Nutrition Guidelines

As a personal trainer, clients will seek your guidance on nutrition for health, performance, and body composition. This topic will provide an overview of what nutrition is and why it's important for trainers to understand, look energy in and energy out (a fundamental concept of nutrition), and the Ministry of Health guidelines for healthy eating.

But before we get into the science of nutrition, let's take a moment to think about food and eating holistically.

Group discussion

Think about why we eat. Is it just to provide energy for the body? Maybe for some people, but food and nutrition are about so much more. Often, we celebrate special occasions with food, food can bring families and friends together, and we might have specific foods that we eat in our own cultures. Some people revolve their whole lives around food - businesses that sell food (restaurants, grocers, and cafes), Nutritionists, YouTube cooking channels, competitive eaters and many others.

• What is your favourite dish to have on special occasions?
• Who prepares it?
• What makes it special or memorable?

Tell us about your favourite dish in the forum. Share a photo or recipe if you can.

Read your peers' responses. Connect over a shared dish or learn something new. One rule - don't yuck someone's yum!

Nutrition is about what makes up the food we eat, how this affects the body, and how we can use nutrition practices to improve health outcomes and reduce the risk of disease. Sports nutrition applies nutrition principles to optimise sporting performance, weight management, and overall health in athletic populations.

Nutrition plays a crucial role in our overall health and wellbeing. Essential nutrients support optimal physiological processes such as muscle contractions, digestion, eyesight, and cellular signalling. Without adequate nutrition, the body is at risk of disease and decreased overall functioning.

Why do personal trainers look at nutrition?

We look at nutrition to support our clients with:

• Health
• Performance
• Body composition

Some groups may fall under more than one category. Think back to what you know about non-communicable diseases. Diet is a major cause of health loss in New Zealand and a key contributor to cardiovascular disease. Cardiovascular disease accounts for 1 in 3 deaths in New Zealand and is the leading cause of death in women globally (Heart Foundation, 2021).

It is important to remember the significance of adequate food consumption and discuss this information with your client when working with them to achieve their health and fitness goals. Good nutrition assists in leading a healthy lifestyle. When good nutrition and physical activity are combined, it can help to reach and maintain a healthy weight, reduce the risk of chronic diseases, and promote overall health and wellness.

Body composition and health

Body composition is directly related to nutrition and can result in various health conditions linked to being overweight or underweight.

Health conditions associated with excess weight:

• Type 2 diabetes
• Cardiovascular disease
• Hypertension
• Metabolic syndrome
• Some cancers
• Musculoskeletal conditions
• Respiratory conditions
• Sleep apnoea
• Gall bladder disease
• Hernia
• Reproductive disorders
• Urinary incontinence
• Fatty liver disease
• Depression and other mental health conditions

Many obesity-related health conditions are preventable and reversible through healthy eating, an active lifestyle, and weight loss.

Health conditions associated with being underweight:

• Body dysmorphic disorder
• Anorexia nervosa
• Binge eating
• Osteoporosis
• Decreased muscle strength
• Hypothermia
• Malnutrition and vitamin deficiencies
• Anemia
• Reproductive disorders
• Decreased immune function
• Developmental/growth delays (in children)
• Depression and other mental health conditions

Fitness professionals are not expected to be experts in these health conditions. However, you may become familiar with some of the common symptoms through your studies and work and therefore may be able to recognise when a client should be referred to a suitable medical or allied health professional.

Alternatively, you may work with clients already diagnosed with one or more of these conditions. In this case, the client will likely have a medical or allied health professional already. You may be able to work alongside these professionals to help develop the fitness component of the client's wellness plan.

So, now that we know why it is important to understand nutrition, what do we need to know?

To understand nutrition guidelines and principles, it is first important to understand the relationship food has with energy - the concept of energy in and energy out.

The human body gains energy through food consumption. This source of energy is known as a calorie. Food calories are absorbed into the body when consumed, creating energy for the body to perform. This is known as energy in.

The body uses the stored energy from the calories eaten for daily requirements such as physical activity and exercise. This is known as energy out.

Energy balance

If someone exhibited more ‘in’ than ‘out’ over time, this would result in weight gain. On the other hand, if someone exhibited more ‘out’ than ‘in’, over time it would contribute to weight loss. However, an active individual with more 'out' than 'in' would experience fatigue during physical activity as their body does not have enough energy to sustain maximum performance. This is why it is essential to monitor and balance your energy intake and energy output.

We can balance energy by manipulating:

• the amount and type of food consumed.
• the time and frequency of consumption.
• energy expenditure (exercise).

Many clients' goals involve energy balance because it is the underlying principle behind weight loss and gain.

Energy in	Energy out
Food Beverages	BMR (basal metabolic rate) TEF (thermic effect of food) Exercise or EAT (exercise activity thermogenesis) NEAT (non-exercise activity thermogenesis)

For general population clients, results are achieved with consistency over time. The tools you learnt for behaviour modification are just as relevant when approaching nutrition as they are to physical activity. Implement small changes for long periods of time to see consistent results.

Big changes for short periods of time results in 'yo-yo dieting'. Yo-yo dieting is a very common situation in which people struggle to maintain their target weight. This is also known as “weight cycling,” which means gaining weight unintentionally and dieting in response, then regaining that weight once again.

The calorie: The measure of energy in food

A calorie is a measurement of energy (or joules/kJ). There are 4.2kJ in 1 calorie (kcal). Kilocalories are often called ‘calories’. For example, someone may say ‘this food is 100 calories’ but the technically accurate statement would be ‘this food is 100 kilocalories’.

Calories power cellular processes and are stored for future energy use (1kg of fat is approximately 9,000 cal). Many clients may have questions about calorie intake or "how to burn off calories". But energy balance and calories are quite a nuanced topic. Watch the video and answer the questions that follow.

After you have watched the video, answer the questions to check your understanding.

It's important to remember that the energy on food labels is not necessarily what your body can use, and may differ from person to person. For example, some foods with high amounts of fibre may not give you all the energy the label claims to, because we cannot digest it all.

It can be difficult to calculate calorie intake and requirements because there are a lot of factors that come into play, such as age, activity level, enzyme level, gut bacteria, intestine length, and sex.

So how much energy is required? We need to determine the quantity of energy required for balance. We can estimate this using 2 calculations:

• Basal metabolic rate
• Total daily energy expenditure

Basal metabolic rate (BMR)

BMR is an estimate of the calories expended if you were to do nothing but rest for 24 hours. It represents the minimum amount of energy needed to keep the body functioning, e.g., breathing, heart beating, nutrient processing, and cell production. In other words, the amount of energy your body needs to maintain homeostasis. It is roughly 70% of total daily energy expenditure.

BMR takes into consideration height, weight (BMI), age, and sex.

Women:

• BMR = 655 + (9.6 × weight in kg) + (1.8 × height in cm) – (4.7 × age in years)

Men:

• BMR = 66 + (13.7 × weight in kg) + (5 × height in cm) – (6.8 × age in years)

Try it out

Let's work through an example together, and then try it yourself.

You have a client who is a woman, weighs 79kg, is 168cm, and aged 34. We can plug this data into the formula to calculate BMR. Remember BEDMAS and calculate the values inside the brackets first.

• BMR = 655 + (9.6 x 79) + (1.8 x 168) - (4.7 x 34)
• BMR = 655 + 758.4 + 302.4 - 159.8
• BMR = 1556

Now it's your turn.

There are many apps and websites that offer BMR calculations which can be handy for quickly calculating BMR on the job. But you should get comfortable using the formula to calculate BMR first, so you can validate any apps or website calculators.

Total daily energy expenditure (TDEE)

TDEE is essentially a multiple of your BMR. It uses the Harris-Benedict Equation to apply an activity factor to the BMR to determine total daily energy expenditure in calories. TDEE is the sum of BMR, NEAT, EAT, and TEF.

Activity	TDEE (calories)
Sedentary (little or no exercise)	BMR x 1.2
Lightly active (light exercise/sports 1-3 days a week)	BMR x 1.375
Moderately active (moderate exercise/sports 3-5 days a week)	BMR x 1.55
Very active (hard exercise/sports 6-7 days a week)	BMR x 1.725
Extra active (very hard exercise/sports and a physical job)	BMR x 1.9

Try it out

Use the BMR formula and the Harris-Benedict Equation to calculate the total calorie requirement for either yourself or a friend or family member.

How does your TDEE compare to standard recommendations of 2,000 a day for women and 2,500 a day for men?

Thermic effect of food (TEF)

The process of digestion requires energy. Protein takes up to 5 x more energy to digest than fats and carbohydrates. TEF is roughly 10% of TDEE.

• TEF = TDEE x 0.1

EAT and NEAT

EAT is exercise activity thermogenesis and NEAT is non-exercise activity thermogenesis. NEAT is the calories used through movement outside of planned exercise. E.g., walking to the bathroom to shower, running to catch a bus, and even shifting around in your seat. It accounts for approximately 15% of TDEE. EAT is the calories from any planned exercise. It accounts for approximately 5% of TDEE.

• NEAT = TDEE x 0.15
• EAT = TDEE x 0.05

Energy balance

Once you have calculated a client's required daily calories, you can use this information to support their weight goals.

• Consume daily required calories to maintain weight.
• Consume more than the daily required calories to gain weight.
• Consume less than the daily required calories to lose weight.

Adhere to professional, safe practice. Simply increased calorie expenditure will yield great results to begin with. Advise against fad or yo-yo dieting, which is a similar approach to an exercise 'quick fix'.

The Ministry of Health (MoH) provides a collection of population-specific nutrition and physical activity guidelines. These guidelines provide the Ministry’s evidence base for nutrition and physical activity advice. The current guidelines are an important tool for anyone providing advice on nutrition and physical activity. You should bookmark the MoH Current Guidelines and Eating and Activity Guidelines for Adults to ensure you are always referring to the latest guidelines and advice.

Eating and activity guidelines for New Zealand adults

Read the Summary of Guidelines Statements and key related information and use this document to answer the questions in this topic.

The guidelines include statements about what and how much we should eat and drink.

Statement 1: Enjoy a variety of nutritious food every day

Every day enjoy:

• plenty of vegetables and fruit.
• grain foods, mostly whole grain and those naturally high in fibre.
• some milk and milk products, mostly low and reduced fat (this includes non-dairy milk alternatives with added calcium).
• some legumes (e.g. lentils, beans, chickpeas), nuts, seeds, fish/seafood, eggs, poultry (e.g. chicken), and/or red meat with fat removed.

Statement 2: Choose and/or prepare foods and drinks...

Choose and prepare food and drinks:

• with unsaturated fats instead of saturated fats.
• that are low in salt (sodium); if using salt, choose iodised salt.
• with little or no added sugar.
• that are mostly 'whole' and less processed.

Whole foods are very close to their natural state, and they have no added fat, salt or sugar. Examples include fresh vegetables and fruit, raw nuts, fish, eggs, chicken or red meat with fat removed.

Less-processed foods have undergone some processing but still retain most of their original nutrients and can be healthy food choices. Frozen or canned vegetables and fruit, canned legumes (e.g. beans and chickpeas), and fish canned in spring water are healthy, convenient and affordable options. Other healthy examples of less-processed foods include pasteurised milk and whole grains such as oats, whole wheat, and brown rice.

Highly processed foods tend to be high in kilojoules, added fat, sugar and/or salt but low in vitamins, minerals, and fibre. Highly processed foods include sweets, sugary drinks, biscuits, muesli bars, cakes, pastries, pies, instant noodles, salami, luncheon, chippies and store-bought burgers and pizzas. Avoid or have them only occasionally.

Choose foods that are low in saturated fat, sugar, and salt. Eating too many foods high in saturated fat (animal fat and coconut and palm oils), sugar and salt can harm your health. Choosing foods with unsaturated fats (from plants, excluding coconut and palm oils) rather than saturated fat can lower your risk of heart disease.

Statement 3: Make plain water your first choice over other drinks

Water is necessary for the body to survive and be healthy. Generally, tap water in New Zealand is safe to drink making it an accessible and healthy choice. Plain water contains no energy so does not contribute to weight gain. It is sometimes necessary to increase water intake such as during pregnancy and while breastfeeding.

Statement 4: If you drink alcohol, keep your intake low

Alcohol contains a lot of energy and can contribute to weight gain. There are also long-term health risks and risk of injury.

This statement includes additional guidance regarding pregnancy and breastfeeding:

• Stop drinking alcohol if you could be pregnant, are pregnant, or are trying to be pregnant.
• When breastfeeding, it is best to be alcohol-free.

Statement 5: Buy or gather, prepare, cook, and store food to ensure it is safe to eat

This statement explains how to minimise foodborne illness including food poisoning. Steps you can take to reduce the risk of food poisoning include:

• not consuming food this is past the use-by date or has been tampered with.
• washing and storing food correctly.
• reheating leftovers until steaming hot before eating.

Pregnant women are at higher risk of foodborne illness, which can also affect the baby. There are additional guidelines for food safety during pregnancy.

Statement 6: Encourage, support, and promote breastfeeding

MoH states that breastmilk is the ideal food for babies and has many benefits for both mother and child. Support helps mothers to breastfeed longer.

If you have clients who are pregnant or have young babies, do keep in mind that there are many reasons why someone may choose not to breastfeed, or cannot breastfeed. The decision is theirs alone and your role as a PT is to support your client, not judge.

Body weight statement

Alongside the eating statements, the guidelines also include a body weight statement.

If you or a client are struggling to maintain a healthy weight, you or they should see a doctor, a dietitian, or a community health care provider.