integrated nutritional periodisation part 1 … · 17 understanding weight loss: integrated...

LIFT THE BAR EDUCATION WORKBOOK

UNDERSTANDING WEIGHT LOSS

I N T E G R AT E D N U T R I T I O N A L P E R I O D I S AT I O N PA R T 1

LIFT THE BAR EDUCATION

03


Integrated Nutritional Periodisation Part 1 As personal trainers we are expected to help the majority of our clients lose weight. However, have you ever wondered why some clients lose weight easily whilst others can do exactly the same and the scales hardly budge?

Maybe you have heard people use terms like metabolic adaptation but not truly understood what it means and how you apply this information to your clients? Ever wanted to understand the science or evidence behind lots of the weight loss studies but feel like you are unable to digest the studies? Then understanding weight loss is for you.

This course aims to breakdown the science of weight loss in an easy to understand and digestible manner, highlighting why we see huge differences in the outcomes of diet and exercise trials, how this impacts your clients results, why exercise may not be the golden ticket for weight loss many believe it is, why maintaining lost weight it so hard and much more!

This 28 part course will put you ahead of all the other trainers in your gym when it comes to understanding weight loss.

Gregg.

Understanding Weight Loss:

UNDERSTANDING WEIGHT LOSS (INP1)

Gregg Slater

1


UNDERSTANDING WEIGHT LOSS: INTEGRATED NUTRITIONAL PERIODISATION PART 104

LESSONS

01 Introduction02 Adherence – (Macro Level)03 Adherence – (Micro Level)04 Fats v Carbohydrate 105 Fats v Carbohydrate 206 Fats v Carbohydrate 307 Physiology of Weight Loss08 Understanding Total Daily Energy Expenditure (TDEE)09 Adaptations to Dieting – Energy Out10 Adaptations To Dieting – Energy In11 Exercise For Weight Loss12 Diet and Exercise For Weight Loss13 Exercise, Weight Loss and Individual Differences14 Adaptations to Exercise and Weight Loss15 The Impact of Exercise on Energy Intake16 The Impact of Exercise and Chronic Energy Intake




LESSONS

17 Under-Reporting 118 Under-Reporting 219 Under-Reporting 320 Successful Dieting 121 Successful Dieting 222 Successful Dieting – There is no magic23 Rates of Weight Loss 124 Rates of Weight Loss 225 Weight Loss Maintenance26 Energy Flux27 Exercise and Weight Loss Maintenance28 Course Summary



This workbook will help you get the most out of the course. You will see the book mirrors the courses lesson format. For each lesson there are a number of aims that represent the key learning points for that section of the course. We have provided space to write your notes as you go through and there is spare note space at the end of the workbook in case you need more than we have provided for any of the lessons.

The space for action points is where the magic happens. We all know that learning is only useful if we do something with the knowledge so for each lesson make a note of what you are going to do as a result of what you have learnt. Make the action as specific as possible and set yourself a manageable timeframe. If you have some kind of to do list or schedule of action points make sure you transfer these actions to that and get them done.

Each lesson has 2-3 quiz questions that need to be completed on the members site in order to proceed. We have provided space for you to make a note of your answers to these questions as you go through the content so you are prepared for the questions. Not only will this workbook help you as you complete the course but, if used effectively, it will also provide you with a source of key information you can refer back to.

Good Luck!

How to use this workbook




THE JOURNEY: A GUIDE TO NUTRITIONAL COACHING05

AIMS:

Key Learning Points

ORIENTATE THE MAP

Client consultation and baselines

― Learn how to prepare for a client ― Decide what information you need to know to work with a client ― Consider how best to gather the information

LESSON:

01


THE JOURNEY: A GUIDE TO NUTRITIONAL COACHING06

Action Points

Quiz Questions

1. Name two areas of information we might want to explore from a client’s past (where have they been)

2. What baseline information should we look to Gather?

AimsThis section will highlight the main learning focus for the lesson

Key Learning PointsUse this area to make notes as you go through the lesson

Action PointsSummarise your learning from the lesson. What actions are you going to take as a result of what you’ve learnt? When are you going to complete it?

Quiz QuestionsWrite your answers to the questions here in preparation for completing the online quiz.



AIMS:

Key Learning Points

This video provides an overview of what the course will cover and the reason it was created.

LESSON:

01

Introduction



Action Points

Quiz Questions

1. As you move through this course what is you main goal?



AIMS:

Key Learning Points

In this video we take a look at the impact of adherence on weight loss long-term.

LESSON:

02

Adherence (Macro Level)



Action Points

Quiz Questions

1. What is the typical pattern of adherence across 12 months of dieting?

2. In the named diets mentioned did macronutrient intake impact dietary adherence?

3. What is the overall relationship between weight loss and adherence regardless of the composition of the diet?



AIMS:

Key Learning Points

In this video we look at adherence on a micro scale (24 hours) helping to highlight not only the potential impact of dietary lapses but also when and where they are most likely to happen.

LESSON:

03

Adherence (Micro Level)



Action Points

Quiz Questions

1. According to the goal-conflict theory what two types of pressure will people be under to eat?

2. According to Forman (2017) where were participants most likely to lapse on their diets?

3. When working with clients what is it important we do?



AIMS:

Key Learning Points

Macro Wars! In this video we look at some of the metabolic ward studies that have looked at the impact of macronutrient intake on fat loss.

LESSON:

04

Fats v Carbohydrate 1



Action Points

Quiz Questions

1. What does the insulin hypothesis of obesity posit?

2. What is the widely accepted definition of a Ketogenic Diet in relation to carbohydrate intake?

3. Is there a metabolic advantage to the Ketogenic Diet based on current evidence?

4. In Kevin Hall’s metabolic ward study was there a clinically significant difference between the reduced fat and reduced carbohydrate diets?



AIMS:

Key Learning Points

We progress on from the metabolic ward studies to compare the impact of fats and carboydrates in a number of meta-analysis

LESSON:

05




Action Points

Quiz Questions

1. According to Wu’s study what was the difference in weight loss between named diets?

2. Can you lose fat and gain weight simultaneously?

3. What was the conclusion of Johanson’s paper in 2014?



AIMS:

Key Learning Points

In the final video of this chapter we take a look at a huge recent study by Gardner (2018) on the impact of fats v carboydrates in the real world over a 12 month intervention.

LESSON:

06




Action Points

Quiz Questions

1. When looking at a study why might average weight loss not always be helpful?

2. In Gardner’s 2018 paper did insulin sensitivity impact weight loss at 12 months?



AIMS:

Key Learning Points

In this video we look at the dynamic nature of the calories in, calories out model as well as the 3500 calorie rule for weight loss.

LESSON:

07

Physiology of Weight Loss



Action Points

Quiz Questions

1. How could we best describe the relationship between calories in and calories out (CICO)?

2. Which bracket would eating through boredom fall into?



AIMS:

Key Learning Points

In this video we take an in-depth look at the individual components of TDEE to lay the foundations for the adaptations to dieting lecture.

LESSON:

08

Understanding Total Daily Energy Expenditure (TDEE)



Action Points

Quiz Questions

1. Which components of TDEE usually expend the most energy from most to least (in individuals that exercise)?

2. What does NEPA stand for?

3. Typically what % of TDEE does the Thermic Effect of Feeding account for?



AIMS:

Key Learning Points

In this video we look at the impact of calorie restriction on energy expenditure. This includes looking at metabolic adaption, reductions in NEAT or NEPA and the spring loaded model of weight loss.

LESSON:

09

Adaptations to Dieting – Energy Out



Action Points

Quiz Questions

1. When we lose weight why might be see a lowering of BMR?

2. What term best describes metabolic adaptation?

3. According to the review by Silva how does weight loss impact NEAT?

4. Does metabolic damage exist?



AIMS:

Key Learning Points

In this video we look at the physiological changes to appetite and energy intake when implementing a caloric deficit.

LESSON:

10

Adaptations to Dieting – Energy In



Action Points

Quiz Questions

1. Which orexignenic hormone may increase when dieting?

2. How can we think of the effort on a diet?

3. According to Polordi’s paper how much does appetite increase per kg of bodyweight lost?



AIMS:

Key Learning Points

In this video we look at the impact of exercise as a standalone intervention for exercise (hint it’s not as much as you think).

LESSON:

11

Exercise For Weight Loss



Action Points

Quiz Questions

1. According to Swift how much weight loss does aerobic exercise typically induce?

2. Where may exercise play a beneficial role over diet alone?

3. Which exercise intensity creates the greatest weight loss?



AIMS:

Key Learning Points

In this video we look at the additive impact of exercise on weight loss and the emerging role of resistance training.

LESSON:

12

Diet and Exercise For Weight Loss



Action Points

Quiz Questions

1. On average which interventions produces the greatest weight loss after 6 months?

2. According to John’s (2014) which intervention has the best outcomes for weight loss?

3. Can small amounts of weight loss from exercise improve health?



AIMS:

Key Learning Points

In this video we look at the wide inter-individual differences seen in many weight loss studies and the emergence of “responders” and “non-responders”

LESSON:

13

Exercise, Weight Loss & Individual Differences



Action Points

Quiz Questions

1. Does a consistent exercise programme lead to predictable weight loss results?

2. What does studying twins allow us to control for?



AIMS:

Key Learning Points

In this video we look at how the body can resist an exercise induced deficit and how this impacts rates of weight loss.

LESSON:

14

Adaptations to Exercise and Weight Loss



Action Points

Quiz Questions

1. In the Di Blasio (2012) Study how did the -Group lower TDEE compared to the +Group?

3. If we increase our exercise efficiency what does this mean for TDEE?

2. People who lose less weight than predicted from an exercise or diet intervention may be classified as what?



AIMS:

Key Learning Points

In this video we look at the impact of exercise on energy intake and the large inter-individual differences seen in some studies in which we see compensatory eating patterns.

LESSON:

15

The Impact of Exercise on Energy Intake



Action Points

Quiz Questions

1. On average how does exercise impact acute energy intake?

3. Which characteristics may identify “compensators”?

3. Why is it important to consider how we label exercise?

2. Thinking about Finlayson’s study (2009) how would over-compensation impact weight loss?



AIMS:

Key Learning Points

In this video we discuss the literature surrounding exercise and long-term changes in appetite and energy intake.

LESSON:

16

The Impact of Exercise and Chronic Energy Intake



Action Points

Quiz Questions

1. Why may we see large differences in studies results when it comes to exercise and chronic energy intake?

3. On average does exercise intensity play a large role on energy intake?

2. In King’s study (2009) the participants were categorised as “responders” and “non responders”. What was the main difference between the groups?



AIMS:

Key Learning Points

In this video we introduce the issue of under-reporting before looking at the impact of metabolism and BMR on weight loss and weight gain.

LESSON:

17

Under-Reporting 1



Action Points

Quiz Questions

1. Was Debbie at greater risk of weight gain due to her slow metabolism?

3. Do slow metabolisms (healthy clients) prevent weight loss?

2. In the Anthanont and Jensen study (2016) did having a slower metabolism predispose individuals to gaining more weight than individuals with higher metabolisms?



AIMS:

Key Learning Points

In this video we look at a number of classic examples of under-reporting caloric intake and what it means for our client’s weight loss outcomes.

LESSON:

18

Under-Reporting 2



Action Points

Quiz Questions

1. If a client believes they are doing everything correct and eating in a caloric deficit whilst actually eating more calories than they realise what might we label them?

3. Is it only the obese that under-report calories?

2. When looking at Lichtman’s study (1992) and the “weight loss resistant individuals” why did they struggle to lose weight?



AIMS:

Key Learning Points

In this video we discuss the ECLIPSE study and the prevalence of under-reporting caloric intake in the United Kingdom.

LESSON:

19

Under-Reporting 3



Action Points

Quiz Questions

1. In the ECLIPSE study what was the average reporting error by all adults?

3. From most to least which form of self-reporting was most accurate in the Poslusna study (2009)?

2. To reduce under-reporting do we need clients to track calories?



AIMS:

Key Learning Points

Success leaves clues and in part one of this series we take a look at the conceptual review of long-term weight loss with Elfhag’s 2005 conceptual review.

LESSON:

20

Successful Dieting 1



Action Points

Quiz Questions

1. Which dietary traits were associated with greater weight loss and weight loss maintenance?

3. With client’s that have gone through many cycles of weight loss and regain what was potentially recommended?

2. Weighing food and recording your bodyweight are types of which behaviours?



AIMS:

Key Learning Points

In this video we look at two systematic reviews on the characteristics of individuals who adhere to long-term lifestyle interventions and what this means for our fat loss clients.

LESSON:

21

Successful Dieting 2



Action Points

Quiz Questions

1. Of the most successful weight loss studies in the Ramage systematic review (2014) which three characteristics were most prevalent?

3. What is the danger of clients setting unrealistic weight loss goals?

2. Why can a fear of exercise increase the chances of attrition on a lifestyle intervention?



AIMS:

Key Learning Points

In this video we take a look at a very recent study (Guo, 2018) that analysed the data from Gardner’s DIEFITS study (2018), seen in video 6. Topics include under-reporting, exponential decays in dietary adherence and weight loss plateaus.

LESSON:

22

Successful Dieting – There is no magic



Action Points

Quiz Questions

1. From months 7-12 both the low carb and low-fat group over-reported their energy intake true or false?

3. During the 12 month trial the participants believed they had adhered to their diets to a similar extent throughout?

2. Why did weight loss plateau at 6 months in both groups?



AIMS:

Key Learning Points

In this video we discuss fast v slow rates of weight loss and why the “slow and steady” mantra is not always right.

LESSON:

23

Rates of Weight Loss 1



Action Points

Quiz Questions

1. In the Nacker’s study (2010) those individuals that lost the most weight in month one went on to do what?

3. Why may a shorter dieting phase be beneficial?

2. When looking at rapid weight loss and loses in Fat Free Mass what must we consider?



AIMS:

Key Learning Points

Having shown some of the studies supporting greater rates of weight loss in the last lesson this video shows the other side of the coin in which we discuss rates of weight loss in more athletic or leaner populations.

LESSON:

24

Rates of Weight Loss 2



Action Points

Quiz Questions

1. In the Das study (2009) which group lost the most weight?

3. Who may rapid weight loss be a poor choice for?

2. In the Huovinen study (2014) what relationship did they find with rate of weight loss and body fat %?



AIMS:

Key Learning Points

In this video we look at long-term weight loss and metabolic adaptation in former biggest loser contestants before exploring some of the key characteristics and behaviours that have been identified by those individuals that have lost weight and kept it off for up to 10 years.

LESSON:

25

Weight Loss Maintenance



Action Points

Quiz Questions

1. In Kern’s biggest loser study what separated “regainers” from “maintainers”?

3. In the national weight control registry which were the two most noteworthy predictors for weight loss maintenance?

2. In individuals that maintain weight loss how is fasting hunger impacted (Nymo, 2018)?



AIMS:

Key Learning Points

In this video we discuss the topic of energy flux, the relationship between increased energy expenditure and energy intake and why all calorie balances may not be created equally.

LESSON:

26

Energy Flux



Action Points

Quiz Questions

1. How can we describe energy flux?

3. Why must we be cautious with the findings from the Paris study (2016)

2. What did Mayher discover about the relationship between energy intake and energy expenditure?



AIMS:

Key Learning Points

In this video we dig into the topic of exercise, it’s important yet paradoxical role in weight loss maintenance and why some studies fail to show a benefit.

LESSON:

27

Exercise and Weight Loss Maintenance



Action Points

Quiz Questions

1. Why has exercise failed to show a positive impact on weight loss maintenance in some randomised control trials?



AIMS:

Key Learning Points

In this video we draw together some of the key concepts and topics from the course.

If you enjoyed this course keep an eye out for “Integrated Nutritional Periodization” coming in 2019.

LESSON:

28

Course Summary



Action Points



Notes



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1

Key Learning / Action Date for Completion

Action Plan

Congratulations on completing the course. The key with any education is how you intend to use what you’ve learnt. Take the time to consider the knowledge you have gained during this course and how you are going to implement it or change what you currently do. Use the space below to summarise or to plan and set goals for the implementation or follow up phase.

integrated nutritional periodisation part 1 … · 17 understanding weight loss: integrated...

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