Quick Hit Summary

The 12th Annual ISSN Conference took place in Austin, Texas (USA) on June 11-13th, 2015. Once again CasePerformance covered the event. In Part II of our multi-part review of the conference we take a look at the following presentations: Sohee Lee, CISSN – Increasing Dietary Adherence; Dr. Joe Klemczewski, PhD, CISSN – Nutrition Strategies for Sustainable Health & Weight Loss and Dr. Brad Schoenfeld, PhD – Manipulating Resistance Training Variables.

Part I Recap

Figure 1 ISSN logo. Image uses with permission.

Thanks for clicking in for Part II of our 2015 ISSN report. Hopefully you enjoyed Part I of our conference review. In case you missed it, a lot of great content was shared in it including…

• Rick Collins, JD, FISSN, CSCS – Nutrition Law Every Fitness Professional Should Know

• Dr. Ralf Jager, CISSN, FISSN, MBA the Gut-Muscle-Axis: Probiotics Flex Their Muscles in Sports Nutrition

• Dr. Stacy Sims, PhD – Dogma of Hydration

• Hallway Chatter

Introducing Carrie Hogan & Korey Van Wyk

Figure 2 A couple new contributors for Part II of our report include Carrie Hogan (far left) and and Korey Van Wyk (middle).

As alluded to in Part I of our 2015 ISSN report, I grabbed a couple friends to help me cover the event – Korey Van Wyk & Carrie Hogan. Korey Van Wyk is a physical preparation coach, training student athletes at Northwestern College in Iowa (USA) has contributed multiple times to CasePerformance. Carrie Hogan is a personal trainer, yoga instructor, sports nutritionist and massage therapist who works Holistic Fitness Training which is based in London, England. How cool is Carrie Hogan? Well, let’s just say the first thing she said to Korey and I when she met us was,

"What better way to get protein-loving individuals in a room together than to talk about getting huge!"

Alright – Enough reviewing of where we’ve been & how we all met; time to get to some great presentations!

Take It Away Carrie…

The ISSN hooked an audience of unabashed Sports Performance “nerds” in perfectly with their kick-off symposium to 2015’s Annual Conference. Self-titled “scientific Bro” Brad Schoenfeld, SoheeFit’s Sohee Lee and “Diet Dr” Joe Klemczewski brought their years of experience to discuss training manipulation, psychological factors and dietary adherence tactics for gaining the aesthetic advantage.

I shall review Sohee and Dr Klemczewski’s applied, practitioner-focused content, which lay the turf for the considered research and specialist practitioner experience shared over the weekend ahead.

My first recollection from these speakers was the closing sentiment Sohee left us with, Dan John’s instruction to "have the courage to take it slow". Spurious online “experts” with their rippling abs and dazzling “before & after” client photos build audiences with cavalier, impersonal advice, but experience will tell us these “dramatic transformations” are rarely as sustainable as one would hope. Dr Klemczewski and Sohee both advocate real-world flexibility, individualized client approaches and respect for total health; a dieting process that takes time, but breeds long-term adherence.

Sohee Lee, CISSN – Increasing Dietary Adherence

Figure 3 Sohee Lee. Image used with permission.

Sohee opened with stating the essentiality of "giving the what and the how" – not blithely telling your client what to do, without expanding to the “how” of applying and maintaining lifestyle upgrades. A client lacking the skills of cooking, for example, is destined for a struggle, and subject to “failure” mindset.

Don’t assume there’s an infrastructure of support around them advised Sohee; ‘outsourced motivation’ in the form of supportive family, friends or time to master le cordon bleu is a luxury, not a given. Micro-adjustments over time are much less vulnerable to collapse when motivation or support is low. Additionally, just applying more willpower isn’t the key either; the skill of behavior modification must be learnt. In this sense, both Sohee and Dr Klemczewski advocated the teaching of relevant “healthy lifestyle” skills and building supportive communities as integral in long-term success. By developing their healthy lifestyle “roots”, we enable clients to stop white-knuckling it through their diet on sheer will-power.

Everything we can do to understand your client’s environment pays forward to appropriately advising them, urged Sohee. Understanding the environment first, gives us the details for changing it, and in turn observing the organic change of behaviour which follows. To attempt to alter behaviour without considering the environment the client exists in is profoundly short-sighted, and plausibly very short-lived in adherence. By designing the environment to feed the behaviour you’re working towards, we programme long-term success. For example, gradually building client’s cooking skills, to enable healthy cooking from the home.

This is where “taking it slow” began to build as an increasingly relevant theme in Sohee’s experienced address. We must allow time to trial things and find what fits each person. Building an infrastructure of “pre-commitment” came next as a means of protecting the client from life’s constant battery of temptation. Write your shopping list before going to the grocery store, select somewhere with healthy options if you’re eating out, do all you can to pre-ordain success by acting and choosing with foresight. The cookies you don’t buy, are the cookies you don’t eat. Fused with the support of an intentional community, applying action & practice, this is a great preserve of willpower.

Will-power or motivation can come in fits and bursts, so recognizing and utilizing it for integral diet-success actions like cooking, meal-planning or food shopping is a helpful trick to keep clients on course. Keeping a note of energy or mood for one week, could help clients elucidate their strongest and weakest times to play to. If Sundays look relaxed and free for some bulk cooking, schedule it! If Friday nights are totally exhausted and prone to large pizzas… Freeze some of that Sunday chow for pulling out on Friday morning. And the old classic: don’t walk into the supermarket hungry!

When long-term adherence builds confidence, applying high-motivation peaks smartly can assist when pitching lifestyle advice at the skill level your client possesses. This fusion of approaches ensures they can maintain habits in high and low motivation moments, because you’re not asking them to overreach from their present skillset. To be “good enough” daily is sure to trump barely managing being “perfect” 50% of the time. As an example, I personally admire that Sohee presents her humanity and flexible dieting approach to the public. Some clients might assume that practitioner’s follows their own advice perfectly, 100% of the time, and feel hopelessly inferior. To share the (often rather different) reality with clients helps them maintain their optimal overlap of “ideal” and “realistic” adherence goals.

As anyone living a healthy lifestyle knows, skills and habits take time to lay down, and results take work to maintain. Sohee’s closing tip to Dan John: “have the courage to take it slow” brings heart and reassurance to those starting upon lifestyle upgrades. It also reminds practitioners that a healthy life is more than the next 28 days of juice, or six weeks to ripped- it’s a day to day pleasure to be developed, integrated and –ultimately- enjoyed.

‘Diet Dr’ Joe Klemczewski, PhD – Nutrition Strategies for Sustainable Health & Weight Loss

Figure 4 The ‘Diet Dr’ Joe Klemczewski, PhD. Image used with permission.

My approach to behavior change… Check out some of the strategies I use in helping others with behavior change in the 2014 Aug-Sept CP Newsletter !

‘Diet Dr’ Joe Klemczewski took the ball from Sohee and ran with it, weaving some additional science into the rich pattern. Continuing on the theme of consistency, he stated that those who maintain their healthy eating routines week-by-week showed a 60% greater chance for maintaining fat loss, and were 1.5 times more likely to stay within 5lb of their target weight. He urged the audience as practitioners that clinging to one’s personal nutrition dogma is a recipe for failure – we must shape our advice to our individual clients, as the design & structure of it potently influences their long-term weight management success.

Klemczewski introduced a spectrum of support- with long-term adherence in mind – "coaching clients to independence". He especially acknowledged that some clients with perfectionist qualities will seek highly prescriptive advice when first starting a plan. With time though, the goal of the practitioner should be to educate, empower and coach all clients towards greater diet flexibility and confidence in their knowledge; This is the highest goal for creating long-term weight management.

In developing the ‘Diet Dr’ online community, for example, Dr Klemczewski has laid a foundation for building independence with positive social support. Over time, Dr Klemczewski works to develop more flexibility into meal plans, cooking lessons, or education about metabolic health, as tools to enrich a healthy lifestyle’s adherence. As Sohee said before, developing their diet toolkit breeds confidence, supports adherence and reduces concern around eating out or special occasions. Supportive communities, perhaps also sourced from a local fitness venue, bring fresh ideas for recipes and aid accountability.

As your client’s results continue, Dr Klemczewski advised working towards "context-based choices", away from the initial structure of meal plans, macronutrient guidelines, or “eat more of/avoid” lists. This takes time, and experience “in the field” as your clients meets holidays, special occasions or general opportunity to “derail”. Let each occasion (especially if it amounted in a wild ice-cream binge) be a lesson, reminding your client that as long as motivation exists, a topple off the wagon doesn’t spell failure.

You may also find that your client benefits from said “departures”, Dr Klemczewski reminded us. Some clients will find a “cheat” (whatever you wish to call it) meal an aid to their adherence, other’s will not. As ever, discuss and decide with your client what is best for them long-term. Following from this, quality discussion about long-term maintenance is crucial. Some clients may wish to “just eat more” to maintain their weight, others may wish to take a more relaxed approach to food on certain days. Sustainability considerations must preface what we prescribe, as well as, – and this was the crutch of what I took from Dr Klemczewski’s address – a willingness to change and adapt your advice, based on the results it produces. Release what you “know” worked for you or others, let go your presumptions. Try another tack if the individual cannot maintain the present one.

Dr Klemczewski showed us that individualizing your client’s guidance, building towards a supportive community and educated independence will lay the foundation for long-term, flexible weight-management.

Take It Away Korey…

As Sean alluded to above, while waiting for Dr. Brad Schoenfeld’s talk to start, the person sitting next to me leaned over and said, "What better way to get protein-loving individuals in a room together than to talk about getting huge!" Indeed, the room was packed and how to maximize getting huge was the goal of Dr. Schoenfeld’s talk. Luckily, there was a distinct lack of “bro-science.” All strategies presented were rooted in applied research; a good portion of which was carried out by Dr. Schoenfeld’s own lab.

Dr. Brad Schoenfeld – Manipulating Resistance Training Variables

Figure 5. Dr. Brad Shoenfeld. Image used with permission.

Evaluating & Utilizing Training Research

One of the first points Dr. Schoenfeld made was that training smart is critical if you want to maximize your genetic potential for muscle growth. However, the source of information is key to your ability to train intelligently. To ensure we are getting proper information, Dr. Schoenfeld suggested using the hierarchy of knowledge (Fig 6) which can act as a guide for knowledge acquisition. Searching for information should start at the top of the hierarchy by scouring recent and relevant published research. Once the research is understood, we can move down to logic and figure out a way to apply the research. There may not always be a clear-cut way to do this which is why we may need trial and error to determine if our reasoning works.). Unfortunately, in the world of bodybuilding vast amounts of knowledge come from the bottom two rungs, and the “experts” in this case tend to be the biggest guys in the gym who may be genetic freaks or ‘chemically enhanced’ individuals who lack a clear understanding of the training process.

Figure 6. A few key strategies to use when evaluating training approaches.

As fitness professionals, it’s important that we start at the top to inform an evidenced based approach to program design. Dr. Schoenfeld was sure to point out that while an evidence based practice is driven by the research, it is ultimately up to the coach find a way to effectively apply research to the athlete or client. This allows the coach to draw from personal experience and take individual differences into account. Expanding on individual differences, Dr. Schoenfeld’s final point before delving into his presentation was that research only reports the means! In virtually every study there are hyper and non-responders to the protocol. Therefore it is up to the coach to consider the entire body of research (by reading more than just a short abstract summary!), use it to inform program design, and understand the individual needs of each client.

Volume

The first variable that Dr. Schoenfeld discussed was volume (sets x reps x load). With regards to hypertrophy, there seems to be a dose-response with volume. However, you can’t just keep increasing the volume and expect continued increases in hypertrophy. Eventually, a threshold will be reached where more volume will lead to overtraining. This is why it’s critical to periodize. Somewhere between single-set training and overtraining there lies a “sweet spot” for volume and optimal muscle growth. How do we know what the “sweet spot” is? Schoenfeld says this is where the art of coaching comes in to play and to follow the evidence based practice paradigm.

Intensity

Muscle growth is intimately related to recruitment of motor units. We also know that the motor units that contain fibers with the greatest growth potential, type II, are the hardest to recruit. Therefore, we lift heavy weights to reach the threshold for recruitment. However, Dr. Schoenfeld pointed out that we also need to consider fatigue regarding motor unit recruitment. As fatigue builds during low-load sets, the threshold for high-threshold units decreases. Therefore, low-load training could recruit type II motor units. The caveat here is that the light loads must be taken to near failure! Dr. Schoenfeld presented data from his lab showing no difference in hypertrophy between protocols (7 exercises, 3 sets each) using 8-12 RM loads and 25-35 RM loads.¹ An additional benefit of using low-loads is the hypertrophy of type I fibers. But, as shown by Dr. Schoenfeld’s protocol, low-load doesn’t mean low effort!

Frequency

It is often debated if total-body or split routines are better for muscle growth. Total body routines may allow you to train a muscle group more frequently (i.e. more than once per week) and at a higher quality while cutting down on total weekly sessions. Conversely, split routines may allow for more recovery between sessions. Again, Dr. Schoenfeld presented data from his lab comparing a volume-equated total body routine (1 exercise per muscle 3d/wk) vs a split routine (3 exercises per muscle; 1d/wk). At the end of 8 weeks, the total body routine was superior with regards to hypertrophy.²

Rest Intervals

Most rest interval recommendations for hypertrophy training are around 60 seconds between sets. However, Dr. Schoenfeld highlighted that there is conflicting evidence in this area. Naturally, his lab ran a study (currently in review) to attempt to answer this question! Twenty one trained men performed an 8-week protocol (7 exercises, 3×8-12, 3d/wk) with either 3 min or 1 min between sets. Interestingly, the 3 min group edged out the 1 min group on thigh and triceps thickness. While the results are somewhat counterintuitive, Dr. Schoenfeld did note that the metabolic stress associated with shorter rest periods may lead to greater gains over time.

Bottom Line

If your ultimate goal is hypertrophy, you need to be training with higher volume protocols most of the time. With that said, it is beneficial to utilize all ranges of loads and repetitions. Higher loads will allow you to become stronger and ultimately use more volume. Training and protocols using lower loads (i.e. very high reps, drop sets, extended sets, etc.) may allow for more global hypertrophy of type I and II fibers if used correctly. Additionally, a total body routine that allows you to train with more frequency at a higher quality (i.e. less fatigue) may be superior to a body-part split. But just like it’s beneficial to change volume and load from time to time, switching up your split may also provide some benefit. So if you’ve been doing a body-part split for a while, trying a full-body routine for a short amount of time may provide a new stimulus for growth.

ISSN Part I Wrap-up.

There you a go – an inside look at a few of the presentations that took place at this year’s ISSN conference. Hungry for more of an inside scoop on the events that took place over the weekend? Stay tuned because in parts II, III and IV we’ll be covering…

• Dr. Richard Kreider – Global Updates & Applications on Creatine Use
• Dr. Mike T. Nelson – Online Monitoring of Fitness
• Alan Aragon – Toward Ending the Dietary Wars
• Dr. Darryn Willoughby – L-citrulline and Glutathione Supplementation
• Dr. Bob Wolfe – Is there an Upper Limit to Protein Intake

As you can see, a lot is still to come so stay tuned!

References

¹ Schoenfeld BJ1, Peterson MD, Ogborn D, Contreras B, Sonmez GT. Effects of Low- Versus High-Load Resistance Training on Muscle Strength and Hypertrophy in Well-Trained Men. J Strength Cond Res. 2015 Apr 3.

² Schoenfeld BJ1, Ratamess NA, Peterson MD, Contreras B, Tiryaki-Sonmez G. Influence of Resistance Training Frequency on Muscular Adaptations in Well-Trained Men. J Strength Cond Res. 2015 Jul 29(7):1821-9.