feel better when we eat. But all is not lost if you want to change your habits for weight loss. The psychology of weight loss works against you in some ways, but it can work for you in others. In order to get past your roadblock, you'll first need to figure out specifically, what that roadblock is. Common Psychological Blocks If you find yourself walking a thin line between sticking to your food plan perfectly or falling off the wagon completely you may be experiencing a cognitive distortion called all-ornothing thinking. Psychologists use the term "cognitive distortion" to refer to persistent exaggerated thoughts that are not in line with what is actually going on in the real world. People who experience all-or-nothing thinking while trying to lose weight believe that they are either a complete success or a total failure based on their food choices. Studies have shown that an all-or-nothing thinking style is closely linked to a perceived lack of control over eating and an inability to maintain a healthy weight. Some researchers have even likened this lack of control to Jekyll and Hydetype behavior.

Emotions and Weight Loss

If you practice all-or-nothing thinking, you probably struggle to return to a healthy eating pattern after enjoying a small indulgence. Instead, you are likely to throw in the towel and overeat based on the assumption that your diet is a complete failure.

Most of us have good intentions when it comes to eating right and exercising more often. And most of us know the basics of what to eat and what to avoid. But even with the best of intentions, we often end up derailing our progress when we feel tired, or stressed, or bored, or frustrated. And let's face it...these emotions pop up often.

If you are trying to change your body size and body shape, it is possible that you are less than satisfied with the way it looks in its current state. Of course, there is nothing wrong with wanting to improve your health or your appearance. But if your body image is too negative it can hinder the weight loss process.

We are all creatures of habit. We find comfort in routine. So, if your routine includes food and activity patterns that have led to an unhealthy weight, it is normal that you seek out

Researchers have shown that body dissatisfaction is more common in those individuals with obesity than it is in those that are normal weight.

For some people, a negative body image is tied to selfworth. They may think that their worth is determined by body, shape, size, or the food that they eat. This can get in the way of success when trying to develop healthy eating habits or trying to reach and maintain a healthy weight.

Researchers are not clear if depression causes weight gain or if depression prevents weight loss, but many scientists believe that there is a link. And even among normal-weight people, depression can be problematic as it relates to weight. In some people, depression can also lead to lack of appetite and weight loss. Research has suggested simply the perception of being overweight increases psychological distress and may lead to depression.

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In addition, a negative body image is linked to unhealthy eating patterns and other problems. Authors of a study published in the International Journal of Behavioral Nutrition and Physical Activity suggest that those experiencing distressing preoccupations about weight and shape may also experience embarrassment in public, avoidance of activity due to self-consciousness, and excessive feelings of fatness after eating. It is not clear if a negative body image leads to unhealthy eating or if unhealthy eating leads to a negative body image. We know that our thoughts impact our emotions and behaviors. What is clear is that feeling a strong dissatisfaction with your body can stand in the way of reaching a healthy weight. There is a good reason that comfort food got its name. For most people, eating feels good. And in times of stress, some people use food as the best way to calm their emotions. While this occasional strategy is not uncommon in people of all body shapes and sizes, it can create problems if you are trying to lose weight or if eating is your only way to cope with stress. Studies have found that overeating can become a chronic coping mechanism for managing life's stressors. The strategy may be more common among those who are already overweight. And it's not just overeating that can be problematic. Your food choices are likely to change when you feel more anxious. A study published in Physiology and Behavior determined that not only do we eat more when stressed, but the foods consumed are foods that are normally avoided for weight-loss or health reasons (foods that are typically higher in calories and added sugar). Lastly, when we are stressed our body produces more cortisol which can lead to weight gain.6 Many people who are trying to lose weight, but are stressed may not see a change in their weight which is completely unrelated to their best efforts but rather related to our body's response to stress. Stress can be a big roadblock for people trying to lose weight or get healthier.

Depression-related symptoms like sleeplessness or fatigue can make weight loss more difficult. And some commonly prescribed antidepressants can cause you to gain weight as well. Some researchers have found that people who were exposed to physical abuse, sexual abuse, or peer bullying are at higher risk for obesity. Those who have experienced emotional trauma may adapt their eating habits to the point that it affects their weight. Some scientists believe that weight gain can be used as an emotionally protective "solution" for survivors of abuse. Of course, not every person who experiences personal or childhood trauma struggles to maintain a healthy weight. But if you experienced abuse, neglect, or bullying there may be a connection. You may have found that one or several of the common psychological barriers to weight loss look familiar to you. It is not unusual to experience multiple hurdles on your journey to a healthy weight. But these roadblocks don't need to prevent your success. There are many experts who are specially trained to deal with depression, past trauma, and other issues that may be standing in the way of weight loss success. You can find a behavioral health specialist who is skilled at treating the underlying emotional causes of overeating and weight gain.

WHEN TO REFER CLIENTS

Professional Coaches do not diagnose mental health risks, but they should know what to look for in case there is a need to provide referrals to another health professional, be it a psychologist, therapist, or appropriate coach - for consultation. The following indicators are examples to watch for: Depression: Clients who are not eating or sleeping in a normal pattern, such as not sleeping or sleeping all of the time, have lost their appetite, or are binge eating, may be showing signs of clinical depression and may need to be referred. Eating disorders: Clients who have lost a great deal of weight without surgery and/or medication, and continue to do so when advised it will be harmful to their health (anorexia), exercise beyond their normal physical capacity, or continue to gain and/or lose 20-30 pounds without stabilizing their weight may be showing signs of an eating disorder and may need to be referred. Substance abuse: Clients who display unusual behaviors, such as acting out or violent outbursts, that are uncharacteristic of their usual behaviors may be showing signs of substance abuse, including steroid use, and may need to be referred.

NOM A D panic IC | 24 Anxiety disorders: Clients who suffer from

attacks, claustrophobic behavior, or shortness of breath may be showing signs of anxiety disorder and may need to be referred to their physician. Honor your Intuitions

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If you have a sense that a client should seek further medical attention or needs resources beyond your expertise, respectfully yet candidly express your concern. If the client then chooses not to engage with additional resources, it is recommended that you terminate the coaching relationship until the client has received the appropriate assistance. Using Other Health Practitioners and Providers It is valuable to build relationships with highly- respected therapists and therapist groups in your area. Situations may arise where you work with professionals in your network with your client concurrently. You can - and should - then refer clients to professionals whom you know and respect. This may also lead to cross-referrals and a lot of targeted business-building. If you don’t have the ability to make such a referral directly, always recommend that clients see their primary care coach or provider for a referral (be sure to document the date and time that you make such recommendations in case it comes up later). If you seek advice about a client that you believe has a mental health problem, be sure to follow the Health Insurance Portability and Accountability Act (HIPAA) rules (privacy of personal health information), taking full precautions not to share the client’s name or any revealing personal information.

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