Diabetes Dollars: ACSM Preps for Coke Revelations

September 16, 2015, 9:10 am

≫ Next: Examining The Global Energy Balance Network, by Dr. Lon Kilgore

≪ Previous: Coca-Cola & ACSM’s Global Energy Balance Retreat

The Global Energy Balance Network story lives on

Coca-Cola funds scientists who mislead consumers about diabetes and obesity. This message spread from Tweets to the Times in weeks.

In response, Coke has vowed to act with “more transparency.” This August, CEO Muhtar Kent promised to release a

“list of health and well-being partnerships and research activities we have funded in the past five years”

In other words Coca-Cola will confirm the GEBN narrative. Greg Glassman’s tweet and Anahad O’Connor’s New York Times article exposed how Coca-Cola funds scientists. Coke’s response will be to show the world how exactly it funds scientists.

Coke may have calculated that its “transparency” campaign will salvage its reputation, but what about the recipients of diabetes dollars? If Coke reveals every dollar it pays the American College of Sports Medicine, how will that hurt ACSM’s reputation?

ACSM Prepares its Members for Coke’s Blow

The Global Energy Balance Network's founders. Source: http://well.blogs.nytimes.com/2015/08/09/coca-cola-funds-scientists-who-shift-blame-for-obesity-away-from-bad-diets/

The Global Energy Balance Network’s founders include ACSM’s former president Steven Blair. Source: http://well.blogs.nytimes.com/2015/08/09/coca-cola-funds-scientists-who-shift-blame-for-obesity-away-from-bad-diets/

ACSM official Steven Blair already had to retract his statements in support of Coke’s Global Energy Balance Network. Blair even admitted that by doubting the link between diet and obesity, he did a “disservice” to nutritional science. But that’s just the beginning.

While we don’t yet know the full details that Coke will release, we already know how the ACSM will react. The ACSM appears so concerned about Coke’s future announcement that it pre-empted Coke’s revelations by emailing all of its members ahead of time.

Soda Funding “Does Affect Objectivity” – ACSM President

ACSM’s email to its members insists that scientists can take money from soda companies without compromising their science. Should the public believe them? Can ACSM take money from soda and still speak honestly about soda’s contribution to diabetes, obesity and heart disease?

Well, ACSM’s own President Larry Armstrong has publicly stated that soda funding DOES influence science. In 2000, he told the Wall Street Journal that soda funding “does affect objectivity.”

If ACSM’s own president has admitted that soda funding compromises scientific integrity, how can the ACSM deny the facts?

How ACSM Can Come Clean

If ACSM really wants to come clean about soda, here are three steps it must take:

1. Publicly condemn ACSM official Steven Blair’s false statements. The ACSM must rebut Blair’s dismissal of diet’s relationship to obesity. If Blair admitted his claims were false, why hasn’t the ACSM taken a stance on this issue?

2. Update and retract their industry-influenced hydration guidelines. ACSM must tell the truth to the public: sports drinks such as Gatorade lower electrolyte concentration levels. In excess, Gatorade can lower electrolytes to fatal levels.

3. Stop fighting CrossFit’s Anti-Soda campaign. Join it. If ACSM truly has the public’s health in mind, why is it loudly lobbying against CrossFit, yet silent on soda? The American Beverage Association has sued San Francisco for warning its citizens about the risks of soda. CrossFit supports San Francisco.

Does ACSM support public health or the American Beverage Association?

Is a can of Coke a day worth losing a limb over? https://instagram.com/p/7S4vQ4tDc8/?taken-by=crossfit

Here’s the email ACSM sent its members to justify its Coca-Cola funding:

ACSM has consistently maintained both a belief in the value of partnering with other organizations, and also a commitment to ensuring that such partnering enables progress and demonstrates the highest degree of independence and, especially, transparency.

It has come to our attention that, in response to recent news, The Coca-Cola Company will soon publicly disclose the health and well-being partnerships it has recently funded. We appreciate Coca-Cola’s commitment to transparency and understand thousands of organizations and their initiatives will be listed, including Exercise is Medicine. ACSM would like to take this opportunity to share the College’s approach to working with all of our partners, whether government, nonprofits, academia or industry.

Should you have comments or suggestions about ACSM’s approach to partner development, please submit them to ACSM’s National Center. All submissions will be reviewed and considered by ACSM leadership.

ACSM Approach to Partner Development
For more than 60 years, the American College of Sports Medicine (ACSM) has advanced and translated – independently and without bias or regard to funding agencies – scientific research to provide educational and practical applications of exercise science and sports medicine. ACSM and its members are dedicated to promoting well-being, sport safety, fitness and physical activity through research, education and public health efforts that positively impact quality of life for athletes, patients and the public worldwide.

ACSM has translated this commitment into a substantial record of scientific and clinical advances for improving health and safety outcomes.

The importance of intersector collaboration has long been recognized by the World Health Organization and many others. To have a substantial national and global impact, the health and science sector has to work with other areas of society. ACSM considers such an approach important as well and, accordingly, pursues and engages in well-designed partnerships with governments, national governing bodies, academia and industry to achieve its goals.

As part of standard operating procedure, ACSM’s leadership:

Reviews and assesses its partnerships to ensure continued alignment with the College’s mission and goals.
Recognizes its ethical responsibility to disclose relationships with funding partners. This has been ACSM’s longstanding policy.
Maintains a clear and well-defined separation between the financial support of partners and the programmatic decisions that are made by the College on matters of science, policy and advocacy.
Continually seeks ways to further strengthen its approach to partnership sustainability and development.

ACSM is committed to scientific integrity and transparency and has worked diligently to maintain these ideals in a rapidly changing world. While ACSM values its partners, none interfere with, influence or keep the College from achieving its mission.

Nate Boudreaux
Director of Corporate Partnerships
401 W. Michigan Street
Indianapolis, IN 46202
Office: (317) 637-9200 x149
Cell: (216) 410-2906
http://www.acsm.org

↧

Examining The Global Energy Balance Network, by Dr. Lon Kilgore

September 17, 2015, 11:48 am

≫ Next: NSCA Admits Publishing False Claims about CrossFit Injuries

≪ Previous: Diabetes Dollars: ACSM Preps for Coke Revelations

Editor’s Note: We are pleased to present this guest post by Dr. Lon Kilgore.

[http://gebn.org]

It is not exactly a new thing to have a large corporation donate money to charities; those donations provide tax benefits and are great for public relations. Coca-Cola is one of those companies that generously doles out millions of dollars annually in support of a spectrum of charities. Research is one of those charities, as is financial support for exercise and sport-related organizations such as the American College of Sports Medicine, the National Strength & Conditioning Association and many others. But the Global Energy Balance Network, GEBN for short, sort of popped up out of nowhere to receive a large share of Coke money. Such a rapid rise from non-existence to fully-funded piques ones curiosity about what it is that the GEBN is really about.

[https://gebn.org/about]

When we look at their mission statement we see an ambiguous statement of purpose:

To connect and engage multi-disciplinary scientists and other experts around the globe dedicated to applying and advancing the science of energy balance to achieve healthier living.

That sounds a lot like a Match.com type of thing for those scientists in “energy balance” and health. The organization’s webpage does later say why the network is proposed to exist:

The Global Energy Balance Network provides a forum for scientists around the globe to come together and generate the knowledge and evidence-based pathways needed to end obesity.

Upon further investigation, the GEBN will host a “Think-Do Tank” Summit in 2016 where the leadership of the network gather together with member scientists and member non-scientists “to identify and evaluate evidence-based solutions that leverage the science of energy balance.”

I’m really curious about this reportedly new take on energy balance, as I’ve been university trained in the subject, and it’s been an interesting topic to me in the context of powering exercise performance. The topic has also had direct personal impact upon me across my lifetime, spending my entire teenage years and early adulthood manipulating energy in and energy out to make weight in wrestling and weightlifting. It affects me currently as this aged body seems to accrue body fat more easily than it did when my athletic career began in 1971.

[https://gebn.org/energy-balance-basics]

But I’m even more curious about the motives of the organization that is bankrolling the network, Coca-Cola. For a company to drop half a million dollars into a start-up academic organization and website does not seem like a wise move for a company that has brilliantly marketed its products to an ever growing international market. But then again, half a million is small change when they report about $12 billion in revenues every three months. I would hope that altruism is the core motive, but I am suspicious.

Regardless, in hopes of an honest effort to improve the human condition, I dutifully filled out the membership application form, which included acceptance of the following set of terms:

“The GEBN invites members to embrace and espouse the following principles as a matter of interest in joining the Network:

Support the science of energy balance in addressing diseases associated with inactivity, poor nutrition and obesity.
Be grounded in sound science and evidence in identifying, implementing and evaluating innovative solutions.
Respect ethnic, cultural and gender diversity and self-determination of people at a local level.
Challenge the status quo and efforts that are not based on the science of energy balance.
Help grow the Network and help raise awareness of the science of energy balance.
Be willing to stand publicly in support of the science of energy balance by agreeing to be publicly affiliated with the Network in name and likeness.
Help foster a community of support for the science of energy balance.
Contribute actively to the affairs of the Network and lead or support leaders in managing the Network.”

If the organization actually does objectively and in an innovative manner use science to improve health and/or reduce obesity … I’d even settle for a group that helped rid us of junk nutritional, exercise, and health science … I’m game to hold up my end.

Immediately upon submission of my application, I received an e-mail from the University of South Carolina stating,

After verification an administrator will be notified to activate your account before you may login. You’ll receive a confirmation when it’s done.

And then I waited. And I’m still waiting.

Maybe the GEBN board doesn’t think I’m GEBN material.

The Board

The executive board of the GEBN is populated by some very notable scientists, and some that are not so notable, as indicated by a PubMed search and review of available curricula vitas.

Arne Astrup, MD PhD
Steven Blair, PED
Wendy Brown, PhD
Gregory Hand, PhD MPH
Marianella Herrera, MD MSc
James Hill, PhD
Nahla Hwalla, PhD
John Peters, PhD
Wenhua Zhao, PhD

If you actually take the time to look at the background of each of the board members, there is a theme that applies to all of them except for one. They all receive or received, directly or indirectly, some type of monetary support from Coca-Cola. It may not be apparent at the superficial level when you look at the disclosures on the GEBN website, but the company has invested in, in several instances quite significantly, in the board.

They all receive or received, directly or indirectly, some type of monetary support from Coca-Cola.

Astrup, Blair, Hand, Herrera, Hill, and Hwalla (although this is not listed on her GEBN bio – rather it is on her publicly available CV) are all recipients of grants, honorariums, or both from Coca-Cola. Several members of the board also list funds coming from the Beverage Institute, the American Beverage Association, and the International Life Sciences Institute. The Beverage Institute is owned by Coca-Cola. Seven of the twenty four executive members of the ABA are Coca-Cola executives, the largest brand representation on the board. The President of the International Life Sciences Institute is a Coca-Cola executive and two members of the GEBN board also are also ILSI board of trustees (who determine who gets ILSI funding). Interestingly those two board members, of GEBN and ILSI, received funds from ISLA. A third GEBN board member, Zhao, appears to have at least indirectly benefited from ISLA funds. However, as Zhou has the least amount of publicly available information, her precise relationship to ILSA is only characterized by appearances in ILSA related documents.

The only member of the GEBN board who has not received monies or benefits from Coca-Cola, directly or indirectly, is Wendy Brown. If she is not a previous recipient of Coca-Cola support as the others, how did she get selected for the board?

Well, it’s a network. And the network begins with Dr. Blair and Dr. Hand who are the co-leaders and funding recipients of over a half-million Coca-Cola dollars to start up the network. They also collaborated on a nearly three quarter of a million dollar “energy flux study” funded by Coca-Cola. Blair’s CV lists five more Coca-Cola funded projects that approach three million dollars in value. But that is only one aspect of the network.

It also appears that along with the funding links of the network board, there is a publication network that also begins primarily with Blair. He is a very busy author, having over 680 science journal papers to his credit (that’s one experiment or review of literature and the associated write up every month over his 49 year career). He has published papers with Astrup, Brown, Hand, Herrera, Hill, Hwalla, and Peters. This leaves Zhao as the sole outlier in publication. So she appears to be connected to the group only through ILSI activity.

If a relationship to Coke or a publication history with Blair are the standards for membership, maybe that’s why I’ve not been added to the membership roster. I’m not one of them.

A Word that Warns

Even considering the incestuous nature of the GEBN leadership, the organization may still serve a purpose if it can affect changes in public behaviors, exercise participation, and nutritional habit. But there is a worrying single word, a business word, included in one of the GEBN’s stated immediate priorities:

identify and evaluate evidence-based solutions that leverage the science of energy balance.

Leverage. In physics it’s related to the use of a lever to accomplish work. But in the business world, the world of Coca Cola, leverage can be the use of some type of financial instrument to increase the return on an investment.

Is the GEBN actually a financial tool for accumulating scientific data and scientists to use in creative marketing efforts intended to increase public consumption of Coca Cola products? Is there a reason to worry here?

Source: http://www.bobcrespo.com/wp-content/uploads/2014/05/coke1.jpg

We really should not have a beef with Coca Cola’s products. We are free to consume whatever we wish as part of our diet. Coke is part and parcel part of American culture. What we should be concerned about is attempts to increase how much and how frequently heavily sugared beverages are consumed across the globe, and this drive to increase consumption isn’t just specific to Coke, Pepsi, Red Bull, and the plethora of other soft drinks (ABA listing of member brands). It’s about the southern staple sweet tea, Gatorade, Thai iced tea, sugar laden designer coffees, fruit drink products, and more.

If Coca Cola is using the GEBN to justify expanding consumption of sugared beverages under the premise of improving health, we have a problem. If the GEBN solution to obesity is simply and only to exercise more so you can drink more Coke, we have a problem. But if the GEBN acts autonomously and responsibly in creating momentum towards making consumption of exercise and quality foods larger than the consumption of Coke, not eliminating its consumption, then we just may have an organization we can get behind.

That is if they let you in.

Should I be Insulted?

Probably not.

A cursory check of my background and online presence would have led them to believe that I might be an ex-academic loose cannon bent on wreaking havoc in defense of CrossFit.

But I’m really not. I’m only really interested in understanding how we can make people fit and in helping people that actually work in the fitness industry understand and improve their practice. I will call out bad science and make my own science based, and thoughtful, conjectures about the science of fitness. Note that I am making conjectures, since in the exercise and nutritional sciences, the data available is generally not convincing enough to theorize. [See Dr. Jeff Glassman’s explanations of conjecture, hypothesis, theory, and law]

GEBN Papers

And that brings me to the papers that the GEBN posted on their website, intended to demonstrate that their position on diet and exercise is unassailable – well maybe not unassailable, but they present it so their position appears to be evidence based and beyond reproach. Do these papers really support the position of the network executive board?

Let’s look at one of the papers that the GEBN uses to support their position.

Gregory A. Hand , Robin P. Shook , Amanda E. Paluch , Meghan Baruth , E. Patrick Crowley , Jason R. Jaggers , Vivek K. Prasad , Thomas G. Hurley , James R. Hebert , Daniel P. O’Connor , Edward Archer , Stephanie Burgess & Steven N. Blair.

The Energy Balance Study: The Design and Baseline Results for a Longitudinal Study of Energy Balance, Research Quarterly for Exercise and Sport, 84:3, 275-286. 2013.

First, notice the first and last author names. Hand and Blair bracket the author list. And note that this is the three quarters of a million dollar research project on energy balance funded by Coca-Cola.

This expensive Coke funded project was published in Research Quarterly in Exercise Science (the official journal of SHAPE – formerly the American Association for Physical Education, Recreation, Health and Dance). That’s a very low impact journal. Was it rejected from other “high impact” journals? Given the status of the authors in the organization, why wasn’t it published in Medicine and Science in Sport and Exercise, put out by the American College of Sports Medicine?

The location of the paper raises a bit of a red flag, as academic researchers actively seek to improve their publication profile by publishing their papers in journals with the highest impact factor possible for the paper being submitted. Why submit the paper to a 1.55 impact journal when the authors have published in journals with impact factors as high as 55.8 (the highest currently possible)? Was there something that rendered the paper of lower quality?

When we read this paper, the first thing noted is that this is a descriptive study that contains no statement of conjecture or hypothesis that the researchers are looking to support or contradict. In a descriptive study this is not a problem as a simple statement of purpose is appropriate. The purpose of the study can best be gleaned from a statement in the introduction;

Results from this study will allow a very precise examination of the extent to which total energy intake and expenditure contribute to changes in body weight and fat over a period of one year.

So it appears that the researchers simply wanted to follow a group of subjects and quantify how many calories they ate and drank over the year (calories in) and how many calories they expended over the year (calories out) and see how that affected bodyweight and fatness. A pretty simple inquiry into the GEBN’s central dogma, energy balance.

So, how did the researchers achieve their purpose? Exquisitely accurate and objective measurement? Well, there seems to be a problem with that. If you actually look at the methods used to create this paper, there is one technique, self-report, used to derive two critical data sets that renders any concrete conclusion proposed by the authors of the paper unwarranted:

(1) “Self-reported weight change (mean +/- SD) over the previous year were 0.92 +/- 5.24 kg for women and 21.32 +/- 6.1 kg for men.”

(2) “Estimates of energy and nutrient intakes were calculated from a self-report of food consumption.”

Self-report is a notoriously errant method of obtaining data on subject characteristics. In general the trend is to overestimate height and underestimate bodyweight. The degree of under reporting in bodyweight can be quite large with published data indicating the rate to be 70% of women and 35% of men reporting bodyweights lower than actual (Bowring et al). Heavier individuals also tend to underreport bodyweight (Gunnare et al).

Self-report of diet also carries with it the same level of inaccuracy with up to 60% underestimation (Kipnis et al).

Self-report of physical activity and exercise amounts also differ from reality to a significant degree (Shephard).

The authors acknowledge the limitations of self-report but go on to call it the “gold standard”. Would not the gold standard, especially in a well-funded study, be to actually measure height, weight, dietary consumption, and energy expenditure in your subjects if that was your stated intention? Yes, it’s expensive, but wouldn’t it be prudent to generate accurate data on a smaller subject pool rather than producing data with well-known and inherent error?

If the researchers were aware of the limitations of their methods, surely they took precautions to control that error in some way, right? They tried, but let’s look at some of the data.

The men were reported (based on self-report) to eat 2,407 calories (for accuracy we are referring to kilocalories or kcal) per day. The men were reported (also based on self-report) to have expended 3,115 calories per day.

That calculates out to a 708 calorie deficit per day, a negative energy balance. When put in the context of the one year study, the cumulative caloric deficit would be 258,420 calories. For a better perspective, we can use the American College of Sports Medicine’s recommended calculations for caloric deficit and weight loss. Using their math suggests that there would be an average 73.8 pound weight loss for the men over the duration of the study. That means that the average 178.8 pound male subject in the study should have weighed 105 pounds at the end of the project.

… The average 178.8 pound male subject in the study should have weighed 105 pounds at the end of the project.

The women self-reported a 597 calorie deficit. This means they should have lost 62.2 pounds over the course of the study. Starting at an average 151.8 pounds in body weight means that they should have weighed 89.6 lbs at the end.

Obviously this extent of weight loss did not happen and was not reported. The researchers only reported self-reported weight change from the previous year with no discussion, likely because they didn’t see a weight loss outcome that matched their outrageously mismatched self-reported energy balance data. The results of their baseline self-report data defies their concept of energy balance as apparently energy deficit from diet and exercise did not cause weight loss in their subjects.

But we shouldn’t look at this paper as an actual research paper, rather we need to look at it as a write up of some ideas the authors had about doing an actual experiment, because that’s more of what it is. But the authors write in the past tense about the experiment and there is no attempt to inform the reader that this paper does not present the actual data of that experiment. Yes there is data presented, framed by the authors to be a span of one year – the duration of the proposed (completed) study. But it’s not until after you wade through the paper’s first sections that you realize that this is a paper that is supposed to lay the foundation for an experiment that was already completed. Data is discussed, conclusions about energy balance are made, and there is much made of the multitude of peripheral high tech measurements that make the project look like good science and might produce some useful information, but this data is not presented the paper. In fact, the results section is frequently used as a platform for discussion. But the elements of the study and the subsequent data presented that could address the stated purpose of the project, to describe how total energy intake and energy expenditure affect body weight and fat, were derived from notoriously inaccurate self-report data and produced demonstrably unfeasible data. We cannot make any conclusions or recommendations on diet or exercise (energy balance) from the data presented. It also does not bode well for the actual long term experiment as the entry data was so flawed. Methodologically, if a set of pristine and immaculate end-data is compared to inaccurate pre-data the result is inaccurate.

We cannot make any conclusions or recommendations on diet or exercise (energy balance) from the data presented.

The Bottom Line(s)

Thanks to the generous grant of $750,000 from Coca-Cola, the researchers successfully produced, at best, a decent pilot or exploratory study that can only serve as a source of information for further conjecture. The authors did get another notch on their publication belts for publishing a paper about designing an experiment that had already concluded. The GEBN received a foundation paper – one that has significant limitations in its ability to support the mission of the GEBN and Coca-Cola (Why aren’t the three published papers that actually present the data of this experiment provided within the resources?). The public got nothing of value from the project, and the resulting paper except for the knowledge that Coca-Cola may not be wisely investing its research grants monies, monies they propose are intended to improve the health and well-being of their customers.

For me, a further e-mail to the GEBN office querying the status of my membership application resulted in a non-response. I suppose this is probably a good thing. Although the organization sounds like a good one and it is VERY well-funded, when you look at the concepts they espouse, the way they communicate, their closed network behavior, the data they use to support their position, and their intimate connections to a huge multi-national corporation who desires their services and papers for marketing purposes (or for tax purposes if we want to be generous), the smart person might want to rethink their application for membership.

I certainly have.

REFERENCES

Bowring AL, Peeters A, Freak-Poli R, Lim MS, Gouillou M, Hellard M. Measuring the accuracy of self-reported height and weight in a community-based sample of young people. BMC Med Res Methodol. 2012 Nov 21;12:175. doi: 10.1186/1471-2288-12-175.

Gunnare NA, Silliman K, Morris MN. Accuracy of self-reported weight and role of gender, body mass index, weight satisfaction, weighing behavior, and physical activity among rural college students. Body Image. 2013 Jun;10(3):406-10. doi: 10.1016/j.bodyim.2013.01.006. Epub 2013 Feb 16.

Shephard RJ. Limits to the measurement of habitual physical activity by questionnaires. Br J Sports Med. 2003 Jun;37(3):197-206; discussion 206.

Victor Kipnis, Amy F. Subar, Douglas Midthune, Laurence S. Freedman, Rachel Ballard-Barbash, Richard P. Troiano, Sheila Bingham, Dale A. Schoeller, Arthur Schatzkin and Raymond J. Carroll. Structure of Dietary Measurement Error: Results of the OPEN Biomarker Study. Am. J. Epidemiol. (2003) 158 (1): 14-21.

American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription (7^th edition). Lippincott, Williams & Wilkins, Philadelphia, 2006.

About the Author
Lon Kilgore earned a Ph.D. from the Department of Anatomy and Physiology at Kansas State University’s College of Veterinary Medicine. He has competed in weightlifting to the national level since 1972 and coached his first athletes from a garage gym to national-championship event medals in 1974. He has also competed in powerlifting, the first CrossFit Total event, wrestling, and rowing. He has worked in the trenches, as a coach or scientific consultant, with athletes from rank novices to professionals and the Olympic elite, as a collegiate strength coach, and as a consultant to fitness businesses. He was co-developer of the Basic Barbell Training and Exercise Science specialty seminars for CrossFit (mid-2000s). He is a qualified National Coach and was a certifying instructor for USA Weightlifting for more than a decade and a frequent lecturer at events at the U.S. Olympic Training Center. He is a decorated military veteran (sergeant, U.S. Army). His illustration, authorship and co-authorship efforts include several best-selling books and works in numerous research journals. He currently delivers vocational education courses through the Kilgore Academy, provides online commentary and analysis of exercise science papers, and works as a writer and illustrator. His fitness standards have been included in textbooks and numerous websites. You can download free PDFs of his standards here. DISCLOSURE: The author is a Pepper. Specifically Dr. Pepper 10 and Sonic Diet Dr. Pepper with vanilla.

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NSCA Admits Publishing False Claims about CrossFit Injuries

September 21, 2015, 1:50 pm

≫ Next: Man Joins CrossFit Box, Quits Big Soda Job

≪ Previous: Examining The Global Energy Balance Network, by Dr. Lon Kilgore

The National Strength and Conditioning Association is asking the public to disregard the claims its study made regarding injuries in CrossFit. After two years of inaction and litigation, the NSCA has finally issued an erratum, or correction, regarding one of its most prominent studies.

The study, “Crossfit-Based High-Intensity Power Training Improves Maximal Aerobic Fitness and Body Composition,” claimed that 16 percent of its subjects cited “overuse or injury” as their reasons for not completing the training. The full text is available here.

Furthermore, the NSCA study employed its alleged injury rate to caution readers about the risks of CrossFit training, explaining,

A unique concern with any high intensity training program such as HIPT or other similar programs is the risk of overuse injury. In spite of a deliberate periodization and supervision of our Crossfit-based training program by certified fitness professionals, a notable percentage of our subjects (16%) did not complete the training program and return for follow-up testing. While peer-reviewed evidence of injury rates pertaining to high intensity training programs is sparse, there are emerging reports of increased rates of musculoskeletal and metabolic injury in these programs(1). This may call into question the risk-benefit ratio for such extreme training programs …

The NSCA study reported that 16 percent injury rate without the slightest base of evidence. CrossFit Inc. and CrossFit 614, the affiliate where the study’s training occurred, each filed lawsuits to protect themselves from the NSCA’s willingly-published false information.

The facts are clear: Every relevant subject in the study has sworn to the court that the study’s injury claims were false. The subjects have also all sworn that the authors made their claims without ever asking the subjects their reasons for not completing the study.

Please read a full review of CrossFit’s case against the NSCA here.

When CrossFit Inc. contacted the NSCA and reported that the authors had failed to substantiate their claims, the NSCA editor-in-chief William Kraemer responded that peer review was sufficient evidence of the study’s validity. In fact, it was not. The NSCA published the Devor study despite knowing the researchers had failed to substantiate their claims.

William Kraemer told Russell Berger that peer review was a sufficient means of ensuring the Devor study’s validity.

The NSCA’s Admits it Published False Information

On Sept. 11, 2015, the NSCA’s “Journal of Strength and Conditioning Research” published ahead of print an erratum.

Erratum, Latin for ‘error,’ is a term some academic journals use in place of “Correction.” Oxford University’s dictionary defines its plural, errata, as “A list of corrected errors appended to a book or published in a subsequent issue of a journal.”

Here is the full text of the NSCA’s admission:

Erratum:

In reference to Smith, MM, Sommer, AJ, Starkoff, BE, and Devor, ST. Crossfit-based high-intensity power training improves maximal aerobic fitness and body composition. J Strength Cond Res 27(11): 3159 –3172, 2013, the authors have stated that the reasons for participants not completing follow-up testing, as reported in the article, were provided to the authors by the club owner. The club owner has denied that he provided this information.

After the article was published, 10 of the 11 participants who did not complete the study have provided their reasons for not finishing, with only 2 mentioning injury or health conditions that prevented them from completing follow-up testing.

In light of this information, injury rate should not be considered a factor in this study. This change does not affect the overall conclusion of the article.

Note that NSCA’s erratum is based on sworn statements made in the context of litigation. Without litigation, the published errors would almost certainly have stood unchallenged. CrossFit’s and CrossFit 614’s lawsuits have proven essential to correcting the scientific record.

While the NSCA’s confession is a first step, it still propagates at least two falsehoods:.

Falsehood 1: Subjects Got Hurt Doing CrossFit Training

The Devor study falsely claimed that CrossFit training is uniquely risky.

Is CrossFit training uniquely risky? This NSCA study made that claim without evidence.

The NSCA’s erratum states two subjects mentioned “injury or health conditions that prevented them from completing follow-up testing.” This gives the false impression that the Devor study’s injury allegation was partially true. And it omits crucial publicly available information.

Neither of those two subjects got hurt doing the CrossFit classes at CrossFit 614. In fact, one of the subjects had a pre-existing medical condition that prevented him from completing the study. The other subject injured himself outside the CrossFit training program examined in this study.

Clearly, injuries cannot be reasonably attributed to the training intervention profiled in the NSCA study. Why does the NSCA omit this fact?

As Dr. Steven Devor told CrossFit Inc. employee Russell Berger,

I can’t control what they’re doing outside of when they’re doing CrossFit or when they’re in the lab. And you’re right, they could have, for all I know, fallen off a ladder and had an injury, and that’s why they didn’t come back, but they’re reporting to us, in some way shape or form, that I’ve got an injury, but—. You’re right, it might not be from directly from doing CrossFit.

Falsehood 2: The NSCA’s Correction Does Not Affect the Overall Conclusion of the Article

The last line of NSCA’s erratum appears to play down the significance of the correction by claiming it “does not affect the overall conclusion of the article.”

As CrossFit CEO and Founder Greg Glassman has said, this “is an obvious lie.” Injury is not a passing line in the Devor study; it motivates an entire paragraph in the Discussion section, cited above, in which the authors editorialize on the significance of the unsubstantiated injury rate.

The paragraph claims that injury is a “unique” concern with this style of training. The claim was baseless when the article was published, and it’s even less true now.

Take the injury claim away – what do you have? The study found that this style of training “significantly improves VO2max and body composition in subjects of both genders across all levels of fitness.”

That aspect of the article may remain unchanged, but now there’s no need to “call into question the risk-benefit ratio for such extreme training programs”—a very significant change indeed.

CrossFit just works.

CrossFit works – no qualification needed.

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Man Joins CrossFit Box, Quits Big Soda Job

September 23, 2015, 5:21 am

≫ Next: Transparency? Coca-Cola Reveals ACSM Payments, Hides Others

≪ Previous: NSCA Admits Publishing False Claims about CrossFit Injuries

Editor’s Note: We are pleased to present this guest post by Priscilla Tallman of CrossFit Fury. It originally ran on CrossFit Fury’s website, under the title, ‘One More Bag in the Cart.”

George Maurice has already found a new place in Texas to get his wods in at CrossFit Katy.

George Maurice is packing up his life in Goodyear, AZ and leaving Fury.

He’s not giving up on fitness or CrossFit for that matter, but after six months working in sales with a major soda company, he’s decided to take his life in a different direction. As Category Manager at a Big Soda company, George is responsible for working with retailers (i.e. grocery and convenient stores) to place as many soda and snack products on their shelves as he can sell. George calculates and crunches numbers to formulate the perfect pitch with one goal in mind – getting more shelf space for his products.

With the promise of increased sales, George sells shop owners on the idea that his product can get “one more bag in the cart per person, per shopping trip” and that means more money for everyone. Combining corporate marketing strategies, product placement, lower price points than competing brands and enticing flavors targeted to lower income demographics, he’s part of what keeps these products in stores and in the hands of consumers.

Food for thought: Regional and national flavor pairings are released in certain markets to target specific demographic groups. Photo: Adam Bow

“How do we get one more bag in the cart? You want one more person to put one more bag in the cart per trip. There was an enthusiasm to sell more junk,” said Maurice.

In fact, George is on the forefront of selling soda and chip products to specific socio-economic demographics within his region – and in the South West that means the Hispanic community. Bone shaped chips for the seasonal market, flavor pairings such as chile lime, multi-packs and licensed characters all priced to sell, not one bag, but multiple bags per person per trip.

However, at an annual strategy meeting in early August, the excitement of selling unhealthy food to targeted demographics and lower-income families started to weigh on George’s conscience.

“I can’t believe I’m doing this for a living. It hit me personally. I do CrossFit, I eat Paleo. I know what I’m selling isn’t healthy for me, but these people should go buy it? It felt hypocritical,” said Maurice.

A veteran of the U.S. Navy, George kept active and fit with triathlons, hiking, hunting and climbing when he got out of the Navy. But it was after seeing a friend transform his life through CrossFit that he started to take a closer look at the sport. With several military and first responder friends who trained for their jobs with CrossFit, he figured if it was good enough for them, there must be something to it.

He started CrossFit Fury in October, 2014. In his first assessment, he was confident his current level of fitness would carry him through the 6-minute baseline WOD: 500 meter row/AMRAP 5-7-9 pull-ups, push-ups and air squats.

“I looked at the whiteboard and it didn’t seem that hard, but I was beat!” said Maurice.

Over the next several months, he was consistent with CrossFit workouts and nutrition and started seeing strength and conditioning gains transfer into his everyday life. Hunting, climbing and camping became easier, as well as every day activities with his kids and family.

At Fury, he got his first rope climb, his first clean and jerk PR and Rx’d his first workout. Coaches were a source of support and encouragement with small cues and tweaks during WODs, making movements more efficient and creating more speed and endurance over time.

But it wasn’t only physical gains keeping George on a consistent routine at Fury, it was the community and confidence he was gaining too. As George transformed his physical life, his professional and personal life began to change as well. He thought not only of what he was doing for himself, but of what he was doing for his community and for the world beyond by selling products he knew were nutritionally barren – products designed to target and prey on demographic groups more susceptible to the marketing tactics his company was using to get more bags into more carts for more people.

Drink for thought: One can of soda contains 41g of sugar (approx. 10 packets of sugar). If you drink one can a day for an entire year, you are consuming 35-lb.. of sugar in a year. Photo: Adam Bow

“I don’t want to be pushing sugar water, I want to get people more active. The confidence you build in CrossFit applies professionally too. If you think you are good enough, you can take a chance,” said Maurice.

George will be taking on a new job with one of the premier sports, outdoor and lifestyle retailers based in Texas. As the Director of Merchandising and Regional Strategy, he’s pitching a new story and developing ways to get more equipment (perhaps even fitness equipment) into the hands and homes of consumers seeking a healthier lifestyle.

And that’s great news for George who just passed a milestone in his life, he turned 42. That was the same age his father was when he had his first heart attack. That’s not all, he also lost a brother to liver failure as a result of Type I Diabetes, so this life change isn’t just for him – it’s part of a bigger picture.

“The immediate is easy – the future looks hard, but if you settle into a routine it gets better. Groups help each other out,” added Maurice.

About the Author:
Priscilla Tallman is CrossFit Fury’s staff writer and social media team member. She holds her Crossfit L1 certificate and is a CrossFit Mobility Trainer, and holds an undergraduate and graduate degree in Clinical Psychology. She teaches a mobility class at CrossFit Fury and is a freelance writer and blogger in her spare time. She is married with two children and in a former life played collegiate and professional volleyball.

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Transparency? Coca-Cola Reveals ACSM Payments, Hides Others

September 23, 2015, 12:17 pm

≫ Next: Stephanie Habif’s Mixify Hydration Advice: Willful Negligence?

≪ Previous: Man Joins CrossFit Box, Quits Big Soda Job

Transparency? http://www.coca-colacompany.com/transparency

The moment ACSM prepared for has arrived: Coca-Cola has released a list of some of the scientists and health organizations it funds.

So just how much does Coca-Cola pay the American College of Sports Medicine? Despite Coca-Cola’s “transparency” claims, it’s not possible to derive a precise answer to that question from the documents Coca-Cola released.

Let’s start by searching for the “American College of Sports Medicine” in Coca-Cola’s Diabetes Dollars Database. Here are the results:

Source: http://www.coca-colacompany.com/transparency-search?keyword=american+college+of+sports+medicine&type=&year=&noCache=true

If we tally up those seven entries, we find that Coca-Cola has paid ACSM and the ACSM Foundation at least a total of $865,000 in the past five years. But that’s not all.

Coca-Cola Directly Funds at least one ACSM Official

Coca-Cola also can influence the ACSM by targeting its officials, not just by funding the organization directly. For example, former ACSM president Steven Blair is on the advisory board of Exercise is Medicine, a joint ACSM-Coca-Cola partnership. EIM is “an initiative focused on encouraging primary care physicians and other health care providers to include exercise when designing treatment plans for patients.”

Here’s what you get when you search for Steven Blair:

http://www.coca-colacompany.com/transparency-search?keyword=steven+blair&type=&year=&noCache=true

So if we add Blair’s total to the previous number, Coca-Cola has paid ACSM and its officials at least $6,342,000 in the past five years. But that’s not all.

Transparency? Coca-Cola is Hiding Some Names and Organizations

Remember that Coca-Cola CEO Muhtar Kent first promised to release this information in response to the New York Times’ expose of the Global Energy Balance Network. GEBN is a Coke-funded project that attempts to “Shift Blame for Obesity Away From Bad Diets.”

Coca-Cola CEO Muhtar Kent: http://media.bizj.us/view/img/584681/muhtar-kent-bs1*1200xx3208-1805-0-110.jpg

The Times piece reported that Coca-Cola’s funded programs weren’t always transparent about their funding:

website also omitted mention of Coke’s backing until Dr. Yoni Freedhoff, an obesity expert at the University of Ottawa, wrote to the organization to inquire about its funding.

In his Wall Street Journal editorial, Kent concluded from the Times expose that Coca-Cola needed to “do better” and act with “more transparency.”

Unfortunately, Coca-Cola’s “transparency” campaign still isn’t fully transparent. Coke admits,

Several individuals with whom we worked in the past have declined to have their names listed.

Nor has Coca-Cola revealed all of the organizations that it pays:

Under our contracts with certain organizations, we are obligated to obtain the organization’s permission to make disclosures like those above. We have made a good faith effort to obtain permission from these organizations, but have not secured it from every organization. The aggregate amount of funding provided to these organizations over the past five years is $ 679,000.

Furthermore, there is a geographic restriction on this information. It omits funding originating from, or paid to, entities outside of North America. Coke states that its database excludes,

1. Research by entities not based in the U.S. or Canada and not funded by Coca-Cola North America (CCNA) or The Coca-Cola Company’s U.S. corporate headquarters;
2. Programs and activities conducted outside the U.S. and not funded by Coca-Cola North America (CCNA) ), The Coca-Cola Company Foundation, or by The Coca-ColaCompany’s U.S. corporate headquarters;
3. Research on ingredients, packaging, products, or brands that is not related to dietary intake, nutrition, and health, or to physical activity;
4. Research and development on new ingredients, packaging, products, or brands; and
5. Payments to third-party service providers for media services, advertising, and logistics in support of the “Partnerships” for Health and Well-Being Programs and Communications Activities listed.

For example, Coca-Cola money that goes to ACSM officials or programs outside of the US is not listed. Judging by the Coca-Cola Foundation’s 2012-2013 tax returns this exclusion may hide a significant amount of Coke funding. Consider “Exercise is Medicine,” an ACSM-spearheaded program. During 2012-2013, Coke paid at least $1,181,000 to Exercise is Medicine programs outside of the U.S.

We also know from the Coca-Cola Foundation’s 2012-2013 tax forms that the majority of Coca-Cola’s donations to health and fitness went to organizations outside the US and Canada. Also, we know that Coca-Cola donated nearly $120 million from 2010-2015 just to organizations in North America. So if the 2012-2013 pattern holds, does that mean that Coca-Cola also donated more than $120 million to health and fitness organizations outside of North America?

For now, Coca-Cola’s not transparent enough for us to answer that question. In that case, however, Coke would have paid closer to $240 million, not merely $120 million, to health scientists and organizations over the past five years.

Coca-Cola and ACSM’s “Exercise is Medicine”: http://brandchannel.com/2013/01/16/coca-cola-continues-obesity-rebuttal-with-new-tv-commercial-video/

Achieving True Transparency

What would it take for Coca-Cola and the American College of Sports Medicine to achieve true transparency?

First, Coca-Cola would need to release the name of every scientist and organization it funds. Hiding the most embarrassing information doesn’t count as transparency. In addition, Coca-Cola should release its funding for activities outside of North America. Soda-related diabetes and heart disease are pressing issues in China and Latin America as well. We cannot ignore Big Soda’s influence on science simply because it occurs outside the U.S. and Canada.

Second, the ACSM should release details on all of its sponsors, and those of its officials. We know that Pepsico and General Mills sponsor the ACSM. How much has PepsicC’s Gatorade brand paid the ACSM over the years? If ACSM has truly managed to prevent its relationship with Gatorade from influencing its hydration guidelines, this should be no problem, right?

Lastly, Coca-Cola should release its contracts with scientists and organizations. What precisely are Coca-Cola’s conditions for funding research and organizations? If Coca-Cola is paying ACSM and its officials over a million a year, on average, how does it make sure that this investment translates into Coca-Cola’s bottom line?

As long as Coca-Cola and the ACSM fail to disclose this information, the public will have good reason to doubt their commitment to “transparency.”

Source: http://www.bloomberg.com/bw/articles/2014-07-31/coca-cola-sales-decline-health-concerns-spur-relaunch

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Stephanie Habif’s Mixify Hydration Advice: Willful Negligence?

October 8, 2015, 8:25 am

≫ Next: CrossFit Helps Coca-Cola Become More Transparent

≪ Previous: Transparency? Coca-Cola Reveals ACSM Payments, Hides Others

source: https://www.flickr.com/photos/52502032@N05/5756783300

In September, I became aware of a website called Mixify. The site is a production of Coca-Cola, PepsiCo, Dr. Pepper Snapple Group, and their mutual advocate the American Beverage Association, and it aims to help youth “balance what you eat, drink and do.” The site is a well-crafted attempt to make Big Soda appear morally responsible despite a growing mountain of evidence that soda is a major contributor to disease.

Mixify teaches children to attain energy balance, which means matching calories expended to calories consumed. This balancing act is based on the belief that total caloric intake (rather than macronutrient ratio or type) is the primary concern in preventing disease. Coca-Cola has championed this belief through its funding—in partnership with the American College of Sports Medicine (ACSM)—of the Global Energy Balance Network. Energy-balance theory not only contradicts data published by UCSF pediatric endocrinologist Dr. Robert Lustig, but it is also based only on conjecture (See Lon Kilgore’s article on this subject).

Children taught to follow an energy-balance system based on conjecture will conclude that sugar is not inherently toxic (contrary to abundant evidence), and that the harmful effects of drinking a can of soda per day can be offset by playing a game with a Frisbee.

Beyond simply confusing kids about the cause of diabetes, Big Soda’s harmful effects extend further. As soda sales decline, sales of bottled water have been steadily rising. Coke and Pepsi alone share about one-fifth of the bottled-water market. So what could be better than using Mixify to recklessly encourage water consumption?

Enter Stephanie Habif. Habif is not a medical doctor, nor is she a scientist. She has a doctorate in health behavior science from Columbia University and teaches a course at Stanford titled “The Consumer Mind & Behavior Design.” In the “Ask The Experts” section of Mixify’s website, Habif answers the question “Why Does the Body Need to Hydrate?”

And here is where things get ugly. Habif proceeds to give dangerous and outdated hydration advice—the same advice produced by the ACSM in conjunction with its platinum sponsor, Gatorade (owned by PepsiCo). Habif’s personal advice is no longer reflected anywhere in current hydration recommendations (thanks in part to CrossFit’s efforts), and the outdated hydration recommendations have actually led to death from exercise-associated hyponatremia (EAH) over and over again. After reading her work, I contacted Habif, who requested I email her. The following is our email exchange:

In response, Habif wrote the following email back:

Note that Habif has not provided actual citations for her claims. She also says it’s “not fair” to claim her comments are erroneous, as if the source of her claims has anything to do with whether or not they are true. In response, I sent a second email:

At the time of this writing, it has been two weeks since I sent this final email. Habif has refused to answer any further emails or text messages. I do not believe Habif knew that her views of hydration were dangerous, misguided and now outdated. An intellectually honest academic should be able to accept constructive criticism of her work based on more reliable information and update it accordingly. Rather, Habif seems to have chosen to ignore my concerns about her advice, which directly contradicts the Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference.

To mistakenly publish dangerous advice is forgivable. To mistakenly publish dangerous advice, learn of the danger, and do nothing is unconscionable. In 2014, two high-school football players died from EAH, both under the impression that aggressive hydration was critical to avoid heat injury and injurious levels of dehydration. Should another death occur, and should it be found that the victim viewed Habif’s article, I hope we hold her both legally and morally accountable.

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CrossFit Helps Coca-Cola Become More Transparent

October 9, 2015, 8:12 am

≫ Next: Guilty: Coca-Cola Admits Advertising to Children

≪ Previous: Stephanie Habif’s Mixify Hydration Advice: Willful Negligence?

Editor’s Note: As covered previously, Coca-Cola has failed to fully disclose its influence on health science. Below CrossFit employee Derek Fields helps Coca-Cola become more transparent.

Big Soda is on the run.

Image source: http://3.bp.blogspot.com/-CSfU-74AAVM/VTKrE_Is5bI/AAAAAAAAMd4/bOtawd0dFBA/s1600/kid.jpg

We have compiled a list of at least 216 organizations dedicated to health, nutrition, fitness, or sport that have taken money from Coca-Cola or PepsiCo. Four of the more influential organizations from the list have terminated their relationship with Coca-Cola (or had their relationship terminated) since Anahad O’Connor’s expose in the New York Times. O’Connor revealed that Coca-Cola-funded scientists have questioned whether food has anything to do with the obesity epidemic.

Four of 216 leaving Coca-Cola behind is just a start, though. Many of the organizations on the following list accept money from Coca-Cola, and yet Coca-Cola hid them from its “Transparency” campaign revelations last week. Also, for some strange reason, PepsiCo funding has escaped scrutiny.

See if your favorite health organization has accepted money from Coca-Cola and/or PepsiCo:

Note that this list is partially built from 2012-2014 tax information, so it’s possible Coke or Pepsi has since ended its relationship with some of these organizations and/or added others.

Image source: http://i.huffpost.com/gadgets/slideshows/343935/slide_343935_3577681_free.jpg

Remember, Coca-Cola hasn’t yet told the whole story. Coke’s recent publications only show health-related funding provided by “Coca-Cola North America (CCNA), The Coca-Cola Company Foundation, or The Coca-Cola Company’s U.S. corporate headquarters” to organizations inside the U.S. and, in some cases, Canada.

Coke influences health on a global scale, though. Digging into the publicly available tax records of the Coke Foundation reveals global donations and some interesting trends.

Here you can see a spreadsheet of all the Coca-Cola Foundation’s 2012 and 2013 donations to health-related causes according to the annual 990 forms the Foundation submits to the IRS. After breaking down 2012 into foreign and domestic grants we found that roughly 60% of the Coke Foundation’s donations to health-related causes went to groups outside the US.

Image source: http://bucket.glanacion.com/anexos/fotos/97/1262997.jpg

If Coca-Cola is hiding approximately 60 percent of its influence over health just because it sent that money somewhere outside of North America, what else is it hiding?

Furthermore, Coca-Cola has not released any information that its corporation paid scientists and health organizations for:

“3. Research on ingredients, packaging, products, or brands that is not related to dietary intake, nutrition, and health, or to physical activity;
4. Research and development on new ingredients, packaging, products, or brands; and
5. Payments to third-party service providers for media services, advertising, and logistics in support of the “Partnerships” for Health and Well-Being Programs and Communications Activities listed.”

Coca-Cola is only transparent to itself.

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Guilty: Coca-Cola Admits Advertising to Children

October 20, 2015, 7:23 am

≫ Next: Exercise is Medicine and the Trainer, by Dr. Lon Kilgore

≪ Previous: CrossFit Helps Coca-Cola Become More Transparent

Editor’s Note: This news first appeared in the Quebec French press. We have paraphrased the story and added some background in order to spread the news in English.

Coke’s website states, “We do not advertise to children under 12 years old.” Their official marketing policy defines “media that directly targets children under 12 as media in which 35% or more of the audience is composed of children under 12.”

Anyone who’s followed the news in 2015 may have reason to suspect that claim. Does Coca-Cola keep its word?

Consider this Fanta Zone in La Ronde Amusement park, in Montreal, Quebec, Canada:

Source: http://www.lapresse.ca/actualites/montreal/201510/17/01-4911032-coca-cola-amende-pour-publicite-illegale-a-la-ronde.php

Beyond Coca-Cola’s policy, Quebec’s Consumer Protection Act forbids advertising to children under the age of 13. The “Fanta Zone” above even included advertisements of children drinking soda. (Fanta is a Coca-Cola Company brand)

The Quebec Coalition on Weight-Related Problems filed a complaint against Coca-Cola in 2013. Acting on that complaint, the Office for Consumer Protection investigated the Fanta advertisement.

Then this October, the Coca-Cola Company pleaded guilty to the charge of advertising to children under 13. This is an intriguing admission given Coca-Cola’s official position. Coca-Cola will have to pay nearly $28,000 Canadian dollars to the Quebec government (worth about $21,000 in USD).

While Coca-Cola pleaded guilty of advertising to children, it still denies intending to do anything wrong. Coca-Cola Communications Director Antoine Tayyar avers,

This area was originally intended for an older audience (youth and adolescents) and is located outside of the area for children.

Consider for yourself whether this is a reasonable assumption for an amusement park’s water play area. Applying Coca-Cola’s own standard, is it reasonable to expect that fewer than 35% of the children playing in an amusement park’s water play area are under 12 years old?

Le Journal de Montreal has published evidence that the La Ronde Amusement Park ad is not an isolated incident. Below is a photo from a maze for children 3 and under from the Jungle Adventure Amusement Park. The Quebec Coalition on Weight-Related Problems has also filed a complaint regarding this ad. We await the verdict.

http://www.journaldemontreal.com/2015/10/16/coca-cola-paie-28000-pour-une-pub-illegale-a-la-ronde

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Exercise is Medicine and the Trainer, by Dr. Lon Kilgore

October 21, 2015, 1:42 pm

≫ Next: A Real Expert Comments on Fitness Licensure

≪ Previous: Guilty: Coca-Cola Admits Advertising to Children

Editor’s Note: We are pleased to present this guest post by Dr. Lon Kilgore.
The concept that exercise behaves as medicine is becoming widespread, repeated often enough by exercise academics and the media that it seems to be nearing acceptance as fact. As such it would appear, superficially, that personal trainers are working as cogs in the field of medicine.

As attractive as this concept is to some, it is not the actual circumstance within which personal trainers find themselves. When the promotional veneer of the exercise-is-medicine initiative is peeled back and its actual basis and workings are examined, it appears that exercise organizations are trying to paint personal trainers into a tiny occupational corner.

A case in point is the American College of Sports Medicine, an academic group which is self-appointed as an authoritative body regarding all things exercise:

As a leader in the industry, ACSM establishes the exercise guidelines that all other certifications use for training and certification, and therefore, we continue to set what we like to call ‘the Gold Standard.’

As one can see by the exaggeration that the ACSM “establishes the exercise guidelines that all other certifications use for training and certification,” the organization fails to appreciate that it, as an organization, has only limited reach and impact on the world of personal training.

Who We Are and Who We Are Truly Interested in Serving

The ACSM originated as a special-interest group within the American Association for Health, Physical Education, Recreation and Dance. In 1954, the group broke away to focus on the scientific aspects of exercise, leaving the practical aspects of delivering fitness to those left behind. Research, not practical application or delivery of fitness training, became the mission of the ACSM. This continues as its main identifying premise today:

ACSM is dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.

This narrow focus began a disconnect between the organization and those in the trenches of physical education, coaching and the slowly emerging occupation of personal training. The divide in mission was large enough that when the National Strength and Conditioning Association was in its formative development, the organizers consulted with the National Athletic Trainers Association, not the ACSM, regarding potentially becoming a subordinate organization.

The ACSM’s exit from AAHPERD, and the nearly universal renaming of university physical education departments to departments of kinesiology, exercise science, movement science, or some other similar name at the end of the 20^th century, marked the diminishment of interest in the actual practice of creating fitness in favor of forging an identity linked to science and medicine. Everyone was running from the stench of the jock strap.

So it seems as though the ACSM’s mission was originally and is still focused on its academic and clinical membership. But that does not stop the ACSM from actively courting fitness trainers as members:

Sure, other fitness associations can offer you networking opportunities, celebrity speakers and useful resources. But look closer. Where are these resources and sports medicine experts coming from? Chances are, many are coming from ACSM. Because ACSM attracts expert clinicians, researchers and academicians, we are the only organization in the world that can give you first-hand access to the leading-edge science, clinical advancements, and policy changes that shape your practice.

Leading-edge science? The premise here is that the scientific findings of its academic members will provide guidance to personal trainers in their work. But only to personal trainers who join the organization, as all of the organization’s findings are locked behind a pay-for-access gateway. Does the money charged for basic membership actually provide useful practical knowledge? For a basic membership fee of US$99 per year, you still have to pay $665 more for a year’s access to its science journal through the publisher’s fee-pay system.

A caution here is that we have seen that its scientific recommendations may not be as authoritative as proposed. The difference between the exercise and fluid replacement recommendations (http://journals.lww.com/acsm-msse/Fulltext/2007/02000/Exercise_and_Fluid_Replacement.22.aspx) and the consensus statement on hyponatremia (http://journals.lww.com/cjsportsmed/Fulltext/2015/07000/Statement_of_the_Third_International.2.aspx) are stark. The organization is also demonstrably disconnected from the gym with its sparse guidance on strength training, a primary profit center of any commercial fitness business, promoting eight to ten exercises for eight to twelve repetitions for one set for essentially all non-sport purposes (in ACSMs Guidelines for Exercise Testing and Prescription and http://www.acsm.org/docs/current-comments/strengthpowerandbabyboomer.pdf?sfvrsn=4). The organization does provide some excellent guidelines for clinical screening prior to exercise testing and participation.

With this clear bias toward experimentation and clinical application, and given the lack of attention to the practical aspects of creating fitness in the gym, is it any wonder that while about 6,000 exercise scientists and clinicians attend the ACSM national conference, only about 900 personal trainers attend their personal trainer’s conference?

Given the approximately 450,000 personal trainers in the U.S. and the fact that only a few hundred of them attend the “authoritative” gathering for personal trainers, one has to question if there is, in fact, a bona fide effort by the ACSM to aid in the development of personal trainers toward creating more fit clients. If there was indeed valuable information that created a means of becoming more successful trainers delivered at the conference, would not more than 0.2 percent of personal trainers in the U.S. attend?

The Red-Headed Step Child of Exercise Occupations

One of the largest disconnects from personal trainers is the “Exercise is Medicine®” certification campaign. And yes, the ACSM trademarked the “Exercise is Medicine” name to exclude other groups from using those words in its certification titles, and because there is money to be made.

The proposed intent of the EIM certification is to:

provide exercise professionals with the opportunity to work closely with the medical community and provide numerous additional benefits to the certified professional.

First, how can a certification provide the opportunity to work with the medical community? There is no defined path for this interaction to occur so that such a promise can be delivered. That in itself, is a problem. But let’s dig a little deeper to see who this certification is directed toward.

It is well documented that the ACSM consulted on the District of Columbia bill that placed personal trainers under the supervision of the DC Physical Therapy Board. But that was not the first time that the ACSM approached physical-therapy groups to advance its licensure and Exercise is Medicine agenda.

In 2013, a representative from the ACSM met with the president of the Maryland branch of the American Physical Therapy Association (APTA) and a national board member for the APTA. The discussion centered on raising awareness of the Exercise is Medicine campaign and licensure for clinical exercise physiologists (CEP). The outcome of that meeting was a recommendation from the APTA officers to the ACSM to consider developing a state licensing board under auspices of the Maryland Physical Therapy Licensing Board. The subsequent ACSM legislative committee minutes reporting that meeting recommended “discussion of CEP licensure with APTA on a national level.” In essence, the ACSM seems willing to negotiate for APTA support of licensure for its flagship certified membership, clinical exercise physiologists, despite the apparent requirement to surrender dominion over CEPs to state boards of physical therapy.

So who is the ACSM representing? Who is Exercise is Medicine intended to benefit (other than the sedentary public)? Who can be certified for Exercise is Medicine?

Not personal trainers.

For the majority of personal trainers, this certification is not accessible. It requires both an NCCA accredited certification from one of 12 organizations AND a bachelor’s degree in exercise science, exercise physiology or kinesiology. That blocks over 70 percent of currently practicing trainers from applying for and receiving the credential. It also blocks physical therapists, nurses, occupational therapists, physician assistants and physicians from receiving the credential (as they do not generally have degrees in exercise or kinesiology, nor will they have one of the specified NCCA approved certifications in exercise).

So who, then? Well, it appears that exercise is medicine is targeted at ACSM’s certified exercise physiology members as they have both the NCCA certification and education required.

This is the ACSMs single largest initiative (funded by Coca-Cola) with its own website – http://exerciseismedicine.org/. Of note when the website contents are read is that the proposed recommendations for the public are only in respect to “physical activity” intended to improve health, not programmed exercise training with the intent to improve fitness. Further, the EIM education committee has a stated mission of developing only “medical education.” Again, fitness trainers seem to be omitted from discussions and support.

So it is clear, whether intentional or inadvertent, fitness trainers are not included in ACSM functions, decisions or plans. This begs the question, are personal trainers, specifically those without university degrees, anything more to the ACSM than a revenue stream?

It’s Not All Bad

Even though fitness trainers have been excluded, the fact that a group is attempting to improve medical education in respect to physical activity—and hopefully exercise training—is important. Practicing physicians rarely have any preparation in respect to prescribing exercise to patients. A number of studies have highlighted this problem:

“While 58% of respondents indicated their typical graduate was competent in conducting a patient evaluation for the purpose of approving that patient to begin an exercise program, only 10% said their students could design an exercise prescription. Only 6% of respondents reported that their school provided a core course addressing the American College of Sports Medicine Guidelines for Exercise Testing and Prescription.”

Source: Connaughton AV, et al. Graduating medical students’ exercise prescription competence as perceived by deans and directors of medical education in the United States: implications for Healthy People 2010. Public Health Rep, 2001.

Over half of the physicians trained in the United States in 2013 received no formal education in physical activity and may, therefore, be ill-prepared to assist their patients

Cardinal BJ, et al. If Exercise is Medicine®, Where is Exercise in Medicine? Review of U.S. Medical Education Curricula for Physical Activity-Related Content. J Phys Act Health, 2014.

Further, when asked about their perceived ability to deliver useful physical-activity prescriptions, medical students felt they had:

less than moderate competence at performing several fundamental PA prescription behaviors.

Vallance JK, et al. Medical students’ self-perceived competence and prescription of patient-centered physical activity. Prev Med 48(2):164-6, 2009.

But then the other shoe drops.

If the ACSM is developing a curriculum to prepare physical therapists, nurses, occupational therapists, physician assistants and physicians to deliver exercise prescriptions as stated on the exercise-is-medicine website, where does that leave fitness trainers?

With half their job removed from their remit, what happens to trainer wages? What happens to client fitness progress when defensive medicine and low-to-moderate intensity physical activity become the standards for exercise prescription? What happens when, rather than recommending joining a gym and working with a fitness trainer, it becomes a national initiative to simply walk to get healthy?

We will see very soon as it’s already happening. And its execution, once again, does not include personal trainers.

http://www.acsm.org/about-acsm/surgeon-general’s-call-to-action

About the Author: Lon Kilgore earned a Ph.D. from the Department of Anatomy and Physiology at Kansas State University’s College of Veterinary Medicine. He has competed in weightlifting to the national level since 1972 and coached his first athletes from a garage gym to national-championship event medals in 1974. He has also competed in powerlifting, the first CrossFit Total event, wrestling and rowing. He has worked in the trenches, as a qualified national level coach or scientific consultant with athletes from rank novices to the Olympic elite and as a consultant to fitness businesses. He was co-developer of the Basic Barbell Training and Exercise Science specialty seminars for CrossFit (mid-2000s) and was an all-level certifying instructor for USA Weightlifting for more than a decade. He is a decorated military veteran (sergeant, U.S. Army). His illustration, authorship and co-authorship efforts include several best-selling books and works in numerous research journals. After a 20-year professorial career in higher academia, he currently delivers vocational-education courses through the Kilgore Academy, provides online commentary and analysis of exercise-science papers, and works as a writer and illustrator. His training concepts and fitness standards have been included in textbooks and numerous websites. You can download free PDFs of his exercise performance standards here.

↧

A Real Expert Comments on Fitness Licensure

October 29, 2015, 8:06 am

≫ Next: Trendy Misinformation, by Dr. Lon Kilgore

≪ Previous: Exercise is Medicine and the Trainer, by Dr. Lon Kilgore

Big Soda-funded organizations such as the NSCA and ACSM are lobbying for fitness licensure. Their cartel claims licensure would “enhance consumer protection.”

But how would licensure really affect fitness? Would it help people, or hurt? Let’s see what a real expert says:

Licensing places higher education and apprenticeships requirements to be able to legally work, which disproportionately impacts the poor and minorities …

[If full licensing of trainers is required], and if the market for trainers is similar to many other occupations, the number of trainers will decline, the requirements to become a trainer will increase, access to their services by clients will decline, and prices will go up …

Many occupations see licensing as a way to regulate the appropriate number of practitioners to maintain income and employment.

– Dr. Morris Kleiner

Dr. Kleiner is the Professor of Public Affairs and AFL-CIO chair at the University of Minnesota, research associate with the National Bureau of Economic Research in Cambridge, Massachusetts, and Visiting Scholar in the economic research department at the Federal Reserve Bank of Minneapolis. Kleiner has also worked at Harvard, Princeton, and the London School of Economics.

Kleiner is no knee-jerk conservative. Besides being the AFL-CIO chair at the University of Minnesota, he has supported the expansion of labor unions.

And Kleiner suggests that licensure would make fitness more expensive and less accessible for both trainers and consumers. He’s not alone.

The Bipartisan Consensus on Licensure

George Bernard Shaw once said, “If all economists were laid end to end, they would not reach a conclusion.” Licensure may prove Shaw wrong.

Barack Obama, not known for radical libertarian advocacy, shares Kleiner’s concerns. His 2016 budget allocates $15 million to “reduce occupational licensing barriers that keep people from doing the jobs they have the skills to do by putting in place unnecessary training and high fees.”

On the other side, Milton Friedman has predicted that industry interests will, “inevitably press for the extension of registration to (government) certification, and of certification to licensure.” The fitness industry has confirmed Friedman’s prediction.

ACSM, NSCA, and CREP / USREPS claim concern for the public’s health and wellbeing. And they profess to value academic expertise. So how do we explain their strident disregard for the expert opinion that licensure will limit access to fitness?

Let’s go back to Friedman’s licensure analysis:

The result is invariably control over entry by members of the occupation itself and hence the establishment of a monopoly position.

↧

Trendy Misinformation, by Dr. Lon Kilgore

November 19, 2015, 12:29 pm

≫ Next: ACSM / Coca-Cola Collaboration Refuses to Come Clean

≪ Previous: A Real Expert Comments on Fitness Licensure

Editor’s Note: We are pleased to present this guest post by Dr. Lon Kilgore.

In October of 2015, the American College of Sports Medicine released a report and the attendant press releases regarding their annual survey that putatively identifies the top trends in the fitness industry.

Source: https://www.acsm.org/about-acsm/media-room/news-releases/2015/10/26/annual-survey-reveals-new-1-fitness-trend-in-2016

This year’s top 10 trends as reported by the ACSM are:

Wearable Technology
Body Weight Training
High-Intensity Interval Training (HIIT)
Strength Training
Educated and Experienced Fitness Professionals
Personal Training
Functional Fitness
Fitness Programs for Older Adults
Exercise and Weight Loss
Yoga

But we need to ask—Is this really a list of the top 10 trends in which consumers are interested?

Let’s consider the merit of the ACSM report. The organization goes to great lengths to paint the report as the result of a carefully crafted, scientific investigation, written up for the world to see. However, while the paper is technically a scientific paper, it is grossly misrepresented in accuracy and generalizability—but certified ACSM members can still gain continuing-education credit for reading the ACSM paper, paying a quick $25, and passing an online quiz offered through the International Dance Exercise Association.

Source: http://journals.lww.com/acsm-healthfitness/Fulltext/2015/11000/WORLDWIDE_SURVEY_OF_FITNESS_TRENDS_FOR_2016__10th.5.aspx

A major problem with the survey is the actual survey items included. This was not a consumer-driven survey, rather the staff and editors of ACSM’s “Health & Fitness Journal” made up a list of 40 items they believed were viable trends. There was nothing scientific about the method of item selection. Twenty-five of the items were simply repeats from the previous year’s survey and the other 15 “were some potentially emerging trends identified by the staff and editors.”

… certified ACSM members can still gain continuing-education credit for reading the ACSM paper, paying a quick $25, and passing an online quiz offered through the International Dance Exercise Association.

Who are those staff members and editors? More than 80 of the list of 90 staff and editors are from universities or are hospital based. This biases any selected item to a specific subset of ACSM membership and is not representative of the fitness industry or its consumers. They created a narrow list of survey items reflecting only academic opinion, clinical opinion and the ACSM agenda, which does not produce a valid instrument to capture consumer demand or interest. This restricts and biases results, regardless of whom is surveyed.

And this leads to another major problem, who was surveyed. The survey results are publicized to be applicable worldwide, implying that the results can be generalized to everyone, everywhere. This is a rather large exaggeration.

They sent out invitations to complete the survey to 26,933 ACSM members. There were 2,833 responses from the ACSM membership. They all received a free ACSM book product and a $100 MasterCard gift card for participation. It’s relevant to note that participation was only solicited with ACSM publications, ACSM websites and member emails. There was no effort to solicit input from anyone other than existing ACSM members or ACSM consumers. So approximately 90 percent of the fitness industry was not given an opportunity to participate. Although there were an undisclosed number of international responses to the survey from international ACSM members or ACSM consumers, they represented only 13 of the 196 countries in the world. Thus, the results are truly not representative of the term “worldwide,” and they can only be generalized to ACSM members and ACSM consumers.

So again we can ask—Is this really a list of the top 10 trends of interest to fitness consumers or trainers?

It does not appear to be.

If the ACSM methodology does not deliver a legitimate list of trends, how do we find out what the top trends are?

Well, most people would just Google it. A search trend analysis can provide evidence of what is being searched for by everyone on the Internet. While it’s not Google, another of the major search engine companies has actually done just this. Let’s counterpoint the ACSM trend list against a list generated from actual consumer searches through the Yahoo search engine.

Source: https://www.yahoo.com/health/the-10-hottest-exercise-classes-right-1298600353529910.html

According to the number of searches for exercise and fitness topics, the top trends are:

CrossFit
Zumba
Pilates
P90X
Bikram (hot) Yoga
Circuit Training
Kickboxing
TRX Suspension Training
Vinyasa Yoga
Insanity Workout

How could there be such a discrepancy between the ACSM’s list and Yahoo’s list?

Why wouldn’t there be? The ACSM survey assessed a very restricted and exclusive data set derived from and delivered to a very small sample population with a very specific organizational allegiance. The Yahoo list derived from the totality of searches conducted for relevant key words or phrases. It is inclusive and unrestricted.

Interestingly, if the ACSM is attempting to provide its members a heads up on what sells and what types of training they might want to learn to teach and sell, their list fails. With the exception of yoga, the ACSM list does not share anything that could aid in leveraging customer desires, as indicated by the Yahoo list, into delivery of desired systems of exercise to clients.

This might lead one to ask—Is the ACSM actually cognizant of the business of fitness and the needs of their commercial members?

Image by Dr. Lon Kilgore.

About the Author:
Lon Kilgore earned a Ph.D. from the Department of Anatomy and Physiology at Kansas State University’s College of Veterinary Medicine. He has competed in weightlifting to the national level since 1972 and coached his first athletes from a garage gym to national-championship event medals in 1974. He has also competed in powerlifting, the first CrossFit Total event, wrestling and rowing. He has worked in the trenches, as a qualified national level coach or scientific consultant with athletes from rank novices to the Olympic elite and as a consultant to fitness businesses. He was co-developer of the Basic Barbell Training and Exercise Science specialty seminars for CrossFit (mid-2000s) and was an all-level certifying instructor for USA Weightlifting for more than a decade. He is a decorated military veteran (sergeant, U.S. Army). His illustration, authorship and co-authorship efforts include several best-selling books and works in numerous research journals. After a 20-year professorial career in higher academia, he currently delivers vocational-education courses through the Kilgore Academy, provides online commentary and analysis of exercise-science papers, and works as a writer and illustrator. His training concepts and fitness standards have been included in textbooks and numerous websites. You can download free PDFs of his exercise performance standards here.

↧

ACSM / Coca-Cola Collaboration Refuses to Come Clean

November 30, 2015, 1:47 pm

≫ Next: Reporting Exercise Effects Without Actually Measuring the Exercise?

≪ Previous: Trendy Misinformation, by Dr. Lon Kilgore

The ACSM / Coca-Cola collaboration known as the Global Energy Balance Network (GEBN) has suffered several serious setbacks. The University of Colorado, home to GEBN co-founder James Hill, returned a $1 million grant to Coca-Cola.

Coca-Cola Vice President Rhona Applebaum has resigned. Applebaum was Coca-Cola’s Chief Science and Health Officer. Coca-Cola won’t replace her. And now Coca-Cola has announced that it will not longer work with the GEBN.

To make matters worse, Candice Choi at the Associated Press has obtained internal emails between GEBN officials and Coca-Cola. While GEBN claimed that Coca-Cola didn’t influence the GEBN, these emails show that Ms. Applebaum had a significant role in directing the network. Choi discovered that, “Coke helped pick the group’s leaders, edited its mission statement and suggested articles and videos for its website.”

Will the GEBN Ever Come Clean?

Perhaps the GEBN’s only hope now is to come clean and apologize for misleading the public. Instead, the GEBN is doubling down on deception.

GEBN co-founder Gregory Hand is the Dean at the West Virginia University School of Public Health, and a Fellow of the ACSM. Hand has stated that, “While I still am involved in discussions with the network about its future, there is no GEBN money at WVU.” Perhaps this is true, but one may hesitate to take the GEBN at its word.

One example of Coca-Cola’s “partnership” with West Virginia University: http://wvucard.wvu.edu/cokepromotion

Hand continued, stating that,

The only Coke funding that flows to WVU is a small subcontract with South Carolina for consultation and data analysis on the research projects that were funded by Coca-Cola.

It doesn’t take much digging to disprove the ACSM fellow’s assertion. Coca-Cola’s misnamed “Transparency” database shows two direct Coca-Cola donations to WVU. These donations do not mention the University of South Carolina, consultation, or data analysis:

http://transparency.coca-colacompany.com/transparency-search?keyword=%22west+virginia+university%22&type=&year=#TCCC

Coca-Cola has paid at least $14,000 to WVU this year, including one grant specifically to Hand’s school, the WVU College of Public Health. In his role as dean, did Hand simply not notice the Coca-Cola funding his school received this year?

As we’ve covered, Coca-Cola’s “Transparency” website only gives a glimpse at Coke’s academic influence. WVU exemplifies this; not listed on the Coca-Cola “Transparency” database is WVU’s “partnership” with Coca-Cola, continuous since 2002.

Source: http://wvutoday.wvu.edu/n/2012/02/27/wvu-and-coca-cola-expand-partnership-through-2017

This pouring rights agreement gives Coca-Cola “exclusive availability for Coca-Cola products across all WVU’s campuses and athletic facilities.” In return Coca-Cola is paying “$50,000 to WVU over the next five years for a University sustainability program.” Furthermore, Coca-Cola is dedicating “$600,000 over the same time period to WVU’s general scholarship fund.”

With fewer than 15 minutes of research, we’ve discovered at least $664,000 in direct Coca-Cola grants to WVU. And none of this funding mentioned anything about the University of South Carolina. It remains unclear whether GEBN co-founder Gregory Hand deliberately misled the press about his school’s Coca-Cola funding, or if he was simply ignorant.

Source: http://publichealth.hsc.wvu.edu/personnel/leadership/?UserID=41687

↧

Reporting Exercise Effects Without Actually Measuring the Exercise?

December 2, 2015, 11:49 am

≫ Next: “Global Energy Balance Network” is Dead: “Exercise is Medicine,” You’re Next.

≪ Previous: ACSM / Coca-Cola Collaboration Refuses to Come Clean

Editor’s Note: We are pleased to present this guest post by Dr. Lon Kilgore.

In a recent paper published in the Journal of Human Kinetics, a multi-university group of academics attempted to compare the levels of antioxidants in plasma following 20 minutes of treadmill running at a submaximal exercise intensity and a maximal effort at the CrossFit workout Cindy. There was no hypothesis forwarded, it was a straightforward descriptive study so no presumptions for direction of any measured changes should be apparent or implied.

While this is an interesting, but not an innovative, idea—to describe a potentially different outcome between a submaximal and maximal exercise protocol—there are a number of misunderstandings and misstatements littered throughout the paper.

The first is an assumption that larger levels of oxidative stress induced by more intense exercise is harmful. The authors posit that monitoring “internal environmental stress fluctuation” would enable determination of harm or benefit. There is no existing data demonstrating a dose-response for exercise-oxidative stress indicative that exercise-induced oxidative stress is any more than a transient disruption to homeostasis that drives adaptation and fitness improvement. They attempt to use two papers by Alessio and Hagerman (2006) and Powers and Jackson (2008) to support their contention of oxidative harm. However, reduced performance and delayed post-workout recovery are markers of disruption of homeostasis—needed to drive adaptation—not evidence of harm.

They further suggest that as CrossFit training does not utilize programmed rest periods, oxidative stress will likely increase. Interestingly, the modality chosen for comparison, running at 90 percent HR_max for 20 minutes, does not utilize rest intervals. This makes the rationale for explaining why CrossFit might increase oxidative stress (no programmed rest) more relevant to the treadmill protocol.

Source: http://games.crossfit.com/workouts/regionals

The CrossFit workout Cindy was described as having a light load and moderate time requirement. The authors completely misunderstand that Cindy is a MAXIMAL workload. They do describe the workout as the maximum rounds of 5 pull-ups, 10 push-ups and 15 squats in 20 minutes, but they fail to appreciate that the amount of work completed in the 20 minutes represents a physiologically maximal workload. It is anything but a light load. If there is a rationale for expecting increased oxidative stress from CrossFit, it is because of the high work outputs compared to submaximal treadmill running. With this said, the researchers did not provide any data on how many rounds of Cindy the subjects accomplished and there was no data on how far the subjects ran on the treadmill, making any conclusion(s) made specious.

It is essential in exercise studies to provide concrete measures of work output in order to enable valid comparisons and conclusions. Why weren’t the number of Cindy rounds reported? Why weren’t the treadmill distances reported? Cindy can produce a tremendous spread of results among individuals, from the pull-up limited person struggling to get more than a half-dozen rounds completed up to the incredibly fit person who works non-stop to approach 30 rounds. The VO_2max data reported on the subjects, 44ml/kg/min or approximately average for young adult males, suggests that the subjects were likely to have completed fewer rounds with many breaks. As part of the basis of the experiment was an assumption that the non-programmed rests in a CrossFit workout makes it more likely to produce oxidative stress; quantifying the number and durations of rest were essential but omitted.

The paper here depended on indirect estimates of exercise intensity, heart rate and rating of perceived exertion, which weakens the paper. How can we know anything about an acute exercise response if we know nothing about the actual exercises used?

Another design flaw was that the interim number of days between sessions was hugely variant. Some subjects came in for subsequent sessions at 72 hours, some came in one week after the previous session. Human research is notoriously difficult as subjects often may not comply with instructions and the researcher has to adapt on the fly. Regardless, the temporal variability in treatment application may have affected the results.

Data That Beats Around the Bush

As for the data that was actually reported, heart rate was consistently higher across all time points for the CrossFit workout compared to treadmill running. This is not surprising as it is a comparison of a maximal-work-output session to a submaximal-work-output session. Also unsurprising was the rating of perceived exertion data. The subjects felt they were working harder during the CrossFit workout compared to treadmill running.

As for oxidative stress data, while some values indicated more oxidative stress after Cindy, it appears that there was not a statistical difference. Although flaws in design may have masked or spuriously affected the outcomes here, the data is the data.

So, in the results section we are told that exercise intensity, as indicated by heart rates and ratings of perceived exertion, are significantly different between the two different workouts, but that the oxidative stress response are statistically similar. Fair enough, even with significant design limitations we have learned something, albeit very little.

But Then Something Weird Happens

Curiously, the authors pen some very creative prose in the discussion that seems to—well, actually does—conflict with the data they produced.

Despite being significantly different between the two exercise conditions, the authors say that the workouts were “normalized for time and HR intensity.” Their meaning here seems to be that they controlled exercise intensity by actively controlling the heart rates of the subjects—apparently they are saying they modulated work done to generate identical heart rates in both workouts? This is absolutely not the case as only the treadmill running incline was modulated to control heart rate. There were no such controls in the CrossFit workout. Further, a case cannot be made that heart rates were the same, their own results section demonstrates this, and by convention the higher heart rate indicates a higher intensity.

This difference in intensity—as they define intensity—negates a substantial portion of their discussion where the authors attempt to align their data to previous works showing that oxidative stress is responsive to differences in intensity. As there were no differences noted in this study, the authors grasp at a straw to make their paper align with others, suggesting that since both the heart rate for Cindy and for treadmill running met the ACSM criteria for “vigorous exercise,” they were de facto the same. This is a rather empty argument not supported by data or physiological fact. Making such a statement is made even more difficult by the RPE data demonstrating a difference in intensity.

Why this argument is made and why the data produced was discounted in the discussion is perplexing. For what reason would a group of researchers go to such great lengths to demonstrate (unsuccessfully) that CrossFit training is physiologically the same as submaximal running on a treadmill?

– – –

Lon Kilgore earned a Ph.D. from the Department of Anatomy and Physiology at Kansas State University’s College of Veterinary Medicine. He has competed in weightlifting to the national level since 1972 and coached his first athletes from a garage gym to national-championship event medals in 1974. He has also competed in powerlifting, the first CrossFit Total event, wrestling and rowing. He has worked in the trenches, as a qualified national level coach or scientific consultant with athletes from rank novices to the Olympic elite and as a consultant to fitness businesses. He was co-developer of the Basic Barbell Training and Exercise Science specialty seminars for CrossFit (mid-2000s) and was an all-level certifying instructor for USA Weightlifting for more than a decade. He is a decorated military veteran (sergeant, U.S. Army). His illustration, authorship and co-authorship efforts include several best-selling books and works in numerous research journals. After a 20-year professorial career in higher academia, he currently delivers vocational-education courses through the Kilgore Academy, provides online commentary and analysis of exercise-science papers, and works as a writer and illustrator. His training concepts and fitness standards have been included in textbooks and numerous websites. You can download free PDFs of his exercise performance standards here.

↧

“Global Energy Balance Network” is Dead: “Exercise is Medicine,” You’re Next.

December 2, 2015, 1:19 pm

≫ Next: Confesiones de Hidratación de Gatorade

≪ Previous: Reporting Exercise Effects Without Actually Measuring the Exercise?

http://www.experiencelife.com/article/decoding-health-media/

In July of 2015, CrossFit CEO and Founder Greg Glassman fixed his sights on the Global Energy Balance Network (GEBN). In less that 140 characters he accurately identified the organization for the soda-funded marketing tool that it was.

@CrossFitCEO: “.@CocaCola‘s @gebnetwk trolls for “scientists” to make a case for hiding metabolic syndrome w/ exercise. Watch @ACSMNews suck the soda tit!”

His observation soon made headlines, and Coke was quickly scrambling to explain its large-scale funding of health professionals and organizations. On the 30th of November, Russ Greene published an article covering the damning internal emails between GEBN and Coke officials. He wrote, “[T]he GEBN’s only hope now is to come clean and apologize for misleading the public.” Perhaps realizing what this would do to the careers of those involved, the GEBN has taken a different strategy: Fold.

A few hours later, the GEBN website published the following statement:

“Effective immediately, GEBN is discontinuing operations due to resource limitations. We appreciate the commitment to energy balance that the membership has demonstrated since our inception, and encourage members to continue pursuing the mission ‘to connect and engage multi-disciplinary scientists and other experts around the globe dedicated to applying and advancing the science of energy balance to achieve healthier living’.”

It seems that without Coca-Cola money, GEBN was dead in the water. The story has quickly spread through the mainstream media, but current reports lack clarity on a single issue: the involvement of the American College of Sports Medicine (ACSM).

Despite the ACSM’s public attempt to distance itself from the GEBN, their relationship has not gone unnoticed to CrossFit. In previous articles, we have exposed the detailed relationships between the two organizations. GEBN Co-founder Steven Blair is a former ACSM president and co-founders Gregory A. Hand and James O. Hill both presented alongside Steven Blair in a symposium titled “The Science of Energy Balance: A Model for Weight Management Intervention” during the 2014 ACSM annual meeting (over six months before the GEBN was formed).

Our Next Target: The ACSM’s “Exercise is Medicine”

Now that the GEBN is dead, we need to turn our attention to its counterpart: “Exercise is Medicine.” Exercise is Medicine (EIM) is an ACSM initiative that aims to build “partnership between healthcare leaders and community stakeholders building a ‘bridge of trust’ for the coordinated care of at-risk population groups.”

EIM is funded by Coca-Cola, who is presumably one of the “community stakeholders” refered to above. Coca-Cola has also identified Robert Sallis, the chairman of EIM and former ACSM president, as a recipient of Coke funding.

Coca-Cola’s Beverage Institute for Health and Wellness (likened to a “Jack Daniel’s School for Safe Driving” by Greg Glassman) even offers a free Exercise is Medicine webinar presented by Sallis. Not surprisingly, the presentation identifies “physical inactivity” (not sugar consumption) as “THE major health problem for our time.” Note that this is the same position taken by the now-defunct GEBN.

“Exercise is Medicine” represents the same ACSM leadership, the same perversion of health science, and the same Coca-Cola funding as the Global Energy Balance Network the ACSM has attempted to distance itself from. “Exercise is Medicine” is nothing but a soda-funded charade designed to confuse the public about the relationship between sugar consumption and chronic disease, and we are coming for them next.

↧

Confesiones de Hidratación de Gatorade

December 8, 2015, 8:01 am

≫ Next: ACSM and CREP Backtrack from State Fitness Licensure

≪ Previous: “Global Energy Balance Network” is Dead: “Exercise is Medicine,” You’re Next.

Originally published in English on May 4th, 2015.

Translated by CrossFit L1 Staff member Gabriel García Merlos

CrossFit Inc. y el Dr. Tim Noakes han actuado sobre Gatorade y sus socios en ciencia del ejercicio. El tema: Hidratación.

Crossfit recibió una conferencia internacional sobre Hyponatremia Asociada al Ejercicio. Noakes fue de la mano con el porta voz de Gatorade y aun publico la historia de la creación de la hyponatremia asociada al ejercicio (EAH ocurre cuando el atleta bebe demasiado durante el ejercicio y diluye el sodio en su sangre por debajo de niveles saludables).

En Jornalista astuto podría construir una carrera descubriendo la magnitud completa del fraude financiado de Gatorade, y la consecuente matanza. Contáctanos y nosotros facilitaremos esto.

Aún así, los dos puntos principales de CrossFit Inc. son francos y fácilmente documentados:

1. La Ciencia Corrupta de Gatorade

La participación de Gatorade en la ciencia del ejercicio ha torcido las investigaciones científicas para vender más producto.

2. Mantente seguro: Bebe cuando tengas Sed

En lugar de seguir sugerencias extremas de hidratación como las del American College of Sports Medicine’s “ la máxima cantidad que puede ser tolerada,” o la de Gatorade “al menos 40oz. De fluido por hora,” etc., los atletas solo deberían beber AD libitum, o cuando ellos sienten la necesidad. Los humanos poseen un mecanismo efectivo para prevenir la sobre-hidratación y severa deshidratación: La Sed.

Después de al menos 17 evitables muertes, oficiales de ambos Gatorade y el American College of Sports Medicine (ACSM) finalmente han confesado en ambos puntos.

For four decades Gatorade spent billions telling consumers to drink more than is necessary, or safe.

¿Qué les tomo tanto?

Hizo falta una generación para que Gatorade y sus socios en ciencia del ejercicio retractarse completamente de sus extremas recomendaciones de hidratación. Aunque 17+ atletas murieron de hyper-hidratación, Gatorade y sus socios resistieron el confesar que beber cuando se siente sed era la forma segura de proceder.

La oposición hacia CrossFit y Noakes fue formidable. Gatorade genera un ingreso para PepsiCo por sobre los $4 billones (miles de millones) al año. Gatorade envía algo de esas utilidades a sus socios en ciencia del ejercicio: la National Strength an Conditioning Association (Asociación Nacional de Fuerza y Acondicionamiento), El American College of Sports Medicine (Colegio Americano de Medicina en el Deporte), y la National Trainers’s Association (Asociación Nacional de Entrenadores).

Gatorade utiliza sus palancas con el ACSM y la NSCA para influenciar las practicas sobre hidratación de entrenadores’ y atletas’. Gatorade y su dueño PepsiCo son un cuanto abiertos acerca de esto. Observa el rol de Gatorade por su posición mercadologica en PepsiCo:

Liderar toda estrategia y ejecución contra la audiencia emergente de entrenadores de fuerza, identificando formas de educar y para que Gatorade agregue valor a este grupo con importante influencia. Liderar sociedades y activaciones con el CSCCa y NSCA en colaboración con mercadotecnia en el deporte…Trabajar de cerca con el equipo de mercadotecnia del GSSI en estrategia y ejecución para los que influyen en la ciencia y su transición a grupos practicantes. Colaborar en los esfuerzos con organizaciones socias claves y en conferencias claves incluyendo el ACSM,ECSS y el GSSI XP.

El entrante presidente de la ACSM Larry Armstrong admitió al Wall Street Journal que la financiación de Gatorade “si afecta la objetividad.” Si le importa algo la objetividad científica, Armstrong debe utilizar su autoridad en el ACSM para remover el impacto corrosivo de Gatorade. El no debe solo terminar la sociedad de Gatorade con el ACSM, sino también prohibir a todos sus miembros de aceptar los dólares de Gatorade.

Gatorade por fin adoptó la ciencia de CrossFit y Noakes:

El verano pasado, tres jugadores de Football de secundaria murieron: William Shogran, Zyrees Oliver, and Walker Wilbanks. Al menos dos de ellos murieron de beber demasiado Gatorade y agua. Esta primavera, Gatorade ofreció un Webinar (Seminario Web) en Football Americano que cambió radicalmente la posición de Gatorade en cuanto a la hidratación. El Webinar de Gatorade llevó las políticas de hidratación de Gatorade mucho más en línea con las directrices basadas en ciencia de CrossFit y el Dr. Noake. Puedes ver el segmento de hidratación comenzando al 42:46 aquí. Un transcrito está disponible aquí. Y puedes leer un artículo en este tema aquí.

El Football Webinar de Gatorade recomendó que los atletas “minimicen los fluidos al tomar ad libitum durante la actividad y remplazando el restante de pérdida de líquido después de la actividad.”

Ad Libitum significa “a voluntad.” En otras palabras, Gatorade advierte a los atletas ejercitándose a beber solo, y solo, si ellos sienten ganas de hacerlo.

¿Por qué el cambio? Gatorade ahora advirtiendo que “tomar mucho fluido” causa Hyponatremia, una condición que “ puede llevar a la muerte.”

Drinking to Thirst
Traditionally hydration scientists have used “ad libitum” and “to thirst” as synonyms. Like Dr. Noakes and CrossFit Inc. Gatorade now recommends that athletes “drink to thirst to minimize the risk of over-drinking.” That is, unless they track their exact sweat rate, urination rate (enjoy!), and (one presumes) their fluid intake rate during exercise. Drinking to thirst means most athletes won’t replace all fluids lost during exercise. No problem; they can make them up when they finish training. In Gatorade’s words,

Beber cuando tengas Sed.

Tradicionalmente los científicos de la hidratación han utilizado “AD libitum” y “cuando sienta sed” como sinónimos. Como el Dr. Noakes y CrossFit Inc. Gatorade ahora recomienda al atleta a “beber cuando tenga sed para minimizar el riesgo de beber de más.” Eso es, al menos que sigan un registro exacto de su tasa de sudoración, tasa de orina (¡disfruta esto!), y (uno presume) su tasa de ingesta de fluido durante el ejercicio. Beber al sentir sed significa que la mayoría de los atletas no recuperarán todos los fluidos durante el ejercicio. No hay problema; pueden hacerlos subir cuando terminen de entrenar. En palabras de Gatorade,

la Sed es una gran guía para que una persona tenga una indicación general de su estatus de hidratación.Definitivamente queremos educar en que la sed puede ser un gran indicador por que si un atleta esta sediento en un campo de football esa es una gran pista de que ellos necesitan, ellos necesitan fluido. Y siendo honesto, durante la actividad, por que no tenemos gran tecnología que aun la gente esta intentando desarrollar, no tenemos una forma de evaluar el estatus de hidratación durante la actividad mientras ellos están usando todo su equipo en el campo de juego por que ellos no van a chequear su estatus de orina, no tenemos la habilidad de pesarlos durante la práctica. Entonces, la sed puede ser en tiempo real, puede ser un indicador de ayuda para alguien. Queremos combinar eso con el tener a las personas sabiendo acerca de sus necesidades de hidratación por que si están de forma consistente perdiendo 2litros por hora, eso les pasa en cada practica durante el ejercicio intenso en el calor, y la práctica es de 3 horas de duración, tenemos una muy buena idea de que ellos van a perder 6 litros. Entonces tal vez queramos intentar recuperar 4 litros de forma que ellos caminen fuera del campo con probablemente solo 3 o 4% de deshidratación en lugar de estar deshidratados 7 u 8 %.

¿Pero que hay acerca de las enfermedades por el calor? ¿Acaso los golpes de calor no son causados por deshidratación? No. Los oficiales de Gatorade aun confesaron, “la evidencia no ha mostrado”que la deshidratación “ pueda incrementar el riesgo por el esfuerzo en enfermedades debido al calor.”

Conoce tus necesidades individuales de fluido basado en la tasa de sudoración.
Consume fluidos basado en la tasa de sudoración durante el ejercicio.
Come una dieta normal con una ingesta adecuada de sodio.
Si pierdes sodio excesivamente en el sudor (líneas blancas en tu cara/ropa) incluye sodio en tus practicas de hidratación.
Durante ejercicio intenso en el calor o practicas con duración mayor de 60 min, consume una bebida además de agua que contenga carbohidratos/electrolitos.
Si no conoces tu tasa de sudoración, debes beber cuando sientas sed para minimizar el riesgo de beber de más.
Educación en el riesgo de Hyponatremia y como prevenirla.

Tabla 3: Consejos para evitar Hyponatremia

Expiación (Desagravio)

Gatorade salió limpio en el 2003, Walker Wilbanks, Zyrees Oliver, Patrick Allen, y otras víctimas de sobre-hidratación podrían haber sobrevivido. Y así, las confesiones de Gatorade en el 2015 no son suficientes para hacer las cosas bien. Un webinar privado y un artículo que lo acompañe no pueden deshacer el efecto de un sin número de carteles publicitarios y anuncios en revistas. Y no pueden regresarle a los Olivers, Wilbanks y Allens a sus hijos.

Zyrees Oliver as a baby. He went on to captain the football team, earn a 3.8 GPA, and die from excessive Gatorade/water.

Zyrees Oliver as a baby. He went on to captain the football team, earn a 3.8 GPA, and die from drinking excessive Gatorade and water.

(Zyrees Oliver cuando era un bebe. El era el capitán del equipo de football, consiguió 3.8 GPA, y murió por el consumo excesivo de Gatorade y agua.)

Gatorade gasto cuatro décadas y billones (miles de millones) de dólares confundiendo atletas y entrenadores sobre la nutrición. Tomará al menos varios años y cientos de millones de dólares para que Gatorade corrija el registro. Esto es probablemente fantasía. Es difícil imaginar a Gatorade y PepsiCo voluntariamente gastando millones de dólares para vender menos producto. Y por eso, volvemos a mencionar la declaración del Fundador de CrossFit Inc. Greg Glassman en el 2014, “ es tiempo de sacar a la gran soda del Fitness y por extensión, de la ciencias de la salud.”

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ACSM and CREP Backtrack from State Fitness Licensure

December 18, 2015, 1:33 pm

≫ Next: Isadore Hall: The Alcohol, Tobacco and Soda Candidate

≪ Previous: Confesiones de Hidratación de Gatorade

The American College of Sports Medicine (ACSM) sent the following email today. First, a caution: it’s wise to regard ACSM’s statements skeptically. ACSM claims it never advocated for fitness trainer licensure. This claim is hard to square with several facts. For example, ACSM is a member of the Coalition for the Registration of Exercise Professionals (CREP) – an organization that advocated for fitness trainer licensure.

Nonetheless, if ACSM and CREP are truly giving up on fitness trainer licensure, that is good news for CrossFit affiliates and the fitness industry. There is less of a risk of additional fitness licensure bills popping up at the state level.

Now, the focus turns to chronic disease. We will make sure that ACSM and Coca-Cola don’t acquire a legal monopoly on treating and preventing chronic disease through their Exercise is Medicine program.

ACSM does not support state licensure of all fitness professionals; CREP coalition revises its position

Due to its dissenting position on the issue of licensure, the American College of Sports Medicine last week led an effort that resulted in the Coalition for the Registration of Exercise Professionals® (CREP®) reconsidering its pursuit of state licensure for all fitness professionals. Although a long-standing member of CREP, ACSM has never supported licensure for all exercise professionals, a position that was inconsistent with other CREP board members until now. After a thoughtful discussion at its recent board of directors meeting, CREP agreed to drop its support and advocacy for licensure at all levels.

“There has been some confusion in the marketplace regarding the issue of licensure, especially as it relates to ACSM’s and CREP’s respective positions,” said Richard Cotton, ACSM’s national director of certification. To be clear, ACSM has never supported licensure for all exercise professionals, while CREP as a whole felt it was something worth considering. The other board members knew of ACSM’s dissenting opinion and were willing to dialogue about what’s best for the profession and clients. I’m grateful for the collaborative work that brought us to a good place.”

ACSM has never supported licensure for all exercise professionals because of the growing scientific evidence about the safety of exercise for healthy populations, resulting rising costs, decreases in practitioners, disruption of businesses and overall lack of compelling rationale. CREP is a consortium of seven certifying organizations that started with a focus on a registry of exercise professionals but, over time, expanded to licensure and occupational regulation- a positon that was not consistent with that of ACSM’s.

While ACSM does not support licensure for every exercise professional, it does support licensure for a select group of exercise professionals that meets all of the following criteria:

Work with patients and clients with medical conditions that require minimal to advanced clinical support
Have earned at least a bachelor’s degree in exercise science
Have a related, accredited certification.

ACSM takes this position to ensure that exercise professionals are appropriately qualified when working with patients in a clinical setting. ACSM does not support licensure for personal trainers working with apparently healthy clients in nonclinical/community settings, such as commercial fitness facilities, YMCAs, etc.

ACSM also provides resources that help employers of fitness centers, wellness centers, worksite health promotion programs and hospitals determine their own hiring criteria for the various exercise professional positions that they have available.

For more information about ACSM’s position, go HERE.

401 W. Michigan St., Indianapolis, IN 46202

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Isadore Hall: The Alcohol, Tobacco and Soda Candidate

January 5, 2016, 9:01 am

≫ Next: The Coca-Cola / ACSM “Exercise is Medicine” Scheme

≪ Previous: ACSM and CREP Backtrack from State Fitness Licensure

CrossFit Inc. thinks soda should come with warning labels, but Pepsi-funded politician Isadore Hall stands in the way. If passed, California Senate Bill 203, the Sugar-Sweetened Beverages Safety Warning Label Act, would require the following label on sugary drinks:

“STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.”

To support the bill, please visit http://crushbigsoda.com/. On a tour to rally support for the bill, Coach Glassman outlined three reasons soda should come with a warning label:

1. Toxicity: Soda significantly increases the risk of obesity, diabetes, heart disease and tooth decay.
2. Corruption: Big Soda funds and distorts scientific research.
3. Targeting CrossFit affiliates: Big Soda funds the ACSM and NSCA, the organizations that have lobbied for licensure bills that would criminalize most CrossFit affiliates.

The LA Times covered CrossFit’s campaign: http://www.latimes.com/health/la-he-0102-crossfit-20160102-column.html

Most Californians agree: Polling shows 74 percent support warning labels on sugary drinks. Until now, though, the California State Senate’s Health Committee has ignored its constituents’ concerns. In 2015, the bill fell one vote short of passing the Health Committee.

Isadore Halls’ No-Shows

Hall finds it easier to show up at concerts and sporting events than scheduled meetings: http://www4.pictures.zimbio.com/gi/140th+Kentucky+Derby+Arrivals+peWY2aKArUkl.jpg

Isadore Hall finds it easier to show up at concerts and sporting events than scheduled meetings: http://www4.pictures.zimbio.com/gi/140th+Kentucky+Derby+Arrivals+peWY2aKArUkl.jpg

Last year, Health Committee member Isadore Hall didn’t bother to cast a vote on soda warning labels. Hall and three other committee members abstained. This is a pattern of behavior for Hall. When the LA Times asked him for a comment on CrossFit’s efforts, he refused to state his position.

Glassman scheduled a December 2015 meeting with Hall to discuss the bill. Hall committed, but then canceled. When they rescheduled, Glassman flew to Los Angeles to make the meeting. Hall bailed again. That is, he twice avoided discussing a topic that directly concerns his constituents; Hall’s district contains 18 CrossFit affiliates and his county is home to over a half million diabetics.

On at least four consecutive occasions the state senator has refused to take a stance on soda warning labels. What is Hall hiding?

In the original, unedited story that reporter Roy Wallack submitted to the LA Times, Glassman explained Hall’s absenteeism on soda. Specifically, he predicted that it was due to Hall’s relationship with soda companies:

“I don’t think he had a choice … Hall’s stuck. He picked his allies early. Well, now I go to Plan B: Support his opponent in his campaign for Congress. His district is 70% Latino, and I’ll back his Latina opponent in the Democratic primary, Nanette Barragan [mayor pro-tem of Hermosa Beach], who is making ‘health inequity’ —unequal health care for minorities — a key issue. I’ll throw $5 million into his face. I’ll have people dig into his finances — and expect to see lots from the ABA.”

The LA Times editor deleted this quote before the story ran, but it does look like Glassman was onto something.

Isadore Hall’s Beverage Industry Dollars

DigitalDemocracy.org has tracked Hall’s campaign funding. We’ve narrowed the list down to beverage companies. (Some seem alcohol-focused, but many also sell sugar-sweetened beverages, such as Pacific Beverage.)

2007-2008:
$3497 from Pepsico Inc.
$3500 from California Beer & Beverage Distributors Community Affairs

2009-2010
$4978 from Pepsico Inc.
$5195 from California Beer & Beverage Distributors Community Affairs
$1000 from California/Nevada Soft Drink Association PAC

2011-2012
$3514 from Pepsico Inc.
$7800 from California Beer & Beverage Distributors Community Affairs
$3900 from Allied Beverages Inc.
$3000 from Ace Beverage Co.
$2800 from Pacific Beverage
$1000 from Mission Beverage Co.

2013-2014
$4916 from Pepsico Inc.
$12300 from California Beer & Beverage Distributors Community Affairs
$4000 Pacific Beverage
$3000 Ace Beverage Co.
$1324 Pepsico Incorporated and Affiliated Entities
$1000 Mission Beverage Co.

The beverage industry has given Senator Hall at least $66,724 reasons to go soft on soda.

Hall is also close with tobacco and alcohol companies. According to the Sacramento Bee, Hall “has the distinction of accepting more tobacco money than all but one other Democratic legislator since 2009.” And Hall has taken more than $100,000 from alcohol companies since 2013, the highest number for any Californian legislator.

Like Big Soda, Big Tobacco has gotten its money’s worth from Hall. The Bee reports “many of the most significant anti-smoking measures died or were watered down in the influential committee Hall oversees.” True to form, Hall declined to comment.

CrossFit Opposes Hall’s Congressional Campaign

Hall is running to represent California’s 44th district in the US Congress. CrossFit strenuously opposes Hall’s nomination. The reason is simple; CrossFit believes that Hall is not fit for public office. California doesn’t need another congressman in the pockets of alcohol, tobacco and soda.

Opposing Hall is fellow Democrat Nanette Barragan. The 44th district is “solidly Democratic.” Hence, whoever wins the Democratic nomination will likely go on to win the general election. CrossFit Founder and CEO Greg Glassman has spoken to Barragan and expressed his support to her campaign.

Barragan and Hall: http://www.latimes.com/local/political/la-me-pc-barragan-and-hall-20150820-photo.html

Barragan is running against Hall: http://www.latimes.com/local/political/la-me-pc-barragan-and-hall-20150820-photo.html

While Hall has attacked Barragan for her legitimate success as an attorney, the real scandal is Hall’s less reputable revenue from the alcohol, tobacco and soda industries. That’s not to mention the profligate campaign spending Hall’s industry cronies have enabled.

http://www.laweekly.com/news/assemblyman-isadore-hall-spent-campaign-funds-at-a-strip-club-in-las-vegas-5108229

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The Coca-Cola / ACSM “Exercise is Medicine” Scheme

January 12, 2016, 1:45 pm

≫ Next: “Exercise is Medicine” Explained in 100 Words

≪ Previous: Isadore Hall: The Alcohol, Tobacco and Soda Candidate

Source: http://www.coca-colajourney.co.nz/stories/exercise-is-medicine-the-best-prescription-to-advance-health

In 2015, CrossFit Founder and CEO Greg Glassman spoke out against the twin scourges of fitness: chronic soda consumption and fitness licensure bills. These issues are closely related; the revenues from the former fund the organizations that lobbied for the latter.

In his speeches on both topics, Glassman addressed the Coca-Cola / ACSM initiative Exercise is Medicine, predicting that,

When “Exercise is Medicine,” according to Coca-Cola, then what CrossFit is will be nothing short of medical malpractice.

“Exercise is Medicine” Explained in 100 Words

Exercise is Medicine is a Coca-Cola-founded plan to implement the Global Energy Balance Network concept by Obamacare mandate, and to require other people to pay for it. Exercise is Medicine serves the joint interests of Coca-Cola and the American College of Sports Medicine. It helps Coca-Cola fight against soda regulation, combat the idea that soda has contributed to the global epidemics of diabetes and obesity, and blame physical inactivity and soda taxes instead. As for the ACSM, it plans to get physicians to refer clients to ACSM-credentialed trainers and mandate full insurance coverage for this training while excluding CrossFit-credentialed trainers.

What follows is a detailed explanation of each concept above.

Exercise is Medicine: The End Goal

Source: http://www.exerciseismedicine.org/assets/page_documents/EIM%20Public%20Presentation_2015_03_20.pptx

EIM’s “end goal” is that:

No patient should leave a physician’s practice without:
An assessment of their current physical activity levels – and –
A physical activity prescription and referral to qualified resources for further counseling

EIM instructs physicians to administer “referrals to qualified physical activity (PA) programs delivered by credentialed EIM Professionals at EIM recognized places.”

Only one body offers the Exercise is Medicine credential: the American College of Sports Medicine. Like its licensure scheme, ACSM’s EIM credential only accepts NCCA-accredited certifications as a prerequisite for the EIM credential, so that excludes CrossFit’s ANSI-accredited L3 certification.

But the EIM plan goes beyond credentials. They mention EIM-branded “programs” and even EIM gyms. It may be strange to think of a gym chain brought to you by a Coca-Cola / ACSM partnership, but that’s the plan.

A Coca-Cola branded gym seems like a joke, but what if you call it “Exercise is Medicine” instead? http://www.sportcourtla.com/featured-sports/details/sports-home-gyms

“Coca-Cola-Founded Plan”

According to ACSM Executive Director Jim Whitehead, Coca-Cola is the “first founding partner” of Exercise is Medicine. The ACSM and the American Medical Association also founded EIM, though the AMA doesn’t appear to have done much with the program since the founding.

Coca-Cola’s influence on “Exercise is Medicine” is so pervasive, it’s impossible for an outsider to fully calculate. Coca-Cola pays the universities and individual scientists involved with Exercise is Medicine. They also pay Robert Sallis, the founder and chair of Exercise is Medicine, not to mention the ACSM itself.

Robert Sallis’ profile picture for Coca-Cola’s “Beverage Institute”: https://www.beverageinstitute.org/webinar/exercise-is-medicine/

“To Implement the Global Energy Balance Network”

In case you missed the Global Energy Balance Network fiasco, the GEBN was a Coca-Cola founded organization that blamed physical inactivity, not poor nutrition, for obesity and diabetes. Exercise is Medicine seeks to implement the GEBN concept by focusing solely on physical activity to solve obesity and diabetes. This similarity between GEBN and EIM is not an accident.

The inspiration for Exercise is Medicine came from a speech by Global Energy Balance Network founder Steven Blair, at an ACSM meeting:

The idea for EIM really crystallized after listening to Steve Blair deliver the Joseph B. Wolffe Memorial Lecture at the 2006 ACSM Annual Meeting. In that lecture, Steve presented a very sound scientific argument for why exercise is medicine. Walking out of the lecture hall that day, I realized if Steve had presented this kind of data on a pill or a medical procedure, I would be heading home with a plan to prescribe this to all my patients. So why should it be any different with exercise?

After the NY Times and Associated Press exposed GEBN as a Coca-Cola front organization, Blair retracted his statements. Blair even admitted that his “dismissal of diet as a cause of obesity did a disservice” to the work of nutritionists.

The GEBN is dead, but Exercise is Medicine has so far escaped relatively unscathed. And EIM still promotes the same concept that Blair disowned: addressing obesity solely as an exercise problem, not a nutrition problem.

By Dan Wasserman: http://www.bostonglobe.com/opinion/2015/08/11/editorial-cartoon-why-boston-fitness-funded-coke/DQj1RKIFt6bH8b6eDMigzL/story.html?s_campaign=bostonglobe:socialflow:twitter

In fact, the ACSM does not permit EIM-credentialed trainers to give out any “specific nutritional advice.” Unlike a CrossFit affiliate, an EIM trainer cannot ask his client to record how many times a week he drinks soda and then recommend that he cut back or eliminate soda from his diet.

We emailed the ACSM to see what they allow the EIM trainers to say about nutrition. They replied:

We are not able to look at someone’s food journal and make any “advice” from that.

Therefore, general nutrition information? YES.

Nutrition ADVICE? Maybe. Depends on the topic. You should try the PINATA Apples as they are very tasty.

Anything more than general information is way out of our scope and should be referred to a Dietician.

EIM goes a step further than the Global Energy Balance Network in promoting a Coca-Cola-friendly agenda. EIM aims to turn public health’s focus away from obesity entirely, and towards physical activity. Coke-funded EIM Founder Robert Sallis explained,

The key is to shift some of the public health focus off obesity and onto physical activity. People need permission to be fat and still be healthy. The way to do it is by getting them more active.

It’s not hard to imagine why this would be an attractive message for Coca-Cola. Focusing on obesity encourages clients to cut back on soda and sugar, whereas focusing on exercise gives them “permission to be fat.”

Source: http://connieb.com/wp-content/uploads/2015/08/LARGE-SodaClimbertake5817-00000002.jpg

“By Affordable Care Act Mandate”

Evaluating the Affordable Care Act as a whole is outside the scope of this article. Nonetheless, ACA supporters and opponents may both agree that it’s a bad idea for Coca-Cola to exploit the law to spread myths about obesity. Here’s how Coke and the ACSM plan to do just that.

The ACA requires that,

A group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum provide coverage for and shall not impose any cost sharing requirements for— “(1) evidence-based items or services that have in effect a rating of ‘A’ or ‘B’ in the current recommendations of the United States Preventive Services Task Force …”

In other words, if the US Preventive Services Task Force (USPSTF) gives a service an A or B rating, then the Affordable Care Act requires insurance companies to cover that service, at no cost to the client.

How do the ACA’s preventive services provisions relate to Exercise is Medicine? Well, one of the services that USPSTF has graded is “physical activity counseling.”

You may recall Russell Berger’s interview with Bob Oppliger, the chair of the ACSM’s Health Science Policy Committee. Oppliger specifically mentioned the ACA’s preventive care provisions, and how they impact physician referrals for physical training.

OPPLIGER: One of the things as you probably know, America’s Affordable Care Act has a lot of preventative health care parts to it
BERGER: Right.
OPPLIGER: And at some point if they ever get the thing going the way it should.
BERGER: Yeah
OPPLIGER: I mean, the doctor’s not gonna’ do the training. He’s gonna’ contract out, so the issue is going to be who –
BERGER: Who’s allowed to get that business.

By “get the thing going the way it should,” Oppliger probably meant lobbying the US Preventive Services Task Force, and getting them to expand the population for which physical activity counseling counts as a fully-covered preventive service. To date, the USPSTF has given physical activity counseling a “B” rating for patients with cardiovascular risk factors. In contrast, physical activity counseling for regular patients, with no risk factors, has a “C’ rating. Thus the ACA does not require insurance companies to fully cover it.

Source: http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/healthy-diet-and-physical-activity-counseling-adults-with-high-risk-of-cvd

http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/healthy-diet-and-physical-activity-counseling-adults-with-high-risk-of-cvd

Felipe Lobelo, director of the Exercise is Medicine Global Research and Collaboration Center, gave a talk at the 2015 ACSM Annual Meeting on just this topic. The title was, “Population Health Management, ACA and USPSTF: A Perfect Storm for EIM Implementation in the US?” The transcript is available here.

After summarizing the USPSTF’s physical activity counseling verdicts heretofore, Lobelo concluded,

Here we have a literature brawl. We need to be advocating for implementation of physical activity counseling, at least for patients with cardiovascular disease risk factors …

The current literature paints a bleak picture for ACSM-modeled physical activity counseling. Lobelo summarized one study which found that, “25 patients need to go through this intervention to get 1 inactive patient to meet the physical activity recommendation.” That’s roughly a 96% failure rate. In another study, women with chronic diseases received free gym access, but only,

about 40% of them activated their membership and only 10% of those, so 4% of the total sample, improved activity levels, or attended the fitness center enough to improve their biologic risk factors

That’s also a 96% failure rate. This is particularly relevant to “Exercise is Medicine,” since if exercise became a preventive service, then clients would receive free exercise training.

In order to win the literature brawl and implement physical activity counseling as a preventive service, the ACSM will need to create new research that supports the “Exercise is Medicine” agenda. Enter Lobelo’s “Exercise is Medicine Global Research and Collaboration Center”:

our job is to … collect the necessary outcome data to show effectiveness and cost effectiveness of Exercise is Medicine in the US, as well as in other countries.

Herein lies the conflict of interest: ACSM purports to create objective scientific evidence, yet it also supports private interests (its sponsors Coca-Cola and PepsiCo, creating exclusive revenue streams for ACSM-credentialed trainers, excluding competitors such as CrossFit from the marketplace, etc).

Take the EIM Global Research and Collaboration Center itself. It is “housed within the Global Diabetes Research Center at Emory’s Hubert Department of Global Health.” Coca-Cola has paid the Global Diabetes Research Center more than $2,000,000 since 2010, and paid Emory as a whole significantly more than that. As Dr. Yoni Freedhoff has said, “Coca-Cola basically owns Emory University.”

Source: http://promotion1.com/blog/emory-the-coca-cola-university/

We’ve already seen what happens when the ACSM’s corporate interests compete with the demands of scientific integrity. Take the ACSM’s Gatorade-funded deadly hydration guidelines, or their baseless hit piece on CrossFit. Will the USPSTF really accept the ACSM’s self-serving research as scientific evidence, given this history?

Nonetheless, with the might of Coca-Cola behind him, Lobelo is confident, noting that

the USPSTF’s recent recommendations really open a door for implementing Exercise is Medicine in the US …

How Coca-Cola Profits from Exercise is Medicine

In Coca-Cola’s 2015 SEC filing, the first risk factor to its business is that “Obesity and other health concerns may reduce demand for some of our products.” And Coke warns shareholders that obesity concerns may motivate additional soda regulation such as taxes or warning labels:

Increasing public concern about these issues; possible new taxes and governmental regulations concerning the marketing, labeling or availability of our beverages; and negative publicity resulting from actual or threatened legal actions against us or other companies in our industry relating to the marketing, labeling or sale of sugar-sweetened beverages may reduce demand for our beverages, which could affect our profitability.

Hence the $106 million dollars that Coca-Cola and its fellow soda companies have spent since 2009 “to defeat public health initiatives at the local, state, and federal levels.”

Coca-Cola and its lobbying representative, the American Beverage Association, often oppose soda taxes by claiming that taxes don’t work. Exercise is Medicine takes an even more aggressive stance against soda regulation than Coca-Cola’s lobbyists. Robert Sallis, the chairman of Exercise is Medicine, blames soda taxes for making people fatter:

Telling people they’re too fat, blaming food companies and pushing short-term, feel-good solutions like bans and taxes have made us nothing but fatter.

Coca-Cola also used Exercise is Medicine in its failed attempt to fight soda taxes in Mexico. It provided logistical support for a talk by Jorge A. Mendoza Lopez on “Physical activity for people living with diabetes.” According to The Guardian, Mendoza “was the first head of the Mexican branch of a global organisation called Exercise Is Medicine.”

Another Exercise is Medicine board member, Dr. María Guadalupe Fabián San Miguel, opposed the Mexican soda tax. In 2012, San Miguel said,

Let’s not punish companies with taxes … The solution isn’t to demonise business, but to educate people

Strangely, San Miguel also questioned whether being overweight has anything to do with diabetes. She “explained that being overweight is not related to diabetes,” since genetic factors also influence the risk of diabetes.

Despite what this Exercise is Medicine official claims, it is NOT true that being overweight is unrelated to diabetes. According to the CDC, individuals with type 2 diabetes are much more likely to be obese than the general population:

During 1999–2002, the prevalence of overweight or obesity was 85.2%, and the prevalence of obesity was 54.8%. Encouraging patients to achieve and maintain a healthy weight should be a priority for all diabetes-care programs.

San Miguel’s claims make no scientific sense, but they do absolve Coca-Cola of responsibility for diabetes.

Source: http://www.dietdoctor.com/share-a-coke-with

How ACSM Hopes to Profit from “Exercise is Medicine”

In December 2015, the ACSM backtracked from promoting licensure for most fitness trainers. Nonetheless, they left an important exception:

While ACSM does not support licensure for every exercise professional, it does support licensure for a select group of exercise professionals that meets all of the following criteria:

– Work with patients and clients with medical conditions that require minimal to advanced clinical support
– Have earned at least a bachelor’s degree in exercise science
– Have a related, accredited certification.

ACSM takes this position to ensure that exercise professionals are appropriately qualified when working with patients in a clinical setting.

In other words, ACSM is advocating for licensure laws that recognize Exercise is Medicine-credentialed trainers to practice in a “clinical setting.” As we’ve seen earlier, ACSM advocates that doctors should only refer patients to EIM-credentialed trainers. And now ACSM has stated it will continue to pursue legislation that mandates such credentials. ACSM’s goal is clear: “Grow the number of EIM-credentialed fitness professionals as rapidly as possible.”

The American Medical Association, a founder of EIM, considers obesity to be a disease. So should it be illegal for non-EIM-credentialed trainers to work with the 35.7% of adult Americans who are obese? That appears to be the Coca-Cola / ACSM plan.

If Coca-Cola / ACSM succeeds at manipulating the USPSTF and exploiting the Affordable Care Act, two things will happen:

1. The Medical Takeover of Fitness

If the USPSTF grants physical activity counseling a “B” rating for the obese and overweight, that will cover over 68% of adult Americans. Therefore, more than 2/3 of adult Americans will be able to get doctor referrals to physical activity counseling, and their insurance companies will have to fully cover this fitness training.

This is where the “Get Other People To Pay For It” part of our 100-word summation comes in. In the fitness industry today, clients mostly pay for their own training. In contrast, the Exercise is Medicine model would require the government and government-mandated insurance companies to pay for exercise training.

A full Exercise is Medicine model would waste billions of taxpayer dollars paying clients to begin fitness programs they won’t complete. On the other hand, the ACSM Certification program would grow quickly.

2. Only Coca-Cola-Compliant Trainers Benefit

As we’ve covered, the Exercise is Medicine plan would only benefit trainers with an Exercise is Medicine Credential. So would CrossFit trainers simply have to get the credential to gain entry into the Coca-Cola / ACSM medicalized fitness industry?

It’s not that easy. The Exercise is Medicine system would require CrossFit trainers to follow ACSM guidelines in their training. For example, the ACSM does not allow an Exercise is Medicine-credentialed trainer to have his clients do a Paleo diet challenge.

As far as training is concerned, consider this Exercise is Medicine program. It requires that,

Only American College of Sport Medicine standards will be used during these sessions based upon the recommendations and restrictions dictated by the referring medical professional.

If a trainer had his clients do Fran and track his sugar consumption, that would violate the Coca-Cola / ACSM standards for acceptable fitness training. As a non-compliant medically-referred preventive service, this could even constitute “medical malpractice.”

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“Exercise is Medicine” Explained in 100 Words

January 12, 2016, 1:45 pm

≫ Next: False Data and Fear: A Marketing Formula?

≪ Previous: The Coca-Cola / ACSM “Exercise is Medicine” Scheme

Editor’s Note: For support and analysis of each point below, please see the accompanying article, “The Coca-Cola / ACSM Exercise is Medicine Scheme.”

Source: http://www.coca-colajourney.co.nz/stories/exercise-is-medicine-the-best-prescription-to-advance-health

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False Data and Fear: A Marketing Formula?

January 25, 2016, 12:20 pm

≫ Next: Craig Patterson: The Sky is Falling, and I’m Selling Umbrellas

≪ Previous: “Exercise is Medicine” Explained in 100 Words

Editor’s Note: We are pleased to present this guest post by Jason Darr, owner of CrossFit 604. Darr has critically analyzed several claims made by Craig Patterson in promotional material for the Mad Lab Group. The statistics we have support Darr’s, not Patterson’s, account. Whence did Patterson get his numbers? It’s not clear. Patterson first claimed Zen Planner as his only named, independent source. Zen Planner has since disavowed Patteron’s claims and Patterson removed any mention of Zen Planner from his article.

“Oh, were you finished? Then allow me to retort.”

– Samuel L. Jackson, Pulp Fiction

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It seems like everyone has got something to say about business models and statistics. Everyone has charts and services for sale that promise to help you be more successful. In the CrossFit industry in particular, there has been some talk from the MadLab Group about CrossFit gyms failing at an alarming rate, slowly going bankrupt, and needing to adapt to the changes coming our way. MadLab Founder and CEO Craig Patterson claims that 90 percent of CrossFit gyms are slowly going bankrupt because they have not yet adopted his way of doing business. Should we listen to him? Let’s come back to that.

First thing’s first… 90 percent of CrossFit affiliates are slowly going bankrupt? Is this accurate? Patterson, in his recent article published on BreakingMuscle.com, claims this is a fact. When I read it I was shocked—90% of CrossFit gyms are going out of business? That’s the best news I have ever heard! My affiliate is most certainly not in decline, so I guess that makes me the 10 percent. I’d better step up my strength training so I can lift my wallet.

OK, let’s get real for a minute. Our box has shown steady growth since the day we opened, and we continue to grow to this day. In our first year we burst out of our 3,000-square-foot box and upgraded to a 6,000-square-foot palace that Carl Paoli called, “The nicest box I have ever seen,” after dropping his bag (and his jaw) on the floor when he walked in for the first time. Going bankrupt? Uh, no. We are the lucky 10 percent. Coincidentally, Craig Patterson’s affiliate is about three kilometers from mine.

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Class at CrossFit 604 in Vancouver, Canada.

This can’t be right. 90 percent? Perhaps I read it wrong—after all, I was just skimming it on my iPhone—so I read it again a little closer. On my second read I noticed that Patterson states his information is based on statistical data that Zen Planner provided him. So, being that I am a Zen Planner customer, I called them and asked them a couple of things.

(Editor’s Note: the latest version of Patterson’s article did not contain any mention of Zen Planner. The screenshot below comes from the first version, which claimed ZP as a source.)

Patterson’s original article claimed Zen Planner as a source, but he removed Zen Planner from the article after Zen Planner disavowed his claims.

The first thing I asked was why my data was being shared with another box owner in my market. Someone’s got some explaining to do, and Zen Planner CEO Jeff Gardner did explain:

“NONE of your personal data was shared with any other customers of Zen Planner. We hold your personal data in the strictest of confidence.”

He further explained that the MadLab Group was one of about two dozen consultants that were testing a new Zen Planner product called “Health Check,” which gives a gym owner a snapshot comparison of how his business compares to other “like businesses.” Gardner further explains below:

About six months ago we began testing a program that we were calling the ‘Health Check.’ I’ve attached a sample of what this report looks like. This program was created based on feedback from boarding thousands of new customers. We’re constantly asked how they compare to other customers, so we developed some queries to aggregate data of ‘like companies’ to provide a benchmark for our customers. The program was very well received by our test sample. Our intent was to roll this out to all of our customers, but we have some data warehousing development that we need to complete to make this scalable.

The sole purpose of this program is to help our customers understand how they stack up, and to provide information to help make them stronger.

Indeed, the statistical data that is being represented in Patterson’s article and MadLab documentation is far from an accurate representation of the current state of the affiliates in the Zen Planner database. Not only does he not have access to that information, but Gardner went on to state that CrossFit affiliates actually showed a 26 percent increase in revenue in 2015 overall.

According to Zen Planner, CrossFit Affiliates showed a 26% increase in revenue in 2015.

Let’s do a little history lesson. Craig Patterson of MadLab opened the very first CrossFit affiliate in Canada. He also was clever enough to scoop up the trademark for CrossFit in Canada. He owned the trademark for a few years until it was recently awarded back to CrossFit HQ legally (or so it was rumored).

Craig is obviously a sharp guy. He and his team have been around for ages and certainly helped launch CrossFit in our community. For that I am grateful. But it seems that Craig has given up on being a CrossFit pioneer and has switched his focus to MadLab. Fair enough.

If the MadLab method is working for gym owners who struggle to keep their businesses afloat, fantastic. If MadLab wants to sell you their secret sauce on “how to operate your business like us,” then good for them. But using false data to try and create fear among your fellow affiliates so you can sell them your product (which looks suspiciously like a pyramid scheme) is just plain shitty.

The CrossFit model has always been structured so that anyone can open a CrossFit gym (Editor’s Note: that is anyone who meets the standard criteria, including passing the L1, proof of insurance, etc), and the superior businesses would thrive while subpar businesses would eventually fall by the wayside. Affiliates are even permitted to open their CrossFit gym next door to another CrossFit gym. If the other gym goes under for offering an inferior product, then so be it. This is business in the real world.

The cream of the crop will rise, and the inferior businesses will fail. Capitalism at its best! This ideology is how we built our business and how we continue to operate. Before we did anything we asked ourselves, “Why would anyone come to our gym over someone else’s gym?” And then we made a very long list of tangible reasons why. We took that list and created a gym that answered the most important question an affiliate should be asking.

We dug deep financially and created something special. We continue to ask ourselves daily how can we separate ourselves from our competitors. Our coaches earn great money, and nobody coaches more than 25 hours per week. All of our interests are aligned with each other, and we operate as a team. We are indeed a successful CrossFit gym, but we will never stop our pursuit of being the best at everything. Rising to the top was not a coincidence. It was all part of our business plan.

For the affiliate owners that do struggle with their business, I’ll give you some free advice. Stop looking for magic beans to fix your problems. A lot of hard work and money goes into starting, growing and maintaining a business. Being a great coach is NOT enough. You need to stop operating like a coach and operate your business like a business from top to bottom. If you are struggling to keep your head above water, perhaps you are doing something wrong.

Maybe you should work for someone else and just get paid to be a great coach somewhere? The MadLab method implies that everyone makes great money from top to bottom, so why bother owning your own business? Seems like you can just be a coach under the MadLab umbrella without the burden of ownership and still make a huge living (assuming the MadLab statistics are correct). Or, maybe you just need to ask yourself how you can improve your value in the market you are in.

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