This is part five of a series of blogs from attendees at ACSM's Conference on Integrative Physiology of Exercise. The following blog is a reflection on the symposium "Metabolic Flexibility in Health and Disease" by Ayland Letsinger. 

Carbohydrate and fat are the dominant fuel sources for energy production in our bodies. Everyone needs energy – from the most sedentary individual to the most elite athletes. On the one hand we often have trouble getting athletes to eat enough food given their high daily energy needs, while on the other hand many sedentary people who do not move much are consuming more energy than they need. In a world where individuals crave the best diet for their needs, Lawrence Spriet, Ph.D., FACSM, of the University of Guelph led a symposium on metabolic flexibility at ACSM’s Conference on Integrated Physiology of Exercise. The discussion provided science-based advice for elite athletes, sedentary people and individuals with obesity and type II diabetes. 

Dr. Spriet opened with a complex image outlining the major pathways that allow the tissues in the human body (i.e. skeletal muscle) to use fat and carbohydrate to produce energy. He commented that, “My students hate when I show this diagram, but it is important to see the whole picture of fat and carbohydrate metabolism in order to make informed choices. They call it the ‘Dreaded Metabolic Pathway Diagram.’” The key point was clear: the impressive and tremendous “flexibility” to alternate between carbohydrate or fat utilization to meet the energy demands of the body is critical for optimal performance and health. And this is most impressive when responding to single and repeated bouts of exercise. The following impressive cast of scientists supported this point with elegantly performed studies.   

Carbs: Friends or Foe? 

The high fat/low carbohydrate diet is being touted as a game changer for improving endurance performance and has become common among non-athletes. Louise Burke, Ph.D., FACSM, presented very convincing evidence showing that low carb/high fat diets had no clear benefit for low intensity exercise and simultaneously ruined high intensity performance in endurance athletes. She let the audience know her studies were followed by a barrage of angry Twitter warriors calling her work poor and claiming the studies were not long enough for the athletes to adapt to the diet. However, Dr. Burke and others have shown humans on a low carb/high fat diet DO in fact adapt and have increased ability to utilize energy from fat. Although, primarily using fat as fuel is less metabolically efficient than using glucose (the total energy yield is lower), glycogen (stored glucose) utilization is impaired, and certain high intensity points in endurance races (think of uphill portions or the final sprint to the finish line) requires carbohydrate usage for optimal performance.  In other words, the improved utilization of fat for fuel means losing vital efficiency in glucose utilization. 

The work of Bret Goodpaster, Ph.D., in studying individuals with type 2 diabetes, has revealed a decreased ability to store fuel (fat and carbohydrate) after a meal and severely impaired metabolic flexibility in utilization of fat and glycogen.  Simple exercise and weight loss programs, individually and together, restored much of the lost ability to store fuel and the flexibility to use it in skeletal muscle and the whole body. The messages were clear: you have to move more, and don’t overeat.  

Deb Muoio, Ph.D., closed the symposium by giving a great illustration of how important the mitochondria are for maintaining metabolic flexibility and health. These are the organelles in all of our cells where the majority of our energy is produced. The mitochondrial volume in cells increases when you are physically active and shrink when you are not. She showed that metabolic inflexibiliy is like a traffic jam in the common carbohydrate and fat utilization pathways that exist in the mitochondria. In simpler terms, a high fat/low carb diet is not the secret to health improvement, as exercise is proven to improve optimal metabolic function.

Finding the “perfect diet” for everyone is likely fleeting, but all four presenters agreed on a similar theme: the body’s ability to utilize both carbohydrates AND fats is critical for optimal performance and health. If you decide to remove either substrate, your body will miss that critical fuel.


Read part 1 of this series: "Can Exercise Fill the Reductionist Gap? Reflections on Dr. Michael Joyner's Keynote."
Read part 2 of this series: "Are Exercise 'Mimetics' a Realistic Substitute for Exercise Training? Reflections on the Debate." 
Read part 3 of this series: "Exercise and Energy Restriction to Improve Health: Recent Research." 
Read part 4 of this series: "Molecular Transducers of Physical Activity (MoTrPac) Update." 


Ayland Letsinger is a Doctoral Student at Texas A&M University. Ayland was presented with an award for poster presentation at ACSM's Conference on Integrative Physiology of Exercise in 2018 for the abstract titled: A High Fat/High Sugar Diet Alters the Gastrointestinal Metabolome in a Sex Dependent Manner. 

This is part four of a series of blogs from attendees at ACSM's Conference on Integrative Physiology of Exercise. The following blog is a reflection on the update regarding the Molecular Transducers of Physical Activity investigation by John Quindry, Ph.D., FACSM. 

In case you missed the Molecular Transducers of Physical Activity (MoTrPac) update at ACSM’s Conference on Integrative Physiology of Exercise (IPE) meeting in San Diego, here’s what you need to know:

Presenters were Marcas Bamman, Ph.D., FACSM, and Karyn Esser, Ph.D., FACSM, two principle investigators in the massive $170 million multi-site investigation. Funded by the NIH Common Fund, both human and animal research will be conducted over the next several years.

The primary points of the IPE update were to convey the phase one timeline and final methodologies determined by the MoTrPac steering committee (the investigators and outside consultants). Dr. Bamman provided updates on the human models (2,600 research volunteers), while Dr. Esser detailed the animal arms (many hundreds of Fisher 344 rats, 19 organs sampled post mortem). I encourage you to check out the particulars for yourself.

Another key point of the update was to share that, in the coming years, outside investigators can petition for tissue access in a grant-specific way. There is no doubt that the outcome of this work will set the stage for the next generation of mechanistic understanding of exercise and physical activity on total body health. In question, however, is whether the respective human and animal study designs will be robust enough to flush out all the potential new leads. The answer is probably not. By virtue of scale, Drs. Bamman and Esser conveyed that this research phase is the best overall study design, but a compromise to say the least. During the Q&A, many top scientists within our ranks raised key points of concern, all of which were conceded by the presenters.

We’re taught in first semester graduate school that no study design is an “end all,” and MoTrPac is no exception. People may find this alarming given the $170 million price tag, but it is worth noting that this investment in preventative exercise has been long coming and is a fraction of a percent of past expenditures directed to curative medicine. I happened to be on the NIH ad hoc review of the original MoTrPac submissions, and we debated many of these same points in the room and wondered more among ourselves quietly in smaller groups during the down time. Having managed my own grant budgets for years, I’m still amazed that $170 million is just as finite a sum as the grant totals for other studies. I trust that the outcomes are going to be revealing and that the next generation scientists in the field will leverage these findings into **BILLION** dollar follow-up studies and even more impactful future discoveries.  

Read part 1 of this series: "Can Exercise Fill the Reductionist Gap? Reflections on Dr. Michael Joyner's Keynote."
Read part 2 of this series: "Are Exercise 'Mimetics' a Realistic Substitute for Exercise Training? Reflections on the Debate." 
Read part 3 of this series: "Exercise and Energy Restriction to Improve Health: Recent Research." 

John Quindry, Ph.D., FACSM, is a member of the faculty at the University of Montana, Department of Health and Human Performance. He served as a co-planner of ACSM's Conference on Integrative Physiology of Exercise. 

This is part three of a series of blogs from attendees at ACSM's Conference on Integrative Physiology of Exercise. The following blog is a reflection on the symposium "Exercise and Energy Restriction to Improve Health: The Crossroads of Energetics and Protein Turnover" by Karyn Hamilton, RD, PhD, FACSM.

What an honor to be part of the IPE symposium “Exercise and Energy Restriction to Improve Health: The Crossroads of Energetics and Protein Turnover” on Friday afternoon. Despite the happy hour time slot and the outstanding weather in San Diego providing a tempting distraction, the session was well-attended.

Dr. Colin Selman served as a perfect chairperson for the event, keeping the speakers on schedule and on task. One notable characteristic of this session, and all of the symposia I attended, was how perfectly focused the collective presentations were—as if the speakers had been working together on the content for weeks.

Dr. John Speakman runs two research groups: one in Beijing China and the other in Aberdeen, Scotland. His contribution to the symposium focused on altering energetics with exercise and energy restriction to impact healthspan. One overriding question of Dr. Speakman’s talk, and this area of research in general, is: Can interventions such as energy restriction and exercise increase human lifespan? Dr. Speakman made compelling arguments about genetic pleiotropy and provided terrific “food for thought” that even attendees who do not focus their work on this area of research could appreciate, such as “What makes you healthy and live a long time, might also make you run more!” I heard some attendees quipping that it doesn’t really matter if calorie restriction makes humans live longer when it makes the adorable grey mouse lemur live longer.

Dr. Tracy Anthony of Rutgers University did an outstanding job of framing the cutting-edge research she does with the integrated stress response, in the context of “Exercise is Medicine.” She pointedly provided an overview of how Exercise is Medicine is actually hormesis in action; The complex physiological stresses evoked by exercise stimulate integrated adaptations that, in turn, provide protection or “resilience” to future stresses. As Dr. Anthony pointed out, “The metabolic path to health is complicated,” but the work in her lab is going a long way to help unravel the complex responses to exercise and other energetic stresses.

I was the final speaker in the symposium—quite intimidating to follow Drs. Speakman and Anthony. This was a perfect opportunity to provide an overview of our findings using four long-lived murine models that have in common both extended healthspan and activation of energetic stress signaling. The work our research team carried out clearly demonstrates activation of mechanisms favoring mitochondrial proteostasis during energetic stress, with the trade-off being slower cell proliferation or growth.

ACSM’s Conference on Integrative Physiology of Exercise provided the perfect opportunity to share published and unpublished data demonstrating the importance of understanding interactions between exercise and pharmacological interventions that also extend healthspan. It is fair to say that if you are interested in the crossroads between energetics and health, you should keep your eye on work emerging from the labs directed by the speakers in this symposium.

Website for Dr. Speakman's lab at the University of Aberdeen. 
Information on Dr. Anthony's lab. 
Website for Dr. Hamilton's lab. 

Read part 1 of this series: "Can Exercise Fill the Reductionist Gap? Reflections on Dr. Michael Joyner's Keynote."
Read part 2 of this series: "Are Exercise 'Mimetics' a Realistic Substitute for Exercise Training? Reflections on the Debate." 


Karyn L. Hamilton, RD, PhD, FACSM, is a member of the faculty at Colorado State University. She serves as a professor in the Health and Exercise Science department, the Director of the Translational Research on Aging and Chronic Disease Lab and Associate Director of the Center for Healthy Aging. She earned her bachelor's and and master's degrees at Montana State University and her Ph.D. at the University of FLorida where she worked in Scott Powers' lab. 

This is part two of a series of blogs from attendees at ACSM's Conference on Integrative Physiology of Exercise. The following blog is a reflection on the debate, "Are Exercise 'Mimetics' a Realistic Substitute for Exercise Training?" between Ron Evans, Ph.D., and John Hawley, Ph.D.

 

The first debate of ACSM’s Conference on Integrative Physiology of Exercise, “Are exercise 'mimetics' a realistic substitute for exercise training?” is in the books, and it was a conversation starter to say the least. Pro-mimetic commentary was provided by Ronald Evans, PhD, of the Salk Institute, while John Hawley, PhD, of the Mary MacKillop Institute for Health Research gave counter arguments on behalf of exercise.

My humble opinion of the session is that both presenters approached the topic from opposite ends on a spectrum of the human condition, albeit providing variable interpretations of the same data. Imagine a Venn diagram where Evans’ mimetics and Hawley’s exercise intersect modestly, but with spirited debate over common ground. At the crux of this particular debate is PPARg, or peroxisome proliferator-active receptor gamma – a name only a scientist could love.

If you haven’t been keeping score at home, PPAR activation is central to many of the well described adaptive responses to aerobic exercise. Staying out of the molecular weeds, it is fair to summarize that PPAR activation results in dramatic alteration in metabolic function to the extent that human exercise capacity is improved in elite athletes, mall walkers and type 2 diabetics alike. Perhaps ten seconds after characterizing this cellular pathway, the search for a medicinal approach to PPAR activation (agonist) began. Think of the potential: countless lives saved or improved, Nobel prizes, swimming pools of cash! Proof of concept experiments were first conducted by Ron Evans’ research team in which “couch potato” mice receiving newly formulated PPAR activators were suddenly running literal circles around their untreated cage mates.

Remarkable as this landmark discovery was, it immediately raised the ire of some in the exercise field. Correction – media-generated overstatements that “exercise in a pill had been discovered” rightfully inflamed the those of us who promote physical activity and exercise a as means to improved health.

So what’s the wrinkle? In short, PPAR agonists (and presumably other exercise mimetics not discussed currently), amazing as they are, are not as robust a stimulus when compared to formal exercise. The metabolic and exercise performance responses to the current forms of these pills are many fold lower than good old fashioned exercise training (think ACSM prescriptive criteria for furry critters).

But you want to know who won the debate.

Sorry, but they both did. Evans very clearly defended the position that PPAR activation, should it be scalable to humans, would be revolutionary to those who can’t exercise due to disease, severe deconditioning or extreme risk for precipitating a medical event with exercise. More pragmatically, most people in the developed world won’t exercise, and there is a solid rationale to suspect that this pill is better than nothing.

On the other side of the argument, Hawley deftly defended the fact that there is no substitute for exercise. No single pill discovered to date can provide the robust multi-tissue, multi-system benefits of a brisk walk.

And by the nature of this meeting, Hawley came to the podium wearing the white hat, but that doesn’t mean Evans had a black hat. Indeed, journalistic irresponsibility in overstating the claims of exercise mimetics has nothing to do with Evans’ position. Evans’ intentions are as altruistic as Hawley’s and it’s worth noting that Evans promoted exercise alongside his mimetic discoveries. In the end Evans mostly spoke to diseased applications while Hawley addressed healthier populations. The Venn diagram overlap, still to be negotiated, pertains to those that won’t exercise—a debate for another day.

Read Part 1: "Can exercise fill the reductionist gap? Reflections on Dr. Michael Joyner's Keynote."

John Quindry, Ph.D., FACSM, is a member of the faculty at the University of Montana, Department of Health and Human Performance. He served as a co-planner of ACSM's Conference on Integrative Physiology of Exercise. 

This is part one of a series of blogs from attendees at ACSM's Conference on Integrative Physiology of Exercise. The following blog is a reflection on the Opening Keynote delivered by Michael Joyner, M.D, FACSM. 

Having just sat through the Michael Joyner keynote talk, the opening event at the ACSM Integrative Physiology of Exercise meeting in San Diego, I’m left wondering if I can go back to graduate school. (I just checked with my wife…the answer is “NO!”) But Joyner’s talk was that inspiring.

As with any engaging academic lecture, Dr. Joyner had three points to make—the first being that the luminaries of modern science have crafted more than a few hollow promises about how omics and big data will solve societies medical woes. Indeed, there is a drug discovery gap, a health outcomes gap and the undeniable reality that when science removes a singular mechanism from a biological system, parallel mechanisms take up the slack.

Dr. Joyner’s second point was refreshingly made from the perspective that genetics do not rule all outcomes. In essence, humans are “plastic.” In true Joyner fashion, the “exercise is good medicine” message was packaged in a nuanced way that I’ll admit I’ve never before heard. The middle point was topped by reassuring the audience that phenotyping is hard—a strong call to do more research that overlaps mechanistic, parallel human and animal models, clinical and translational.

The final point was perhaps best of all: Dr. Joyner shared eight novel research ideas. Each idea, if performed correctly, would likely prove to be a landmark study. Are you sure I can’t go back to grad school?! He also coined the “Joyner criteria” for whether regenerative medicine is a success: benefits of new interventions should exceed that of exercise training.

So yes, I was inspired. Safe to state that in a room of smart people (everyone has or is earning a terminal degree of one type or another), Dr. Joyner is quite probably the brightest. His ability to bring food for thought is unparalleled within the ACSM umbrella. His talk was definitely worth the price of admission.     

See this news release for more details on Dr. Joyner's keynote. 

John Quindry, Ph.D., FACSM, is a member of the faculty at the University of Montana, Department of Health and Human Performance. He served as a co-planner of ACSM's Conference on Integrative Physiology of Exercise. 

The ACSM-GEI Exam update may affect you - this FAQ explains how and why

Summary:

• The ACSM-GEI exam will change on December 3, 2018.
• The exam crosswalk document (below) compares the 2010 and 2018 versions of the ACSM-GEI exam.
• The exam content outline (below) provides specific topics you need to know and/or be able to perform.

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Why is the exam changing?
The ACSM Committee on Certification and Registry Board (CCRB) performs job task analyses (JTAs) of its exams on a regular basis. JTAs survey currently practicing professionals in what they are expected to know and be able to perform for their job. In addition, the JTA captures important changes in industry and standards of practice.
The role of a Group Exercise Instructor has undergone tremendous change in the past decade. As a result, the ACSM CCRB has revised the ACSM-GEI exam to be consistent with the ever-changing demands of a Group Exercise Instructor.

How do I get started?
STEP 1. A good place to start is to review the exam crosswalk document. The crosswalk provides an overview and side-by-side of exam changes from 2010 to 2018. 

2010-2018 ACSM-GEI crosswalk

STEP 2. Next, you should review the 2018 exam content outline. This document provides a deeper dive into job tasks and specific knowledge and skill statements.

2018 ACSM-GEI Exam Content Outline

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FAQ: Do current ACSM-GEIs need to retake their exam?

They do not.

FAQ: What are cognitive levels?
The ACSM CCRB included a new section on the exam content outline called “cognitive level.” The job of a Group Exercise Instructor can range between simple to complicated tasks. Much in the same way, the ACSM-GEI exam is written at different levels. Cognitive level is a way to describe how complex certain job tasks are.

ACSM uses three cognitive levels: recall, application and synthesis.

Recall is remembering certain facts.
Application requires you to understand a process and know what to do with it.
Synthesis requires you to examine a complicated situation and provide an answer based on new information.

You can find sample questions in the Exam Content Outline. 

Be sure to connect with us on Twitter, Facebook, and LinkedIn to keep up with the latest updates, expert insights and more. 

Good luck on the ACSM exam! We look forward to you becoming a part of the ACSM-certified family!

In health,
Francis Neric, MS, MBA
ACSM National Director of Certification

How to increase your success as a fitness professional, using the 5 Step Sales framework, and identifying the 4 key behavior styles.

The sales process is a skill that can be learned and developed by anyone and is especially useful to be aware of when you are interacting face to face with people. I have always thought about the sales process as thinking about what you are going to do before you do it. I learned the hard way through trial and error in my early years as a personal trainer and medical sales professional and wondered what I was doing wrong until I had some training on the sales process.

"Knowing your sales target involves understanding your own behavior style"

5 Step Sales Framework

The sales framework breaks down a sale into a five-step process from establishing a relationship, demonstrating a need, working through concerns, and, eventually, closing a sale:

Approach – establish rapport and break the barriers of pre-occupation

Interview – identify needs, challenges and motives

Demonstrate – show how your products and services fill identified needs

Validate – cause people to trust you and believe your claims

Negotiate – understand and work through problems and concerns

Close – ask for an appropriate commitment to action

4 Behavior Styles

Knowing your sales target involves understanding your own behavior style, identifying the style of the potential customer and adopting your style to mirror that of the potential customer. Mirroring essentially is where you mimic verbal and physical behaviors of a potential customer to build rapport. While this seems strange at first, it happens naturally among like-minded people. Imagine seeing your high school friend that you haven’t see in years. You will often speak with same cadence and tone, use the same physical gestures, etc. People tend to let their guard down and open up to when using this method*:

Talker - Outgoing and friendly, not as interested in details, values personal relationships, makes decisions based on emotions and facts.

Doer - Direct, forceful and results oriented. Requires concise, focused information. Makes quick decisions. Has clear objectives to achieve.

Supporter - Needs time to process information. Likes to establish trusting relationships. Reluctant to change current buying habits. Laid-back and friendly.

Controller - Detail-oriented, deliberate and organized. Relies on facts, evidence and data. Weighs all options before making a decision. Lower manifestation of energy and emotion.

*Which one are you? Try identifying the behavior style of those around you.

My Personal Experience:
Identifying as a Doer, the biggest mistake I have made, and still make from time to time is skipping the approach. Being too direct and forceful makes it harder to mirror and build rapport with the potential customer. A terse communication indicates an awkward negotiation that comes across as forceful, which makes it even harder to close. Recognizing and becoming aware of this mistake as part of my behavior style has taught me to spend more time on the approach, listen more during the interview process, and ultimately make a better sale. Coming across as a real person instead of a sales person, identifying what the potential customer needs, and demonstrating that what you have provides value, using the framework above, will increase your success as a fitness professional.

Author 
William Coale is a fitness and health education professional who wears many hats, but still has time to get at least 30 miles of running and a few thousand kettlebell swings into his week. 

William collaborates with orthopedic trauma surgeons and podiatrists to determine the best medical device and bracing solutions for their patients and help GPs and cardiologists learn more about diagnostic solutions for improved patient care. 

At his private practice, Proprius, William focuses on training and motivating individual clients to achieve their personal goals, perform their best, prevent overuse injuries, execute physical rehabilitation plans, and maintain mobility and flexibility. 

William graduated with a B.S. in Kinesiology from Indiana University where he also competed as a varsity cross country and track and field athlete. He is a licensed massage therapist and has a Corrective Exercise certificate.

Publishing original research is critical to academic and professional achievement. When selecting the journal to which you will submit your work, it is important to consider the options very carefully. While there are many academic journals, 30,000 or more in fact based on some reports, it is estimated that around 10,000 journals employ “predatory publishing” practices and should be avoided at all costs.

What is a predatory journal?

Predatory journals exploit the need for academics and researchers to publish their work, and they use questionable business tactics such as charging the author to publish and then not providing the professional services of a reputable academic journal. The checklist below includes a list of signs that a journal may be predatory. 

Why should you avoid publishing in a predatory journal?

There are a number of possible consequences to publishing in a predatory journal. These include:

• Published work is not protected
• Work will receive poor or no peer review
• Work could disappear, or you could lose access if the journal is dissolved
• It may be difficult for others to find your work, and when/if it is found, academics may be reluctant to cite it
• There are documented cases in which publishing in a predatory journal, though inadvertently, resulted in ethics accusations and career injury
• Once work is published in a predatory journal, it can be very difficult, if not impossible, to have that work removed and published elsewhere in a reputable academic journal

 

How can you avoid predatory journals?

Start by visiting the website Think. Check. Submit. This site provides a checklist and FAQs that can help to guide you through the process of evaluating a journal before submission.

 

If you have any doubts about a journal’s reputability, consult with a librarian. Librarians are trained to know the publishing process, and those employed by universities work with a wide variety of academic journals daily. Also consult with your colleagues, an advisor, faculty member or mentor. Their experiences can help guide your way.

 

Other helpful resources:

• COPE – Committee on Publications Ethics
• The Scholarly Kitchen
• ALPSP – Association of Learned and Professional Society Publishers
• OASPA – Open Access Scholarly Publisher’s Association
• DOAJ – Directory of Open Access Journals
• Cabell’s
• Beall’s List

Watch the ACSM Webinar "Navigating the World of Predatory Publishing," presented by the authors of this blog and moderated by ACSM's Chief Content Officer, Katie Feltman. 

L. Bruce Gladden, Ph.D., FACSM, is a professor at Auburn University’s School of Kinesiology. His work is focused on the role of lactate in skeletal muscle and whole-body metabolism. He is the author or co-author of more than 75 refereed research articles and reviews, and his investigative work has attracted research funding from the National Institutes of Health, National Science Foundation, NATO and private research foundations. Dr. Gladden has served as president of the southeast chapter of ACSM, a member of the ACSM Board of Trustees and he is currently the editor-in-chief of Medicine & Science in Sports & Exercise_®. He was the recipient of an ACSM Citation Award in 2015 in recognition of his significant contributions to sports medicine and the exercise sciences. 

Jeffrey A. Potteiger, PhD, FACSM, is dean of the graduate school at Grand Valley State University (GVSU) and professor in the Department of Movement Science. He received his Ph.D. from Auburn University, his M.S. degree from McDaniel College, and his B.S. degree from Indiana University of Pennsylvania. He has more than 100 published research articles, books, and book chapters much of which have involved work with students. Dr. Potteiger recently published the 3^rd edition of the textbook titled ACSM’s Introduction to Exercise Science. Dr. Potteiger serves as the GVSU authorizing institutional official for all research activities and as the university’s research integrity officer. Dr. Potteiger serves on the editorial boards of several journals and as the chair of the ACSM’s Publications Committee. His broad research interest is in how physical activity and nutrition influence health and disease. Much of Dr. Potteiger’s recent research activity has been focused on the role of exercise and dietary intake on the use of carbohydrates and fats by the body.

It is back-to-school time and this often means a new schedule and more small trips, especially with children. This is also a good time of year to establish new routines like using active transportation, which has many co-benefits including improved physical and mental health as well as environmental and economic savings. Incorporating active transportation with kids and around their schedules can be a wonderful opportunity to role model healthy living. As health professionals, we want to promote all types of physical activity, and active transportation can help prevent climate change, too.  This can be a more challenging behavior for some, but it does not have to be all or none. It may take a while to gradually increase your participation in active transportation, but starting small can help you add a new behavior. 

Here are some strategies you can use to begin incorporating active transportation into your daily life with children (or furry ones):

• Walk/bike with kids to school. (Safe Routes to School)
• Weekend errands/outings.
• Drive child to lessons and park car; walk to errands from there.
• Start with shorter walkable distances then progress to bicycling if desired or try other human-powered modes such as scooters, skateboards, or roller blades.
• Many businesses are dog friendly —walk your dog to get morning coffee. ("Dog Walking is Good for You", NYT 2018)

Work-related/on your own strategies:

• “Free Ride Fridays” Emission-free bike/walk to work. Fridays tend to be a bit more relaxed in relation to schedule and dress codes.
• Drive most of the distance of a trip, then park and walk/bike last mile (or half mile or two miles).
• From work, walk to lunch or errands during the day as you may be closer to resources near work than at home.
• Ride/walk to fitness center, park, other physical activity —no worries about being sweaty (I regularly ride to yoga).
• Consider practicing walking or bicycling a route at a quieter time of day/week when there is less time pressure to determine best commuting time and route.

The type of active transportation may vary with lifestyle/family. Before children, I rode my bicycle for most errands in town (supermarket, farmers market, pharmacy, bank, cafes) and commuted to work 1-2 days per week in fair weather. With young kids, I pulled them along in a bike trailer. Now with older kids, we will ride together for errands, to the park (or to get ice cream!) or will walk to school. My community does not have many sidewalks, so it has meant waiting until my children were old enough to properly navigate our winding rural roads. Advocating for walking and bicycling infrastructure (sidewalks, crosswalks, protected bike lanes, etc.) will increase safety, accessibility and convenience, so attend your local planning and zoning committee meetings. Take any opportunity to prevent further climate change and protect our health by incorporating active transportation, even in small steps.

Check out ACSM’s “Getting Started With Cycling” info sheet for help selecting a bike, helmet, and clothing that will lead to a more enjoyable and successful trip.

Want more information on walking and biking for transportation and how it benefits health, helps mitigate climate change, and boosts the economy? Explore resources and webinars on the ActivEarth webpage.

Melissa W. Roti, Ph.D., FACSM, ACSM-EP, GEI
Professor, Director Exercise Science Program
Westfield State University
Member, ActivEarth Task Force
On Twitter: @MelissaRoti

BREAKING NEWS Legislation would help consumers reduce cost of fitness and sports activity, equipment

(Indianapolis)- The U.S. House of Representatives Wednesday passed House Resolution 6199, the Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018, by a vote of 277-142. The Personal Health Investment Today (PHIT) Act, a bill that provides Americans with the ability to invest in active, healthy activities that promote improved health, was included as part of H.R. 6199. The legislation now moves to the Senate for consideration. 

The PHIT Act, sponsored by representatives Jason Smith (R-MO) and Ron Kind (D-WI), would amend the Internal Revenue Code to allow a medical care tax deduction in health savings accounts for up to $1,000 ($500 single filer) of qualified sports and fitness expenses per year. The bill defines "qualified sports and fitness expenses" as amounts paid exclusively for the sole purpose of participating in a physical activity, including fitness facility memberships, physical exercise or activity programs, and safety equipment for a physical exercise or activity program. 

“The number of individuals not meeting physical activity guidelines is staggering, and cost has become a barrier for too many Americans,” said Jim Whitehead, CEO and Executive Vice President for the American College of Sports Medicine. “The PHIT Act will lower this barrier and help move more Americans from inactive to active, addressing a critical health issue in our culture today.”

ACSM has been actively involved in advocating for the PHIT Act through direct advocacy, its annual Capitol Hill Day and Action Alerts, and it will push for its adoption into law. As the bill continues down the legislative path, ACSM will work with Congress to ensure that the legislation meets its intended goals of creating health care policy that promotes active, healthy lifestyles. 

For updates on this and other legislation supported by ACSM, be sure to follow @ACSMAdvocacy on Twitter.

 

By popular demand, ACSM’s Guidelines for Exercise Testing and Prescription – our flagship title- is available for pdf download.

For this month’s featured download, we’re offering Chapter 1 of the 10th edition. This introductory chapter serves as a great example of what you'll find in the most recent edition.

 

Visit our dedicated ACSM Guidelines for Exercise Testing and Prescription page for the download and more details

ACSM’s Guidelines for Exercise Testing and Prescription is the flagship title from the American College of Sports Medicine, the prestigious organization that sets the standards for the exercise profession. This critical handbook delivers scientifically based standards on exercise testing and prescription to the certification candidate, the professional, and the student. This manual gives succinct summaries of recommended procedures for exercise testing and exercise prescription in healthy and diseased patients.

Important insight for the ACSM Personal Trainer Exam and ACSM Exercise Physiologist Exam, from the National Director of ACSM Certification, Francis Neric, along 3 new members studying for these ACSM Certification exams.

Some of the most common questions ACSM gets are: "what certification is right for me?"; "how long does it take to prepare?", and, "what material should I use to study?" ACSM's National Director of Certification, Francis Neric, will introduce you to three folks who are planning ACSM's exams and document their journey in becoming certified. Francis will also provide you valuable test insight in how to get started.

Special thanks to: Whitney Leyva, Cat Perry, and Jen Aragon

✅ For more information on how to start your ACSM Certification journey, visit us at http://www.acsm.org/get-stay-certified

It is not too late to register and attend the 2018 ACSM Specialty Conference, “Integrative Physiology of Exercise (IPE),” to be held at the Sheraton San Diego Hotel and Marina in San Diego, California on September 5-8, 2018.

This exciting meeting will begin with a keynote lecture, "Can Exercise Physiology Help Fill the Reductionist Gap?" presented by Dr. Michael Joyner at 6:30 PM on Wednesday, September 5, 2018, with a welcome reception to follow. 

To emphasize the rapid research developments in key areas of exercise physiology, the IPE 2018 symposia program and debates will address the following major topics:

• Cancer Prevention by Exercise: Role of Endocrine and Immune Function
• Interactions between Mitochondrial Morphology and Turnover in Healthy and Diseased Skeletal Muscle
• Understanding the Physiological Basis for Sex Differences in the Response to Exercise and Pathological Stimuli: A Role for Estrogen and Ovaries
• Debate: Are Exercise Mimetics a Realistic Substitute for Exercise Training?
• Debate: Do Genetics Really Influence Exercise Capacity or Trainability?
• Recent Advances in Exercise and Arterial Stiffness
• Metabolic Flexibility in Health and Disease
• Exercise Pressor Reflex Function in Health and Disease
• Exercise and Energy Restriction to Improve Health: The Crossroads of Energetics and Protein Turnover
• The Role of Exosomes in Skeletal Muscle and Systemic Adaptation to Exercise
• Men ≠ Women: Effects of Sex Hormones and Physical Activity on Vascular Function
• Molecular Transducers of Exercise-induced Muscle Hypertrophy
• How Exercise Promotes Brain Health in Aging
• Is Mitochondrial Respiration a Limiting Factor of Oxidative Metabolism? An Integrated Approach to Exercise

To achieve a balanced schedule, both the symposia and debates have been organized to cover a broad array of important topics in exercise physiology. The symposia lectures will be given by internationally recognized scientists and are intended to provide a springboard for dynamic scientific exchanges. Importantly, each symposium will include aspects of how advances in basic science lead to changes in practice. 

Scientific poster sessions are scheduled on each day of the conference, and these unopposed poster presentations will comprise a key component of the conference. Indeed, the outstanding abstracts presented at this meeting will shape the exchange of information and ideas that transpire in this exciting venue. We are confident that you will thoroughly enjoy this outstanding scientific meeting in beautiful San Diego. For more information on program content, registration and the venue, please see the IPE Conference webpage.

Scott K. Powers, Ph.D., FACSM, is a UAA-endowed professor and distinguished professor in the Department of Applied Physiology and Kinesiology at the University of Florida in Gainesville. He investigates effects of muscular exercise and inactivity on both cardiac and skeletal muscle. His research is focused on exercise-mediated changes in cardiac and skeletal muscle antioxidant systems and the role of these changes in protecting against ischemia-reperfusion injury. 

*Dr. Powers is chair of the 2018 Program Committee for ACSM’s Integrative Physiology of Exercise Conference. He is joined on the committee by three additional highly accomplished scientists who have contributed to the planning process: L. Bruce Gladden, Ph.D., FACSM; Karyn Hamilton, Ph.D., FACSM; and John Quindry, Ph.D., FACSM. 

Long Term Athletic Development (LTAD) Paraphrased:  Coaches should be cognizant of the principles and train their athletes accordingly.  Again, basics first – walk before you run.

Certifications are awesome!  They certainly serve a purpose of continuing education and constant growth for professionals.  However, it is one thing to know the material but can you actually teach it?  Do you have the knowledge of the teaching methods to actually get the point across to the students?  Bridging the gap between the academic and the practical is essential but doesn’t often happen, particularly in the more “academic” of certifications.

One of the problems that we in the U.S. face is the lack of coaching/teaching education.  Everyone gets the knowledge to get the letters after their name, but it is difficult to find programs that actually show you how to break it down and teach it.

That being said, it is important to get back to the beginning.  Where do we start?  If you check out YouTube you will find the latest, greatest videos of what the best in the world are doing or should be doing.  But do they really get to the basics of how to teach the concepts you see?

“…we are responsible for getting kids caught up with the basic skills that they have sorely missed in their upbringing."

 

For coaches, the concept of “walk before you run” is a pretty effective way to go.  Teach the basics before trying to have your students do the more advanced stuff.  In all fairness, the coaches are not all at fault for the need for immediate gratification that most of us are used to, and have the tendency to just skip right to the more advanced skills. 

The problem goes back as early as training and educating our youth.  How many elementary physical education classes have gone by the wayside?  How often do you see sport coaches pushing their young athletes to compete year-round and specialize way too early?  Heck, for that matter, how many times do you see kids sitting inside playing on their video games rather than being outside playing?

Having taught high school physical education and weight training for many years, it was frustrating to ask the kids to do a simple “power skip” down the gym for a dynamic warmup and a handful of the students didn’t know how to skip!  Forget trying to do anything more advanced when they didn’t even know the basics.

Unfortunately, with our education system deleting physical education programs, these basic skills are not being taught.  It is being left up to the “professionals” who are certified as coaches and trainers to catch up with skill development that should have been covered long ago.  But, is your academic background preparing you to go out and teach what you are learning from those certifications?  Can you “bridge the gap” between the knowledge and the practical application.

To paraphrase some of the concepts of LTAD (Long Term Athletic Development), coaches should be cognizant of the principles and train their athletes accordingly.  (Again, basics first – walk before you run). 

For example:

                FUNdamental Stage:   Males age 6-9 / Females age 6-8

• Basic overall sports skills leading to physical literacy
• Introduced through fun and games
• Developmental progression of fundamental movements and skills
  • Fundamental locomotor movement
  • Speed and agility
  • Strength and power
  • Endurance
  • Balance and stability
  • Body control
  • Object control

                Learning to Train Stage:   Males age 9-12 / Females age 8-11

• Further develop all fundamental movement skills and teach general, overall sports skills.
• Further develop endurance, flexibility, speed and change of direction
• Develop strength with bodyweight exercises as well as medicine balls and swiss balls
• Structure competition to address differences in training age and ability
• Ratio of 70% training to 30% competition
• Still continue to encourage unstructured play

The reasoning behind showing this general information on the LTAD strategies is to let our certified professionals know that there is more to be done than just learning the science or the academics behind training.  It is to reiterate to professionals in the field that we are responsible for getting kids caught up with the basic skills that they have sorely missed in their upbringing.  And, even more importantly, getting our professionals caught up on the basic teaching skills that they have been missing in their educational “upbringing”.

Stay tuned for more detailed information in later blogs on some of the strategies to make these basic skills teachable.


Bio: Coach Leo Totten MS, USAW 5
He is a Senior International Weightlifting Coach (USAW 5), and has been named as one of 65 Most Influential Strength Coaches of All Time. Coach Totten has been inducted into the USA Weightlifting Hall of Fame, and is the Head Coach for the East Coast Gold Weightlifting Team, with 20 time National Team Champions. He is the owner of Totten Training Systems, LLC  2012-current, and  Director of Strategic Outreach for Elite Sports University.

The prevalence of Type II Diabetes (T2D) continues to rise globally, and particularly in Western nations (1).  Without proper treatment, T2D may lead to cardiovascular diseases, neuropathy, kidney failure, and death (2).

Authors: Gabriel Zieff, B.S., Andrew Borror, B.A., Claudio Battaglini, Ph.D., FACSM, Lee Stoner Ph.D., ACSM-CEP, ACSM-EIM

Department of Exercise and Sport Science, University of North Carolina at Chapel Hill

BACKGROUND

The prevalence of Type II Diabetes (T2D) continues to rise globally, and particularly in Western nations (1).  Without proper treatment, T2D may lead to cardiovascular diseases, neuropathy, kidney failure, and death (2).

The major goal of T2D treatment is the regulation of hyperglycemia (high blood sugar). Lifestyle behaviors such as eating a healthy diet and engaging in exercise can be effective strategies for mitigating hyperglycemia and improving insulin sensitivity in T2D (3, 5). In terms of exercise, muscle-contraction-mediated glucose uptake provides a means for glucose to exit the bloodstream and enter the muscle tissue independent of insulin. Specifically, repeated muscular contractions stimulate transient translocation of the GLUT-4 transporter protein to the cell-membrane to facilitate the uptake of glucose from the circulation into the muscle.

Given the importance of managing hyperglycemia in T2D, it is not surprising that glucose elevation following meals is of particular concern for this population. Thus, postprandial exercise may be a useful strategy to combat the glycemic response to a meal while preserving insulin sensitivity. Unfortunately, the optimal timing and prescription of postprandial exercise to maximally reduce postprandial hyperglycemia have not been clearly elucidated.

Recently, a systematic review was conducted to assess the effects of postprandial exercise on glucose regulation in T2D (6). This article: i) reports the outcomes of the systematic review; ii) discusses the appropriate timing, modality, intensity, and duration of exercise; and iii) addresses the practical considerations that need to be accounted for when prescribing and monitoring exercise in this population.

SYSTEMATIC REVIEW FINDINGS

The systematic review identified 12 randomized crossover trials, with a total of 135 participants (108 males, 20 females, 7 unknown), none of whom were being treated with insulin. The crossover trials included an acute exercise bout, and a non-exercise control. The exercise bouts were performed within a three-hour period following a standardized meal.

The analysis revealed that postprandial aerobic exercise (11 studies) decreased short-term glucose area under the curve (AUC) by 3.4% to 26.6% and 24-hour prevalence of hyperglycemia by 11.9% to 65% (6). Resistance training (2 studies) decreased short-term glucose AUC by 30% and 24-hour prevalence of hyperglycemia by 35% (6–8). Further, the review showed that while pre-prandial exercise also conferred beneficial effects on glucose regulation, greater improvements occurred with postprandial exercise (6-10). It is likely that when postprandial exercise is performed, maximal exercise-induced glycemic regulation is most aligned with peak blood glucose (11). In contrast, pre-prandial exercise may not allow for such coordination between exercise-induced glycemic regulation and blood glucose elevation.

Unfortunately, as far as we know, no studies have examined whether the attenuation of postprandial glucose improves clinical outcomes, such as cardiovascular events. However, the evidence from the review suggests that postprandial exercise decreases blood glucose levels to below 8.6 mmol/L for up to 24 hours, which approximately corresponds to a glycated hemoglobin (HbA_1C) level of 7% (8–10, 12–14). Chronic decreases in HbA_1C to this extent are associated with a reduced risk of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke (12). While the findings from the systematic review should be considered preliminary, the 24-hour reduction in blood glucose is potentially clinically meaningful.

APPROPRIATE TIMING, INTENSITY AND MODALITY OF EXERCISE PRESCRIPTION

Timing and Intensity: Longer duration (30 to 60 minutes), moderate-intensity, aerobic exercise in the 3-hour period following a meal seems to most consistently result in improved glucose regulation among individuals with T2D (6). Lower intensities and shorter durations of exercise were not as effective in promoting glucose regulation (6). A likely explanation is that a driving factor behind the glucoregulatory effects of postprandial exercise is total energy expenditure.

Modality: While less evidence exists regarding the glucose improvement related to postprandial resistance training, the available evidence does suggest resistance training and moderate-intensity aerobic exercise are similarly effective (6).

CONSIDERATIONS FOR EXERCISE PRESCRIPTION

The American College of Sports Medicine (ACSM) recommends accumulating 150 minutes of moderate intensity or 60 minutes of vigorous intensity aerobic exercise per week. It also recommends performing 2 to 3 non-consecutive days of resistance training per week at intensities between 50% to 80% of 1-repetition maximum (1-RM) and targeting all major muscle groups using a scheme of 1 to 4 sets of 8 to 15 repetitions per exercise. We recommend that the current ACSM guidelines, which are similar to those provided by the American Diabetes Association (ADA), be adhered to. However, we suggest that exercise be performed within three hours of the largest meal of the day. We also suggest that several other minor modifications to these guidelines be considered, as discussed below.

With regards to ACSM guidelines, the findings of the systematic review lead to several important considerations. First, while the ACSM recommendations for aerobic exercise are stated in terms of cumulative minutes of exercise achieved per week, due to the transient (≈ 18 to 48 hours) nature of contraction-mediated glucose uptake, we suggest that no more than two days should occur without engaging in aerobic exercise (15). In line with this we suggest that, between aerobic and resistance exercises, only one “rest-day” be taken each week. In terms of resistance training, we suggest that a moderate-intensity range of 50% to 60% 1-RM be maintained to prevent large increases in blood pressure and minimize delayed-onset muscle soreness. These recommendations will help to optimize safety and compliance. Lastly, clinicians should aim to help individuals with T2D work up to a duration of 60 minutes of exercise (regardless of aerobic or resistance) at least 6 days per week to maximize energy expenditure.

It is important to note that these guidelines are ideals and rigid adherence to them may be unrealistic. Therefore, the most important underlying themes of lifestyle-based glycemic regulation should be prioritized. In particular, strategies for relapse prevention should be prioritized. For example, if the prescribed exercise following the largest meal cannot be achieved for a given day, engagement in any form of physical activity, such as taking the dog for a walk or gardening, should be encouraged.

CONCLUSION

Postprandial hyperglycemia is a significant problem for individuals with T2D. The current evidence indicates that postprandial exercise may help reduce hyperglycemia, thus preventing the progression of T2D and associated complications. Although the optimal intensity and timing of initiation are not clear, energy expenditure seems to be an important factor.

Based on this, we suggest that clinicians and fitness professionals help individuals with T2D adhere to the current ACSM and ADA guidelines. However, we suggest that a greater emphasis be placed on meeting these recommendations during the three-hour period following the largest meal of the day.

References:

1.        World Health Organization. Diabetes [Internet].WHO. 2017

2.        Cavalot F, Pagliarino A, Valle M, et al. Postprandial blood glucose predicts cardiovascular events and all-cause mortality in type 2 diabetes in a 14-year follow-up: lessons from the San Luigi Gonzaga Diabetes Study. Diabetes Care. 2011;34(10):2237–43.

3.        Rabi DM, Edwards AL, Southern DA, et al. Association of socio-economic status with diabetes prevalence and utilization of diabetes care services. BMC Health Serv Res. 2006;6:124.

4.        Oberlin DJ, Mikus CR, Kearney ML, et al. One bout of exercise alters free-living postprandial glycemia in type 2 diabetes. Med Sci Sport Exerc. 2014;46(2):232–8.

5.        Goodyear LJ, Kahn BB. Exercise, glucose transport, and insulin sensitivity. Annu Rev Med. 1998;49(1):235–61.

6.        Borror A, Zieff G, Battaglini C, Stoner L. The effects of post-prandial exercise on glucose control in individuals with type 2 diabetes: A systematic review [Internet]. Sport Med. 2018; In Press.

7.        Heden TD, Winn NC, Mari A, et al. Postdinner resistance exercise improves postprandial risk factors more effectively than predinner resistance exercise in patients with type 2 diabetes. J Appl Physiol. 2015;118(5):624–34.

8.        van Dijk J-W, Manders RJF, Tummers K, et al. Both resistance- and endurance-type exercise reduce the prevalence of hyperglycaemia in individuals with impaired glucose tolerance and in insulin-treated and non-insulin-treated type 2 diabetic patients. Diabetologia. 2012;55(5):1273–82.

9.        Haxhi J, Leto G, di Palumbo AS, et al. Exercise at lunchtime: effect on glycemic control and oxidative stress in middle-aged men with type 2 diabetes. Eur J Appl Physiol. 2016;116(3):573–82.

10.      Colberg SR, Zarrabi L, Bennington L, et al. Postprandial walking is better for lowering the glycemic effect of dinner than pre-dinner exercise in type 2 diabetic individuals. J Am Med Dir Assoc. 2009;10(6):394–7.

11.      Poirier P, Tremblay A, Catellier C, Tancrède G, Garneau C, Nadeau A. Impact of time interval from the last meal on glucose response to exercise in subjects with type 2 diabetes. J Clin Endocrinol Metab. 2000;85(8):2860–4.

12.      Zoungas S, Chalmers J, Ninomiya T, et al. Association of HbA1c levels with vascular complications and death in patients with type 2 diabetes: evidence of glycaemic thresholds. Diabetologia. 2012;55(3):636–43.

13.      Gillen JB, Little JP, Punthakee Z, Tarnopolsky MA, Riddell MC, Gibala MJ. Acute high-intensity interval exercise reduces the postprandial glucose response and prevalence of hyperglycaemia in patients with type 2 diabetes. Diabetes, Obes Metab. 2012;14(6):575–577.

14.      Manders RJF, Van Dijk J-WM, Van Loon LJC. Low-intensity exercise reduces the prevalence of hyperglycemia in type 2 diabetes. Med Sci Sport Exerc. 2010;42(2):219–25.

15.      Lehnen AM, De Angelis K, Medeiros Markoski M, D´Agord Schaan B. Changes in the GLUT4 expression by acute exercise, exercise training and detraining in experimental models [Internet]. J Diabetes Metab. 2012 [cited 2018 Jan 22 ];(10) available from: http://dx.doi.org/10.4172/2155-6156.S10-002. doi:10.4172/2155-6156.S10-002.

The American College of Cardiology (ACC), American Heart Association (AHA), and other organizations recently released updated blood pressure guidelines. Please be aware that ACSM Certification Board will adopt the new hypertension guidelines in 2018 and 2019 as follows:

ACSM-GEI: use the JNC 2003 hypertension guides until December 2, 2018. Beginning December 3, 2018, the ACSM-GEI exam will reflect the updated 2017 ACC/AHA thresholds for high blood pressure and related terminology (i.e., "elevated blood pressure").

ACSM-CPT: use the JNC 2003 hypertension guides through Dec 31, 2018. Beginning January 1, 2019, the ACSM-CPT exam will reflect the 2017 ACC/AHA thresholds for high blood pressure and related terminology (i.e., "elevated blood pressure").

ACSM-EP: use the JNC 2003 hypertension guides through Dec 31, 2018. Beginning January 1, 2019, the ACSM-EP exam will reflect the 2017 ACC/AHA thresholds for high blood pressure and related terminology (i.e., "elevated blood pressure").

Clinical exercise physiologist: RCEP and CEP exams taken prior to October 31, 2018 will be based on JNC 2003 hypertension guidelines. Beginning December 3, 2018, the ACSM-CEP exam will reflect the 2017 ACC/AHA thresholds for high blood pressure and related terminology (i.e., "elevated blood pressure").

JNC (2003)	2017 ACC/AHA thresholds
Normal: <120/<80 mm Hg	Normal: <120/<80 mm Hg
Prehypertension: 120-139/80-89 mm Hg	Elevated: 120-129/<80 mm Hg
Stage 1 hypertension: SBP between 140-159 mm Hg or DBP between 90-99 mm Hg	Stage 1 hypertension: SBP between 130-139 or DBP between 80-89 mm Hg
Stage 2 hypertension: SBP ≥160 or DBP ≥100 mm Hg	Stage 2 hypertension: SBP ≥140 or DBP ≥90 mm Hg

 

 

Please visit the following links for more information:

• What's Changed: New High Blood Pressure Guidelines 
• AHA Updates Blood Pressure Guidelines 
• American College of Cardiology and American Heart Association Task Force on Clinical Practice Guidelines

Simple tips on what you can eat before and after a workout, for performance and body composition.

By: Amy Goodson, MS, RD, CSSD, LD on behalf of the National Dairy Council

I recently shared some tips with my friends @DairyGood on what to eat before and after a workout. I thought fitness professionals and some of my fellow sports RDNs may be interested in my suggestions for a balanced training diet, too. Here’s a summary of what I generally recommend.

After a workout, you need to focus on refueling and recovery. Think these three Rs: Replenish, Rebuild, Rehydrate

Pre-Workout

Before a workout, you need to fuel-up and provide your body with the energy it needs to workout, whether cardio, weight–training or a combo of the two. Ideally, two to four hours before a workout, eat a meal that is rich in complex carbohydrates (think oatmeal or brown rice), moderate in lean protein (think chicken or low-fat and fat-free dairy foods), lower in fat (think nuts and oils) and fiber (think broccoli and cauliflower) and includes plenty of fluids (think water or low-calorie beverage). Nutrient-rich examples of pre-workout meals include:

• Oatmeal with berries, a few nuts, low-fat Greek yogurt and water
• Grilled chicken, brown rice, green beans and unsweetened-tea
• Turkey and cheese sandwich on whole wheat bread with lettuce, tomato and avocado, a fruit and water

If you workout early in the morning and don’t have time to eat hours before, try a granola bar, banana or even dry cereal or crackers 30 minutes before you get moving. If the workout will be intense or extra long, pump the snack up to a peanut butter and jelly sandwich, protein bar or even a smoothie with whey protein, fruit and water.

Post-Workout

After a workout, you need to focus on refueling and recovery. Think these three Rs:

• Replenish your muscles with carbohydrate to replace what was burned off in exercise. Simple carbohydrates are ideal immediately post-workout because they break down quickly.
• Rebuild your muscles with protein. Exercise can cause muscle breakdown and high-quality protein, like milk, yogurt, eggs, cheese and lean meats can help rebuild and repair muscle fibers. Whey protein is a good choice after a workout as your body can digest it quickly and it contains the highest content of leucine, an amino acid that has been shown to help build and repair muscles after a workout.
• Rehydrate with fluid and electrolytes you sweated out during exercise.

The goal is to eat within 45 minutes post-workout. If you can do it sooner, then great! Because many people are not hungry immediately after they workout, shakes and smoothies can be a nutrient-rich option to start recovery – plus, they can count toward rehydration. Here are some post-workout recovery snacks:

• Low-fat chocolate milk
• Vanilla yogurt with fruit and honey
• Smoothie made with low-fat milk, whey protein and fruit

Get a quick snack right after a workout, then follow it up with a meal of complex carbohydrate, lean protein, veggies and fluid, like beef stir fry or a veggie omelet with whole wheat toast. You can get more of my tips on my blog or by following me via social media.

Author Amy Goodson, MS, RD, CSSD, LD is a registered dietitian in the Dallas-Fort Worth area with an emphasis in overall health, wellness and sports nutrition. She has 11 years of experience as the sports dietitian at Ben Hogan Sports Medicine and has worked with Texas Christian University Athletics, the Dallas Cowboys, Texas Rangers, FC Dallas Soccer, Jim McLean Golf School and many PGA Tour players as well as with many middle school, high school and endurance athletes. She received her Bachelor of Science in speech communications from Texas Christian University and Master of Science in exercise and sports nutrition from Texas Woman’s University. She is also a Certified Specialist in Sports Dietetics.  

The National Oceanic Atmospheric Association Administration has just released data that show that May 2018 was the hottest May on record at an average of 65.4 degrees Fahrenheit. Every state in the U.S. reported record temperatures, and there were 8,540 record highs recorded in May. The record high of 100 degrees Fahrenheit occurred in Minneapolis on May 28, 2018, when many attendees started to arrive for the 65th ACSM Annual Meeting.

Higher temperatures lead to higher ground level ozone, which is a pollutant that affects everyone, especially people who live in urban areas. Cities are growing in population, especially in certain parts of the U.S. where rapid increases in population lead to more cars on the roads. Motor vehicle traffic is concentrated along highways and major urban thoroughfares. Increased temperature and ground level ozone lead to poor air quality, leading to more air quality action alert days (Code Orange or Code Red) where outdoor activities need to be limited either for sensitive groups or for all. The populations most affected are persons of lower socioeconomic status, minority populations, children, senior adults, and persons with chronic diseases. Air pollution and high ground level ozone can promote asthma attacks and cause direct damage to blood vessels, making persons with heart disease vulnerable to heart attack and stroke. These challenges are not limited to the U.S. in that poor air quality, climate change, and its effects on health are global problems.

The World Health Organization advocates that by addressing and investing in active transportation, municipalities can address air quality, climate change, and health equity.  Walking, bicycling, and use of public transportation reduce vehicle emissions that add to pollution and ground level ozone while increasing the health of the active transport participants. Planting more trees not only leads to increased neighborhood aesthetics, the increased shade helps lower ambient temperatures for those persons walking and biking to help reduce urban heat island effects. Trees can capture both carbon dioxide and ozone. If municipal leaders emphasize active transport and aesthetic walking and biking routes they will help mitigate some of the effects of climate change, including its effects on air pollution, while promoting physical activity and health equity. As leading experts in sports, exercise, health, medicine, and physical activity, it is important that we collaborate and advocate for active transport as a way to improve air quality and reduce the effects of climate change for everyone.

Janet R. Wojcik, Ph.D., FACSM, ACSM-EP, ACSM/ACS CET
Associate Professor and Program Director, Exercise Science
Winthrop University
Chair, ActivEarth Task Force

Healthy knees just might help with longevity and better performance

As amazing as the human body is, it is still prone to injury.

Taking part in any physical activity is obviously good for us; it builds strength and flexibility, and the stronger and more flexible we are the less likely we are to get injured. Our reactions are faster and we have better balance and coordination.

"...the desire to improve performance – to be faster, stronger or more flexible – can lead to the body being stretched beyond its natural limits which can lead to strains and sprains."

Below is a list of the type of injuries that involve the feet and knees and how to recognize and treat them.  That said, because muscles, tendons and ligaments are repeatedly and rapidly flexed and contracted during exercise, it is important that we are aware of how to care for them in order to avoid unnecessary injuries, especially as the desire to improve performance – to be faster, stronger or more flexible – can lead to the body being stretched beyond its natural limits which can lead to strains and sprains.

How to maintain healthy knees

Let’s look at how we can maintain healthy feet and knees while running by looking at sprains and strains – how to recognize them and what to do about them so that you can spend more time enjoying what you love, and less time recuperating. 

To help prevent such injuries from occurring, runners can learn about their RUNNING RATE, which will help many of the common injuries from impacting on your performance.  Sprains are injuries to ligaments, the tough bands connecting bones in a joint.  Strains are injuries to muscle fibers or tendons, which anchor muscles to bones.

As with all things, knowledge is power, so the more you know about how to recognize and treat injuries that can sometimes occur, the faster you will be able to recover from them and get back to your training.

Discover the type of injuries that involve the feet and knees and how to recognize and treat them.

About Technogym

Technogym, world-leader providing innovative products, services and solutions in wellness and fitness to enhance quality of life through physical activity. www.technogym.com

5 ideas about how your business can head outside for the summer

By: MINDBODY

As the weather warms up, people are spending more time outside. While you could throw in the pool towel, summer is actually the perfect opportunity for your business to celebrate the outdoors with special events.

We’ve gathered up five ideas about how your business can head outside for the summer to get you started:

• Move class outside - If your business offers classes, take the opportunity to conduct a special class outdoors. Host a Pilates session in a park, team up with a local hotel for rooftop yoga or teach a water-based boot camp at a local pool. Advertise the class on social media and your newspaper to maximize how many people attend—you might end up with a number of new customers. If you do decide to hold an event, don’t forget about the details. A business management software like MINDBODY can help you manage bookings and registrations for your event, as well as collect payments and waivers from participants.

   

  "Don’t forget to think about youth programs. Many summer or day camps will host guests to educate their students, so there’s a good chance that a program near you will welcome you."

   

• Get active in a local event - Does hosting your own event sound like a logistical nightmare to you? Then look into joining other events being put on by community organizations. From 5Ks to charity walks, summer is loaded with events where you can sponsor a team or host a booth. Some events even offer the opportunity for your business name and/or logo to be on a T-Shirt, which gets your brand in front of potential customers AND helps your community at the same time.

   

• Don’t forget about International Day of Yoga - Does your business offer yoga? Keep an eye out for a local International Yoga Day celebration, traditionally celebrated on June 21. While the biggest event annually is in Times Square, cities and studios around the country take part—and if your local area isn’t planning anything, hosting an event is a great way to move your business outside for a day to increase visibility into what you do.

   

• Get a booth at a Farmers’ Market - Even if you focus solely on appointments, you could benefit from taking advantage of the season. Contact your local Farmers’ Market to find out if they have a wellness week, and if not, ask about having a booth to educate your community on living healthy. For example, if you run a physical therapy business, offer free consulting sessions to people who drop by. You never know who might turn out to be a valuable customer for you!

   

• Go back to summer camp - As you think about how to engage with your community, don’t forget to think about youth programs. Many summer or day camps will host guests to educate their students, so there’s a good chance that a program near you will welcome you. Teaching at a summer camp offers you an opportunity to do community outreach and service at the same time. The only limit to what you can do is your creativity—these five options are just a spark to get you thinking about your own ideas on how to get your business outside.

And, if you do set up a special class, MINDBODY can help you manage it.  We’re happy to show you how. https://partner.mindbodyonline.com/acsm

About MINDBODY

Headquartered in San Luis Obispso, Calif., MINDBODY is the leading technology platform for the wellness services industry. Local wellness entrepreneurs worldwide use MINDBODY's integrated software and payments platform to run, market and build their businesses. Consumers use MINDBODY to more easily find, engage and transact with wellness providers in their local communities. For more information on how MINDBODY is helping people lead healthier, happier lives by connecting the world to wellness, visit https://partner.mindbodyonline.com/acsm