O.K., let’s get this out of the way: Nutrition-related scope of practice and standards of care is not the sexiest topic of discussion. I’ve been trying to think of exciting ways to kick off this article for the past couple of days and nothing has worked. That said, it’s an important topic for health coaches and exercise professionals to understand, as changes in the industry and in technology have greatly broadened the types of services you can offer to your clients and participants while staying within your defined scope of practice. Being able to offer these expanded services can enhance your practice, allow you to make more money and grow your business in the long run. And, of course, your clients benefit as well.

Nutrition can be an intimidating topic for a lot of health coaches and exercise professionals. The science can be complex and evolves so quickly that people sometimes don’t know what to believe. On top of that, the nutrition-related scope of practice can be confusing, and you may be unsure of the fine line between offering “nutrition advice” and “meal planning.” A lot of professionals simply opt to do nothing when it comes to nutrition and instead tell clients and participants that they can’t discuss the topic at all. If you make that choice, however, you may be undermining both their results and your business.

The first step to embracing nutrition as part of your practice is a change in mindset. “Don’t think of your scope of practice as a set of limitations,” says Chris Gagliardi, MS, Scientific Education Content Manager at ACE and an ACE Certified Personal Trainer, Health Coach, Group Fitness Instructor and Medical Exercise Specialist, “but rather as a set of opportunities.”

There is plenty of room within your scope of practice to play an important role in other aspects of clients’ and participants’ lives beyond your sessions or classes, explains Gagliardi. You should refer when necessary, but don’t make unnecessary referrals when you could instead empower your clients to make dietary changes on their own (with your support). This is something that Gagliardi says ACE Certified Professionals can “safely and confidently do within the scope of practice.”

Using Technology to Enhance Your Services

The scope of practice for ACE Certified Professionals isn’t changing, but technology and phone apps offer more options for providing support without stepping outside of that scope. According to Gagliardi, this gives you more of an opportunity to be involved in your clients’ or participants’ lives outside of your sessions or classes.

There are so many ways to use technology to enhance conversations about nutrition and bring this complex topic to life. Thousands of health- and nutrition-related apps are available, from calorie-counting apps that allow users to share their data with their health coach or exercise professional, to apps that allow them to share pictures of their meals before sitting down to eat. As Gagliardi points out, people tend to make better choices when they know their coach or trainer may be offering support in real time. These apps are essentially a technological update on traditional food diaries and food-frequency logs, but instead of being reviewed at each weekly session, they allow for in-the-moment behavior-change coaching and feedback.

“People have become a lot more open to doing things using technology now,” says Gagliardi, “and apps and things like Zoom are a great way to take advantage of that.” Zoom, FaceTime and similar tools can be used to record or livestream cooking demonstrations and educational sessions, or even to virtually join clients or participants as they do their grocery shopping, walking them through how to approach a store’s layout or compare food labels. Again, this is a way to use technology to expand your services while staying within scope of practice.

Using Nutrition to Round out Your Practice

Tying nutritional intake to physical activity, behavior change, stress management and other health-related topics of interest to a particular client or participant rounds out the full picture of health—and you simply can’t do that without discussing nutrition.

Dominique Adair, MS, RD, is an ACE Scientific Advisory Panel Member and a private practice fitness and nutrition adviser. She says that many clients focus almost exclusively on the exercise side of things—the “output” half of the weight-loss or wellness equation—and then are surprised when they don’t achieve their goals. So, providing services on the “input” or nutritional side is vital, not only for helping clients reach their goals but also in terms of getting to where you want to be as a professional. Never forget that having more successful clients equates to more success for you and your business.

Rather than getting caught up in a set of rules or terms you can and cannot say, Adair suggests that when you have a client or participant in front of you, ask yourself, “Am I the best person to help this individual?”

Starting with this high-level question will position you to provide the best standard of care.

If the answer is yes, ask yourself, “Am I familiar with the most current science available so that I can best help this person?” If yes, go ahead and provide advice and support while being mindful of scope of practice. If no (or not yet), tell the person that you will do some research so that you can discuss the topic more thoroughly during your next session.

If the answer to that big-picture question is no—perhaps because they were recently diagnosed with diabetes or are at risk for heart disease and the topic is therefore outside your range of expertise and scope of practice—then your responsibility is to build a network of clinicians and other professionals who you can refer out to so that you can support those clients.

The bottom line is, you never want to say, “I’d love to be able to help you, but I can’t.” You either want to be (or become) the expert or refer the person to the appropriate professional. That way, you maintain your credibility, stay within your scope and provide the optimal standard of care.

Answering Commonly Asked Questions

There are several commonly asked questions that all health coaches and exercise professionals should be prepared to answer. If your advice is relevant, within scope and evidence-based, you can feel comfortable and confident helping your clients or participants get a better understanding of nutrition and develop healthier eating patterns.

Nutrition lends itself to mythology and misinformation. “The area where I have seen the greatest opportunity, and I’m so grateful to the fitness professionals who are doing this, is in the area of myth-busting,” says Adair. When clients ask questions like, “Do eggs cause heart disease?” “Do I need to eat 200 grams of protein every day to build muscle?” or “Do I have to drink a gallon of water each day to stay hydrated?” you can offer science-based responses that further their understanding of nutrition.

At the end of the day, explains Adair, “anything that encourages healthy, plant-dominant and not overly restrictive eating” is going to be very helpful to most clients and participants.

Perhaps the most asked questions center on the use of supplements. When this topic arises, Adair suggests that ACE Certified Professionals always start by talking about real food. Encourage clients and participants to contemplate the definition of the word supplement: “Think about what the word means,” she says. “We supplement when something is deficient.”

So, the first step should be helping the individual develop an eating pattern of healthy foods that they enjoy. Then, if it is determined that the client is deficient in a particular nutrient, they can start thinking about whether they should supplement. Importantly, that is a conversation for a registered dietitian, not a health coach or exercise professional, as it is outside your scope of practice to diagnose or address nutrient deficiencies or recommend supplements.

That is a great example of when a referral is required. But, as a health coach or exercise professional, you can shift the conversation to one about sources of particular nutrients. For example, if a client or participant asks about protein shakes or supplements, you can discuss healthy sources of protein and provide strategies on how to distribute them throughout the day.

In Conclusion

This last scenario is an example of what Adair calls “helping with the how.” Perhaps the greatest role of a health coach or exercise professional is to empower clients and participants to develop and implement plans to do what they already know they should be doing. And this goes for all areas of wellness, not just nutrition and exercise.

Your role is to help clients and participants bridge the intention–action gap by providing them with education and tools that take them from what they’re doing now and what they want to do moving forward to actually making lifestyle changes.

“That doesn’t require a PhD in nutrition,” says Adair. “It requires a deep interest in, and understanding of, human behavior.” This, of course, is something with which any good health coach or exercise professional is already equipped.  

Expand Your Knowledge

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