dotFITCertificationCourse

21stCenturySolutions ModernTimesRequireModernSolutions
OneofthecorebeliefssharedbytheentireteamatdotFITisthateveryonehastheabilitytoreach andmaintaintheirhealth,fitnessandweightcontrolgoals.Weunderstandthateveryonemaynot havetherighttools,informationorcontinuousmotivationtheyneedtobeandstaysuccessful. dotFITiscommittedtousingtechnologyandcurrentinnovationstoprovideprogressivesolutions thataddressmoderndayissuesincludingthecomplexbiologicalandenvironmentalfactorsthat driveunwantedweightgain.Indoingso,weareconfidentthattogetherwecanturnthetideonthe obesityepidemiconepersonatatime. TheInternet Theinternetsimultaneouslyreachesmillionsofpeoplearoundtheworld,allowinginstantaneous communicationandaccesstovariousproductsandservices,24hoursaday.Nearlythreequarters oftheU.S.populationhaveinternetaccessandmanyseekweightloss,nutrition,exerciseand medicalinformationonline. 1 Deliveringinternetbasedweightcontrolsolutionsenablespeopleto obtainservicestheywouldnotnormallyseekduetocost,locationortimeconstraints.Online programscanalsoprovidesocialsupportandpersonalizedfeedbackwhileallowingclientsto remainanonymous,thusavoidinganypotentialembarrassmentwithfacetofaceprograms.Indeed, internetweightlossprogramswhichincorporatebehavioralprincipleshavebeenshowntoimprove weightloss. 2,3,4Featuresofonlineweightlossprogramsthatareassociatedwithproducingpositive resultsincludeastructuredplanofdeliveringtheprogram,continuoushumancontact, individualizedfeedbackfromacoachandsocialsupportintheformofmessageboardsand motivationalstories.5 Otherstrongpredictorsofweightlossincludeactivityandintakecalculators, progresschartsandjournals.Webbasedprogramshavealsoproventohelpmaintainweightloss specificallywiththeuseofwebchatsandothermodesofsocialsupport.5,6Hence,aproperly structuredinternetbasedweightcontrolprogramisafeasiblemethodtohelpmeettheneedsof thoseseekingweightlossandmaintenance. SelfMonitoringandRegulation

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21stCenturySolutions
Recallthatamajorchallengewithcontrollingweightinthe21stcenturyistheinvisibilityoftheslow andsteadyweightgainthateventuallyleadstooverweightandobesity.Eatingamere10extra caloriesperdayaboveonesdailyneedsresultsinonepoundgainedbytheendofayearand30 poundsofunintentionalweightgainbythemidpointofoneslifespan.Notknowingorseeingweight gainoccurringishalfthebattle,andgainingcontinuousvisibilityofdailyenergyimbalancesallows peopletoselfregulatefoodintakeandmovement.Thatis,adjustmentscanbemadetotheamount offoodthatisconsumedandactivityperformedinordertosuccessfullymanageweight.The moderndaylifestyleconsistsofcontinualaccesstolargequantitiesofenergydense,inexpensive foodcoupledwiththeinnatetendencytoeatandtakethepathofleastresistance.Purposeful alterationofbehaviormaybetheonlynoninvasivewaytoconsistentlyoffsettheseforces.Having awarenessofdailyenergybalanceallowspeopletoseeiftheyaremaintainingacaloriedeficitfor weightloss.Balanceforweightmaintenanceorsurplusforweightgain.Thisisturnprovidescritical decisionmakinginformationwhethertoalterfoodintakeorincreaseactivitytostayongoal. RegularWeighins Allstudiesinvestigatingselfweighingasaweightcontrolstrategyhavedemonstratedthatmore frequentweighinsleadtogreaterweightloss 7 ,maintenanceoflostweightandpreventionof weightgain. 8,9,10 Researchstudiesalsovalidatedthereverse:thelessoftensubjectsweighedin,the lowertheirchanceofsuccessincludingweightgainforthosewhoseldomornevercheckedtheir weight.7Presumablybythetimetheyweighedthemselves,ifever,itwastoolatetoundothe damagewithoutasignificantlifestylechange,hencetheycontinuedtogainweight. Figure1displaysthestrikingresultsofregularweighing.Subjectswhoconsistentlyweighed themselvesovertimecontinuedtoreducebodymassindex,whichiscompletelyoppositeoftodays norm.7Individualsweighingmultipletimesaweekreportedthatanytimetheirweightwasnot trendinginadesireddirectiontheywouldmakeasimpleadjustment.Sometimeseatingslightlyless byskippingamealoralteringexercisewillallowthemtomaintainaneasy,steadycoursetothe goal. 11 Thesimpleactofweighingineachday(ormostdays)influencespeopletothinktwice beforeconsumingsomethingthatmightresultinanundesirableweighin.Whilesomenutritionand weightlossexpertscautionagainstfrequentweighinginanattempttoavoidpotentialdisordered behaviors,casesofregularweighingcausingeatingdisordersarenotsupportedbytheliterature

dotFITCertificationCourse

21stCenturySolutions
whilethepotentialforpreventingweightgainandaidingweightlossisconsiderable.Studieson collegefreshmenshowedthatdailyweighinghelpedmaintainbodyweightandavoidthe Freshman15whereasthosewhodidnotweighdailygainednearlysevenpoundsintenweeks.11 Inessence,checkingweightregularlyappearstohelppeopleselfregulateeatingandactivity behavior,andthusmanagetheirweight.

Figure1showstheresultsofweighingfrequency:thedarkbarsrepresentBMIchangeinsubjectsattemptingweight loss.ThewhitebarsrepresentBMIchangeinsubjectsattemptingtopreventweightgain.Theseresultsillustratethe strongrelationshipbetweenregularweighingandweightlosssuccess. Selfweighinginweightgainpreventionandweight losstrials.LindeJA.2007.AnnBehavMed.ReproducedwithpermissionofSpringer.

LifestyleActivity Shortboutsofactivitythatareincorporatedintoonesdailyroutinesuchasshortwalks,house chores,yardwork,climbingstairsandplayingwithkidsisconsideredlifestyleactivity.Calorie restricteddietscombinedwithlifestyleactivitychangeshavebeenshowntobeequallyeffectiveat producingweightlossasdietingcombinedwithtraditionalstructuredaerobicexercise(e.g stationarybike,briskwalking). 12,13,14 Addingphysicalactivityintodailyroutinesisalsoimportant formaintainingweightloss. 15,16 Sinceeverycalorieconsumedorstoredasbodyfatcanbeburned withactivity,anymovementisbeneficialbecauseagreatercalorieburnallowsmorefoodtobe consumedorfasterweightlossresults.Therefore,keepinmindthatanyactivitythatcanbe performedstandingorpacinginsteadofsittinginstantlyincreasescaloriesexpended,asimpleand practicalsolutionforthosewhobelieve,oftenincorrectly,thattheyhaveaslowmetabolismor

dotFITCertificationCourse

21stCenturySolutions
impairedthyroidgland.Thetablebelowprovidesacomparisonofthecaloriesburneddoing lifestyleactivitieswhilesedentaryversusactive.
Table1ExamplesofSedentaryandActiveEnergyExpendituresforCommonActivities*

Fora150poundindividual Active Basketball, casually shooting baskets 1hr. 322 Chopping/Splitting wood 30 mins 214 Standing for 3 10-min phone calls 64 Washing Dishes 30 min 82 Vacuuming for 30 min 125 Cooking for 30 min 89 Raking leaves for 30 min 154 Push-mowing for 60 min/wk 392 Washing and waxing car, 1 h/mo 322 Walking dog for 30 min 107 Walking 1 min, talking (standing) 3 min 8 Walking up Stairs 1 min 6 Unloading full shopping cart 5 min 14 Shopping at mall, walking 1 h 164 Swimming, casually for 30 min 250 Climbing 1 flight of stairs, 3x/wk in mall 3 min total 18 Parking in 1st spot, walking 3 min, 5/wk 8 Walking 15 min to bus stop 2/d + riding bus for 40 137 min * Foractivitiesthatshownocalorieburnontheleftsideofthetable,itcanbearguedthattheindividualwouldburn caloriesevenrestingduringthesameperiodoftimestatedontherightsideofthetable.Inthatcase,use34calories perhalfhourofinactivityforthesameperson. 108 0 36 0 0 36 125 89 18 2 5 1.5 7 108 36 4 0.5 87 Sedentary Sitting at a sporting event, spectator 1 hr. Buying Wood presplit Reclining for 30 min of phone calls Using Dishwasher Hiring someone to clean/vacuum Waiting 30 min for pizza delivery Using a leaf blower for 30 min Riding lawn mower Using car wash 1/mo Letting dog out the back door Sending e-mail to colleague, 4 min Taking elevator up 3 flights 1 min Letting cashier unload shopping cart 5 min Shopping online 1 h Sitting in a whirlpool for 30 min Riding escalator 3 times Parking as close as possible, 10-s walk Driving 40 min, walking 5 min (parking)

Currentphysicalactivityguidelinescallforadultstoperformtwoandahalfhoursperweekof moderateintensityphysicalactivitysuchasbriskwalkingoronehourand15minutesvigorous intensityactivityperweektoimproveandmaintainhealth. 17 Performingfivehoursaweekof moderateintensityactivityresultsingreaterhealthbenefitsandisstronglyencouraged.Muscle strengtheningactivity(e.g.resistancetraining)ofallmajormusclegroupsshouldbeperformedat leasttwiceaweek.Allclientsshouldbeadvisedtoregularlyachievetheseexercise recommendations,andlifestyleactivitycanserveasanadjunctweightcontroltooltoincreasedaily expenditure.Forclientswhoarentwillingorfeeltheycannotperformtraditionalexercise,much lessmeetthesedailyguidelines,creatingwaysforthemtomovemorewithlifestyleactivityisan importantfirststep. BodyMonitoringDevices

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21stCenturySolutions
Pedometersandotherbodymonitoringdevicesgiveusersinstantfeedbackandquantifytheir activitylevel(e.g.numberofsteps,minutesofphysicalactivity)whichprovidesmotivationto becomemoreactive.Asystematicreviewofresearchstudiesusingpedometersrevealedthatthey areassociatedwithsignificantincreasesinphysicalactivity,decreasesinBMIandotherfactors beneficialtohealth. 18 Inadditiontowearingapedometer,settingadailysteptargetandtracking dailystepsarehelpfulstrategies.Otherfeedbackdevicesprovidedailyenergyexpenditureand energybalancedata,whicharemorespecifictoweightcontrol.Inbothcases,thecontinuous feedbackraisesawarenessofactivitylevel,allowingtheusertoimmediatelychangetheirdaily routineandfoodchoicestoavoidanenergyimbalanceandunwantedweightchanges.The psychologicalimpactofthisisenormous,sincetheclientisabletoinstantlycorrectsmalloverages infoodintakeinsteadofruiningtheentiredayorweekandstartingoveronMonday. ThedotFITProgram ThedotFITnutritionandfitnessprogramaddressestheissuesoftodaybyprovidingawarenessof dailyenergybalanceincludingdailyandweeklypredictedweightlossorgainwhenfoodislogged. Dailycalorieintakeandburntargetsareprovidedbasedonthegoalandclientparameters.To increaseawarenessofenvironmentalinfluencesonfoodintakeandcurrenteatinghabits,aneasy touseoptionalfoodloggingapplicationwithanextensiveCalorieKingfooddatabaseis incorporatedalongwithvariouseducationaltools,tips,articlesandvideos.Regardlessofwhether foodislogged,eachweeklyweighinisfollowedbyindividualizedfeedbackbasedonweight changesandspecificsuggestionsaregivenasneeded.Progresscharts,reportsanddailyjournalsare providedastheyhavealsobeenshowntoimproveweightlossoutcomes. Toincreaseclientsuccessandadherence,therearevariousoptionsforcoachingeitherbyemail, phoneorinpersonwithafitnessprofessional.Extensivesocialsupportisprovidedwithwebchats, messageboardsandvideos.Thesefeaturesgivepeopletheinformationtheyneedtoselfregulate behaviorandincludestrategiesforhowtomakethoseneededadjustments.Inaddition,dotFITisan internetbasedserviceallowingforeasyandwidespreadaccess.Otherelementsoftheprogram include

dotFITCertificationCourse

21stCenturySolutions
Numerousmenusdesignedbyregistereddietitiansincludingathleticperformance, vegetarian,specialty(Mediterraneandiet,lactoseintolerant,40/30/30)andlifestylemenus (healthyfastfood,nightout)

Avastlibraryofarticles,videosandfrequentlyaskedquestionsonweightloss,health, exercise,nutrition,performance,womenshealth,seniorhealthandyouthtopics Personalizeddietarysupplementrecommendationsbasedonamedicalscreeningandgoals WalkingandexerciseprogramsdesignedbytheNationalAcademyofSportsMedicine. Programsarebasedonthegoal,desiredworkoutfrequency,durationandtypeofequipment availableandvideodemosareincludedforeachexercise

Optiontoaddabodymonitoringdevicetotrackcaloriesburned,stepsandactivity

Finally,fitnessprofessionalsareprovidedwithsuggestedsessionformatsincludingidealtimesto schedulesessions,duration,andtopics.Effectivecoachingtechniques,goalsettingandmethodsfor conductingclientsessionswillbepresentedinthenextsection.

Summary
ThedotFITplatform,nutritionalstrategiesandpartnershipwithcertifiedprofessionalsdelivera comprehensive21stcenturysolutionwhichaddressesthechallengesofweightcontrolintodays environment.Fitnessprofessionalsareaninvaluablepartofthissolutionastheyoffertheessential humantouch,whichtechnologycannotduplicate.Asnewmethodsandtoolsemergewithscience andtechnology,dotFITiscommittedtoprovidingfreshsolutionsandpartneringwiththosewhoare passionateandcommittedtohelpingotherssucceedthroughfitness.

dotFITCertificationCourse

21stCenturySolutions

1PewInternet&AmericanLifeProjectSurveys,March2008August2008.Availableat

2TateDF,JackvonyEH,WingRR.EffectsofInternetBehavioralCounselingonWeightLossinAdultsatRiskforType2

http://www.pewinternet.org/trends/Internet_Adoption_102008.pdf.AccessedonNovember19,2008.

Diabetes.JAMA.2003;289:1833:1836. 3HarveyBerinoJ.Changinghealthbehaviorviatelecommunicationstechnology:usinginteractivetelevisiontotreat obesity.BehavTher.1998;29:505519. 4 TateDF,WingRR,WinettRA.UsingInterenttechnologytodeliverabehavioralweightlossprogram.JAMA. 2001:285:11721177. 5KrukowskiRA,HarveyBerinoJ,AshikagaT,ThomasCS,MiccoN.Internetbasedweightcontrol:therelationship betweenwebfeaturesandweightloss.TelemedJEHealth.2008Oct;14(8):77582. 6HarveyBerinoJ,PintauroS,BuzellP,GoldEC.EffectofInternetsupportonthelongtermmaintenanceofweightloss. ObesRes.2004;12:320329. 7LindeJA,JefferyRW,FrenchSA,PronkNP,BoyleRG.Selfweighinginweightgainpreventionandweightlosstrials. AnnBehavMed.2005Dec;30(3):2106. 8FujimotoK,SakataT,EtouH,FukagawaK,OokumaK,TeradaK,KurataK.Chartingofdailyweightpatternreinforces maintenanceofweightreductioninmoderatelyobesepatients.AmJMedSci.1992Mar;303(3):14550. 9KlemML,WingRR,McGuireMT,SeagleHM,HillJO.descriptivestudyofindividualssuccessfulatlongterm maintenanceofsubstantialweightloss.AmJClinNutr.1997Aug;66(2):23946. 10WingRR,TateDF,GorinAA,RaynorHA,FavaJL.Aselfregulationprogramformaintenanceofweightloss.NEnglJ Med.2006Oct12;355(15):156371. 11LevitskyDA,GarayJ,NausbaumM,NeighborsL,DellavalleDM.Monitoringweightdailyblocksthefreshmanweight gain:amodelforcombatingtheepidemicofobesity.IntJObes(Lond).2006Jun;30(6):100310 12AndersenRE,FranckowiakSC,BartlettSJ,FontaineKR.PhysiologicChangesAfterDietCombinedwithStructured AerobicExerciseorLifestyleActivity.Metabolism.2002;51(12):15281533. 13AndersenRE,WaddenTA,BartlettSJ,ZemelB,VerdeTJ,FranckowiakSC.Effectsoflifestyleactivityvs.structured aerobicexerciseinobesewomen:arandomizedtrial.JAMA.1999;281(4):335340. 14DunnA,MarcusB,CamperJ,GarciaM,KohlHIII,Blair S.Comparisonoflifestyleandstructuredinterventionstoincreasephysicalactivityandcardiorespiratoryfitness.JAMA. 1999;327334. 15KrugerK,BlanckHM,GillespieC.Dietaryandphysicalactivitybehaviorsamongadultssuccessfulatweightloss maintenance.IntoJBehavNutrPhysAct.2006.3:17. 16ElfhagK,RossnerS.Whosucceedsinmaintainingweightloss?Aconceptualreviewoffactorsassociatedwithweight lossmaintenanceandregain.ObesRev.2005.6:6785. 17U.SDepartmentofHealth&HumanServies.2008PhysicalActivityGuidelinesforAmericans.Availableat www.health.gov/PAGuidelines/factsheetprof.aspx.AccessedOct7,2008. 18BravataDM,SmithSpanglerC,SundaramV.Gienger,AL,LinN,LewisR,StaveCD,OlkinI,SirardJR.UsingPedomters toIncreasePhysicalActivityan.dImproveHealth.JAMA.2007;298(19):22962304.