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  • Cognitive Benefits of Physical Activity for Older Adults

    by Caitlin Kinser | May 20, 2022

    Cognitive Benefits of Physical Activity for Older AdultsPhysical activity improves both physical and cognitive health, especially among older adults. Cognitive health encompasses many aspects of our daily functioning: memory, maintaining attention and concentration, dealing with distractions, solving problem and making decisions. Those cognitive functions tend to decline as we age, and physical activity can greatly prevent cognitive decline. For example, a meta-analysis has shown that adults participating in higher levels of physical activity had a 38% lower risk of cognitive decline in follow-up years. For low to moderate activity, there is still a 35% lower risk of cognitive decline. So, the message is simple: any physical activity can help. No need to lift heavy weight at the gym or run marathons to reap the benefits. For those looking at a more specific program that could be done at the gym, an example could be five to seven movements at 60-80% 1 RM, two sets, with two minutes rest, twice a week. For older adults with more limited mobility, some exercise with resistance band, or/and with a chair can be helpful. Aging is also associated with arthritis, so doing exercises that require fine motor skills with fingers can help maintain finger joint function. This is especially important for being able to grab and manipulate small objects such as silverware or a pen or opening a water bottle. Ideally, an exercise program for older adults should include some aspects of aerobic and resistance training, along with balance exercises to prevent falls.

    Studies with older adults have shown that physical activity specifically impacts executive functions. Executive function refers to processes that control, direct and coordinate other lower cognitive processes and goal-directed behaviors associated with the frontal lobe. Examples of tasks requiring executive function include scheduling, inhibition, planning, working memory, problem solving and task switching. Those skills are critical for the activities of daily living, and this is why physical activity can help prevent cognitive decline and promote healthy aging.

    How does exercise impact cognitive functioning? Mechanisms are still being investigated but the main ones with empirical support include improvements in cardiovascular function and the associated influence on the cerebrovascular system, reduction in stress and anxiety, reduced inflammation and improved insulin sensitivity. When focusing on the brain, molecular and cellular mechanisms are the two main explanations for improved cognitive functions. Regarding molecular mechanisms, being physically active increases brain-derived neurotrophic factors, which regulates synaptic plasticity and memory. Exercise also alleviates growth factors such as insulin-like growth factor and vascular endothelial growth factor, important for vascular health. Exercise also improves cognitive functioning via cellular mechanisms. Specifically, exercise promotes neurogenesis (development of new neurons) and synaptogenesis (formation of synapses). Those molecular and cellular benefits are also associated with neuroelectric changes. Indeed, it appears that increased fitness and greater participation in long-term exercise is associated with a larger P300 amplitude (more attention resources) and shorter P300 latency (faster information processing), but more studies are needed to provide more definitive recommendations.

    What activities should be considered for older adults? Any activity that is safe and enjoyable. This could include walking, gardening, dancing, swimming, biking or any other activity that gets them moving. The best activity is the one that is enjoyable, and often doing it with other people helps to make it more fun. Being active with others also helps with cognitive benefits and mood as social interactions are important for healthy aging. If you cannot find anyone to exercise with, walking your dog could also be a good way to make yourself accountable and integrate physical activity in your daily routine.

    Jean-Charles Lebeau, Ph.D., CMPC, is an assistant professor of sport and exercise psychology in the School of Kinesiology at Ball State University. He is also a Certified Mental Performance Consultant® through the Association for Applied Sport Psychology.

  • Alcohol Consumption and Exercise Performance

    by Greg Margason | May 19, 2022
    Alcohol Consumption and Exercise Performance

    Alcohol consumption is a topic that is not often discussed with respect to exercise performance. Typically, people joke about alcohol consumption, in general; and yet, alcohol abuse is a very serious subject. In addition, it has been well established that alcohol negatively affects health and exercise performance. Alcohol has been shown to result in damaging effects to the heart, metabolism and body temperature regulation.

    In addition, many athletes consume greater amounts of alcohol compared to the overall population, and may binge drink more than the overall population. The effect of alcohol on exercise performance is complex and depends on things like when a person consumes alcohol after exercising, how much time they had to recover between workouts, if they were injured, and the amount of alcohol consumed. Binge drinking is related to greater negative effects on exercise performance and recovery compared to a person who drinks a moderate amount of alcohol. In general, alcohol use can lead to calcium loss in the body, which can lead to bone loss over time.

    Alcohol consumption can also lead to decreased testosterone production in men, and decreased muscle growth in women and men. It can lead to increased estrogen production, blood pressure and fat storage. Many of these effects might not be seen immediately, but can be observed over time, especially in those who binge drink.

    Despite the many negative effects of alcohol on exercise performance, some researchers have found that aerobic fitness was better in people who moderately consumed alcohol compared to those who did not consume alcohol, and compared to those who consumed a lot of alcohol. In addition, others have reported that cardiorespiratory fitness was no different between a group of people, about 25 years of age, when they consumed alcohol, compared to when they abstained from alcohol.

    Health professionals working with recreational or elite athletes need to educate their clients to ensure that they understand the negative effects of alcohol on exercise performance. More importantly, they need to educate them on the long-term physiological effects of alcohol intake, especially high intakes of alcohol and/or binge drinking. Health professionals, and athletes themselves, need to monitor their alcohol intake.

    If athletes do consume alcohol, Barnes states that approximately 0.5 grams per kilogram of body weight will be the least detrimental to exercise performance and recovery.

    Related content:  
    Journal article | Alcohol and Athletic Performance
    Blog | Exercise and Energy Drinks: What Does the Research Say?
    Visual Abstract | Individualized Hydration Plans for Endurance Athletes

    Stella VolpeStella Lucia Volpe, Ph.D., R.D.N., ACSM-CEP, FACSM, is professor and head of the Department of Human Nutrition, Foods, and Exercise at Virginia Tech, Blacksburg, VA. Her degrees are in both Nutrition and Exercise Physiology; she also is an ACSM Certified Clinical Exercise Physiologist® and a registered dietitian. Dr. Volpe's research focuses on obesity and diabetes prevention using traditional interventions, mineral supplementation, altering the environment to result in greater physical activity and healthy eating; as well as in sport nutrition. Dr. Volpe is chair of the ACSM American Fitness Index, and is on the Board of Trustees for the Institute for the Advancement of Food and Nutrition Sciences. Dr. Volpe is an associate editor of ACSM's Health & Fitness Journal®, the Translational Journal of the American College of Sports Medicine, and Exercise and Sport Sciences Reviews. She also is editor-in-chief for Current Nutrition Reports.

  • Mental Health Awareness and the Role of Exercise Professionals

    by Greg Margason | May 16, 2022
    Mental Health Awareness and the Role of Exercise Professionals

    May is Mental Health Awareness month, which the American Heart Association calls “a time to raise awareness of those living with mental or behavioral health issues and to help reduce the stigma so many experience.” We might increase awareness by letting people know about the National Suicide Prevention Lifeline, which provides around-the-clock emotional support for people in crisis. We might also raise awareness about the Crisis Text Line, which allows people to communicate via text message by texting HOME to 741741.  

    But we can also raise awareness about our roles as exercise professionals within the complex system of mental health care. 

    Disparities in Mental Health  

    Early release of selected estimates from the 2020 National Health Interview Survey indicates that 11.3% of adults regularly had “feelings of worry, nervousness, or anxiety”, and 4.5% of adults experienced “regular feelings of depression.” Overall rates of depression seem to be increasing, and mental and behavioral health issues can affect anyone, although some groups may be affected more than others.  

    In 2019, according to the Centers for Disease Control and Prevention, women were more likely than men to experience symptoms of depression; moderate depression symptoms were experienced by 4.4% of adults aged 18-29 years, 3.8% of adults 30-44 years, 4.5% of adults aged 45-64 years, and 3.8% of adults 65 years and older. Further, the same data indicate that 19.3% of non-Hispanic Black and non-Hispanic white adults experienced symptoms of depression within the last two weeks, indicating greater prevalence of symptoms of depression within the last two weeks than Hispanic adults and non-Hispanic Asian adults. It is clear, though, that although some groups are more likely to experience symptoms of depression than others, no group is immune. 

    Mental Health and the COVID-19 Pandemic: Disparate Impact? 

    Living through the COVID-19 pandemic had an impact on mental health that appears to differ based on race and ethnicity. For example, in a snapshot of time from June 24th to 30th, 2020, 40.8% of Hispanic adults (of any race) reported an anxiety or depressive disorder, which was higher than the rates for “other race or multiple races, non-Hispanic” adults (33.2%), non-Hispanic Black adults (30.2%), non-Hispanic white adults (29.2%), and non-Hispanic Asian adults (18.0%). The pandemic also disproportionately affected the mental health of individuals with low socioeconomic status. The same data suggest that the highest rates of anxiety or depressive disorders were among people with the lowest household incomes. Further, the mental health needs of Black, Hispanic and Asian adults are more likely to be unmet.  

    The Role of Exercise Professionals 

    It has been suggested that mental health practitioners have an advocacy role, especially for people at an increased risk of adverse mental health outcomes. What if exercise professionals also share a role in advocacy? Perhaps exercise professionals can also increase awareness of the benefits of a physically active lifestyle. We can raise awareness both for clients and our colleagues in allied health professions. 

    Exercise has robust effects on mental health, including depression and anxiety. In a recent meta-analysis, Dr. Felipe B. Schuch and colleagues concluded that exercise has a large effect on depression, using both moderate and vigorous intensities and in both supervised and unsupervised settings. Further, exercise has a protective effect against the development of depression and anxiety

    Recommendations have been made for the use of exercise to treat major depressive disorder. A recent publication by Dr. Stephanie L. Cooper, ACSM-CEP, in the Health & Fitness Journal, published by the American College of Sports Medicine® (ACSM) provides an excellent and accessible overview of the role of exercise in mental health; this includes useful recommendations for using physical activity to enhance mental health outcomes. Notably, this was the journal’s Paper of the Year for 2020. ACSM also has a handy handout from Dr. Amanda Paluch, “6 Ways to Support Your Clients’ Mental & Physical Well-Being,” with useful tips for the practicing exercise professional. 

    Additionally, we can work to be inclusive, reduce resource barriers to physical activity and develop culturally appropriate programs for clients. The book Physical Activity in Diverse Populations: Evidence and Practice examines how social determinants impact physical activity and provides evidence-based strategies for promoting physical activity. 

    What would a more central role for exercise professionals look like? Perhaps it would include more collaboration and partnership with colleagues in allied health professions, physicians, and mental health care providers. For example, enhancing physical activity referral schemes could provide clients with a multifaceted approach to care and improve mental health outcomes


    Given the reliable effects of exercise on mental health outcomes, perhaps it is time to involve exercise professionals more in conversations about mental health, especially as the burden of mental illness increases and people experience pandemic-related stressors. This May, let us continue to increase awareness of life-saving services like the National Suicide Prevention Lifeline and the Crisis Text Line among our clients. Let us also raise awareness about the importance of a physically active lifestyle and the inclusion of exercise professionals for promoting overall health and wellness — which includes improved mental health outcomes and psychological well-being. 

    Access mental health resources

    About the authors: 
    Dr. Zachary Zenko is an Assistant Professor and the graduate program director in the Department of Kinesiology at California State University, Bakersfield. Dr. Andrea Lopez is an Assistant Professor in Public Health and faculty in the Department of Kinesiology at California State University, Bakersfield.  

  • Effects of Physical Activity on Mental Health in Vulnerable Populations

    by Caitlin Kinser | May 16, 2022

    woman in head scarf smilingIf you or someone you know is managing a mental illness, then you or they are not alone. Many Americans struggle with mental illnesses. Almost one in five adults live with a mental illness (52.9 million in 2020). Mental illness is defined by the National Institute of Mental Health as a mental, behavioral or emotional disorder that can vary in impact from mild to severe. Mental health problems are equal opportunity, regardless of your race, gender, age, income or education, mental illness can affect all of us. Exercise has been shown to positively affect mood, quality of life and overall mental health. This can include walking around the block, giving your body a good stretch or even doing some pushups or squats. The intensity can vary as well—just the act of movement can have profound effects!

    Certain vulnerable populations are at even greater risk for having poor mental health or mental illness. Pregnant women, cancer patients, inmates and substance users are groups that are likely to have mental health struggles and lower levels of physical activity. These groups do not often receive the attention that is warranted.

    The World Health Organization (WHO) acknowledges that 10-16% of pregnant women and 13-20% of postpartum women experience mental disorders. Pregnant women can suffer from mental health issues including depression, anxiety or bipolar disorder. When these illnesses are severe enough, they can lead to negative pregnancy outcomes. These can be a result of low social support, a history of depression or anxiety, life stress, unintended pregnancy or intimate partner violence. Pregnant women can improve their mental health by adding exercise into their routine. Exercise has also been shown to lower rates of antenatal depression and anxiety.

    The number of cancer patients dealing with psychological disorders is high, affecting approximately 33%. Rates of major depressive disorder in cancer patients are thought to be up to three times as high as the general population. Cancer patients can experience depressive symptoms because of their diagnosis. Life may look bleak, or patients might be overcome with despair following this traumatic news. For these reasons it is even more important that their mental health needs are met. Just participating in leisure time physical activity has been shown to increase well-being, mental health and overall outlook on life.

    Prison inmates may also be more prone to dealing with mental health struggles because of their incarceration. High rates of mental illness are seen in this population, with a study showing that 64% of jail inmates, 54% of state prisoners and 45% of federal prisoners reporting mental health concerns. A survey showed that structured exercise within the prison population reduced rates of depression, anxiety and hostility scores.

    Unfortunately, substance use and mental disorders can go hand and hand. Numerous national surveys found that about half of those who abuse substances will also experience a mental illness during their lives, and vice versa. There is a high co-occurrence of substance use and anxiety, depression, bipolar disorder and borderline personality disorder. This overlap is concerning. Research suggests that physical activity programs and even mind-body programs can positively effect depression, anxiety, stress and even cravings.

    If you don’t know where to start, getting the heart pumping doing some aerobic activity and resistance exercise you enjoy has been shown to be associated with lowered depression and anxiety levels. Jogging, swimming, cycling, walking, gardening, lifting weights, playing sports and dancing can all have an impact on improving your mental health. ACSM, the CDC and WHO recommend cancer patients, pregnant women and general population adults get at least 150 minutes of moderate-intensity aerobic physical activity each week. Aerobic activity has also been shown to reduce drug cravings, depression, anxiety and increase drug withdrawal rate among drug users. Lastly, prison inmates should be getting one hour of physical activity a day, five days per week. Most importantly, this should include outdoor recreation and sport activities, which can help to eliminate feelings of hopelessness and increase social opportunities which can lead to better mental health. Mind-body exercises such as yoga and meditation can have profound effects on our mental states. In addition to the benefits of the yoga movements that include creating a more positive mood and increasing endorphins, yoga can strengthen connections in your brain that allow you to have better memory, attention, awareness, thought and language. Yoga can also be an effective long-term remedy for depression and anxiety.

    During Mental Health Awareness Month, we should take some time to remember how life stressors can affect us all differently. Take some time for self-care and to care for and support one another. Keep in mind those who are in challenging situations and how their mental health can be affected. Even though someone may not feel comfortable talking about their mental health, doesn’t mean they aren’t facing challenges.

    Access Mental Health Resources

    Jordan TaylorJordan Taylor, MPH, is a graduate from The University of Memphis with his bachelor’s in psychology and master’s in public health. He is a member of the ACSM Leadership & Diversity Training Program and currently works as a fitness coach in Memphis, TN. Jordan has a passion for helping people achieve their best selves physically, emotionally, and mentally through health and fitness.

  • We are Back! The 2022 ACSM Annual Meeting & World Congresses

    by Greg Margason | May 16, 2022

    The 2022 ACSM Annual Meeting & World CongressesAfter two years away, we’re thrilled to be back in person this year in beautiful San Diego, California. It will be wonderful seeing colleagues filling the lecture halls, exploring the posters, viewing the exhibits and gathering for networking.

    Featuring both on-site and online programming, the 2022 ACSM Annual Meeting, World Congress on Exercise is Medicine and World Congress on the Basic Science of Exercise and Vascular Health showcases the latest in exercise science and sports medicine.

    The in-person program offers 200+ hours of education, with 30.75 CME/CEC credits, 1,800+ scientific abstract/clinical case presentations, networking events, exhibits and more. Over 50 hours of recorded live sessions will be available on the on-demand online program starting June 13, with 90-day access.

    Highlights for the meeting include:

    • Opening keynote — Joseph B. Wolffe Memorial Lecture delivered by Karin Pfeiffer, Ph.D., FACSM, on “The ABCs of Movement in Early Childhood: Building Blocks for Lifetime Physical Activity”
    • D.B. Dill Historical Lecture on “50 Years of Title IX: View through the Eyes of Athlete Turned Orthopaedic Surgeon” presented by Mary Lloyd Ireland, M.D., FACSM
    • The Integrative Plenary Lecture on “Team-Based Approach to Treating an Injured Athlete: Integrating Basic Science, Clinical Care and Coaching to Successfully Return an Injured Athlete to Competition” by Kevin R. Vincent M.D., Ph.D., FACSM

    Check out the other named lectures, as well as all of the additional outstanding lectures being offered this year.

    Our 2020, 2021 and 2022 honor and citation awardees will be recognized during the Friday evening banquet. Be sure to congratulate them as you see them throughout the week.

    On behalf of the entire program committee, I hope to see you next month in San Diego and online. Check out your registration options

    Anastasia FischerAnastasia Fischer, M.D., is a member of the Division of Sports Medicine in the Section of Ambulatory Pediatrics at Nationwide Children’s Hospital and is a clinical associate professor of pediatrics at The Ohio State University College of Medicine. Dr. Fischer obtained a master’s degree in exercise physiology at the University of Georgia before attending medical school at The Ohio State University College of Medicine. She then completed a family practice residency at University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania, and a primary care sports medicine fellowship at Maine Medical Center in Portland, Maine. Dr. Fischer is the current president-elect of ACSM.

    Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily represent ACSM positions or policies. Active Voice authors who have received financial or other considerations from a commercial entity associated with their topic must disclose such relationships at the time they accept an invitation to write for SMB.