As a society, we are facing ballooning rates of obesity, Type 2 diabetes, heart disease and high blood pressure, conditions that drive up health costs, decrease productivity and erode quality of life. Exercise can have a positive impact on all of these conditions, yet many people don’t have access to informed, competent professionals who can guide them in addressing these problems.

At the same time, many potential fitness professionals are questioning the wisdom of pursuing a degree in exercise science or a related field of study. Is it worth incurring the debt that so often comes with a college degree? 

Within the last decade, the American College of Sports Medicine® (ACSM) amended its requirements for certification as a group exercise instructor or personal trainer to include those with a high school diploma or equivalent. Now women and men of all ages and backgrounds who already enjoy being physically active and working out for personal reasons can make an indelible mark on the health status of all segments of the population by becoming certified through ACSM. 

This topic is dear to me; my path to ACSM certification was not traditional. I spent nearly two decades as a steelworker at a Pittsburgh area mill but always loved working out. While I had already been certified as a personal trainer, I really wanted to earn the industry’s “gold-standard” ACSM certification. Without a bachelor’s degree, that path was closed to me. 

My opportunity came at a meeting at my church for members who had any background in health and wellness. In attendance was the associate director of the University of Pittsburgh Center for Minority Health. The university was starting a community wellness program to help people attenuate the effects of high blood pressure and diabetes. My participation in the program as a health coach would eventually lead me to earning both a bachelor’s and master’s degree, starting a personal training and wellness practice, and creating the Community Wellness Initiative, a nonprofit organization that aims, among other goals, to provide similar and even greater professional opportunities than those afforded to me.

Today, those who aspire to ACSM certification face fewer hurdles. While a college degree offers clear advantages, with intense study and preparation, a meaningful career as a health professional is open to them. I urge current health and wellness professionals to encourage those just starting out by mentoring promising individuals of any age and work experience to follow their dreams. We need them if we are to make an impact on the health issues undermining the lives of so many today.

Additional Resources: 
Blog | 5 Skills of High Performers in the Fitness Industry
Download | ACSM Career Guide
Jobs | ACSM Career Center

Christopher E. Howard, M.S., ACSM-EP, is the founder and executive director of the newly launched nonprofit organization the Community Wellness Initiative of Pittsburgh. After a career as a steelworker, Chris earned a Bachelor of Science in exercise science at the University of Pittsburgh and a Master of Science in exercise science with a concentration in health promotion, wellness and fitness at California University of Pennsylvania. He is an ACSM Certified Exercise Physiologist® and established the personal training and wellness practice C. Howard Fitness in 2012. 

I just found out that Thursday the 30th of March is “Take a Walk in the Park Day” here in the U.S., and although it sort of sounds like a “Go jump in a lake day,” I have to admit — on reflection — that the founders of this holiday are on to something good. After all, as I type this blog, I’m sitting in a climate-controlled office in front of a laptop computer screen completely separated from nature, with the possible exception of the wood my desk might actually be made from. 

And yet, even here in Los Angeles, I’m spoiled for choice on park opportunities. From beach walks to mountain canyon trails, I have nearly 39,000 acres of park land right here in the city, with an additional 27,000 acres spread throughout the county. And that’s just Los Angeles. You folks in places like Washington, D.C., or the Twin Cities or Houston or Seattle fare even better per capita according to data from the Trust for Public Land. As a matter of fact, even the U.S. National Park Foundation reports that we have 424 national park sites that cover 84 million acres throughout the country with opportunities to engage in physical activity beyond that of walking. 

If “Take a Walk in the Park Day” is all about getting us to recognize and utilize the parks available to us, I say it’s high time we do. Spring is on the way in many parts of the country, so a walk in the park is a good way to break that hibernation groove following a long, cold winter. This is good not only for our physical health but for our mental well-being too. Study results referenced from a 2020 American Psychological Association blog similar to this one justify our need to connect with nature. The APA reports that cognitive development in children improves from having parks near schools and mood states improve across all age groups when we connect with nature. I was surprised to learn from a 2019 study cited by the APA that even the sounds of nature (e.g., ocean waves, crickets) improve subject performance on cognitive tests when compared to subjects who listen to city sounds. 

We need nature. Experiencing nature directly, by getting out there to take a walk in the park, also connects us to our communities and helps us to understand how much that we and our built environment influence our surroundings and how, ultimately, our natural world governs the quality of our lives. Among the most enduring images in my mind during the COVID-19 pandemic are those of wild animals tentatively roaming the streets of our cities as we retreated indoors during lockdown. I doubt they missed us much, but I know I missed them. 

Take a walk in your local park on Thursday the 30th. Get away from the screen, get some fresh air, and don’t be surprised if your escape becomes a habit. In more ways than one, you’ll be better off for the effort.  

Christopher Berger, PhD, FACSM, ACSM-EP, CSCS is an Exercise Physiologist with Occidental College in Los Angeles where he never needs a national holiday to enjoy a walk in the park.

Cardiorespiratory fitness (CRF) is an important component of physical fitness and represents the ability of the heart and the lungs to deliver oxygen to the working muscles during maximal-effort exercise. Over the past decades, CRF has been shown to be inversely related to many common and prevalent chronic diseases, including but not limited to cardiovascular diseases, diabetes and several cancers. Also, CRF has been shown to be directly related to mental health. 

One of the most important roles of an exercise professional is to assess and evaluate CRF to develop an appropriate aerobic exercise prescription. Indeed, the American Heart Association issued a Scientific Statement that CRF be considered a vital sign. Submaximal exercise testing using a treadmill, a cycle ergometer or a stepping bench is commonly used to assess CRF in many health fitness settings. The utilization of these tests necessitates the exercise professional having the skill to assess heart rate accurately and to estimate maximal heart rate (HR_max).  

Measurement of heart rate is commonly done through either palpitation or the use of wearable technology. However, there are shortcomings to both approaches; thus, exercise professionals should be aware of the pros and cons of both methods. There are also some drawbacks associated with estimating of HR_max. Although several regression equations can be used to estimate HR_max, all of them are subject to interindividual variability (i.e., SEE= ± 3-12 bpm) which makes these estimations less reliable than direct measurement from a maximal exercise test. Both the inability to measure heart rate correctly and the inaccuracy of estimating HR_max, can lead to prescribing exercise at intensity levels that are higher or lower than intended. 

In our March/April 2023 article published in ACSM’s Health and Fitness Journal, we sought to provide exercise professionals with practical examples of submaximal exercise testing to illustrate potential shortcomings associated with these common practices. For example, we demonstrated how small heart rate measurement errors and miscalculations can lead to substantial under- and overestimation of CRF. We provided insight into steps that the exercise professional can take to develop a more accurate exercise prescription. These simple steps include regular calibration of testing equipment, choosing appropriate and population-specific HR_max equations, following testing instructions, selecting test protocols that suit the individual, meeting the submaximal exercise testing assumptions, measuring heart rate accurately and utilizing the rating of perceived exertion (RPE) scale as a supplementary tool. 

The accurate estimation of CRF using submaximal exercise testing helps exercise professionals prescribe an appropriate exercise intensity for their clients. Intensity is an integral part of the FITT (Frequency, Intensity, Time, and Time) principle of exercise prescription as described by ACSM. The knowledge, skill and ability to correctly conduct submaximal exercise testing and understand the limitations of these assessments is a critical skill for all exercise professionals. 

Meir Magal, Ph.D., FACSM, is the chair of the School of Mathematics and Sciences as well as program director and professor of exercise science at North Carolina Wesleyan University. Dr. Magal served on ACSM’s Committee for Certification and Registry Boards (CCRB) in several capacities, including as chair of the International Subcommittee and as the chair of CCRB. He also served as an associate editor of the 10th edition of ACSM’s Guidelines for Exercise Testing and Prescription and as a coeditor on the sixth edition of ACSM’s Fitness Assessment Manual. 

Deborah Riebe, Ph.D., FACSM, is the interim dean of the College of Health Sciences and professor in the Department of Kinesiology at the University of Rhode Island. Dr. Riebe served on ACSM’s Board of Trustees, as chair of the ACSM International Health & Fitness Summit and as chair of the CCRB. She is the senior editor of the 10th edition of ACSM’s Guidelines for Exercise Testing and Prescription and has authored more than 80 articles in refereed journals and book chapters. 

Q: Angiogenesis function? This is new to me. Are there are references you can point me/us to? 

Franks I. Gut microbes might promote intestinal angiogenesis. Nat Rev Gastroenterol Hepatol. 2013;10(3). doi: https://doi.org/10.1038/nrgastro.2012.227. 

Hassan M, Moghadamrad S, Sorribas M et al. Paneth cells promote angiogenesis and regulate portal hypertension in response to microbial signals. J Hepatol. 2020;73(3):628-39. 

Q: Is there a recommended test for to assessing dysbiosis?  

The most direct measurement for now would be to have a GI map done on a stool sample.    

Q: Does wine (red/white/rosé) count as a fermented food/beverage?  

It’s more likely that the polyphenols in red wine contribute to the growth of beneficial bacteria as the benefits are seen in alcohol-free wine as well. Excessive alcohol consumption has also been found to break down the tight junctions and damage the intestinal epithelium.    

Q: Dr Osterberg discussed the negative effects of strenuous exercise and overtraining on the gut. What amount of overexercising could cause this effect?  

This is likely very dependent upon the individual’s fitness and training environment, diet, lifestyle, etc.  Some studies say that “overexercising” is anything over 60 minutes of moderate exercise, but the athletes in many of the studies I mentioned did much more than that, as do most elite athletes.  

Q: Thank you for your presentation! Can you please comment on “leaky gut” and lectin-containing foods? Many athletes are leaning on a plant-based intake and they are getting protein and fiber from lentils and legumes, but Internet info raises concerns about leaky gut.  

There may be some genetically susceptible people for whom lectins can cause an inflammatory reaction. I believe this is an autoimmune response, and I don’t have statistics on the prevalence of this, but if it’s like other autoimmune conditions, it would only affect a small number of people.  

Q: what would you say should be our one to two takeaways to teach our clients?  

Eat a wide variety of plant foods. Exercise regularly. Find ways to reduce psychological stress. 

Q: Are you providing a rationale for carbs? What does this mean for the keto people? 

Carbohydrate from plants is very important for health and supported by many epidemiological studies. A ketogenic diet reduces microbial diversity. For some people, especially those with seizure disorders, a ketogenic diet can improve symptoms, but it still reduces microbial diversity. 

Q: Can you recommend a reliable fiber-screener tool to use with clients?  

I don’t know of one, sorry. 

Q: Would you please explain the difference between prebiotics and probiotics?  

Prebiotics are fibers from plants that support the growth of beneficial bacteria in the gut. Probiotics are live bacteria that are ingested. 

Q: Are you aware of any literature addressing how long it takes to “change” or “shift” a person’s microbiota after changing their diet? Curious as to length of that process within the gut. 

Populations can shift very quickly — in as little as 24 hours. Most studies are short term, but the changes should last for as long as the dietary change is in effect.   

Q: Realistically, how easy/effective is the process of adding to/getting your micro biome and gut health back to normative levels after years of bad diet and overusing antibiotics?  

It’s a great question. A dietary change (from say Western to plant-based) would probably change microbial communities very quickly. The antibiotic piece is difficult to predict as it probably requires more than a “shift” but rather a repopulation.   

Q: Meditation and gut health — could you please provide sources?  

I didn’t have one when I made the comment — just a suggestion for reducing stress. But see below: 

Jia W, Zhen J, Liu A et al. Long-term vegan meditation improved human gut microbiota. Evid Based Complement Alternat Med. 2020. doi: 10.1155/2020/9517897. 

Q: With so much research proving a plant-based diet’s benefits for the gut, why would you say in your talk today that you’re not promoting the diet?  

I fully support and would recommend a plant-based diet. I think my comment was that I wasn’t necessarily promoting a vegetarian or vegan diet. An omnivorous diet can also be healthy as the study I cited showed poultry, fish and low-fat cheese were also strongly associated with a healthy gut microbiota.  

Q: How do you see the role of fermented food helping gut health?  

Eating fermented food is essentially eating food that contains probiotics. When food is fermented under the right conditions, an acidic environment is created, allowing for the growth of beneficial bacteria (many Lactobacillus species) and the inhibition of pathogenic bacteria. 

Q: Any caution regarding alcohol intake on gut health?  

Excessive alcohol intake can increase gut permeability and damage epithelial cells.  

Q: Do you have a theory for why the marathoners had that strain of microbiota spike so greatly after the marathon vs. during training? Was the exertion that much greater on race day, perhaps?  

It’s a great question! It may have been related to exertion or maybe fueling … or lack thereof?   

Q: Has there been any study comparing gut health and performance of athletes with plant-based diets (vegan & vegetarian) vs. those who consume meat?  

There are many studies comparing plant-based to omnivores in humans, but nothing that measured performance (that I know of). 

Q: Are there any good studies with recommendations for fermented food intake? Including frequency and amount? 

I don’t know of any specific recommendations.   

Cold weather training doesn’t place the same thermal stress on the gut. Blood flow to the gut is more easily maintained because it doesn’t have to be diverted to the skin for cooling. 

Q: Do supplemental probiotics need to be taken indefinitely, or do they eventually colonize in the body?  

It’s a great question. I’m not sure if it’s ever a case that they colonize, but I do think they help balance total communities in favor of beneficial bacteria. I think the amount of time you would need to take them would depend on the reason they’re being taken (diarrhea, food intolerance, immune function, etc.). 

Q: Does sodium bicarbonate supplementation impact gut microbiota?  

Great question! My guess is that most sodium bicarbonate is absorbed in the small intestine, so it would not impact microbiota to a large extent. 

Q: You discussed the Veillonella rat study, increasing run time in rats. There are now some probiotics that include this bacteria. Could taking these pre race improve performance? 

Interesting! I didn’t know this, but I can’t wait to see if supplementation helps!   

Q: You mentioned that high cardiorespiratory fitness and more intense exercise increases bacterial diversity. How is intense exercise different than exhaustive exercise? And how do we determine helpful vs. harmful levels of exercise?  

Intense exercise is exercise that is done at a high percentage of VO2 max. Exhaustive exercise is generally defined as exercise that continues until a certain minimum % VO2 max or max wattage can no longer be maintained. Intense exercise doesn’t have to be exhaustive. As for your second question, I don’t have a good answer in the context of gut microbiota. It’s likely multifactorial and based on many other factors in any individual athlete’s life, including diet, fitness, lifestyle, etc. 

Q: Toward the end you mentioned avoiding cutting blood flow to the gut? How would one be cutting circulation? 

Intense exercise, especially exercise in the heat, diverts blood flow away from the gut and to muscles (for fuel and oxygen) and skin (for cooling). This decreases blood flow to the gut and can damage the epithelium and increase the likelihood of gut permeability. 

Q: How would you compare “themed” diets like keto, paleo, etc. with their effect on gut health? 

Studies would suggest that the more plants and fiber the diet contains, more microbial diversity would be present in the gut. 

Q: What is a good way to determine if the gut is irritated by consumption of certain food? Should that food be cut out for good?  

There are certainly conditions that call for cutting out the food for good (celiac disease, for example). For some people, eliminating foods that contain certain components (FODMAPs) can help ameliorate symptoms of GI distress. When a person is in dysbiosis, they may respond to food components differently than they would if their gut is healthy. In general, I would recommend keeping as many plants in the diet as possible.  

Q: Comments on fecal transplants?  

Definitely works for certain conditions (C. diff). 

Q: From a sports medicine standpoint, do you think objective measures of gut health could realistically be something incorporated into a preparticipation exam? Or should it be more athlete specific during the season?  

Really good question! My guess is that it would be athlete specific simply because you’d have to have an athlete that was motivated and willing to make changes if you found dysbiosis. In my experience with athletes, if they don’t have a good reason to change their dietary habits (e.g., they feel bad), they won’t.       

Q: Do you have any information as to how bariatric surgery would affect the microbiome?  

It seems to have a large impact. Here is a study that outlines some of the effects: 

Ulker İ, Yildiran H. The effects of bariatric surgery on gut microbiota in patients with obesity: a review of the literature. Biosci Microbiota Food Health. 2019;38(1):3-9. doi: 10.12938/bmfh.18-018. 

Q: I know whole foods are best, but what do all of the additives and preservatives in various foods do to the gut?  

Zhou X, Qiao K, Wu H, Zhang Y. The impact of food additives on the abundance and composition of gut microbiota. Molecules. 2023;28(2):631. doi: 10.3390/molecules28020631.