Fitness Resources


The REAL Scoop on Protein Powders

by Matthew Kadey, MS, RD on Sep 06, 2019

Research suggests more protein foods and less powder will balance training needs.

Protein powders, especially the whey variety, have long been glorified in fitness circles for their muscle-building benefits. “Pump some iron and chug back a protein shake” is a preferred muscle-making formula. But research published in the journal Nature Metabolism, led by scientists from the University of Sydney, suggests that while the essential branched-chain amino acids (BCAAs) leucine, isoleucine and valine—found in high amounts in certain protein powders—can indeed help muscles recover and grow in response to training, excessive consumption of BCAAs may have unwanted side effects if taken at the expense of other amino acids from additional protein sources.

For instance, supplementing with high doses of BCAAs leads to high levels in the blood, potentially triggering competition with another amino acid, tryptophan, for transport to the brain. This can negatively affect mood, as tryptophan is a precursor for the feel-good hormone serotonin. Lower brain levels of serotonin can also stimulate appetite, leading to possible excess consumption of calories and, in the end, weight gain.

The take-home message is that it’s fine to include a scoop of whey protein in your daily diet to support training needs, but it’s best to eat a wide range of protein foods—including those from plant sources like legumes—to get a better balance of amino acids.

Correcting Misconceptions About Fat

May 22, 2019

Fitness Handout

A dietitian explores the latest research and clears up some common myths about fat.



For years, fat was demonized as dietary “Public Enemy Number One.” Despite the essential roles it plays in the body, including temperature regulation, hormone production and protection of organs, we were told it was also responsible for weight gain and other health woes. As a result, people stocked their kitchens with low-fat items.

Now the tide has turned. New research and popular diets like paleo and ketogenic have caused the fat stigma to wear off. But what is the real truth about fat?

Matthew Kadey, MS, RD, James Beard Award–winning journalist, Canada–based dietitian, freelance nutrition writer and recipe developer, explores the latest research and clears up a few common myths.

The Myth: Fat-Free or Low-Fat Is Healthier


The low-fat craze led to the formulation of thousands of lower-fat products, from yogurts to cookies. “But when the fat is reduced or removed from a food, you lose much of its flavor,” explains Michelle Babb, MS, RD, author of Anti-Inflammatory Eating for a Happy, Healthy Brain (Sasquatch Books 2014). “So to make up for the flavor shortage, manufacturers often add sugar, artificial flavors and salt, which is hardly a nutritional upgrade.” For instance, the calorie savings in reduced-fat peanut butter is negligible owing to its higher sugar numbers. When you opt for fat-free salad dressings, you won’t fully absorb the fat-soluble antioxidants—like lycopene and beta-carotene—that are found in vegetables.


As long as you are mindful of portions, Babb says, there is no reason you can’t enjoy foods that are closer to their natural, full-fat state.

The Myth: High-Fat Is Healthier Than High-Carb


In a study published in The Lancet, higher carb intake was associated with an increased risk of total mortality, whereas total fat intake was not found to raise death risk (Dehghan et al. 2017). But context is key: The typical American diet is roughly 49% carbs, 34% fat and 16% protein, so it cannot be considered especially high in carbs or low in fat. In turn, we shouldn’t use research like this as permission to greatly fatten up our diets.

But that’s beside the point. David Katz, MD, MPH, director of the Yale University Prevention Research Center and founder of True Health Initiative, feels strongly that we need to stop paying attention to such studies, as they do the public a major disservice. “Depending on the foods you choose, you can eat a low-fat, high-carb diet full of jelly beans and soda that’s terribly unhealthy and raises your disease risk, or you can eat a high-fat diet rich in fried foods that does the same.” So if the diets in the aforementioned study were skewed toward higher intakes of processed carbs like white bread and white rice and higher intakes of beneficial fats like olive oil and nuts, it’s not surprising fat came out on top.


Look past simplified recommendations and instead look at diets in the context of what you are eating overall. In other words, choose mostly healthful foods, and the healthful fats and carbs will take care of themselves in whatever percentages suit a person’s tastes.

The Myth: Coconut Oil is a “Superfood”

Busting Myths About Coconut Oil as a Superfood
Coconut oil is not nearly the health-boosting miracle its fans want it to be.


Often demonized for its super-high saturated fat content (91% of calories), coconut oil has experienced a renaissance. But coconut oil is not nearly the health-boosting, fat-fighting miracle its fans want it to be.

“There’s no strong evidence directly tying coconut oil to either a greater or reduced risk of cardiovascular disease,” says Patrick Wilson, RD, PhD, assistant professor of exercise sciences at Old Dominion University in Norfolk, Virginia. Officials at the American Heart Association still say we should steer clear of coconut oil, citing concerns about its potential impact on cardiovascular health (Sacks et al. 2017).


If you like its flavor or the moist­ness it adds to baked goods, it’s probably fine to include modest amounts (no more than a tablespoon daily) as part of an overall healthy eating plan.


Dehghan, M., et al. 2017. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): A prospective cohort study. The Lancet, 390 (10107), 2050–62.

Sacks, F.M., et al. 2017. Dietary fats and cardiovascular disease: A presidential advisory from the American Heart Association. Circulation, 136 (3), e1–e23.

Fitness Journal, Volume 16, Issue 6

A Woman’s Place Is in the Weight Room

by Tessa Yannone on Jan 15, 2019

Ex Rx

Optimize workouts to account for differences in musculature and hormones.

Every day, more women are moving from the cardio room to the weight room. It’s a welcome transition; getting stronger can transform their self-esteem, confidence and self-efficacy.

Supporting your female clients’ strength-training ambitions is fundamental to their long-term success. Women and girls enjoy a wealth of benefits from resistance exercise: reduced injury risk, better cardiovascular health, stronger bones, protection against diabetes, and less inflammation, to name a few. As more women flock to strength training, however, fitness professionals face a host of challenges. For starters, the research on weight training for women is relatively new, and there are fewer studies on women than there are on men. Also, the physiological differences between genders is either misrepresented or not discussed.

We aren’t that much different. In equally trained men and women, research finds most strength differences result from differences in muscle size, not gender (Bishop, Cureton & Collins 1987). These findings suggest that a man and a woman with the same muscle size should display the same amount of strength. Thus, we can retire terms like “toned” and “girl pushups”—and the pictures of pink dumbbells—because women should and can do the same exercises your male clients do. You, of course, already know this.

You should consider two crucial points, however:

  • Women and men have different muscular fiber type compositions, making women less prone to fatigue (Hunter 2014).
  • Female sex hormones, especially those involved in the menstrual cycle, can affect program timing and recovery (Sung et al. 2014).

Understanding these differences is pivotal to building programs that will help your female clients achieve muscle growth, strength gains and training success.

Fiber Types in Women vs. Men

Type I and type II. Generally speaking, the skeletal muscles of men are larger than those of women, and, in men, some muscles possess “a greater proportional area of metabolically and functionally faster muscle fibers,” whereas in women there is “a greater proportional area of the ‘slow’ type I fibers” (Hunter 2014). The higher concentration of type I fibers makes women more resistant to muscle fatigue. Men have a higher glycolytic capacity based on their larger concentration of type II fibers, priming males for quick, explosive activities like sprinting and weightlifting.

While muscle fiber type plays a large role, it is important to remember that the tendency to fatigue depends a lot on task conditions, including contraction type, speed and intensity; the muscle group involved; environmental conditions; and state of arousal (Hunter 2014).

Metabolism. The makeup of muscular tissue affects the energy substrates that each gender uses. Women typically carry 6%–12% more fat than men. Women are also better at handling fat and using it for energy during exercise, which spares muscle glycogen and decreases exertion ratings, again playing into fatigue resistance. Additionally, women are more sensitive to insulin across the entire body and are better able to take up glucose (Lundsgaard & Kiens 2014).

Program design. If muscle growth is a female client’s main goal, keep in mind that she is probably more resistant to fatigue than a male client would be. Programming sets in the 6- to 10-rep range seems to yield maximal muscle growth (Schuenke et al. 2012) and maximal increases in strength.

Because women can theoretically handle more work, your general-population clients might benefit from harder-intensity training sessions with supersets and timed rest periods. Consider challenging them to fatigue a little faster than they normally would, since you need to push them beyond their comfort zone to achieve muscle growth.

Sex Hormone Differences

Menstrual cycle. Women’s menstrual hormones fluctuate throughout their cycle, which usually lasts 28 days (hormonal contraceptives and other issues can alter the cycle). Hormonal fluctuations play a huge role in strength training, a reality only recently discussed in academic literature. By opening up this conversation with your female clients, you can tap into their strengths a little more and use biology in their favor (Sung et al. 2014).

The menstrual cycle has four phases:

  • menstrual (days 1–5)
  • follicular (days 1–13)
  • ovulation (day 14)
  • luteal (days 15–28).

The luteal phase triggers sharp hormonal changes—progesterone peaks and then plunges, along with estradiol. Hunger increases, moods change suddenly, core temperature rises, and more calories are burned; in fact, basal metabolic rate has been shown to increase by as much as 9% (Webb 1986). In this phase, symptoms of premenstrual syndrome often discourage interest in going to the gym.

The follicular phase, by contrast, is the time for women to really push themselves in hard workouts because estrogen hits its peak at this time, improving mood, energy and strength.

Estrogen vs. testosterone. These sex hormones have the most impact on the relative strength of women and men. Men have much more testosterone, affecting their baseline strength. Thus, men start out stronger with higher absolute strength, but relative strength gains are about the same for both genders.

Estrogen, on the other hand, has proved to have some anabolic and protective effects against various injuries and diseases. Within muscle, estrogen has been shown to influence contractions and postexercise muscle damage by acting as an antioxidant and a stabilizing membrane and by binding to estrogen receptors (Enns & Tidius 2010). Estrogen also has regenerative properties, which is why combining exercise and hormonal therapies can increase lean tissue mass (Velders & Diel 2013).

Program design. Maintain an open dialogue with your female client: Ask how she is feeling and if she would like to disclose the current phase of her menstrual cycle. Explain that while she doesn’t have to push through the bothersome symptoms of the luteal phase, she will benefit from some type of movement.

In the luteal phase, steer clear of high-intensity interval training and avoid going for personal bests or heavy strength sessions. Save these for the follicular phase. The luteal phase is an optimal time for deloading if the client is on a strength program. It’s also a great time for moderate conditioning or low-intensity cardio training.

Optimize periodization around her cycle. For instance, if she usually does strength training three times a week, you might keep the frequency the same during the luteal phase and ramp it up a session or two during the follicular phase (Sung et al. 2014). See “Sample Program Design,” below, for more.

Putting It All Together

Though men and women are different, your approach to strength training should be similar: Optimize physiological differences to produce peak training performance. As a fitness professional, you need to do three things to avoid alienating female clients by suggesting that their strength training programs are somehow inferior to men’s:

  1. Lead by example. Show pictures, videos and articles of women doing what men (and other women) do. Show what these women’s bodies look like, what they are capable of and how they got there, while also (if you are a female trainer) disclosing the importance of strength training in your own life. You have the power to be a role model and a leader. Be the example, and your female clients will follow.
  2. Banish biased language. Remove gender-labeled equipment and exercises from your vocabulary: Words like long, lean, toned and girl pushups have no merit or place in this space. This kind of language reinforces the false notion that women require a different type of exercise that will not make them “bulky” or “manly.”
  3. Make room for self-discovery. Strength training can be scary and intimidating. Women almost never approach weight training wholeheartedly unless they’ve grown up around it. Let your clients draw their own conclusions about the experience—what they like or dislike. Female clients will appreciate having the space to find what they love about moving their bodies in this way. When the motivation comes from within, they will be more likely to stick with the activity and see the benefits of a strong body and mind throughout their entire lives—inside and outside of the gym.


Bishop, P., Cureton, K., & Collins, M. 1987. Sex difference in muscular strength in equally-trained men and women. Ergonomics, 30 (4), 675–87.

Enns, D.L., & Tidius, P.M. 2010. The influence of estrogen on skeletal muscle: Sex matters. Sports Medicine, 40 (1), 41–58.

Hunter, S.K. 2014. Sex differences in human fatigability: Mechanisms and insight to physiological responses. Acta Physiologica, 210 (4), 768–89.

Liu, D., et al. 2010. Skeletal muscle gene expression in response to resistance exercise: Sex specific regulation. BMC Genomics, 11.

Lundsgaard, A.M., & Kiens, B. 2014. Gender differences in skeletal muscle substrate metabolism—molecular mechanisms and insulin sensitivity. Frontiers in Endocrinology, 5, 195.

Schuenke, M.D., et al. 2012. Early-phase muscular adaptations in response to slow-speed versus traditional resistance-training regimens. European Journal of Applied Physiology, 112 (10), 3585–95.

Sung, E., et al. 2014. Effects of follicular versus luteal phase–based strength training in young women. SpringerPlus, 3 (668).

Velders, M., & Diel, P. 2013. How sex hormones promote skeletal muscle regeneration. Sports Medicine, 43 (11), 1089–1100.

Webb, P. 1986. 24-hour energy expenditure and the menstrual cycle. The American Journal of Clinical Nutrition, 44 (5), 614–19.

Fitness Journal, Volume 16, Issue 2

© 2019 by IDEA Health & Fitness Inc.

About the Author

Tessa Yannone

Tessa Yannone IDEA Author/Presenter

4 Ways to Incorporate Whole Foods Into Your Diet














Did you know that the closer a food is to its natural state, the more nutrient-dense it is? Whole foods give you the best bang for your caloric buck since you are eating the entire food with all its vitamins, minerals and fiber, and the food has not been subjected to potentially damaging processing.

Make a goal this year to include more whole plant–based foods in your diet. You probably already eat berries as whole foods. Try these other suggestions from Lourdes Castro, MS, RDN, adjunct professor at New York University’s department of nutrition, food studies and public health.

1. Beets, Garlic, Sweet Potatoes

Why eat these foods? Roots, tubers and bulbs grow underground and function as a plant’s nutrient-storage system, so it’s no surprise they are packed with vitamins and minerals. They provide antioxidant benefits, such as protection against many chronic diseases and conditions associated with aging.

Whenever possible, use the entire plant from root to leafy greens. Different parts of the plant may require different cooking methods, but the nutrient density is worth it.

Try this at home. Roasted beets with sautéed garlicky beet greens are delicious and easy. Remove the beet tops where stems meet the root, and roughly chop. Quarter the beets and lightly toss with olive oil, salt and pepper. Roast in the oven at 425 degrees Fahrenheit for 35 minutes, or until beets are fork tender. Meanwhile, finely chop 1–2 cloves of garlic and place in a pan with 1 tablespoon olive oil. Place over medium-high heat and add beet greens when the garlic begins to sizzle. Sauté until all greens are wilted. Serve with roasted beets.

Alternative. Roast sweet potatoes and substitute watercress for the beet greens.

2, Lentils, Chickpeas, Fresh Snap Peas

Why eat these foods? Legumes are seeds that grow in pods. The seeds can be fresh or dried, the pods edible or inedible. Legumes are rich in protein, fiber and iron, and they get an extra punch from folate. High folate intake can decrease cardiovascular risk (Willet 2001).

Try this at home. Dried lentils are quick-cooking and versatile. Simmer them in water until tender and then drain and cool. Toss with tomatoes, arugula, corn and carrots, and drizzle with olive oil and a squeeze of lemon. Eat this salad alone or augmented with sliced chicken breast. It also makes great leftovers.

3. Chia Seeds, Walnuts, Ground Flaxseeds

Why eat these foods? All nuts and seeds are rich in healthy monounsaturated fats and help stabilize blood sugar levels. But these foods are especially high in essential omega-3 fatty acids, which lower inflammation throughout the body (Calder 2006). This is especially good for people with arthritis and other inflammatory diseases.

Flaxseeds must be ground to enable your body to absorb all their beneficial nutrients, because the whole seeds pass through the intestines undigested. Chia seeds, on the other hand, do not have to be ground and have a longer shelf life because they can be left whole.

Try this at home. Soaking a table-spoon of chia seeds (or ground flaxseeds) in water will form a gel. Add this gel to your berry purée for a thick smoothie.

4. The Sea Has Vegetables, Too

Why eat these foods? Sea vegetables (types of seaweed) such as dulse, wakame and hijiki are high in both iron and vitamin C, which make them high-value iron sources because vitamin C is necessary for the absorption of plant-based iron. Sea vegetables are thought to have an anti-inflammatory effect, and regular ingestion has been linked to low blood pressure (Wada et al. 2011).

Try this at home. Crumble dulse or wakame leaves and sprinkle over salads, soups, noodles or rice dishes.


Calder, P.C. 2006. N-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. American Journal of Clinical Nutrition, 83 (6), 1505S–19S.

Wada, K., et al. 2011. Seaweed intake and blood pressure levels in healthy pre-school Japanese children. Nutrition Journal, 10, 83.

Willet, W. 2001. Eat, Drink, and Be Healthy. New York: Free Press.

Fitness Journal, Volume 13, Issue 1

Ask the RD: Farmed or Wild Fish for Nutrition Value?

by Sanna Delmonico, MS, RDN, CHES on Jun 19, 2019

Food for Thought

Exploring the nutritional benefits of wild and farmed fish.


I have been trying to eat more salmon for the omega-3 fatty acids. What’s better nutritionally, wild or farmed fish?


All fish are good sources of protein. Fatty fish like salmon, mackerel, tuna, trout, anchovies and sardines are also good sources of vitamin D and omega-3 fatty acids. The American Heart Association recommends two 3.5-ounce servings of fish every week, especially fatty fish, because omega-3 fatty acids help reduce the risk of heart arrhythmias and lower blood triglycerides and blood pressure (AHA 2019).

The nutritional content of a fish depends on its diet. Wild salmon get omega-3 fatty acids from plankton, smaller fish and other seafood. These salmon get their color from pink and orange crustaceans like krill. Farmed salmon, raised in pens, are fed pellets made from fish meal, fish oil, plant proteins (such as corn and soy), animal proteins, vitamins and minerals, as well as carotenoid pigments to turn their flesh orange (NOAA 2018).

Because of differences in diet and how active and, therefore, relatively lean the wild fish are, Atlantic farmed salmon has twice as much total fat as Atlantic wild salmon (13.5 grams per 100 g, compared with 6.5 g per 100 g), significantly more omega-6 fatty acids, and three times as much saturated fat (USDA n.d.). Farmed fish can be higher than wild fish in omega-3 fatty acids, too. Since the early 2000s, however, the composition of farmed salmon has been changing. Fish meal and fish oil for feed have become scarcer and more expensive, so these ingredients are being replaced by plant proteins and plant oils in fish feed. Farmed salmon in 2015 had about half the omega-3 fatty acids it did in 2001 (Sissener 2018).

When it comes to choosing salmon, both farmed and wild are low in saturated fat compared with red meat. Salmon is delicious, but why not try some less popular sources of omega-3s, like anchovies or sardines? Quickly grilled, these small, flavorful fish pair extremely well with fresh herb sauces like gremolata, chimichurri or salsa verde.


AHA (American Heart Association). 2019. Fish and omega-3 fatty acids. Accessed Mar. 10, 2019:

NOAA (National Oceanic and Atmospheric Association). 2018. Feeds for aquaculture. Accessed Mar. 10, 2019:

Sissener, N.H. 2018. Are we what we eat? Changes to the feed fatty acid composition of farmed salmon and its effects through the food chain. Journal of Experimental Biology, 221, jeb180976.

USDA (United States Department of Agriculture). n.d. USDA food composition databases. Accessed Mar. 15, 2019:

Daily Steps and Health | Walking Your Way to Better Health

Kyle Sprow, MPH | Jun 14, 2019

Walking 10000 Steps a Day Physical Activity Guidelines ACSM

Walking 10,000 steps a day – what is the correct number? ANSWERED by the Physical Activity Guidelines Advisory Committee.

Being physically active is one of the most important actions people of all ages and fitness levels can take to improve their health. A 2017 survey suggests that more than 75% of U.S. adults acknowledge that “being in shape and looking good are ‘very important,’” yet only 31% of those surveyed exercise regularly and almost half are inactive. Beyond “being in shape and looking good,” exercise and physical activity provide a myriad of health benefits, many of which are easy to achieve.

In November 2018, the Department of Health and Human Services released the second edition of the Physical Activity Guidelines for Americans. Some of the key updates are: an expansion of the list of health benefits associated with physical activity; greater flexibility on how to achieve those benefits; and highlighting the many proven strategies to help people be more active. The key guidelines for adults and older adults have a few main takeaways:

  • Adults should move more and sit less throughout the day. Some physical activity is better than none. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.
  • For substantial health benefits, adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity.
  • Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes of moderate-intensity physical activity a week.
  • Adults should also do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.

There are many ways for adults of all ages and fitness levels to achieve these federally recommended amounts of physical activity. However, simplifying the guidelines into something such as daily step counts may be an easy way for the majority of Americans to understand and achieve these guidelines. Step counts provide a straightforward metric of physical activity, and measuring daily step counts through a physical activity tracker is an easy and accessible way to monitor and set physical activity goals. In many health and fitness circles, a goal of 10,000 steps/day is often prescribed. In fact, some countries are adopting a 10,000 steps/day target as a national public health goal.1 However, the research supporting the 10,000 steps a day recommendation is limited and many believe this recommendation was derived from the name of a Japanese-made pedometer sold in the 1960s called Manpo-kei, which translates to “10,000 steps meter.2

Given the simplicity and utility of steps/day as a metric for physical activity, translating the “150 to 300 minutes per week of moderate-to-vigorous physical activity” into a steps/day recommendation is important. As a result, the Physical Activity Guidelines Advisory Committee (PAGAC), who produced the scientific report that informed the development of the physical activity guidelines, systematically reviewed the literature to better understand the relationship between steps/day and health.

The PAGAC results were first published in the 2018 PAGAC Scientific Report but have recently been updated in ACSM’s journal, Medicine & Science in Sports & Exercise. This recent publication, titled Daily Step Counts for Measuring Physical Activity Exposure and Its Relation to Health, identified eleven studies that evaluated the relationship between daily step counts and all-cause mortality, cardiovascular disease morality, incident cardiovascular disease, and type 2 diabetes mellitus. In short, the investigators found that, compared to people who accumulated the least number of steps/day, those who accumulated the most steps/day were less likely to suffer from cardiovascular disease, type 2 diabetes, and experience premature mortality. The authors acknowledge and specify that many research gaps still exist, and that more evidence is needed before these findings can be accurately translated into public health guidelines. However, the investigators suggest that step counts in the range of 7,000 to 9,000 steps/day may result in health benefits that are similar to achieving the federally recommended amounts of 150 to 300 minutes per week of moderate-to-vigorous physical activity.

The physical activity guidelines encourage all adults to move more and sit less throughout the day. Locomotion, specifically walking, is an easy and popular form of physical activity for most Americans4 and can be of moderate-intensity. Worldwide, the average number of steps accrued daily is approximately 5,000. In United States, it is 4,800.3 So, whether it is somewhere in the range of 7,000 to 9,000, 5,000, or 4,801steps/day, let’s keeping walking our way to better health.

View the Full PAG Library

: Kyle Sprow, MPH is a Cancer Research Training Award Fellow with the National Cancer Institute. He was part of the federal staff that supported the Physical Activity Guidelines Advisory Committee and the development of the second edition of the Physical Activity Guidelines for Americans.


  1. Duncan MJ, Brown WJ, Mummery WK, Vandelanotte C. 10,000 Steps Australia: a community-wide eHealth physical activity promotion programme. Br J Sports Med. 2018;52(14):885–6
  2. Lee I, Shiroma EJ, Kamada M, Bassett DR, Matthews CE, Buring JE. Association of Step Volume and Intensity With All-Cause Mortality in Older Women. JAMA Intern Med. Published online May 29, 2019. doi:10.1001/jamainternmed.2019.0899
  3. Althoff  T, Sosič  R, Hicks  JL, King  AC, Delp  SL, Leskovec  J.  Large-scale physical activity data reveal worldwide activity inequality.  Nature. 2017;547(7663):336-339. doi:10.1038/nature23018
  4. Watson, K. B., Frederick, G. M., Harris, C. D., Carlson, S. A., & Fulton, J. E. (2015). U.S. Adults’ Participation in Specific Activities: Behavioral Risk Factor Surveillance System–2011. Journal of physical activity & health12 Suppl 1(0 1), S3–S10. doi:10.1123/jpah.2013-0521

Men’s Health Month: Improving cardiorespiratory fitness reduces heart failure mortality

Written by
Steve Farrell, PhD, FACSM

Posted in

Wednesday, Jun 05, 2019

June is Men’s Health Month, which is a great opportunity to raise awareness about the importance of preventive health care for men.

When you look at the statistics from the Centers for Disease Control (CDC), it looks grim. Women are 100% more likely than men to visit the doctor for annual exams and other preventive health care measures. Men die at higher rates than women from 9 of the top 10 causes of death and die an average of 5 years earlier than women.

The number one cause of death is still heart disease, which can largely be prevented, or at least delayed by making positive lifestyle choices such as eating healthy, not smoking, and getting more physical activity. We know after decades of research that increasing physical activity to improve aerobic fitness is key to living a longer, healthier life.

Nearly 6 million Americans are living with heart failure, a condition where the heart’s ability to pump and fill properly steadily declines. Heart failure is the leading cause of hospitalization in the U.S. for individuals ages 65 and older, and accounts for nearly 60,000 deaths annually. Well-established risk factors for heart failure include hypertension, diabetes, age, obesity, smoking, heart valve disease, previous heart attack, and family history.   

A sedentary lifestyle is another known risk factor for heart failure, but previous studies focused solely on self-reported physical activity levels. The problem is that self-reported studies of physical activity usually come from a questionnaire and are not an objective measurement of physical fitness. In fact, the self-report numbers can be quite different from the reality of a true fitness assessment. This is why studies from the Cooper Center Longitudinal Study (CCLS) are so important. The CCLS is the largest and longest-running study in the world that uses measured fitness rather than self-reports of activity.

A CCLS study by researchers at The Cooper Institute shows that baseline levels of cardiorespiratory fitness are strongly predictive of future risk of heart failure mortality. Results from the study showed:

  • Moderate and low fit men were 1.63 and 3.97 times more likely to die from heart failure, respectively, compared to those in the high fit category.
  • Unfit men with no heart failure risk factors were 2.5 times more likely to die from heart failure than fit men with no risk factors. The same trend was seen in men with any one, two or more risk factors.
  • Fit men were substantially less likely to die from heart failure than unfit men, regardless of the number of heart failure risk factors present.

The authors concluded that low levels of cardiorespiratory fitness are a powerful and independent risk factor for heart failure mortality. The recommendation is that all men should consider annual checkups and be counseled on physical activity by their health care provider, with the goal of achieving at least a moderate level of cardiorespiratory fitness in order to reduce risk of heart failure mortality.

But this doesn’t just apply to men. All adults can do more to reduce the risk of heart failure and heart disease death with these tips:

  • Monitor and control your blood pressure if you have hypertension.
  • Control your blood glucose level if you have diabetes.
  • Avoid obesity. Lose weight if you are overweight.
  • Avoid tobacco in all forms.
  • Avoid a sedentary lifestyle. Aim for at least a moderate level of cardiorespiratory fitness.
  • Eat more unrefined plant-based foods, such as fruits, vegetables, whole grains, raw nuts, seeds, and legumes and increase your intake of reduced-fat dairy.

Everyone is encouraged to meet the current public health guidelines for aerobic activity. The guidelines recommend a minimum of 150 minutes per week of moderate-intensity aerobic activity, but don’t be afraid to hold back. Exceeding these guidelines is very likely to result in higher fitness levels, further decreasing the risk of heart failure mortality.


Farrell, S., Finley, C., Radford, and Haskell, W. (2013). Cardiorespiratory fitness, body mass index, and heart failure mortality in men: Cooper Center Longitudinal Study. Circulation:Heart Failure, 6:898-905. Doi: 10. 1161/CIRHEARTFAILURE.112.000088.

Blumenthal, J. et al. (2010). Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure. Arch Intern Med, 170(2), 126-134.


Faster Meal Prep: 5 Kitchen Hacks to Master

Everybody has that friend who claims to be a meal prep master. They’ll batch cook all weekend and fill the fridge with colorful containers brimming with pre-cooked food. Then there’s the obligatory posting of pictures with all of the wholesome meals they’ve made ahead. But do you ever wonder, “Where do they get the time?!” or, “…that had to have taken all weekend!”

If you’d like to make it through the week without worrying what’s for dinner (but you don’t have all weekend to do so), here are five time-saving tips to give your meal prep process a makeover.

1. Write it Down

As Benjamin Franklin once said, “If you fail to plan, you are planning to fail.” If you want to succeed in making meals ahead of time, you need a plan—preferably in writing. If your kitchen prep steps start by opening a cabinet or sharpening a knife, switch it up and get in the habit of reaching for you notebook instead (or an app on your phone).

Map out ahead of time what your upcoming week looks like and exactly for which meals need prepping. Do you have plans to go out with a friend one night? Do you have a work lunch on the calendar? Chart on paper how many breakfast, lunch and dinner meals you will need for the upcoming week. And don’t forget to include snacks.

2. Set a Timer

A successful meal prep plan includes multiple steps, such as outlining the number of meals and snacks, researching the recipes, purchasing the ingredients and putting it all together in the kitchen. Even the best-designed meal prep plan can fall flat if you don’t allot adequate time to execute all of these actions.

Consider that most people use part of their weekend to meal prep for the upcoming week. You may not accomplish a whole week of meal prep if you don’t start until Sunday night. Set aside a chunk of time earlier in the weekend to select the recipes you want to prepare. Setting a time limit or timer for yourself to get this step finished can be incredibly helpful. Many a well-intentioned meal prepper has gone down the rabbit hole of online recipe research never to return to actually prepare those dishes.

3. Reuse Recipes

The easiest way to streamline meal prep is to reuse recipes or meal ideas that already work for you. If you’re trying to knock out dinner for the upcoming workweek, it may not be realistic to try five new recipes. Try limiting yourself to one or two new recipes and relying on old standbys that you know you like and will actually eat.

Keeping track of meal ideas can be tricky in an age where every recipe is readily available at our fingertips. Go old school and print the recipes you’ve tried, taking notes on what worked and ditching those that didn’t work. Save time by keeping your recipes in a folder organized by breakfast, side dishes, slow cooker mains, etc.

4. Call on Convenience Foods

Convenience foods can get a bad rap as being expensive or unnecessary. But there are some really innovative items at the grocery store that can save you time when you get back in the kitchen.

While you could peel and scoop and chop and roast a butternut squash, buying pre-cut bagged vegetables (such as butternut squash) can save you hours in the kitchen. Other shortcuts to check out in the produce section include tubes of fresh herbs and spices and pre-washed, chopped salad mixes and greens.

When it comes to the middle aisles, bottled marinades and sauces can be a meal prepper’s savior. Check out lower-sodium canned beans and spice packets that can make whipping up flavorful foods a snap.

5. Befriend Your Freezer

If you’re going to take the time to cook it once, you might as well make enough to eat it twice. Double your efforts by doubling your recipes and freeze the leftovers for future weeks. You can even pre-portion your larger batches into containers or baggies before popping your food in the freezer.

Put these time-saving tips to work and get your make-ahead meals made faster.

Interested in learning more about health and fitness or possibly making a career change? Become an ACE Certified Health Coach!

Post Author


Katie Ferraro


Katie Ferraro, MPH, RDN, CDE is a consultant dietitian and diabetes educator specializing in nutrition communications and family feeding. As a mom to 5 small children and creator of the popular blog The Fortified Family, Katie believes that good food fuels strong families. You can read more of her work at

How Much Protein Should You Eat—and When?

by Christopher Mohr, PhD, RD on Jun 03, 2016

Researchers find we’re eating too much protein at the wrong times—and not enough at the right times.

Protein is always a hot topic. Carbs have been demonized. Fat has been on the chopping block. But protein? It earns a health halo, often connected to everything from weight loss to muscle gains. Maybe this is for good reason. After all, researchers and protein experts around the world are investigating protein’s optimal role in aging and satiety across the lifespan. Yet that doesn’t mean our diets get protein right. Researchers find we’re eating too much protein at the wrong times—and not enough at the right times. Namely, we need more high-quality protein at breakfast and less protein at dinner, the research suggests (Mamerow et al. 2014).

Protein: How Much Is Enough?

Nutrition experts recommend that protein accounts for 10%–35% of all the calories we eat daily (IOM 2002). How are we doing with that recommendation? A paper published in the American Journal of Clinical Nutrition found that, on average, men and women up to age 70 get about 15% of total calories from protein. While that is within the 10%–35% recommendation, the author of the paper suggests boosting the minimum to 25%, “given the positive benefits of higher protein intake on satiety and other physiologic functions” (Fulgoni 2008).

Examining diet in more depth exposes us to a raft of acronyms representing how much of specific nutrients the experts say we should consume. For instance, the Institute of Medicine has several DRIs (dietary reference intakes) for protein:

• RDA (recommended dietary 

• EAR (estimated average 

• AI (adequate intake)

All these DRIs are based on nitrogen balance studies, under conditions of energy balance (DGAC 2010; Rodriguez 2015).

The most familiar of these acronyms is the RDA—which for protein is 0.8 gram per kilogram of body weight for adults 19 and older. Protein experts like Stewart Phillips, PhD, FACSM, FACN, professor at McMaster University, suggest this level can be misleading.

“That level of protein—0.8 g/kg/d or the RDA—is the minimal level of protein to offset negative nitrogen balance in 98% of individuals. The RDA is really, in my opinion, the MDI—minimal dietary intake. Thus, nothing about that level should be recommended, and you’re allowed to eat much more. In fact, for older persons and athletes, there are benefits to consuming protein at levels above the RDA.”

Protein Intake and Timing

Recently, protein research has moved beyond investigating the optimal amount of protein to eat and has examined the optimal times to eat it. > > Nutrition researchers have found that most Western diets skew protein consumption toward the evening meal—breakfast is typically carbohydrate-rich and protein-poor, while the evening meal is often much higher in protein and calories (Mamerow et al. 2014).

In keeping with this, some of the National Institutes of Health and Nutrition Examination Survey (NHANES) data on protein consumption in the U.S. demonstrates that men typically consume about 15 g of protein at breakfast, while women consume about 10 g (Rains et al. 2013). It’s also important to note that only about 40% of Americans actually eat breakfast. Thus, not only are many Americans consuming low-protein breakfasts, but the majority are not consuming any protein at all. And there is increasing evidence of a causal link between breakfast skipping and obesity (Ma et al. 2003).

This unbalanced intake doesn’t quite give the hard-working muscles what they need, nor does it do the job of helping curb appetite throughout the day. “Unlike [with] fat or carbohydrate, the body has limited capacity to store excess dietary protein/amino acids from a single meal and use them to stimulate muscle growth at a later time,” says Douglas Paddon-Jones, PhD, professor at the University of Texas Medical Branch and a leading protein researcher. “In other words, your large salmon dinner tonight is probably not going to influence muscle growth at lunch tomorrow.”

His research and that of other experts suggest it is best to distribute protein intake evenly throughout the day, starting with breakfast. “It makes perfect sense,” says Phillips. “You’ve just gone 10 hours without food [and] your muscles are catabolic. Protein at breakfast gives your muscles their first chance to rebuild after you’ve slept. It’s a good idea to aim for around 20 g of protein if you’re younger or 30–40 g if you’re older, to give your muscle its best chance to rebuild, since these doses of protein are at the top end of what your muscles need.”

This balanced concept suggests that a moderate amount of high-quality protein three times per day may be better than the typical Western diet with too much protein at dinnertime and not enough at breakfast. The balanced protein distribution concept isn’t just about muscle growth and repair, though. It has the potential to affect many health outcomes, such as blood sugar control, moderate calorie intake and satiety (being full) (Leidy et al. 2015).

Let’s explore the benefit of satiety. Of course, being more full may affect how much a person eats. If you eat less because you’re already feeling full, theoretically that could help with weight loss.

Heather Leidy, PhD, an assistant professor at the University of Missouri, has done a lot of the work on protein and satiety. Her group recently completed a 12-week, long-term randomized controlled trial study comparing the effect of eating a normal-protein vs. a high-protein breakfast in those who had habitually skipped the morning meal (Leidy et al. 2015).

This study illustrated that those who added a high-protein breakfast containing 35 g of protein every day for 12 weeks prevented gains in body fat compared with those who continued to skip breakfast. In contrast, eating a normal-protein breakfast did not prevent fat gains. In addition, only the high-protein breakfast reduced daily hunger and led to voluntary reductions of about 400 calories in daily food intake. “These data suggest that a simple dietary strategy of eating a protein-packed breakfast can improve weight management,” Leidy said.

To read more about how the timing of protein consumption impacts the body’s ability to rebuild muscle, please see “Tapping the Power of Protein” in the online IDEA Library or in the January 2016 print issue of IDEA Fitness Journal. If you cannot access the full article and would like to, please contact the IDEA Inspired Service Team at (800) 999-4332, ext. 7.


Nutrition Technology Optimization

by Shirley Archer, JD, MA on Oct 12, 2018

Nutrition Tech

Apps, digital solutions and “smart” devices are flooding the market to cash in on interest in eating for weight management, better performance and health enhancement.









Can technology improve people’s eating habits? This is the multibillion-dollar question challenging developers. Consumer applications and integrated digital solutions for food tracking, menu planning, grocery shopping, eating out, and nutrition and lifestyle coaching are proliferating. Innovations include scanners that identify nutrients, wearables that gauge real-time calorie intake and breathalyzers that measure metabolism.

“Food tech is the final frontier to be explored by using apps, sensors and wearables,” said Ted Vickey, PhD, founder and CEO of FitWell in San Diego.

Consumer interest has spurred development. As of March 2017, 26% of people aged 18–29 reported regularly using apps to track diet and nutrition, as did 17% of people aged 30–45, and 9% of those 45–60, according to Statista survey (Statista 2018a). The Super­Tracker website for recipe or menu analysis, food intake and physical activity tracking served 27 million users before the federal government terminated it in June (USDA 2018). The more popular food-tracking apps include MyFitnessPal (, with 11 million active users per month (Statista 2018b), and Lose It!, with over 3 million active monthly members, according to its website (

With so much acceptance, fitness pros need to know what technologies are available and how to assess their potential for health and performance improvement.

Types of Dietary Apps

Mobile phone-based apps are the most popular technologies—some singly focused, for calorie and nutrient tracking, for instance, and others with integrated digital solutions that include live coaching and detailed biometric data. More complex digital solutions integrate tracking with other wearables and smart devices, like scales and water bottles. Here’s a sampling of what users select for tracking and advice on healthful dietary choices:

  • Calorie tracking. MyFitnessPal and Lose It! combine food and water consumption self-reporting with physical activity tracking and social support. Both products offer extensive validated databases—with millions of grocery and restaurant items—and barcode scanning. Lose It! also has a photo feature. You snap a picture of food for quick nutrition information then manually enter portion size (although the app cannot analyze multiple ingredients in foods like a cheeseburger). Calorie Mama ( has a more sophisticated photo tracker that pro­vides detailed nutritional analysis.
  • Meal planning and recipes. MyPlate Calorie Counter (, has a food tracker with a smaller database than either MyFitnessPal or Lose It!, but it adds personalized meal planning and healthy recipes and includes shopping lists. San Francisco-based Suggestic Precision Eating™ ( takes meal planning one step further by using artificial intelligence (AI) and augmented reality (AR) to offer real-time, location-based eating suggestions.Shai Rozen, CMO and co-founder of Suggestic, says, “We believe the biggest obstacle in people changing behavior around food is choice. We remove part of the decision-making effort by providing contextual, highly relevant tips in real time. With most food trackers, users log items after eating. Suggestic takes your goals and recommends what to eat before you eat it. Users can follow preferences like vegan or paleo.” With Suggestic, a user can hold a smartphone camera over a restaurant menu; the app uses AR to highlight and rank menu items, providing real-time suggestions. The app also uses AI to find behavior patterns over time and learn to make “smarter” recommendations.
  • Recipe and nutrient analysis. Nutrients (, a detailed database of 200,000 items with nutrition information for individual foods and meals, offers recipe analysis and is particularly valuable for people with specific food intolerances. Registered dietitians like that it takes emphasis away from calories and focuses on foods’ nutritional value. “People should be food-group oriented instead of counting calories,” advises Felicia D. Stoler, DCN, MS, RDN, a clinical nutritionist in Red Bank, New Jersey, and author of Living Skinny in Fat Genes: The Healthy Way to Lose Weight and Feel Great (Pegasus 2011).

    Another app, Fooducate (, provides an analysis of calories, macronutrients and percentage of minimally processed foods. To increase awareness of calorie quality, the app provides color-coded food grades. It breaks down calories consumed from solids or liquids and offers suggestions for healthier choices in place of highly processed foods. As Meagan Moyer, MPH, RDN, LD, clinical nutritionist at Emory Healthcare in Atlanta and author of Bits and Bytes: A Guide to Digitally Tracking Your Food, Fitness, and Health (Academy of Nutrition and Dietetics 2017), says, “You need to know not only what you shouldn’t eat, but also what you should.”

  • Grocery shopping. Shopwell™ (, created by registered dietitians, enables grocery shoppers to scan barcodes and nutrition labels for immediate nutrition information, personalized food scores and recommendations. It can analyze affiliated supermarket shopping receipts to show how well purchases align with nutritional goals and dietary restrictions, such as food allergies or diabetes. Fooducate also gives advice on healthier alternatives.
  • Eating out. Several apps help people find healthy options when dining out, but many are regional, so check out which ones cover your neighborhood. Examples include Food Tripping (, Clean Plates (, and HappyCow for vegans ( Suggestic’s menu assessment feature includes scoring for over a half-million restaurants nationwide.
  • Nutrition coaching. More sites are integrating opportunities for live or distance fee-based coaching with registered dietitians. Rise ( allows people to describe their goals to a registered dietitian. Participants submit photos of what they eat to their coach, who checks in daily with suggestions for how to modify dietary choices. Users can sign up on a monthly or quarterly basis. Moyer thinks this trend will grow, as most apps are not personalized, food logs are often inaccurate and people need individualized counseling.
  • Coaching interface. Some apps integrate a coaching interface to enable an authorized personal trainer, health coach or dietitian to log in and see client data. MyNetDiary ( and Healthie ( provide these platforms. Other web-based solutions are designed only for health professionals, like Diet ID™ (, which enables a coach to use food photographs to identify client eating patterns that need improvement.

Emerging Technologies

New technologies are emerging for more personalized data on specific foods, rather than a generic database. Products that are still being perfected include lasers, wearables and an array of smart devices.

  • Lasers. New handheld laser devices like Tellspec® ( and SCiO™ ( potentially enable users to scan food to analyze what’s inside it, including pesticides, gluten, or proportions of carbohydrates, fats and proteins. Cloud-based technology sends data to a user’s smartphone. This spectrometer technology is being installed into a smartphone that will be available in China in 2019 (
  • Wearables. Wearables are still in development. For example, “Healbe’s GoBe 2 ( claims to automatically measure calorie intake through a wearer’s skin,” says Bryan O’Rourke, CEO at the Fitness Industry Technology Council in Mandeville, Lousiana. “The product was met with mixed reviews . . . including skepticism about whether it does what it says. If the calorie-counting technology works, it would be groundbreaking.”
  • Smart devices. As tech tools become smaller and more affordable and cloud-based computing becomes more powerful, smart devices that connect with one another, aka the Internet of Things, can potentially monitor every aspect of our lives. For example, Lumen (, a device scheduled for 2019 release, looks like a handheld breathalyzer with data that shows what energy pathway—carbohydrates or fats—is currently being used for fuel to optimize training, time nutrient consumption or achieve weight goals. Hidrate Inc. offers Hidrate Spark 2.0 (, a smart water bottle that recommends daily water intake based not only on biometric data but also on weather from GPS information; it tracks water consumption, glows for drink reminders, and syncs with other fitness programs like Fitbit or Apple Health.

Addressing Behavioral Change

While we may learn what’s inside specific foods and what’s going on inside an individual’s body, the apps’ tracking, goal-setting, meal-planning and even nutrition coaching don’t address emotions and habitual behaviors that drive unhealthy eating habits.

“Integrating behavioral science is the holy grail of disruptive health technologies,” said Vickey. “Trainers need to use [tech] tools to educate clients on the behavioral change aspect of what they’re doing. Sometimes apps and wearables give too much information.” Vickey advises us to “follow the KISS principle.”

  • Mindful-eating programs. Some developers are tackling these issues with mindful-eating apps that provide suggestions and exercises, such as Mindful Eating Tracker ( and “In the Moment” Mindful Eating app (­eating-phone-app).

    Mindfulness and addiction expert Judson Brewer, MD, PhD, director of research at the Center for Mindfulness and associate professor at the University of Massachusetts Medical School in Worcester, Massachusetts, created Eat Right Now® (ERN) (, an app-based program with craving-specific tools, expert coaching and a supportive community to help people who struggle with weight loss, binge eating and cravings. ERN has a “flipped classroom” model, so professionals like personal trainers can teach, assign homework and interact digitally with clients in the community. Brewer also developed a program that targets anxiety since that can be part of the issue (see Resources below for more information).

    “We’re offering behavior change facilitator trainings, so coaches can combine their skills with the program,” said Brewer. “The combination of a facilitator with the course is effective. Clinical studies show a 40% reduction in craving-related eating (Mason et al. 2018) and close to 50% reduction in anxiety symptoms in 28 modules with 1–2 months of daily use.”

    “Food-recording apps like MyFitnessPal can be useful behavior management tools to supplement professional advice and teach autonomy to clients,” says Neal Pire, MA, national director of wellness services at Castle Connolly Private Health Partners in New York. “Apps are useful tools to increase clients’ awareness and empower them to change and adopt better eating behaviors [when they’re not with their trainer].”

Choose Tech Wisely

Both fitness and nutrition experts agree that technology is only a tool, and it’s not for everyone. “Clients should be learning more how to eat by themselves and make informed choices,” says Wesley Delbridge, RDN, spokesperson for the Academy of Nutrition and Dietetics in Phoenix.

Stoler notes that people should not become so dependent on their phones that they can no longer make eating decisions without them or feel stressed that they can’t log every bite. “It’s like training wheels—to give a course of action and knowledge base that they hopefully find useful—but at a certain point, people need to graduate.”

Experts emphasize that solutions need to fit individualized needs. “There are many tools, but they’re not necessarily stand-alone,” says Moyer. “Often people need help to stick with dietary changes. Support groups built within apps are a great source. Pay-to-play apps [where people bet on weight loss] can work for some people, but not all. Every person is different.”

Fitness professionals need to stay within scope of practice when using these apps and must refer to a registered dietitian when appropriate. Ken Baldwin, director of education and training for Perform Better Australia, in Brisbane, says, “Personal trainers need to be able to address issues like sleep, water, recovery, mood changes, hormones, age and gender differences . . . but they should not think about giving advice beyond their scope of practice. They should create a great professional network.”

Apps Support the Human Touch

The tech market for tracking eating patterns is bursting with tools that support the quantified self; the future seems limited only by the imagination. At the same time, eating healthier foods is dependent on a person’s financial resources and personal initiative. No program can control what a person eats. Behavioral change is complex.

Data alone does not improve health or performance. What makes a difference is how data is interpreted and applied. People are not machines; food is not simply a nutrient source. Fitness professionals have an opportunity to help clients understand these tools and to optimize training, but at the end of the day, people need to find joy and satisfaction in what they eat and drink and find happiness with their bodies and their lives. Fitness professionals can be the wise proponents of these truths.


Mason, A.E., et al. 2018. Testing a mobile mindful eating intervention targeting craving-related eating: Feasibility and proof of concept. Journal of Behavioral Medicine, 41 (2), 160–73.

Statista. 2018a. Percentage of U.S. adults who use an app to track their diet and nutrition as of 2017, by age. Accessed Sep. 7, 2018:

Statista. 2018b. Most popular health and fitness apps in the United States as of July 2017, by monthly active users (in millions). Accessed Sep. 7, 2018:

USDA (United States Department of Agriculture). 2018. SuperTracker discontinued June 30, 2018. Accessed Sep. 7, 2018: