Archives For March 2012

I have to hold my hand up at the outset and acknowledge that this post is going to be little more than a highly abridged version of Gary Taubes work in “The Diet Delusion“. That is to say, your time may be profitably spent reading his book instead of this post. I’m writing this really only to vent my frustration at the endless repetition of myths that Taubes so compelling takes apart in his book.

There have been a quite surprising volume of health/nutrition related programmes, and news features on UK television recently, ranging from: ‘Supersize vs. Superskinny’; to news coverage of the Harvard School of Public Health’s ‘Red meat increases cancer risk’ study; to Horizon documentaries like ‘The Truth About Fat’ and ‘The Truth About Exercise’.

What I find particularly remarkable about so much of the content is not what’s included, but what’s left out. That is to say that all of these programmes that I have seen assume that the viewers are already in possession of various ‘facts’ that require no explanation or back up. Things that we all ‘know’, such as: Dietary fat is bad for you, saturated fat is especially bad for you, cholesterol is bad for you, vegetable oils are more healthy than animal fats, wholegrains are healthy, high fibre is good, starches should form the basis of our meals, milk is healthy if it’s low fat…etc.etc.

Some time ago I saw another news story in which a member of the public was interviewed about lifestyle, and came out with the line: “We all know how to eat healthily…”. Obviously this is true, we’ve all heard it many times, and we can look at the Department of Health website if we’re not sure, that will show us the ‘Eatwell Plate’ to guide us to the right choices.

This is the conventional wisdom: low fat, high carbohydrate; 5 a day; and, increasingly, eat less meat. The question that Taubes set out to answer in “The Diet Delusion” was: ‘If we know so much about healthy eating, and sales of low fat and fat free foods have been so strong, why are obesity (and heart disease) rates still rocketing up?’ The answer, of course, is that we’ve been given bad advice on how to eat for the last fifty years or so.

Horizon’s ‘The Truth About Exercise’ was the first programme to make me think about the regurgitation of  conventional wisdom. The point of the programme was apparently to look at how exercise might prevent the presenter form succumbing to diabetes. One of the segments looked at his blood lipids (how much fat was in his blood) after eating, and if exercising before eating had an impact on his blood lipid profile. The meal used for this was a ‘typical’ Scottish breakfast.

The expert, Dr John Gill  of the Institute of Cardiovascular and Medical Sciences at Glasgow University made a point of the fat in the breakfast (making no mention of the sugars present in the beans, bread, tomato etc.), and then took some of the presenter’s blood after eating, showing the viewer the level of fat in his blood. The message was very clear – eat fat, and the fat in your blood will increase. I’m no biochemist, but my understanding is that the mechanisms of digestion are a little more complicated than that. For example, if you’re eating fruit, and you’re muscle stores are full of glycogen then your liver will turn the fructose from the fruit into triglycerides (fat) that will then be transported by your blood to fat cells.

Horizon also presented ‘The Truth About Fat’ a couple of weeks later. It was refreshing to see that the gastric surgeon turned presenter for the programme changed her view of obese people (it turns out they don’t just lack her self-control). Disappointing to find that the ‘Truth’ that the programme offered lay in surgery, or hormone regulation medication that may be developed. Also disappointing to see the presenter selling the programme on breakfast television and casually mentioning the hormones that make fat people “want fatty foods”. A throwaway remark perhaps, and yet more reinforcement of the idea that fat makes you fat. The evidence is that it is carbohydrate that makes you fat, and addicted to it, to boot. (Read ‘Wheatbelly‘ for more on the addictive properties of wheat in particular).

The view of obese people often seems to be that they are greedy and lazy, and that if they only had more discipline, and exercised more, they would lose weight. I can accept that there are a lot of obese people who are continually consuming manifestly bad stuff – high sugar fizzy drinks, doughnuts etc., and I’m also sure that there are plenty of people who are trying hard to lose weight by “eating right”, but unsuccessful because what we’ve been told is the right way to eat is almost exactly the opposite of what will encourage weight loss. (According to Taubes the truth about healthy eating was being established by German scientists before the second world war but, tragically, there work was ignored – German science having been discredited by the horrors of the Nazi regieme).

Another BBC news story that I happened upon was about the popularity of ‘free-from’ foods (gluten-free, dairy-free etc.). The segment confidently asserted that only 1-2% of us are allergic to certain foods (subtext = it’s a fad). Whilst a small percentage of people may be allergic to gluten, testing is often unreliable, and many more of us may not tolerate gluten well. You don’t have to be celiac to suffer negative effects from gluten, possieffecting not on the gut, but the brain!   The dietician interviewed in the piece suggests that, if we exclude things like wheat and dairy, not only will we be eating a limited range of food, but we may be in danger of becoming malnourished (around 1:40 in the clip if you’re really interested). The story was followed by a discussion in the studio. The BBCs obligation to impartiality clearly doesn’t extend to nutrition, as the BBCs resident GP was the only person on hand to comment. Amongst her advice to viewers: “Do not consult a nutritionist, they are unregulated. Only consult a dietician” – like the one in the segment who thinks that eliminating wheat and dairy from your diet may result in malnutrition! If you visit the website of the British Dietetic Association seeking advice on healthy eating you will quickly find yourself looking at the ‘Eatwell Plate’, pictured above. Yes, meals based on starches, that we know make us fat. In fact, unless we are indulging in regular endurance type activity, we do not need any dietary carbohydrate because, by a process called gluconeogenesis, our body can make carbohydrate from other sources. (I’m not advocating a zero-carb diet, just trying to underline the crassness of suggesting that carbohydrate needs to form the basis of all our meals).

The Harvard School of Public Health’s study implicating red meat consumption represented another opportunity for the BBC news to cover itself in glory, presenting the story in an entirely uncritical light, and featuring a representative of Cancer Research declaring that “We now know that red meat causes cancer.” (To understand why this study is only fit for “lining a budgie’s cage” please see herehere, or here.)

There was no explanation of any possible mechanism, no-one to question how the data was gathered or interpreted. This was not a clinical trial that could legitimately be said to prove anything, yet the ‘findings’ were presented as incontravertible fact. Later that day in the gym I heard a trainer confidently asserting  that his client must get his protein needs from sources other than red meat. Fairy tale has become fact.

You might well argue that misrepresentations about eating red meat are less serious than those about how we become and remain fat – the consequences of people eating less red meat aren’t likely to be nearly as serious as the consequences ofoverweight people beingadvised to eat less fat and more starch (slow releasing sugar is still sugar). The pressing question is how we can be fit and well as a society if poor information, through repetition (often by authority figures), becomes popular belief? What’s the definition of insanity? How about repeating the low fat/high carbohydrate mantra and expecting obesity/cardio vascular disease rates to go down.

There’s a wealth of information available, not least of which is Taubes’ incredibly extensively referenced book. If you don’t fancy reading that, perhaps consider listening with a sceptic’s ear next time there’s a media story on nutrition/health.

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I just tried an internet search for “pilates low back pain” and Google returned 1, 380, 000 results. Google scholar also offers hundreds of ‘scholarly articles’ that touch on the subject. Amazon offers several DVDs of Pilates for low back pain, but their offerings are dwarfed by the hundreds of YouTube videos on the same subject. Another Google search for the same terms but in the News section suggests that in the last month English language newspapers and magazines have also had hundreds of articles on this subject. Coupled with my own experience of Pilates ‘fixing’ my low back pain, is it any wonder that I’ve spent years believing that Pilates offered the best solution for anyone suffering from this nearly ubiquitous affliction?

The Dummies.com website has a page, attributed to Ellie Herman on: ‘Easing Your Back Pain with Pilates‘ in which she explains that the causes of back pain are “faulty posture” and “sedentary lifestyle”. While we might like to suggest some other possible causes, I don’t suppose that many Pilates teachers would disagree with her – it seems like pretty basic stuff: you sit and/or stand badly, your postural muscles get lazy, you ability to stabilise your spine is compromised, and from there you’ll be very lucky if you don’t wind up in pain.

So, why is Pilates so good at helping relieve low back pain? Well, of course, it targets your ‘core’, deep postural muscles that give your lower back its stability. The less uncontrolled movement that you have in your lower back, the less likely it is that you will have pain. As your stability improves Pilates can help to develop efficient movement of the whole of your spine, encouraging good posture during a variety of activities. In addition, helping areas of relative stiffness to become more supple, and areas of relative ‘looseness’ to become more  stiff (stable) can help to bring more balance to our structure, and integrate our limbs into our trunk.

I was lucky enough to receive a pretty high level of training as a Pilates teacher (certainly by UK standards), and to work with some truly brilliant teachers from the UK and the US. I hope that I can reasonably consider myself to be well steeped in the principles of Pilates, and how to apply them when faced with clients with chronic pain and/or injury. I know about ‘working away from the pain’, and I’ve particularly enjoyed Ron Fletcher’s anecdote on that subject in his conversation with Kathy Grant (I referred to this DVD in a previous post) – Fletcher (a dancer at the time) explains that he went to see Pilates for help with a knee injury. Every time he went to Pilates’ studio he would be given exercises to do that had nothing to do, and Pilates would ignore Fletcher’s protestations that it was his knee that was the problem. After a few sessions Fletcher discovered that his knee was better.

So, I think my training has equipped me to help clients deal with back pain fairly well. I also believe that I understand a lot of the potential causes of back pain, as well as the importance of posture in maintaining a healthily functioning spine. I’ve been fixated (in my teaching) with hip mobility for years, and ‘get’ its importance relative to spinal stability and functional movement. I know, too, that most of us could do with working on upper back extension (and probably rotation and side-flexion too), and that the consequence of that will be less pressure on our necks. The list could go on, and that’s not really the point. In short, I felt that I had the basic understanding that I needed to do my job well, and that Pilates taught well was the ideal solution for all manner of problems. I certainly didn’t imagine that the world of strength and conditioning would have much more to offer in that regard.

More recently my perspective has been challenged. First of all by learning some of Mike Boyle‘s ideas (if you follow the link you’ll see just the kind of website that fit my prejudice completely – all it’s missing is advertising for protein powder) from his book ‘Advances in Functional Training’. (Actually this info is second-hand since it was my wife who bought the book and then explained it to me – I am nothing without her.) Boyle explains the body from the ground up as a series of joints that require, alternately, mobility then stability: ankle joint needs mobility, knee needs stability, hip needs mobility, lumbar/pelvic joints need stability, thoracic spine needs mobility, cervical spine (neck) needs mobility. Genius!

Being peripherally involved in a Pilates teacher training programme I understand how tricky anatomy and physiology can be to get to grips with, not least because it rarely seems to be straightforward, and how often students crave some dependable, simple answers. I’ve suffered the frustration, and seen it in many students too, of different books giving different answers for muscle functions. I know now that anatomy is an evolving subject, not a science in which all the answers have been found and set in stone. Thus, an explanation of what we need from our joints, expressed as simply as Boyle does, feels like a wonderful breath of fresh air. Mobility: stability: mobility: stability….It also seems to fit perfectly with ‘working away from the pain’ – you leave the problem area alone, and look for the adjacent compensations/weaknesses/stiffnesses. I think I had learned the same thing previously, but perhaps in a way that meant I didn’t see the wood for the trees – I knew it in pieces, and had never heard it said so succinctly. Lots of bits of information fell into place as I mused on this idea, and it’s become a constant reference point when I’m teaching.

Following that I was listening to a podcast recently in which the two hosts (one a strength and conditioning coach and the other an olympic weightlifting coach) were answering a question about exercising with a herniated lumbar disc. In discussing the question they came up with an equation something like: “If your hip joints are mobile, and your thoracic spine is mobile, you probably won’t have low back problems. If your hip joints aren’t mobile, and your thoracic spine isn’t mobile, you probably will have problems with your lower back at some point”. More genius! 

It’s just like Mike Boyle said! (Mobility, stability, mobility, stability….) Again, I knew already what they were saying, in fact I’ve probably been saying the same thing to clients for years, just not in such a clear and straightforward way. Perhaps I’ve just been lagging behind all these years, thinking I knew more than I did – certainly I need to view other disciplines with a little more humility than I have in the past. In any case, when trying to learn more about what I do for a living, casting my net wider has definitely been rewarded.

To return to the Ellie Herman piece on http://www.dummies.com, posture may well be a part of the picture, but there’s more to it, and you may be able to make a significant difference to your risk, or management of back pain, by going beyond her advice to:  “sit and stand up tall, keep your belly pulled in, and keep your shoulder blades pulling down your back”. Maybe even by listening to the advice of weightlifters.

Why go Primal?

March 15, 2012 — 2 Comments

Around June 2011 a friend of mine (let’s call him Glen, since that’s his name, and he may often make an appearance on this blog) told me about a book that he was reading, ‘The Diet Delusion‘. It sounded interesting, so I bought it, and was amazed by what I read in the first few chapters.  I won’t go into details here, suffice it say that the author dismantles, with the help of an astonishing array of references, many of the ‘sacred cows’ of healthy eating that I had believed in for years (the book is pretty dense, for a summary you can watch this video).

Talking to Glen about what I’d been reading, he suggested looking at the website Mark’s Daily Apple. Discovering this site was the watershed for me, and before long the shelf above my desk looked like this:

‘The Primal Blueprint’ is the manifesto of Mark (‘s Daily Apple) Sissons, and became my guide to applying the information of “The Diet Delusion’ to my life. The blurb on the cover offers “…effortless weight loss, vibrant health, and boundless energy”, and Sissons is very clear that the Primal Blueprint concept is not a diet, but a lifestyle. Nutrition is a significant slice of the Primal pie, but exercise, sleep and sun also play a part.

I didn’t start reading either of these books thinking that I needed to lose weight, but I certainly knew that I ate more sugar than was good for me, and had had a nutritionist point out to me that my diet was dominated by wheat. My daily food might look something like: toast and jam for breakfast; pain au chocolat and perhaps a croissant too during the morning; sandwich, with fruit, and probably chocolate for lunch; muffin/brownie/chocolate coated peanuts and maybe more fruit afternoon snack; and pasta or pizza for dinner. On the whole I considered myself to be reasonably fit and healthy (on reflection I may be very lucky with my genes…) and I knew that cutting back on sugar was very difficult for me. The transformation in my eating began, as I learned about the role of carbohydrate in fat storage, with trying to increase my protein intake – opting for sausage and egg croissant instead of the pain au chocolat, for example.

The more I read (and one of the things I enjoy about the Primal/paleo community is how much information people offer for free), the more I started to believe that eating grains was a bad idea, and with that I found it surprisingly easy to cut back on my wheat consumption. The shift in my eating probably took four or five months, and was amazingly easy. At first it was very difficult to find ‘primal’ snacks when I was out of the house but as my eating changed more I discovered that I don’t need snacks – four to five hours without food is perfectly manageable if you’re not carbohydrate dependent. A year ago I could easily eat an entire bar of Green & Black’s creamy milk chocolate (36% fat, 50% carbohydrate) – I might have felt a bit sick afterwards, but that wouldn’t have stopped me. Now I find one square of milk chocolate a) doesn’t taste of chocolate at all and b) is so sweet I can hardly bear it. At the same time Lindt 90% cocoa dark chocolate (55% fat, 14% carbohydrate) tastes truly wonderful.

As I mentioned earlier, ‘The Primal Blueprint’ isn’t just a diet book, so what else is there?

These are the 10 Primal Blueprint Laws. Some may need a bit of elucidation: ‘avoid trauma’ in an earlier edition of the book was ‘avoid stupid mistakes’, and is essentially to do with being more conscious of one’s environment, so as not to get hurt; ‘avoid poisonous things’ largely refers to eating foods that contain anti-predation chemicals/elements that we’re not made to digest – these would include almost all grains and legumes (I’m not the ideal person to explain why – please click on the links for Sisson’s own explanation).

I’ve not done so well with the insect eating, lots of sleep is sometimes tricky (especially when living with an excitable kitten…), and I don’t play as much as I might, but on the whole it’s been a very positive experience trying to stick to them. In fact, the changes to the way I eat, and approach exercise have led to one of the biggest transformations of my life.

Pilates definitely had a hugely transformative effect on me – it freed me from 18 months or so of chronic pain, and opened the door to the first real career that I’d ever wanted (and I met my wife through Pilates). It’s inspired me to learn, and allowed me the chance to be a part of running a thriving business. Probably because of my nature, Pilates also allowed me to have a somewhat entrenched view of ‘proper’, or worthwhile exercise, and a limited perspective on physical health. (Let’s be clear, these are my shortcomings. Please see my earlier post for more thoughts about Pilates and health).

And how has the Primal lifestyle transformed me? I’ve lost body fat (I had no idea I stored so much fat in my legs…); I feel like I have more energy; I’m stronger; my eczema is a thing of the past; I don’t feel bloated after eating; I’m less gassy, and my digestion from (ahem) start to finish is generally better. The weightlifting appears to have made me more flexible, and has also made me work some muscles much more than I’d managed previously – I’d never felt my back extensors work like they have to when I squat properly. I’ve also learned that activities like weight lifting have more in common with Pilates than I might have imagined – the language and the application is different but you still have to work from your centre, and the load is supported from your centre.

Physical things aside, there are plenty of other benefits. I’ve discovered that I really enjoy cooking, and, better still, the pleasure of cooking for friends and family who appreciate the food. I’ve developed a relationship with some of the people that I buy food from, and get a surprising kick from the whole process of eating, from the buying of fresh ingredients to the preparation and cooking (no more ready meals in our house…). As well as taking up weight-lifting and other high intensity exercise, I’ve also been introduced to other approaches to exercise/movement like MovNat and Exuberant Animal (see ‘Useful Links’), that I’m really excited to be learning more about. My inspiration to learn is greater than it has been in a long time, and I’m optimistic that I will be able to offer more to my clients over the coming years as a result. I’ve been led toward quite diverse reading material that has helped me to reframe thoughts about a variety of subjects, and to be more considerate of how my actions effect my immediate environment, and the larger world.

In the same way that we try to encourage clients at our Pilates studio to feel responsible for their health and well-being, the primal lifestyle really  fosters personal responsibility  that, in turn, encourages a positive outlook. If I believe that I’m in charge of my health, and I’m making sensible choices to support it, then I can feel optimistic about remaining healthy, fit and strong as I get older.

Zealotry

March 10, 2012 — 1 Comment

Listening to as many podcasts as I have, I’ve heard several questions addressed to the presenters along the lines of “How can I spread the word better?”, “What name could we use instead of ‘Paleo’ to get more people interested?”, “How can I convert my family/friends?” etc. etc. More often than not the response is something like “Why waste your breath? If people want the information they’ll come looking for it.” The trouble is that the answer is probably being given by someone who receives 100’s of emails every day seeking help, and that’s not the case for the amateurs out there like me, who are excited by what they’ve learned and want to pass it on.

It’s a cliche for good reason that people who have successfully given up smoking become the most vigorous advocates for going smoke-free. Perhaps it’s deep in our DNA to be this way. Since discovering and embracing the primal lifestyle I’ve seen in myself an apparent need, reflex, desire, urge… (one or more of those) to evangelise about food. Specifically the food that I believe it’s right to be eating. I was a vegetarian for many years (there’s that reformed smoker thing), and quite a stroppy one at that. I was younger, it was an emotional/sentimental thing, and there may have been a girl in the picture that helped my choice to give up meat. I don’t think that I was quite as enthusiastic about spreading the vegetarian word as I am at spreading the primal/paleo word, but I certainly wasn’t shy about letting people know what I felt about meat eating.

I know that I am not alone in wrestling with the problem of not being able to shut up about nutrition – the friend that showed me the path to the paleo way has had his own struggle with this. It appears that a lot of people in the paleo ‘community’ latch on to the idea very strongly because the framework of evolutionary biology seems so logical. Perhaps it’s inevitable that if something works for you, and resonates with you, the urge to spread the word is strong. I had back problems for about 18 months before someone pointed me toward Pilates, and in a very short time the practice of Pilates had ‘fixed’ me. I was pretty excited, and convinced that everyone with back problems should do Pilates. And hey, why just back problems? Anyone with any physical problem or injury will surely be fixed by Pilates. As a teacher I’ve seen this pattern repeated many times –  Pilates helps someone overcome chronic pain and consequently changes their life. As a result Pilates then becomes ‘bigger’ than a mode of exercise, and reaches the status of miracle, at which point evangelism may well follow.

What drives us to evangelise? I realise that in choosing this word I’ve gone into the realm of religion, and this highlights for me the whole problem of feeling the need to share. I’d rather base my ideology in science, and specifically evolution. I think I can reconcile this, and perhaps simply need to choose my words more appropriately. While Christian evangelism is dedicated to saving people from one unprovable idea (hell), and giving them hope of another unprovable idea (heaven), the lifestyle that I’m espousing offers the real possibility of health and longevity, and salvation from the equally real possibility of ill-health and disease. Surely that’s a reasonable thing to be trying to share?

I had a great lesson recently in the value of sharing information with people that aren’t very interested. We had family staying with us, part of the Belgian arm of my family, for whom bread is the principle component of, typically, two of their daily meals. Perhaps I was conspicuous in my non-eating of bread (perhaps I may have said something about the evil of wheat-but I don’t think so…), either way, one of the teenagers in the family asked me what the problem was with wheat. I launched into an explanation of the trinity of bad things about wheat (gluten, lectins, phytates), and quite succinctly, as I recall. I didn’t have high hopes but still felt slightly crushed when he, and the rest of the family, still attacked the bread with gusto at the next meal. As my wife is inclined to say to me when I tell her about an exciting new nutritional nugget that I’ve picked up: “It’s just someone’s opinion”…. (Of course that’s often not the case, but it serves to reign me in a little).

I’ve noticed in my 8 year old son an enthusiasm for acquiring knowledge that often extends to an enthusiasm for sharing that knowledge. On the whole it’s quite charming in a child, but perhaps not so much in an adult. I recognise in myself the danger of sharing information  with too much of a “listen to how much I know” motivation – definitely something that I would like to control as much as possible. The struggle is to balance this with wanting to pass on things that I imagine others might want to know. I’m reminded of reading John Pilger years ago and feeling sure that lots of people would want to know about all the evils that he described being perpetrated in our names. Even as I write this the parallel seems even stronger than I had thought – the collected information from sources such as ‘Good Calories, Bad Calories‘, ‘Wheat Belly‘, and ‘The Vegetarian Myth‘ adds up to something looking very much like governments and vested interests misleading the people, disempowering them and making them sick (while multinational corporations make VAST profits, and public and private healthcare costs spiral beyond comprehension). Who wouldn’t feel pissed off about that?

What to do? I care about the health of my family and friends. I care about the well-being of the people that I teach. What does that require of me? Respect for their values, certainly, and support too. I know that my vegetarian friend doesn’t want me trying to persuade her of the merits of eating meat, but if I hear her talking of trying to lose weight by eating carbohydrate, instead of protein and fat, I’m bound to say something….

So here’s a pledge to everyone that knows me:  I will try really hard to only offer information when there’s a hint of invitation, and to assume that, if you take soy milk in your coffee, you probably don’t want to know why that’s a bad idea.

Pilates for…..health?

March 6, 2012 — 5 Comments

Many books about Pilates list the “6 principles of Pilates”, a number of them have extended 6 to 8 or 9, but many teachers will be able to tell you that the ‘original’ principles of pilates are: Breath; Centre; Control; Concentration; Precision; and Flow[ing movement].
These 6 principles do not appear in any of Pilates’ own writing and, in fact, appear to originate in ‘The Pilates Method of Physical and Mental Conditioning by Friedman & Eisen, and first published in 1980 (13 years after Pilates’ death).
The guiding principles of Pilates’ method, to be found in his 1945 book ‘Return to Life‘ are: Whole body health; Whole body commitment; and Breath; and have a very Pilates-esque no-nonsense simplicity to them. Why have 9 principles when 3 will get the message across?
Clearly things have changed in the years since Pilates’ death, we have a much better understanding of biomechanics, physiology and anatomy, along with entirely different ways of even considering human anatomy. (It should be said, too, that Pilates may not have been much concerned with those details – one of the highlights of the conversation between ‘Elders’ Ron Fletcher and Kathy Grant, available on DVD, is Fletcher’s reminiscence that, when asking Pilates what a particular exercise was for he received the gruff reply “It’s for the body”.) Despite these advances I can’t think of any compelling reasons to stray from his original 3 principles.

I’m all for asking for total commitment from our clients, especially if they have goals that they want to reach through Pilates, or expectations of what Pilates might do for them. This then begs the question (of me, at least): In teaching people Pilates, are we offering (the possibility of) whole body health?

Perhaps borrowing for the Pareto Principle, it seems to be widely accepted on fitness/exercise related internet resources that body composition is 80% determined by diet, meaning that exercise has a relatively limited effect on how fat we are. I’m not advocating a fixation on body fat, but all Pilates teachers must be aware that being overweight is highly likely to take an orthopaedic toll on an individual’s body. For example, the Johns Hopkins Arthritis Centre reports that ‘being only 10 pounds overweight increases the force on the knee by 30-60 pounds with each step.’ Joint problems are just one of many potential health issues related to being overweight or obese.

Having used it repeatedly in the paragraph above, I want to avoid repeating weight – I don’t think someone’s weight is as useful a measure of health as their body composition, how much fat they are storing. Hence how one’s clothes fit is a better indicator than a set of scales. It can be hugely challenging to address a client’s body composition, and requires that a relationship be established between teacher and client first of all (unless both are pretty thick-skinned). Nonetheless, if Pilates teachers (as fitness professionals, not alternative therapists), are to help clients towards whole body health I think we may have a responsibility to address such tricky topics. As you may have gathered if you’ve read earlier posts on this site, I lean quite strongly towards a particular way of eating – (in the interests of simplicity) low carbohydrate, moderate protein, high fat  – and, having read quite a lot on the subject, I’m happy to get into a conversation about nutrition with anyone these days (yes, maybe too happy, and more on that next time). The chances are that my nutrition views aren’t shared by all Pilates teachers, perhaps only a few, and I’m not arguing that we should all be preaching paleo eating to our clients. In the past I have had clients say to me “I know I need to lose some weight” and I’ve probably mumbled awkwardly and equivocated – now I think that, without getting into an epic conversation, I could have simply asked what they were doing, or planning to do, to accomplish the fat loss. I am not a nutritionist, but I can encourage clients to get help with shedding body fat, in the same way that I might encourage them to go to a physio or osteopath if that seems appropriate.

A lot of the clients that come to our studio list ‘weight loss’ as one of their goals. All other benefits aside, I don’t believe that Pilates is an effective means of achieving such a thing. Indeed, I think the evidence shows that eating is far more important to body composition than exercise. As fitness professionals I think we do have a responsibility to address nutrition (and maybe to mention that sleep quality and cortisol levels have a significant impact on our metabolism), even if that is no more than encouraging clients to seek professional help (or perhaps to read Gary Taubes’ “Why We Get Fat: And What To Do About It“). I’d love to hear what any fellow Pilates professional (in fact, anyone who may be reading) thinks….