In a recent issue of CERTIFIED, five of ACE’s leading subject matter experts each presented a study they think all ACE Certified Professionals should know about. Here, we turn our attention to nutrition—a complex and dynamic topic that lends itself to a wealth of misinformation and misunderstanding. It’s also an area that is too often driven by fads and quick fixes. To counter that narrative, we asked five practicing health and exercise professionals to identify a piece of research they think you should know about, explain why they find it so intriguing and explore how it might change the day-to-day practice of health coaches and exercise professionals.

What Impact Does the Consumption of Ultra-Processed Food Have on Weight Gain?

Cassandra Padgett, MS, is a senior health educator for a pediatric medical group in San Diego, Calif., a private nutrition coach for women at www.cassandrapadgett.com, and an ACE Certified Health Coach. She focuses on improving nutrition habits while rejecting the diet mentality by combining intuitive eating with nutritional science.

Ultra-processed Diets Cause Excess Calorie Intake and Weight Gain 

This 2019 clinical study highlighted the importance of reducing ultra-processed foods in the diet in favor of more satiating whole foods. Investigators provided participants with either ultra-processed or unprocessed diets for two weeks, and then had them switch diets. Presented meals were matched in terms of calories, energy density, macronutrients, sugar, sodium and fiber, and participants were instructed to eat as much or as little as they wanted. On average, those eating ultra-processed diets consumed approximately 500 more calories per day and gained 1.3 to 2.6 pounds (0.6 to 1.2 kilograms) over the course of two weeks. In contrast, those eating the unprocessed diet lost an average of 1.3 to 2.6 pounds (0.6 to 1.2 kilograms).

1. What is it about this research that you find so compelling or intriguing?

What I find compelling about this study is the research method. This was a four-week clinical trial comparing an ultra-processed diet to an unprocessed diet. While the results are probably not surprising to health and fitness pros (the ultra-processed group consumed more calories and gained weight, whereas the group eating an unprocessed diet lost weight), this study specifically focuses on the importance of reducing ultra-processed foods because they are not satiating and, because they’re highly palatable, they can easily be overconsumed. 

2. What is the key take-away message that you want health coaches and exercise professionals to understand?

Interestingly, the gut-brain mechanisms and hormones that signal hunger and fullness do not function effectively when the body is fueled solely with ultra-processed foods or drinks, which can contribute to increased cravings and overeating. This isn’t to say that clients should never have ultra-processed foods, but rather that protein and fiber should be prioritized in the diet to promote satiety.

3. How might the findings impact the work of health coaches and exercise professionals?

While much of the nutrition discussion in the media is about which diet is “wrong” vs. “right,” this study suggests that macronutrient breakdown, a focus on keto, high carb, vegetarian, etc., does not matter as much as intake of protein, fiber and whole foods. Coaches can feel free to support clients in eating whichever way the client feels best, while increasing more whole foods and protein intake. This study promotes the idea that a nutrient-dense, balanced diet is most effective in terms of weight loss and health.

Another thing to consider: The cost of the unprocessed diet was about $50 more per week than the ultra-processed diet in this study. Some individuals may have a more challenging time decreasing processed food intake due to access or cost, cooking ability, etc. These factors may be targeted in coaching by discussing topics such as cooking skills or meal-prep skills, shopping on a budget and time-saving food preparation tips. 

Can a Diet Designed to Drive Weight Loss Also Reduce Hot Flashes and Night Sweats in Postmenopausal Women?

Niki Campbell, NDTR, owner of The Flourish Group, an executive and workplace wellness coaching firm, specializes in working with busy professionals to improve their nutrition, fitness and lifestyle behaviors. She is also an ACE Certified Health Coach and Personal Trainer. Her coaching approach focuses on improving the Five Foundations of Flourishing—stress, sleep, hydration, food and fitness—in a way that fits in with her clients’ demanding careers and over-scheduled lives.

Effects of a Dietary Intervention and Weight Change on Vasomotor Symptoms in the Women’s Health Initiative

This study, which included more than 17,000 women between the ages of 50 and 79, evaluated whether a dietary intervention designed to reduce fat intake and increase intake of fruit, vegetables and whole grains would also reduce vasomotor symptoms (i.e., hot flashes and night sweats) in postmenopausal women. They found that women who lost 10 or more pounds (≥4.5 kg) in one year of the dietary intervention were significantly more likely to eliminate these symptoms compared to those who maintained their weight.

1. What is it about this research that you find so compelling or intriguing?

I work with busy professionals who are usually in their middle-age years and, for the most part, female. A common challenge these clients face is not only midlife weight gain, but all the symptoms of menopause, such as lack of energy, night sweats, hot flashes, etc. All of this, combined with hectic schedules and demanding careers, keeps many of them from establishing healthy, sustainable habits. This, in turn, can snowball into more weight gain and other physical ailments.

What I found interesting in this research is that the same things that contribute to a generally healthy lifestyle and weight loss (reducing fat intake and increasing intake of fruits, vegetables and whole grains) can also reduce the most challenging of menopause symptoms—night sweats and hot flashes. This research shows that there are simple, accessible and affordable ways to improve your symptoms while improving your health. It’s a win-win for women who don’t need complicated, time-consuming nutrition interventions added to their already busy lives.

2. What is the key take-away message that you want health coaches and exercise professionals to understand?

Focus on the tried-and-true nutrition concepts we already know to be healthy for weight loss with the added understanding and science that shows these same concepts can reduce the severity of menopausal symptoms. This gives women in this stage of life a more natural way of dealing with the symptoms while also contributing to maintaining a healthy weight and reducing risk factors for other diseases.

3. How might the findings impact the work of health coaches and exercise professionals?

It provides more evidence that a balanced diet and healthy weight are good for overall health and wellness. And it’s another tool for those who work with menopausal and postmenopausal women to help them lessen their symptoms, which will lead to more energy for other important healthy behaviors, such as restful sleep and regular exercise.

What is the Role of Plant-based Dietary Patterns in the Primary Prevention of Type 2 Diabetes Among Adults?

Jessica Matthews, DBH, NBC-HWC, FACLM, is associate professor and director of the Master of Science in Kinesiology – Integrative Wellness program at Point Loma Nazarene University. Dr. Matthews also serves as Director of Integrative Health Coaching at UC San Diego Health and is a research team member in the Krupp Center for Integrative Research.

Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes

This review and meta-analysis of nine studies—totaling more than 300,000 participants with more than 23,000 cases of type 2 diabetes—found that plant-based dietary patterns reduced the risk of type 2 diabetes. This effect was enhanced when participants regularly consumed healthy plant-based foods, such as fruits, vegetables, whole grains, legumes and nuts.

1. What is it about this research that you find so compelling or intriguing?

What’s so compelling about this research is that it further supports what is already well documented throughout the literature, which is that a plant-based eating pattern is foundational to health and well-being, to include the prevention of prevalent chronic diseases, such as type 2 diabetes. As noted in the paper, a plant-based dietary pattern does not necessarily imply that it is plant-exclusive—rather, such a dietary pattern focuses on emphasizing the consumption of predominantly plant foods while simultaneously lowering or excluding the consumption of animal products.

What is particularly compelling about this research is that while a plant-based dietary pattern was associated with a reduced risk of type 2 diabetes, the association was further strengthened when quality plant-based foods were emphasized, such as whole grains, vegetables, fruits, legumes and nuts.

2. What is the key take-away message that you want health coaches and exercise professionals to understand?

When it comes to improving health and preventing chronic diseases, such as type 2 diabetes, eating more plants is powerful and essential. It is particularly important for professionals to understand that when it comes to plant-based eating patterns, quality does matter, as whole and minimally processed plant foods are most impactful in terms of eliciting the greatest health benefits.

3. How might the findings impact the work of health coaches and exercise professionals?

Clients are constantly navigating a world of conflicting and confusing nutrition information (and often misinformation), complete with false claims and fad diets—each of which claims to be better than the next. However, as evidence-based practitioners, we have the opportunity to shine a light on what we know with immense clarity through the review of decades of quality scientific research: An eating pattern consisting of predominantly whole and minimally processed plant foods is essential to promote and restore health, as a plant-predominant eating pattern is effective not only in the prevention of chronic lifestyle diseases like type 2 diabetes, but also in the treatment and even remission of these conditions.

Through our work as health coaches and exercise professionals, we can support clients in better understanding the vital role healthful nutrition plays in optimizing health and well-being, while also empowering individuals to apply practical, science-based principles in their daily lives to improve their eating habits through the consumption of more quality plant foods. As opposed to the diet mentality, which focuses almost exclusively on what to avoid eating—often fostering an unhealthy relationship with food—there is an exciting opportunity for us as professionals to partner with clients in exploring the plethora of simple, delicious, creative and nourishing ways to add more whole and minimally processed plant foods into their meals, taking into account individual preferences, as well as community and cultural considerations.

How Do Protein Quality and Quantity, in Combination With Exercise, Impact Overall Health?

Hope Barkoukis, PhD, RDN, LD, FAND, is Chair of the Department of Nutrition, a past Board member for The Academy of Nutrition & Dietetics, and the creator/faculty lead for the Jack, Joseph, Morton Mandel Wellness & Preventive Care Pathway program for medical students in Cleveland, Ohio. Additionally, she was appointed by the CWRU Board of Trustees as the inaugural recipient of the Jack, Joseph, Morton Mandel Professorship in Wellness and Preventative Care.

Dietary Protein Quantity, Quality and Exercise Are Key to Healthy Living

This research review discusses the protein quality and amount that should be consumed to maximize muscle mass throughout life, thereby improving overall function, health and quality of life. The goal was to look beyond recommended dietary allowances, which cover basic needs, and consider protein needs for individuals with an active lifestyle. The authors recommend a shift to whole food–based guidelines that consider food interactions and other required nutrients for potentially optimizing the health effects of food.

1. What is it about this research that you find so compelling or intriguing?

Maintaining muscle mass is fundamental to independent functioning and quality of life at all ages, particularly for healthy aging. Significant loss of muscle mass results in functional impairment, poor quality of life, increased risk of chronic disease and mortality. Additionally, successful outcomes for athletes and fitness enthusiasts depend on maintaining optimal muscle mass. We know that the relationship between the rates of muscle protein synthesis and breakdown ultimately determine whether an individual has a net gain or loss of muscle mass.  We also know that certain factors, such as dietary patterns, (particularly protein-rich food intake), training status, various exercise modalities and age, strongly influence muscle protein synthesis.

This research is important because health professionals should provide the most up-to-date evidence-based recommendations for overall health, well-being and performance. What I like about this research is that it provides a broad perspective for the professional to understand the complexity of the topic, the areas of protein research and muscle protein synthesis that are still debated, as well as the areas that are now fully understood.

2. What is the key take-away message that you want health coaches and exercise professionals to understand?

The key takeaway message is that many factors influence muscle protein synthesis, including one’s age as well as the various non-protein components within the whole food matrix. Translated for health coaches and exercise professionals, this means that there is no “one-size-fits-all” message when talking about maintaining muscle and the role of optimal dietary patterns and protein with their clients. In older adults, the amount of leucine in foods (a specific essential amino acid that the body cannot synthesize), appears to be an important factor regulating muscle protein synthesis, whereas this may not necessarily be as critical for younger adults. Specifically, studies have confirmed that older adults optimize muscle protein synthesis when their postprandial blood levels of leucine are high. By contrast, a defined high blood level of leucine does not seem to be a major factor regulating optimal muscle protein synthesis for younger adults. (Note, the exact age of an “older adult” is not identically defined in all these studies.)

3. How might the findings impact the work of health coaches and exercise professionals?

The important impact of this research for health coaches and exercise professionals is to realize that while the importance of protein quality for optimal muscle protein synthesis is well established, we have considerably more to learn about the complexities of various food choices on muscle protein synthesis. In particular, we need more information about the dose, timing and optimal source of ingested protein, as well as how the interactions among the various components in foods influence muscle protein synthesis. Hence, the best evidence-based messaging (beyond physical activity, of course) is to focus on encouraging a wide variety of whole-food choices, including high-quality proteins, consistent with the dietary patterns recommended by the Dietary Guidelines for Americans for optimal health, well-being and maintaining muscle mass.

Does Replacing Saturated Fat in the Diet with Vegetable Oil Really Reduce the Risk of Heart Disease?

Leila Finn, MA, NBC-HWC, is the author of Health Coaching Tips and Case Studies to Improve Your Coaching Skills and has served as a health coaching instructor for several certificate programs, including ACE, Emory University, Georgetown University and the University of Arizona Center for Integrative Medicine.

Re-evaluation of the Traditional Diet-Heart Hypothesis
In this study, the authors reexamined data (including previously unpublished data) from two influential studies testing the diet-heart hypothesis: the Sydney Diet Heart Study (1966-1973) and the Minnesota Coronary Experiment (1968-1973). Both studies posited that replacing saturated fat with vegetable oil would decrease serum cholesterol and reduce heart disease. Their review of the Sydney Diet Heart Study found that replacing saturated fat with vegetable oil lowered serum cholesterol but increased the risk of death from heart disease. This article details their review of the data from the Minnesota Coronary Experiment (MCE). Their findings mirror those of the review of the Sydney Diet Heart Study and add to growing evidence that the benefits of this dietary change have been overestimated. 

1. What is it about this research that you find so compelling or intriguing?

The idea that saturated fat raises cholesterol and causes heart disease has become almost gospel; this study illustrates the need to reexamine the diet-heart hypothesis. It’s striking that the studies reviewed helped influence federal dietary guidelines. The author’s review of unpublished data resulted in new findings, which reminds us that study conclusions can be flawed and raises questions about the foundation of the heart-health hypothesis.

2. What is the key take-away message that you want health coaches and exercise professionals to understand?

This article brings to light the fragile nature of what we consider nutritional truths. About nutrition and health, the authors write, “Given the limitations of current evidence, the best approach might be one of humility, highlighting limitations of current knowledge and setting a high bar for advising intakes beyond what can be provided by natural diets."

3. How might the findings impact the work of health coaches and exercise professionals?

The findings challenge assumptions many of us have about dietary fat and health and remind us to be cautious when asked about food. As health coaches and exercise professionals, we are often asked about the health benefits and dangers of different foods and nutrients. The authors remind us that natural diets—traditional foodways—are the best reference for a healthful diet.

In Conclusion

Nutrition is a rapidly changing science. Because of the interest this topic holds for clients and the public at large, it is essential that, as a health and exercise professional, you handle conversations on nutrition with a measured, evidence-based approach that avoids fads, trends or one-size-fits-all solutions. By doing so, you establish yourself as a reliable source of information and a go-to expert for your clients. There are many ways in which you can collaborate with, and empower, your clients and class participants to improve their nutritional intake while staying within your scope of practice. Reviewing, evaluating and sharing peer-reviewed research is a great place to start.

Expand Your Knowledge

	ACE Fitness Nutrition Specialist Help your clients make healthier, long-lasting food choices through nutrition education and behavior change.
	Precision Nutrition Level 1 – The Essentials of Nutrition and Coaching Master the science of nutrition and the art of behavior-change coaching with this practical nutrition course.
	Applying Nutrition Principles – Course Bundle These courses will equip you with information and meaningful behavior-change techniques to help you support your clients in healthier food choices and implement into your practice immediately.