WebMD Live Events Transcript

The fitness choices are out there: personal trainers, group instructors, video instructors and online personal training. Who can help you get the most benefit from your workout plan? Cedric X. Bryant, PhD, chief exercise physiologist of the American Council on Exercise, joined us to discuss how to evaluate your options and set a course for fitness.

The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Hello Dr. Bryant. Thank you for joining us today. Would you recommend that someone starting a fitness program work with a trainer?

Bryant: There are several reasons.

The first and perhaps most important is that personal trainers can provide the necessary and proper instruction for a novice trainee.
They can assist them with basic program design.
They can monitor that they're exercising at an appropriate intensity level.
They can also provide instruction regarding proper exercise technique and form.
A trainer can provide motivation and improve the individual's long-term commitment and adherence to an exercise program.
They can also monitor and assess your progress and further refine the exercise program.

Member: Where are good places to find a trainer who won't break the bank? The Y?

Bryant: Well, the Y is certainly a viable option. But in addition to just simply looking at the cost, it's important to consider the quality of the training that will be provided. What would probably be a smart option is to consult some of the leading reputable certification bodies, all of which have web sites with directories for competent, affordable personal trainers. And those reputable certification bodies would include the following organizations:

The American Council on Exercise
The American College of Sports Medicine
The National Strength and Conditioning Association

Just in terms of establishing a benchmark of what would be reasonable in terms of fees, generally speaking they will range anywhere from $35 to $50 per hour and what determines where you are in that range will be geographic location, in that the fees tend to be higher in the metropolitan areas, the largest cities, and so forth.

Member: I can't afford to work with a trainer very often. After we set up an initial program, how often should I work with my trainer?

Bryant: What would be a wise approach is to utilize the trainer's expertise to help you establish the program and then after approximately 10 to 12 weeks of following the program is to meet with the trainer again for a follow-up session to assess the effectiveness of the program and determine if any modifications or adjustments need to be made. So what is occurring is you're using the trainer to initiate the program and then at periodic intervals thereafter you're utilizing the trainer's skills to assess the effectiveness of the program to determine if any modifications or adjustments need to be made.

Member: I am considering joining the local gym. However, the trainer wanted to advise me about diet and supplements, too. What kind of training do fitness trainers have to advise about those issues? Or is the gym just trying to sell me supplements (which they do sell)?

Bryant: Generally speaking, most trainers do not have the necessary education, training, and background to offer advice regarding nutritional supplements. It tends to be beyond what is defined as a personal trainer's scope of practice. Unless that individual possesses a credential such as being a registered dietitian, they would be offering advice outside their sphere of competency. The potential result would be placing the client at potential risk for some form of adverse reaction as well as placing themselves at some form of liability risk. And just a general note is that most of the nutritional supplements that are widely seen in health and fitness facilities tend to be substances that have not been well researched and that are not without potentially serious side effects. So in most cases any potential or perceived benefit tends to be greatly outweighed by the risk.

Member: I was a member of a gym chain briefly, but the personal trainer seemed more interested in "upselling" me to more expensive training and classes. Kind of like a car salesman in spandex. Is this a typical experience for the big-name fitness chains?

Bryant: While it wouldn't be fair to indict all the big-name fitness chains, it is unfortunately true that many such chains require that their trainers be focused on selling a variety of products and services to their clients, in many cases, taking unfair advantage of the unique relationship and trust that is often established between personal trainer and client. And if your personal trainer is constantly attempting to "sell you" I would consider that to be a red flag and probably seek out a different trainer.

Member: My trainer is certified by the gym where he works. Is this certification OK? He seems to be helping me.

Bryant: The term certification unfortunately has lost some of its meaning, in that there are pretty precise established guidelines for what a certification is. Those guidelines have been established by an independent organization called the National Organization for Competency Assurance. It is a group that sets and establishes guidelines for professional organizations from fitness professionals to dental hygienists to CPAs, any group of professionals that need to take an exam to demonstrate a level of competency and proficiency at a given skill or demonstrating a level of knowledge with regard to a subject matter.

What these guidelines state is that the certification process must undergo or must involve certain steps. Just to highlight the most significant ones, the certification process should begin with what is referred to as a valuation study. A group of experts in that field or industry defines what are the critical tasks or job functions associated with whatever that certification will be assessing. Then once that's been established the next step is to take a group of experts to construct items or questions that assess those critical skills or job functions. Then the third step is a group of statisticians evaluate how well the constructed items of questions predict ultimate performance. Then the final step is to see how effective the test is at predicting the same result. In other words, if I give the same individual the test on repeated occasions, will I arrive at the same conclusion regarding their competence level?

Following this type of process helps to insure that the test appropriately screens and identifies individuals who have the requisite knowledge and skills to safely and effectively perform the job function.

In direct answer to the individual's question, most self-generated, or I should say club-generated, certification exams do not adhere to these processes. As a result, they tend not to be the most valid and reliable methods of assessing an individual's capabilities. But if the trainer that you are working with is helping you to safely achieve the results that you are looking for, there would be no compelling reason to seek a different trainer.

Moderator: Some people can't go to a gym to work with a trainer for a variety of reasons (cost, distance, etc.). For those people, is it possible to work out at home with the aid of a training program from a book or videotape? And how do you choose which book or tape to use?

Bryant: It's better than doing nothing at all. In terms of selecting an exercise video or tape, I think there are several questions you would want to ask:

Is the person certified by a reputable organization?
Does that individual have appropriate training and background, or is the person simply a celebrity?
Before you purchase the tape, ask the question, does a friend own the same tape or can I rent the video so that I can take it for a test drive?
In the marketing of the tape, do they make outlandish claims: Things such as lose 20 pounds in two weeks or firm up in only five minutes? If such claims are made, I would be a little bit wary of the quality of the content on the tape.
Do you need any special equipment or props to use the tape? And if so, are those things that are affordable within your budget and things that you have space for?
Does the tape and the information shown on it match your needs and desires?
Can you find reviews of the tapes by reputable experts?

But in conclusion, I think it's important that people understand that becoming physically active needn't be overly complicated, and that the real key, particularly if general fitness and weight control are your fundamental goals, is to simply move, and that movement can range from simply walking to playing games, dancing, a variety of movement activities that I think many people don't associate with exercise, can be very viable options.

Moderator: But almost all tapes and books claim to have the answer to great abs or beautiful bodies with minimal effort. Are there any that you would recommend as safe and effective?

Bryant: Probably the safest and most effective form of exercise for the vast majority of individuals is walking. That's why there's an initiative under way that's referred to as America on the Move, which is a program based upon some work that was done in Colorado that was supported by the National Institutes of Health, whereby individuals are encouraged to try to cover 10,000 steps per day. What the research clearly shows is that individuals who can achieve that level of activity tend to do a very effective job at maintaining a more normal body weight and being at a significantly lower risk for a variety of diseases, to include heart disease, certain forms of cancer, and type 2 diabetes.

It's interesting, in that the average individual who has a sedentary occupation will tend to cover somewhere between 1,200 to 1,800 steps per day. So what the 10,000 steps program really does, it helps the person to become very conscious of how little we do move as Americans with the variety of labor-saving devices that we have access to. So by wearing a pedometer to measure one's steps and movements serves to motivate individuals to look for ways to be physically active. So rather than taking the walking tram, an escalator, or elevator, the individual walks or takes the stairs. Rather than sending an interoffice email, the individual leaves his or her desk and walks to the person they need to communicate with.

Moderator: How far is 10,000 steps? A mile? More? Less?

Bryant: Approximately every 2,000 steps that the average individual takes are equivalent to approximately one mile. So the 10,000 steps program, which suggests the individual is going to cover approximately five miles per day, would mean that the individual probably is going to need to be physically active for about one hour each day. But the important thing for individuals to understand is that it's one hour over the course of an entire day. It is not an hour-long exercise session, necessarily. So the individual could get 10 minutes here, 20 minutes there, and that total should add up to 60 minutes to produce those beneficial effects. The reason why that is true is that the benefits and effects of exercise are cumulative, in that much like loose change in your pocket, they all add up.

Member: Is there evidence that people who try to begin a fitness program at home with books and videos are likely to injure themselves?

Bryant: There is not any scientific study that I am aware of that has conclusively shown that.

Member: My library has a number of old workout videotapes. Are older popular fitness methods, things like Jazzercise or Jane Fonda tapes, etc., still considered safe and effective? Have any older fitness methods been "recalled" by the experts?

Bryant: Some of the older fitness methods have been called into question recently. And the reason being, is that many were developed under the notion or premise that more was better, and you had terms such as "go for the burn," "no pain, no gain," and unfortunately, such thinking can increase an individual's potential for sustaining an injury. Today, we think in terms of providing the minimum effective dose of exercise as opposed to more is better, going for the burn, etc.

You mentioned two examples, some of the Jane Fonda tapes and the Jazzercise. Some of Jane Fonda's earlier tapes would be examples of the go for the burn, or more is better mentality or approach, whereas Jazzercise, which still is in existence today, would be an example of what I would call a more moderate and reasonable approach to becoming physically active, and therefore can still considered to be an acceptable alternative for people today.

Member: My husband is interested in the BowFlex exercise machine. What is your opinion?

Bryant: The BowFlex is a home gym, strengthening device that allows the individual to perform a large number of exercises while requiring a limited amount of space. As home gym equipment goes, it is a fairly high quality piece. The exercise movements tend to be pretty biomechanically sound. The only caveat would be if the individual has a high strength capability the resistance load might not perfectly match their needs. But for the general individual who is average to slightly above average fitness level, it's a reasonable option for home strength training, because it does provide an adequate or acceptable training stimulus, and it does it in a space economical fashion.

The only other comment is that one shouldn't expect to necessarily experience the rapid results that are often marketed with the product.

Member: Is it true you should build strength (a weight program) before building endurance (a running program), so you're less likely to injure yourself?

Bryant: To a certain extent, that is true, that you would like to make sure that the integrity of your musculoskeletal system, that is the muscular and bones and connective tissues, are strong and able to withstand the stresses that can be applied to them during most aerobic or endurance activities. It's probably more of a concern for the more mature individual who is just beginning an exercise program.

Member: I am 51-year-old female. My weight and height are at appropriate levels. I do some exercise every day (treadmill) but I can't seem to get rid of a flabby belly. Should I just accept because of my age or is it possible to firm it up?

Bryant: It's great that you're exercising regularly on the treadmill. But it would also be very beneficial and worthwhile to supplement your treadmill workout with some strength training activities. The reason being is that as we age, we tend to lose muscle mass and, particularly important for women, bone mass. By engaging in an exercise program consisting of both aerobic activity and strength training, we're able to arrest greatly or slow the age-related decline in muscle mass and bone mass. The benefits are significant, in that by maintaining more muscle mass, we're able to maintain a higher resting metabolism as we age, which will ultimately help one to better control their weight. And by maintaining more bone mass, you're able to significantly lower your risk for developing osteoporosis.

Now with regard to if there are specific exercises that one can perform to shape and tone and firm the abdominal regions, there are no such magic exercises that will allow an individual to selectively trim or firm up a specific area. And that whole concept is referred to as spot reduction. What research shows is that you can perform very high amounts of, for example, abdominal exercises and have little or no consequence on flattening your abdominal region. The reason being is that the abdominal exercises strengthen the abdominal muscles, but have relatively no impact on the subcutaneous layer of fat that covers those muscles. So unless the individual is able to lose overall body weight and body fat to reduce those subcutaneous layers of fat, the abdominal muscles are always going to be incognito. Because the fact of the matter is that virtually everyone has a set of washboard abdominals. The problem for most of us is that they're hidden by a layer of subcutaneous fat. The best way to reduce that layer of subcutaneous fat is through regular exercise involving both aerobic activities and strength training, and combining that with a sensible eating plan.

Moderator: Dr. Bryant, we are almost out of time. Before we wrap up for today, do you have any final comments for us?

Bryant: As a nation, we are unfortunately becoming less active and as a consequence, paying an enormous price for that lack of activity, in that both children and adults are suffering from obesity, type 2 diabetes, and a variety of other conditions and ailments at alarming rates. The best thing that we can do is to get up out of our seats and move. If we can all find simple ways to move more, the benefits will be tremendous, both to us personally as individuals and to us economically as a nation. Again, it doesn't have to be very strenuous, nor does it have to be complicated; we just have to move.

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