Service Skills Australia. Fitness Training Package Consultation. April 2014

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1 Service Skills Australia Fitness Training Package Consultation April 2014 The Dietitians Association of Australia (DAA) is the national association of the dietetic profession with over 5500 members, and branches in each state and territory. DAA is a leader in nutrition and advocates for better food, better health, and wellbeing for all. The DAA appreciates the opportunity to provide feedback on the Fitness Training Package Consultation by the Service Skills Council Contact Person: Kate Paul / Kristy Parsons Position: Professional Services Dietitian Organisation: Dietitians Association of Australia Address: 1/8 Phipps Close, Deakin ACT 2600 Telephone: Facsimile:

2 DAA interest in this consultation DAA is interested in this consultation as there are a number of real risks that have been recognised. DAA is concerned that these risks have not been considered by Service Skills Australia in the development of these modules and courses. Accredited Practising Dietitians provide medical nutrition therapy and evidence based dietary advice to all people across the health spectrum. Recommendations 1. DAA does not endorse the proposed fitness training package. 2. That the scope for all personal trainers ( Cert IV Diploma) regarding nutrition is the same and does not go beyond the provision of general healthy eating advice based on national guidelines to healthy adults. General concerns It appears that the nutrition units of the fitness training package have been developed based on demand from personal trainers and their clients. DAA argues that there is not a need for personal trainers to attempt to provide individualised dietary advice to their clients as this demand can be met by qualified APDs and that individuals with less training put themselves and their clients at risk. The fitness training package attempts to replicate already existing high quality training and courses that lead to graduates with assessed, validated, minimum level competency standards in dietetics and exercise science. The replication in this training is not equivalent to existing tertiary degrees. If a personal trainer wants to advance their skills in nutrition and provide individualised dietary advice to clients, they can do so by completing an existing accredited dietetics degree at a tertiary institution. This will provide the Personal trainer with improved job prospects. The fitness training packages do not produce graduates who can apply knowledge in the workplace safely. Personal trainers do not have the relevant prerequisite knowledge no background in science based subjects to provide Healthy Eating Information for Body Composition goals. This training is insufficient for personal trainers to work at the level of individualised advice for any client; this includes assessment on shopping, dietary habits and then developing meal plans and providing advice. 2

3 General nutrition advice to healthy adults, based on the Australian Guide to Healthy Eating/ Australian Dietary Guidelines is within scope of personal trainers at all levels. There are a number of risks related to personal trainers working outside of their scope, including client safety, professional reputation, and professional indemnity insurance coverage. DAA questions whether there are appropriate governance processes in place to ensure ongoing competence in nutrition skills and knowledge of graduates of these units. DAA is concerned about how RTOs will interpret the units of competency and whether they have staff with relevant expertise to deliver the nutrition units appropriately. Specific comments on Fitness Units of Competency All units: Correct spelling of dietitian. The industry does not use dietician. Cert III Fitness core unit SISFIT006 Provide Healthy eating information The provision of healthy eating information to clients by personal trainers should be limited to healthy clients not those with medical conditions or chronic diseases, for example, diabetes, high cholesterol, or those wishing to manage their weight (loss or gain). Obtain information from clients about current food and beverage consumption - Collecting an accurate diet history from an individual is a specialised skill developed by dietitians in training. Access, download and print healthy eating information from identified healthy eating guidelines resources. Resources used should only be the nationally endorsed and recognised, evidence based resources such as the 2013 Australian Dietary Guidelines and supporting material. relationship between healthy eating and common chronic diseases, medical conditions or healthy eating concerns (arthritis, cardiovascular disease, celiac, gallstones, hypertension, lactose intolerance, type 1 diabetes, type 2 diabetes, gestational diabetes, mental illness, obesity, gastrointestinal reflux, ulcers, inflammatory bowel disease, lactose intolerance, crohn s disease, gout, pregnancy, gallstones, cancer, anorexia, bulimia, overweight or obesity, nutritional deficiencies including iron, calcium, dehydration, food allergy and intolerances, weight gain). Personal trainers should acknowledge there is a relationship between the above conditions and eating but any client presenting with a condition above should be referred to an APD for individualised medical nutrition therapy not provided with healthy eating information which in many cases would be contraindicated. 3

4 Cert IV Fitness core units SISFIT 042 Provide healthy eating information for body composition goals Suggest use of weight management rather than body composition in the title. Comparing client food and beverage choices, preparation methods and serve sizes with reference standards such as Australian Dietary Guidelines is part of individualised nutrition assessment which should only be performed by an APD. Personal trainers should be trained to provide credible general health eating information to healthy individuals. Discussing how to overcome barriers to achieving body composition goals is also individualised nutrition intervention that should only be performed by APDs. Clients who are overweight or obese should be referred to APDs to assess and educate regarding appropriate nutritional interventions. This unit does not cover identifying whether the client s body composition goals are appropriate. For example, the client may be underweight (as indicated by BMI) but are requesting weight loss advice. Take out reference to Foundation Diet and Total Diet. Personal trainers should not be providing clients with diets; rather they should discuss general healthy eating information and principles with clients. For example, the importance of including all 5 food groups and having a varied diet. Develop a personal healthy eating plan and provide clients with meal plans from identified healthy eating resources and provide client with meal plans and food group ideas from identified resources describes individualised nutrition advice and should be out of scope and is the scope of APDs. Monitoring body composition may be appropriate but adjusting food intake of clients is out of scope and within the scope of APDs. The need for referral to an APD must include: the client s need/ desire for personalised/ individualised nutrition assessment and provision of evidence based dietary counselling (nutrition education) and any personalised meal plan. Also, any client who is assessed as obese. Remove reduces the chances of toxicity from anyone food or food group from benefits of a wide and varied diet with weekly eating patterns under Knowledge Evidence. Without foundation training in biochemistry undertaken by APDs at accredited tertiary institutions, inclusion of daily energy requirements incorporating consideration of: basal metabolic rate; activity effect on metabolic rate; muscle and lean body mass; thermogenesis should be removed. SISFIT015 Collaborate with medical and allied health professionals DAA would like to see this unit a core (non elective) unit for personal trainers. 4

5 There are no specifics on dietary advice or nutrition mentioned in this unit. Collaboration between personal trainers and APDs is important. DAA suggests that screening and referral pathways are included in this unit with reference to specific allied health professionals including APDs. Diploma of Fitness nutrition electives SISFIT 035 Apply healthy eating guidelines to client weight management 1.1. Review pre-exercise screening information and ensure client does not require referral to a medical or allied health professional. Change to. Review pre-exercise screening information and assess whether client requires referral to a medical or allied health professional 4.1. Collaborate with general practitioner or Accredited Practising Dietitian regarding lifestyle recommendations to be made to the client, as required. How would this occur in practice? Would the personal trainer provide recommendations to the client then send their GP and APD a letter to describe what was discussed (with the client s consent)? This assumes the client is already seeing an APD. These components Assist client to make healthy eating plans based on the Australian Dietary Guidelines and tailor to dietary preferences of individual. and Recommend a daily reduction in energy intake, as per the Australian Dietary Guidelines and Australian Government recommendations. describe individualised dietary advice and intervention which is in the scope of an APD. liaise with client on shopping trips and home visits to decide on how to improve food choices at home and using the template for adapting the Australian guide to healthy eating to assist clients to make informed food choices also describes individualised dietary advice. SISFIT 036 and 037 unit titles appear to be confused and mixed up on the online system. SISFIT 036 Apply healthy eating guidelines to general population clients These activities Observe the client s choices and actions on a food-shopping trip. and Analyse the contents of the client s food pantry and fridge and assist client with using the Australian Dietary Guidelines, Australian Guide to Healthy Eating in order to make healthy food choices when grocery shopping and eating out describe individualised dietary advice which is in scope for APDs. The elements Provide client with information regarding their food habits and health status and Develop healthy eating plans to improve health also describe individualised dietary advice. 5

6 The following does not describe a client s nutritional status rather some food related habits: Create a client profile regarding their current nutritional status. This must include: food kept in pantry and fridge; frequently purchased items in the supermarket; food preparation and handling habits; food choices when eating out. SISFIT 037 Apply healthy eating guidelines to training of general populations As for 036 and other units above. SISFIT 043 Recognise the dangers of providing food advice to clients Performance Evidence Identify when referral to an Accredited Practising Dietitian or doctor is required should be based on client needs not the availability of services, ie. when community based programs are available. Referrals to APDs should also be made when the personal trainer identifies that the client s needs are out of their own scope of practice/ competency level for any reason including complex medical conditions. If a client asks for personalised/ individualised nutrition/dietary advice or meal plans etc, this is an indication to refer to an APD also. This unit should also cover the risk of personal trainers providing nutrition advice to any clients. For example, the risk of litigation/ loss of registration/ complaints/ insurance premium rises of the profession etc. should the advice provided to the client be detrimental to the client s health. 6

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