Evidence Based Fitness: The New Model
Evidence based fitness is all the rage these days.
The fitness industry is a fertile farmland for fads, and being evidence-based is the latest and greatest buzz word used to draw attention and ascend into the upper echelon of exercise excellence.
…but what is it, exactly?
Evidence based fitness is a vague shadow creature in the minds of the public. It’s often misunderstood and misrepresented. Few really know it, and fewer still know how to go about actually doing it in practice.
What a shame.
An evidence-based way of approaching training and nutrition is the surest way to get the best results for yourself and your clients amidst this chaotic industry of smoke, mirrors, and sensationalism.
With that in mind, here I will clear things up, break things down, and show you my workable model of how I go about evidence-based fitness practice.
You will learn:
- The fundamentals of the the evidence-based fitness model
- How to use the model in practice
- How to improve as an evidence-based fitness professional
With this, you will be better equipped to accomplish your goals and those of whom you work with.
We will be taking this step by step moving through each portion of the process of effective evidence based fitness practice.
First, we’ll start with the evidence base itself:
The Evidence Based Fitness Model Pyramid
You & I…we are a driven by a goal.
Think about this goal of yours. What is it?
To gain muscle…
To lose fat…
To achieve the ultimate aesthetic physique…
In an ideal universe, we could snap our fingers and arrive at this goal instantaneously in a puff of magic pixie dust. Better yet, the mere thought of something would usher it into existence.
But we do not live in an ideal universe, so we must determine the optimal process that we must undertake to arrive from point A to point B. From here to your idealized state…
But what is in a process?
Well, that takes proper know-how and proper execution.
And because I’ve just demonstrated that anything other than instant, magical success is already extra work from the ideal scenario, you must make sure that whatever you’re doing as part of that process from A to B is indeed correct, optimal, most efficient, and minimizes waste/friction so that you obtain the results you seek in the simplest, most enjoyable way possible.
Reread that paragraph until it sinks in nice and deep.
It’s applicable to much more than fitness.
Optimal and correct, then.
That’s where evidence based practice comes in.
The goal of evidence based practice is determining what is the truth behind the way things work so that we may use this truth with confidence under our power to achieve our goals in the best way possible.
…What is truth?
But what is truth?
How do we come to know things as human beings equipped with our 5 corporal senses (sight, hearing, taste, touch, smell) and our other cognitive senses (reason, relation, etc) ?
That is the question.
A question that has puzzled philosophers for millennia. Let’s first determine what we are looking for when it comes to truth in fitness.
There are several kinds of truth.
For example, the truth that 1+1=2 is different from the truth that the sky is blue, that George Washington was the first President, or that when I drop my pen, it will fall to the floor. All of these are true, but they are not true in the same way.
When it comes to achieving our goals in fitness, we are most closely concerned with the last type of truth: performing actions that will lead to a predictable, replicable result.
But because in fitness we are dealing with a vastly complex & dynamic system such as the body, we often cannot say that something is true in the same way that we can say that my pen will fall when I drop it.
There is a tremendous amount of variation between individuals, and so we are typically limited to general principles associated with the nature of living beings or the Universe itself.
- Calories in vs. Calories Out
- The Principle of Specificity
- Progressive Overload
As such, evidence based fitness is about determining the highest probability and accuracy that we can – not absolutes.
Determining Truth in Fitness
We can get a glimpse at truth in fitness in several different ways, and each has its pros and cons.
Furthermore, each must be ranked differently because each offers a different degree of accuracy and truth that we then collectively use to form a strong evidence base for our pursuits that we apply in practice.
As noted, our aim is to form our decision making based on
With this in mind, in order of most powerful to least powerful and most generalized to most zoomed in (ed: originally I had written “most important to least important”, but this is incorrect, for they are all important), they are:
- Scientific Research
- Practical Experience
- Personal Experience
Each tier builds off of the next if and when possible, and together, they serve as a toolbox of truths that you apply to the process as an evidence based fitness practitioner to achieve the best outcomes for the person you are working with, be that yourself or a client.
We will now take each of these individually before proceeding onwards to the next step in the evidence based fitness model.
The foundation of the evidence based fitness approach is the scientific research.
In fact, evidence based fitness is often thought of as science based fitness. This isn’t entirely false, for science IS the base of the evidence based pyramid after all, but it is misguided when science alone fitness is used for developing the optimal program, hence the pyramid.
The human body is a complex system that operates through various actions and reactions, and the scientific method is hands down the #1 method for discovering how the body works with regards to our fitness goals.
Through science, we are able to create controlled experiments that help us to isolate variables, identify cause/effect relationships, and make comparisons between alternate strategies to gain further understanding into the truth of the way things work.
Although it receives a lot of hype, there is nothing magical about it. The “magic” is in the methodology, and that is accessible to us all to a degree. Properly funded, peer-reviewed research conducted by experts simply offers a higher degree of value. Remember that.
Essentially, it enables us to explore relevant questions in fine detail such as:
If I do/don’t do X, what will happen?
If I do more X, what will happen?
How do X & Y compare in terms of results towards Z?
This will enable us to build a “profile” of sorts for each variable – or tool – at our disposal as aesthetic architects constructing a program for a particular person.
With this, we will know what to do, how to do it, where to do it, when to do it, and how to modify it based on the results and other factors.
Each study offers another glimpse at the truth from a particular angle, and as more and more studies are done from various angles, our knowledge thickens, oftentimes laying up the opportunity to perform a systematic review or meta analyses, which you will see next:
Even within the scientific evidence itself, there is a hierarchy involved, so not all evidence is weighted equally in our quest for truth.
This is important when evaluating the strength of the research you come across.
In contrast to the evidence based fitness model, this pyramid has the least powerful means of evidence at the bottom and the most powerful at top, with meta analyses perhaps sitting slightly above systematic reviews.
Each level builds upon the next by offering more precise and powerful explanatory power that gets us closer to the truth we are concerned with.
Mechanistic vs. Applied
Another element of hierarchical organization refers to whether the research is mechanistic or applied.
For example, let’s say your goal is to gain muscle. If you had a choice in studies, would you prefer a study studying muscle growth or muscle protein synthesis? You’d probably prefer the one showing which group made the best gains in muscle*. Why? Because it’s closest to your actual goal.
Muscle Protein Synthesis (MPS) =/= Muscle Mass Increase
Muscle Mass Increase = Muscle Mass Increase
As a general rule, applied research has a stronger evidence value than mechanistic, although mechanistic research is important for thickening our bed of knowledge by filling in the gaps and offering insight as to what role that mechanism has in the bigger picture with regards to the results we care about.
*If you said you want the study that measures both, you win a gold star.
More examples would be:
- MPS vs. muscle growth
- Hormone levels vs. muscle growth
- Muscle activation vs. muscle growth
Lastly when speaking of hierarchical organization of research for strength, we can look at factors such as:
- Study design (crossover, single/double-blind)
- Length (context dependent)
- Sample size (for statistical power)
Such factors and their impact on conclusion drawing is complex and can very well take their own posts, however I mention them here for completeness sake and to alley-oop me to the next point to address when thinking of research for evidence based fitness:
Limits of Science
Despite its strength for our cause, every single scientific study has its limitations and must be viewed critically before being able to extrapolate the findings.
Here are just a few possibilities that may influence the conclusions you take away from a study:
- Training Status
- Sample size
- Nutritional Intake
- Uncontrolled variables
- Length of study
- Measurement method
On top of that, what’s to be said about research that hasn’t been done or adequately explored yet? We can only speculate and take our best shot based on the available evidence we do have.
And perhaps most importantly, research speaks of averages and can not give definitive answers to what will work optimally for everyone.
The middle line in the above diagram represents the mean of the normal distribution, but that doesn’t signify that everyone conforms to that value. We can only speak of probabilities.
As such, you can’t stop at the research alone and expect to get the best results. Each study is a piece of a giant puzzle. While we can gain more power through meta-analyses and systematic reviews (above), the truth remains:
Research is useful for establishing general guidelines that must then be tailored to the individual.
At the end of the day, you’ve got to get out there and experience the real world. In fact, what you see in the real world is oftentimes exactly what gets you doing the research in the first place.
Dr. Brad Schoenfeld is one textbook example. Perhaps no one has done more relevant research for the lifting community than he has, and many of his research questions stemmed from what he saw in his experience as a trainer and competitor.
Nevertheless, because science is the standard, as we work up the pyramid as evidence based practitioners, we must maintain the spirit of science in everything we do in practice and on a personal level.
Bodybuilding is unique from other sports in that in relies exclusively upon tangible physical changes to bring about success. Whereas many other sports are won by heavy reliance on technique and teamwork, with bodybuilding, we are most concerned with what will grow muscle and drop fat the best to create our masterpiece.
Practical experience is the second tier in our evidence based fitness pyramid, and it refers to what we observe in the real world as we apply various tactics to get the result we want.
For most of (lifting) history and even in modern times, this was the way knowledge of what works was spread.
Lifters look at what the biggest, most popular guys do and take it as truth. They make decisions based on what their intuition and feelings tell them. This is what’s known as “bro-science”.
Despite its ridicule by evidence based fitness elitists, such a method has its place – but only when supported atop a rational scientific evidence base as part of a larger model such as the one I propose here.
Why else is practical experience valuable?
As noted, science has its limitations, and we are often limited to the particular protocol or population studied.
What are we to do?
…wait until every study has been done?
This is foolish.
Absence of evidence is not evidence of absence, and at a certain point, we must take the conclusions we have gathered from research and make judgment calls as they apply in various situations to observe the results obtained.
Through careful implementation & proper tracking, we can try things out in the real world and see what occurs to then calibrate as needed.
As evidence based coaches and trainers, you could even argue that we are conducting our own research over time. The first name that comes to mind is Martin Berkhan , who implemented intermittent fasting protocols in himself and clients with success as he fine-tuned the approach before it was studied in research.
Lastly, we come to personal experience at the top of the pyramid.
Scientific research and practical experience can tell you volumes, but none of them can tell you exactly how YOU will respond.
Research speaks of averages, and there are outliers on either side of the bell curve that can’t be forgotten. If you apply the average as an absolute, you may be missing out. As such, this model incorporates a feedback loop to monitor individual response and add to your collective evidence base.
Additionally, you may decide to implement a certain protocol on yourself that hasn’t necessarily been well researched in the same conditions to observe a result. With a highly controlled subject such as yourself, this may offer insight that can trickle down the pyramid.
Limits of Personal Experience
Personal experience is dangerous business and has its bright and glaring limitations, however.
We are limited by our own bias and narrow perspective, and it takes honest and rigorous introspection to get to the bottom of things and remove our ego from the picture.
Anecdotes can be the perfect antidote of acceptance.
Consider the following two examples I’m sure you’ve heard:
“All guys are jerks/all women are hoes”
“Yeah, but it worked for me“
While there is an element of truth in these statements, it is fallacious to use your limited vision of reality based on past experiences to then make blanket statements about the world or efficacy of a particular approach.
When it comes to personal experience, there is one more reason that it is useful in getting optimal results…
The Subjective Experience
The various ways of analyzing methods and results are fundamental parts of the evidence based fitness approach.
But they’re missing something:
What it’s “like” on a personal level.
We are human beings – not simple machines.
As human beings, we have consciousness and one of the products of that consciousness – subjective experience.
Without digging deep into the philosophical implications of this, subjectivity is the ability to tell you what something “feels like” on a personal level.
While true that we can perform surveys in research over subjective experience and discuss these things through clear and open communication with our clients, these are still inadequate when compared to actually going through the process yourself.
For example, describe to me what it’s like to see the color blue.
What about how it feels to be in a cutting diet at shredded levels and going to hit the gym for a heavy workout?
The answer is no.
This must be experienced firsthand to truly understand. You cannot teach a blind man what it means to see.
Taking your body to its aesthetic peaks is no easy task. If it were, the world would look much different, now wouldn’t it. The entire process is predicated on challenging the system beyond its current comfort zone to maintain homeostasis. See Law #6 here.
What does all of this mean for your clientele?
It means that you are able to connect on a deeper level with your client & audience because you’re right there on the front lines with them.
You are in the same fight. You know what it’s like.
The difference this makes is unquestionable.
The best in the business are or have been members of the iron game themselves.
There is no better teacher than time in tricky territory, and self desire for greatness will lead you to great heights and wisdom should you channel it properly…
Further, some of the most powerful leaders in history such as Napoleon Bonaparte and Alexander the Great (who Napoleon greatly admired, himself) were so celebrated and respected by their men because they were right there on the battlefield with them.
As a coach, you are more than just a mind behind the muscle. You are a mentor, a leader, and a friend.
Never underestimate the power of human connection.
Personal experience will take you there.
Forming Your Evidence Base
Collectively, these 3 forms of evidence arranged hierarchically form your evidence base and work synergistically to get the best results.
Evidence based fitness is not science alone, and it does not neglect the real world or personal factor.
These various methods of accessing truth are like various rooms looking out of the window on different sides of a building. They all have different viewpoints into seeing what’s going on out there. What science can see, personal experience may not be able to see. And so on.
Only with all sides can you form a true picture of what’s going on…
..but wait! What about the 4th side?
That’s exactly why you’ve got to be humble. Law #9.
I’m a pragmatist, so to help you in furthering your evidence base, here are my suggestions to you to become more well versed in evidence based fitness:
The scientific research can be intimidating to the uninitiated.
It is often a lengthy, confusing process that presupposes a certain level of understanding of the core concepts and preexisting literature. This often leads to frustration and abandonment of looking to research as a guiding tool.
Therefore, I recommend you take this approach for self-study:
You’d be surprised at how many up & comers dive headfirst into Pubmed and try to pick apart research papers. I advise against this.
Go and get yourself a solid set of textbooks at the store or library, read them cover to cover, take notes, study, and create lists of things that you’d like explore in more detail.
There are many out there, but for the audience reading this post, The Science and Development of Muscle Hypertrophy by Dr. Brad Schoenfeld is an excellent comprehensive resource.
Reading is a lost pastime, but if you want to become your best, dedicate 20-30 minutes a day to reading new content that will grow you and expand your horizons.
And if you want to come with excuses, this podcast from Danny at Sigma Nutrition discusses relevant topics with industry experts. No hands or eyes required. Simply hit play while you drive or work.
- Research Review
For in depth analyses and commentary on studies, a well-written research review is a useful companion to your education.
You will see first-hand how an experienced evidence based fitness practitioner goes through research. Note what they comment on, critique, challenge, and take away from a study.
The Alan Aragon Research Review (AARR) is a great example. For years, Alan has dropped monthly editions delivering immense value. As a free option, Yoda of getting yoked, Lyle McDonald has written several as well that can be found here.
Gaining practical experience is gained by implementing different strategies and observing the results in your clientele.
You can talk shop with other coaches and see how their results differ or align with your own.
If you’re a young gun without much client experience yet, have no fear. Your experience here is always growing, and through online forums, social media, and so on you can take a look at what others are doing and the results this brings about.
It is also interesting and useful to study how strategies and methods came about, worked, and changed across different periods in history.
Finally, when it comes to personal experience, there are no shortcuts other than diligence and dedication over decades.
Through the process of fine tuning and experimenting with your own physique, you will learn a tremendous amount about yourself. This is one of the greatest joys of lifting.
Before proceeding into the next phase of the model, there is one more thing to make note of regarding the evidence based fitness model pyramid:
It is a constant work in progress.
Although the human body has remained relatively constant over the last few thousand years, the way we understand it is continuously changing, growing, and being refined. Evidence based fitness is dynamic.
On top of that, you are not an omniscient overlord. There is always more out there to learn, and continued education through seminars, self-study, and reflection are important aspects of being the best evidence based fitness practitioner you can be.
Your success is in your hands.
With the evidence base you’ve formed, you will consult with the client and begin to form a landscape of the terrain that you are about to trek through.
If you are self-coached, this will take place internally.
This is a critical step and why I am not a proponent of cookie cutter programs, meal plans, and workout splits in the slightest.
We are all human beings, but we are not all the same person.
Who am I dealing with here?
So then what goes into what makes someone an individual from a coaching perspective?
These are the main variables of interest to us:
- Current State
- History (Training/Injury/Medical/++)
- Physical parameters
- Psychological parameters
- Lifestyle factors
Each person is a puzzle and the approach will change based on who they are.
You must figure out who they are and what makes them tick. You must be able to walk a mile in their shoes and see life through their eyes. This is the way to the ultimate prize.
Gaining true, comprehensive data over all of these factors is not possible overnight. But over time, you will build a stronger coach/client relationship that will further refine your results together.
Having a detailed client questionnaire and frequent, detailed interaction with clients is key for information gathering to fuel your approach for them.
What is their goal?
And now we come to the single most important element of any fitness program: The goal.
Everything that you do in your program must support this goal, and you must be able to satisfactorily justify why you are doing XYZ with regards to this goal. If you can’t, you better find out real quick.
This will channel that evidence base and client analysis into a workable program that accomplishes their goal:
Application of the Evidence Based Fitness Model to the Client
Now that you have all the information laid out before you…
How do you go about applying this to get the desired results?
That’s an excellent question – If you don’t know how to APPLY the knowledge base that you’ve accumulated, you’ve got nothing.
Those 3 pillars of evidence based fitness are nothing more than tools that you’ve forged in the fires of the fitness furnace, and now you’ve got to USE them to create your masterpiece based on the block of marble that has been brought to your workshop by your client.
This is where the art of fitness comes into play. To point you in the right direction, here’s how you do that:
The 3P Approach
When it’s time to create a great fitness program, simply remember the 3Ps I’ve developed:
In fitness, it’s far too common to see an emphasis given solely to the first P, physiology. This is a mistake. If you really want the best, long lasting results, you need the other two. You must seek harmony amongst these 3 Ps to design the optimal program.
Because you are not only dealing with a body.
You are dealing with a body that is wielded by a person with thoughts, tastes, desires, and feelings that is living a life that entails far more than the weight plates and dinner plates.
This is but another reason why I choose to distinguish personal experience as an element of the evidence base.
Here are some simple questions to ask yourself when it comes to each area:
- What is this person’s goal and how can I use what I know about the principles and this person as an individual to optimize this in their body?
- What is most enjoyable and satisfying to this person?
- What motivates them?
- Are they detail oriented and meticulous or prefer simplicity and general rules?
- What is this person’s life like on a macro level?
- What is their schedule like?
- What do/don’t they have access to?
Strike the balance
Optimizing the arrangement of these artistic elements of training is different for each person and may require tradeoffs, but when you nail these 3 factors, you will ensure consistency, adherence, and satisfaction with your methods.
In turn, this will lead to successful maintenance of the results you’ve obtained once you accomplish your goal. It’s not just about results. It’s about sustaining them and loving the process.
(Full in depth post on the 3P Approach coming soon. Subscribe to be notified when it drops)
Evidence Based Fitness Program
After the prior steps have been taken, you will be left with a program that is designed to accomplish the goal that has been designated and tailored to the individual.
It should then be clearly communicated to the client so that it is fully understood and can be executed as intended.
Questions should be addressed and should be open to feedback from the client, explaining the rationale where necessary.
The Feedback Loop
In as dynamic a system as the body with as many variables as are required to create a muscled masterpiece, no plan will be perfect from the get-go.
And even if it was, it would soon be obsolete because fitness success is quite literally built upon progression and adaptation.
By the time you’ve hit your mark, it’s moved.
Therefore, every single program needs a feedback loop where the client can provide feedback that will then be analyzed and weighed to be judged objectively by the coach/trainer to decide what change – if any – must be made to the program in order to better optimize the game-plan to get to the desired goal in a way that seeks harmony between the 3Ps.
Periodic Progress Checks
Progress measurement is a critical part of every fitness program and should be done using a variety of measures in conjunction to be able to observe what’s happening in an individual on several levels.
Most commonly, these are:
- Gym performance
In addition to these, client experience should be communicated to understand more of the subjective psychological and practical factors.
- Overall experience
- and so on
Based on this feedback, the results should be analyzed against what should be happening in theory to achieve the designated goal in harmony amongst the 3Ps.
If changes are to be made, you once again look at the collective evidence base of the evidence based fitness model and consult with the client before making modifications and implementing an updated version of the program.
Evidence Based Fitness: Conclusion
And now, we’ve come to a close.
You now have a further, accurate understanding of evidence based fitness and how to approach things with regards to your own results and those of your clients.
As you can see, it’s not so scary after all. You just need the right approach.
Now go make it happen.
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Til next time.
This framework for approaching evidence based fitness was first expressed in my book, Architect of Aesthetics. I have adapted and expanded it in this article to be accessible to a wider audience and serve as the model for evidence based fitness practice.
For exclusive, 1 on 1 coaching utilizing this evidence based fitness approach, contact me here.