Trainers are often asked by their clients to talk about exercise, nutrition, supplements, and more, yet they’re often unsure of what they should and shouldn’t talk about. As a qualified trainer, you likely possess a fundamental knowledge of human anatomy and physiology. Given your choice of profession, you’ve likely committed yourself to doing what you can to help your clients improve their health, body composition, and performance.
Your experience tells you that nutrition and training go hand-in-hand and that results come only when both are improved. So I have no doubt that you want to talk about both areas with your clients. However, it’s possible that employers, dietitians, and other health-care practitioners have discouraged you from discussing nutrition as it relates to your clients’ goals. Perhaps you’ve even been told that it’s illegal to talk about nutrition with clients. Well, that’s not exactly the case.
Although each state and province in North America has different rules for dispensing nutrition advice, in most states it’s well within the scope of practice for personal trainers who possess fundamental nutrition knowledge to address questions and concerns their clients may have. Notice I emphasize the “fundamental knowledge” part. With specific training, such as that provided by the ISSA’s Specialist in Fitness Nutrition Course, you’ll possess that knowledge and be better able to discuss nutrition with clients.
Of course, it is true that the domain of the personal trainer is limited concerning nutrition. Technically, in many North American states and provinces, anyone can make general nutritional suggestions. However, offering Medical Nutrition Therapy (i.e., prescribing nutrition for a variety of health conditions and illnesses) is another story.
For example, certain states have statutes that include an explicitly defined scope of practice. In these states, the performance of Medical Nutrition Therapy is illegal without first obtaining the dietitian credential and then applying for a license from the state.
These states include Alabama, Alaska, Arkansas, California, District of Columbia, Florida, Georgia, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, and West Virginia.
It should be noted that in these states it’s perfectly legal for you to make nutritional suggestions for healthy, active individuals. It’s also legal for anyone to share nutrition education through materials that originate from a public or well-known entity such as the American Heart Association, the Centers for Disease Control and Prevention, the American College of Nutrition, the ISSA, etc.
It’s only illegal to prescribe nutrition for medical conditions unless you’re a licensed dietitian.
Other states have statutes that limit the use of titles such as “licensed dietitian,” or “certified nutritionist.” These states do not necessarily limit the practice of making nutritional prescriptions.
These states include Connecticut, Delaware, Hawaii, Indiana, Nevada, New York, Oregon, Utah, Vermont, Virginia, Washington, and Wisconsin. In these states the laws are more liberal, allowing for those without dietetics licensure to offer specific nutrition recommendations as long as they’re certified in nutrition and registered with the state as certified (for the latest nutrition statutes in your state, please see www.nutritionadvocacy.org).
In analyzing these definitions, the differences between “general nutrition suggestions” and Medical Nutrition Therapy aren’t always apparent. After all, what’s the difference between a co-worker giving some general tips on weight loss for cholesterol reduction and a personal trainer giving the same tips in-between sets of squats?
And what’s the difference between recommending certain breakfast foods for general good health in a type II diabetic and recommending the same breakfast foods for controlling blood sugar? Well, in the case of gray areas, the decision is made by the state, so it’s best to check your state’s laws, rules and regulations regarding nutritional recommendations.
To remain safely within state guidelines, trainers with nutrition continuing education credits such those obtained in the ISSA Specialist in Fitness Nutrition Course, often make suggestions related to optimal rest, hydration, and food intake.
Such topics directly relate to gym performance and usually include recommendations for adequate sleep (7 to 9 hours per night), adequate hydration (6 to 12, eight-ounce cups per day), pre-workout nutrition (a light meal within an hour or so of training), and post-workout nutrition (usually some protein and carbohydrate nutrition).
Further, trainers often make suggestions to support in-the-gym weight loss and muscle-gain efforts, providing ideas or education on the following topics:
Again, in most cases giving general advice on these topics is acceptable. However, it’s also important to recognize that there are many nutritional issues that fall outside the scope of practice. For example, giving nutrition advice for health problems such as diabetes, heart disease, liver dysfunction, kidney stones, etc., is definitely the domain of registered dietitians and medical practitioners, as is giving advice for eating disorders such as anorexia and bulimia.
Giving this type of advice—again, Medical Nutrition Therapy—is well beyond the scope of the personal trainer’s practice (and likely expertise) and certainly goes against the regulations of many states. This is why every trainer should know when to refer, whom to refer to, and how to refer. I suggest developing a relationship with a qualified local nutrition partner (a dietitian who is also certified in sports nutrition) to refer clients to when necessary.
In the end, your level of nutritional discussion with clients will likely be based on the following:
1. Your particular state or province’s regulations - Most states allow you to address client questions and concerns with respect to nutritional advice, although different states have different regulations
2. Your client’s likelihood of working with both you and a nutritionist - If your client has the means to work with both you and a dietitian also trained in sports nutrition, this is likely your best bet as long as you trust the dietitian’s advice. If not, you may want to talk about nutrition with your clients as long as you stay within your scope of practice.
3. Your client’s health - If your client has health problems or specific nutrition-related diseases, it’s best to refer him or her to a licensed dietitian also trained in sports nutrition as long as you trust the dietitian’s advice. There should never be a time when you, as a personal trainer, offer Medical Nutrition Therapy.