I was just wondering if you have any information on Crohn's Disease. I have a client who wants to increase his weight and tone up, but I am not entirely sure which exercises to prescribe. Moreover, he has been told by his doctor to consume cakes and take away to increase his calorie intake as his metabolic rate is apparently three times faster than a "normal" individual. Is this the best way to get a balanced diet for someone with this disease? Any help would be much appreciated.
Let me first start out by saying, you are going to need more than just training to help a client with a dysfunction such as Crohn's Disease. You need to take the lead and start getting a team together or developing relationships with other people in the field in order to help this client. Your best bet would be to work along with a Holistic Nutritionist (CHEK Nutrition and Lifestyle Coach, HHP, someone at the Poliquin Institute), a Chinese Medicine Doctor and someone who practices Functional Medicine to do some lab testing with (www.biodia.com).
I will start by giving you some basic nutrition and lifestyle recommendations that will help with a client such as this. These are things that you can RECOMMEND in order to facilitate healing. The bottom line is that this client needs to be assessed nutritionally, needs his lifestyle to be assessed, as well as needs some lab work (GI stool testing for parasites, bacteria, fungus sIgA, dysbiosis, C-Diff and so forth). If you refer to the article series by Paul Chek called "You Are What You Eat," this should help you to get started. I would also refer him out to get further assessments, testing and nutrition and lifestyle recommendations.
You can also begin the 4R (remove, replace, reinocculate and repair) program with your client. Each phase is about three months long:
- Remove: This entails eliminating anything in their life that may create parasites, bacteria, fungus, etc. As well, eliminate any environmental derived toxic substances including conventional foods, plastic, microwaves, hygiene and cleaning products. There is always organic!
- Replace: This entails replenishing enzymes and other digestive factors that may be limiting healing. The key ingredients are pancreatic, digestive and liver enzymes.
- Reinocculate: This entails reintroducing good microflora back into the gut. This means pre and probiotics. Prebiotics are synergistic flora and mucosal cell regeneration.
- Repair: This entails providing nutritional support for regeneration and healing of the GI mucosa. You can also add in glutamine, fish oils, zinc and pantothenic acid. This will reduce inflammation and regenerate the mucosa of the gut.
As far as training goes, you don’t want to create more stress for this client. Stress creates inflammation, and inflammation is one thing you want to get rid of with a client with Crohn’s Disease. The first thing I would do is assess your client. You need to know what is short (so you can stretch it) and what is elongated (so you can strengthen it). That is the bottom line when writing a program. From there, you need to take your client through the basic stability-strength-power paradigm. Depending on the client, you might have one to three phases within each of the above.
While your client is getting his gut back in order, which will increase his immune system as well (75 percent of the immune system is housed in the GALT system in the gut), I would start by having him do some simple daily Qi Gong. This will pull him more into a parasympathetic state. This will decrease inflammation and allow for repair to take place. As well training wise, I would keep him in a Base Conditioning Phase for someone who has what is called a High Physiological Load.
You would use the exercise examples below with your client:
- Light cardio (conversation level)
- Light walking
- Aqua walking
- Tai Chi, Yoga or Qi Gong
- Flexibility routine
- Light corrective exercises (Primal Patterns, prone cobra, supine bridging on floor, forward ball roll, supine lateral ball roll, to name a few). You would just want to make sure that these are not too challenging (increasing internal stress) and that the variables are as follows:
- Rest +70 seconds
- Intensity –2reps
- Reps 8-12
- Tempo 2-1-2, 2-0-2, 3-0-3, 2-1-1 or breathing pace (slow)
There are many pieces to the healing puzzle. You need to figure out which ones your client needs but also in what order. Training is important, but it might not be first on the totem pole of importance. Good luck.