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  • 5 Fitness Gift Ideas for Friends and Family

    by Greg Margason | Nov 28, 2023
    fitness gifts

    We’re well into the holiday season, and maybe you’re scrambling to find the perfect gifts for friends and family. Uh oh. 

    Fortunately, there are plenty of fitness tools and accessories out there that might fit the bill, and at a range of prices. 

    (Of course, discretion is important too — it’s probably best to only give fitness gear to people who are likely to use it. You don’t want to send the wrong message.) 

    A crucial question, though, is how useful and/or effective many of these options are. Crazes often burn through the fitness world and fitness-adjacent culture, and the Next Best Thing is regularly a flash in the pan that may or may not provide any actual benefit. You don’t want to be the friend or family member giving out what will be seen next year as a tired fad — or worse, spending your hard-earned money on a gift that doesn’t actually do what it claims to. 

    The following five suggestions are drawn from a top 10 holiday fitness gift list compiled by Charles Fountaine, Ph.D., FACSM, published as a sharable resource in ACSM’s Health & Fitness Journal, and provide a little context about each. 

    1. Fitness trackers and smart watches

    At the high end of the gift-giving hierarchy, there are fitness trackers and smart watches. Wearable tech ranked No. 1 in last year’s ACSM’s Worldwide Survey of Fitness Trends, and has been in the top three every year since its introduction to the survey in 2016, so it could be a good bet for a special someone who’s interested in logging the details of their workout and resting lives. This is a big investment, of course. And you probably want to know a little bit about what the recipients needs and wants in terms of a data-tracker, so make sure you covertly or overtly get the intel you need before you take the plunge. 

    2. Massage gun

    A step down in price from wearables are massage guns, aka “percussive massagers.” Even if you haven’t used one, you’ve probably seen them on box store shelves or in infomercials. These are handheld devices with a reciprocating end — sometimes provided with interchangeable attachments — that you can use to massage sore muscles. According to a 2023 systematic literature review, “PT delivered by massage guns can help improve acute muscle strength, explosive muscle strength and flexibility, and reduce experiences of musculoskeletal pain,” though others don’t go so far in their assessment of the devices’ benefits. 

    3. Compression sleeves

    Used to support joints, compression sleeves are another holiday gift-giving option. There are many products on the market, and we should be careful to distinguish between sleeves and other garments. Research on the effectiveness of these products is mixed — knee sleeves, for example, seem to show some signs of benefit. According to a 2017 literature review, “knee sleeves can effect functional improvements to knee problems. However, further work is needed to confirm this hypothesis, due to the lack of homogeneity and rigor of existing studies.” That said, other compression garments, such as below-knee compression socks, show more mixed results, so it’s important to know exactly what it is you’re buying, and why. 

    4. Stretching straps and resistance bands

    If compression sleeves don’t fit the bill, consider stretching straps or resistance bands. These can be an affordable option, and are probably familiar to most yoga practitioners and many other fitness enthusiasts. Resistance bands may be particularly beneficial — a 2019 systematic review and meta-analysis found that “resistance training with elastic devices provides similar strength gains when compared to resistance training performed from conventional devices.” Meaning that resistance bands can be a great portable, low-cost training tool.  

    5. Socks

    Now, this last category is sort of a classic Christmas canard — “Oh no, not socks!” But for fitness enthusiasts, a good pair of socks can be a real blessing. There are many types for many modes of physical activity, and finding the exact right pair that fits the needs of the person you’re buying for will show that you really pay attention to what they do for fun. Hiking? There are socks for that. Skiing? Yep. Olympic lifting or deadlifting? Yep. There are great socks for those too. Don’t count socks out — a nice, cozy pair over the holidays can make all the difference, not just at the gym or on the trail but in front of the fireplace too. 

    For more gift ideas, check out Dr. Fountaine’s “Ten Holiday Gift Ideas for the Fitness Enthusiast,” available as a shareable resource from ACSM’s Health & Fitness Journal

  • A Ph.D. Student’s Take on ACSM’s Leadership & Diversity Training Program

    by Greg Margason | Nov 22, 2023

    Rafael AlamillaRafael Alamilla’s affiliation with ACSM’s Leadership & Diversity Training Program (LDTP) began with an interesting coincidence.

    An IU President’s Doctoral Fellow in Indiana University’s Department of Health Sciences, Alamilla had heard about ACSM’s LDTP somewhat by chance — whether it was from ACSM social media, an email, or some other communication, he can’t exactly recall. But it appeared in his orbit, it seemed like a fruitful opportunity, and he emailed his advisor to get her opinion on the matter.

    Said advisor happened (and still happens) to be ACSM Past President NiCole Keith, Ph.D., FACSM. Keith responded by sending Alamilla a manuscript she helped write that outlined the establishment and impact of program she helped found. This was, of course, an endorsement.

    Which carried a lot of weight — Alamilla is quick to praise Keith as an advisor: “She has always been in my corner since I’ve been in my program. She is my mentor, obviously. But nowadays she is kind of my research mom.”

    Naturally, Alamilla applied.

    When you visit the LDTP’s page on the ACSM website, you read that “ACSM’s Leadership & Diversity Training Program exists to mentor and retain minority members by offering three different levels that require ACSM membership, involvement in the ACSM Annual Meeting and committees, and pursuit of ACSM professional presentations & publications with the ultimate goal of obtaining ACSM fellowship.”

    Besides being paired with an experienced mentor, those accepted into the program receive a free year of ACSM membership and have their ACSM meeting travel and registration expenses covered. Accepted applicants matriculate into LDTP at Level 1, 2, or 3 depending on their academic background. Roughly speaking, those enrolled in a master’s program will join Level 1, those enrolled in a Ph.D. program join Level 2, and those who hold a terminal degree will enter at Level 3. Mentees can take part in the program for up to five years.

    Critically, participants don’t merely communicate with their assigned mentor — when the ACSM Annual Meeting rolls around, the mentees often meet up with a number of the participating mentors.

    As Alamilla puts it: “They very much encourage you to go talk with other mentors. It’s like: ‘Yes, your primary mentor is the one who you’ll be spending a lot of time with during the conference, but also don’t be afraid to pick other peoples’ minds and network. I've had the wonderful fortune of talking to a lot of the mentors and learn from them.”

    But for Alamilla, who is in his second year in the program, the greatest benefit has been the community of mentees that LDTP brings together.

    “The program has helped facilitate me meeting other people who look like me,” he says. “Even if they do not do similar work, their perspectives are very insightful to me because everybody comes from different backgrounds. It is like, that’s the nice thing about national ACSM — you get to meet people and share stories with people you otherwise wouldn’t have met.”

    If LDTP is a progressive program with a well-defined path and series of goals, the journey that brought Alamilla into its ranks was somewhat less linear. Alamilla hails from San Bernardino, CA and earned a Bachelor of Science in kinesiology from California State University-San Bernardino before moving on to a master’s degree in the same field at the University of Illinois Urbana-Champaign, which he describes as period in which he was focused on basic science. But after graduation, he moved to Memphis, Tennessee, where his future wife was completing her own master’s program.

    In Memphis, he took a job with HealthFitness, which changed his trajectory entirely. Through HealthFitness, he was brought in to help run FedEx’s health and wellness programming.

    “And that’s when I feel like I got hit a Mack truck in terms of being able to understand health disparities and inequities,” he says. “But also what it really means to work with people. Because up to that point, mind you, I had never gone outside of academia.”

    Alamilla soon turned his attention to education again — but this time in pursuit of a Ph.D. that would allow him to address the disparities he’d seen.

    LDTP App promo

    “That’s what spurred me to want to do a Ph.D.,” he says. “I knew my skill set was not there to do the type of work that I wanted to do. So I knew I had to go back to school.”

    It was while searching for the proper university that Alamilla became aware of Keith; she’d taken part in a panel Alamilla attended held by a research collaborative run by Dr. Mark Stoutenberg. The work Keith discussed intrigued Alamilla — it seemed like what he too wanted to do — and he sent her an email.

    One thing led to another, including a series of long phone calls discussing their mutual research interests, and Alamilla eventually found himself studying with Keith at IU; his focus is on improving access and adherence to physical activity in underprivileged minority communities. Key to his efforts, he notes, are partnerships with community leaders and local fitness facilities — and getting constant feedback from the people his programming serves.

    “With this type of work, there’s a certain degree of tailoring that happens, right?” he says. “You’re tailoring an intervention to the needs of a specific person or group of people. Whoever it is that you’re working with.”

    As Alamilla’s academic career progresses apace, LDTP serves as a place where he can rub shoulders with others who have shared experiences, both in their personal lives and in their work.

    “All the folks in LDTP are people of color or from a minority group,” Alamilla says. “And so a lot of us have those same experiences. A lot of us are first-generation college students. Many of us work with minority communities. A lot of us have had similar experiences going through academia. In turn, having that that shared sense of camaraderie is really powerful because it makes you feel like you’re not alone.”

    If you or someone you know is interested in applying for LDTP, you can learn more here.

  • Hot Topic | The Importance of Cardiorespiratory Fitness — A 10-Year Update

    by Greg Margason | Nov 20, 2023
    The Importance of Cardiorespiratory Fitness — A 10-Year Update

    This year marks the 10-year anniversary of the American Heart Association’s (AHA) policy statement “The Importance of Cardiorespiratory Fitness in the United States: The Need for a National Registry.” In my teaching and lecturing, I have often commented that the field of exercise physiology is a very young area of science. Much of the foundations for exercise physiology in the United States were set from the work of D.B. Dill and colleagues at the Harvard Fatigue Laboratory in the 1930s. 

    A fundamental measurement in exercise physiology is that of maximal (or peak) oxygen uptake (VO2max); this year also coincides with the 100-year anniversary of the work of Nobel Prize-winning scientist A.V. Hill’s studies that first developed the procedures to make the measurements for VO2max

    Cardiorespiratory fitness (or CRF), one of the components of physical fitness, refers to the capacity of the cardiopulmonary systems to deliver oxygen to skeletal muscles to power physical activities and is measured as VO2max. Most of the research over the first 50 years since Hill’s original publication was focused on performance or functional ability. However, in the 1960s and ’70s, physicians, including Bruno Balke, Robert Bruce, and Kenneth Cooper, began recognizing the cardiovascular health-related aspects of CRF. Undoubtedly, the paper that put CRF in the forefront as an important marker of health, “Physical fitness and all-cause mortality. A prospective study of healthy men and women,” was published in JAMA in 1989 by Dr. Steven Blair and colleagues with the Cooper Clinic cohort. 

    Over the next 20+ years, research established that CRF was indeed a key marker for health; however, a limiting concern was the lack of reference standards for interpreting CRF measurements. Thus, the AHA policy statement published in 2013 led to the development of the Fitness Registry and the Importance of Exercise National Database (FRIEND). 

    The FRIEND registry initiated the process to acquire exercise test data from clinics and laboratories throughout the United States and released an initial set of reference standards for directly measured VO2max for tests performed on treadmills or cycle ergometers. FRIEND continues to acquire exercise test data from clinics and laboratories and last year published updated reference standards for CRF. The FRIEND reports have been selected by the editors of the American College of Sports Medicine's® (ACSM's) Guidelines for Exercise Testing and Prescription as the reference standards for interpreting CRF values. The FRIEND registry has proven to be a great resource for research on other variables obtained during a maximal exercise test, as can be noted by doing a search on PubMed using the term “Fitness Registry and the Importance of Exercise National Database.” Additionally, FRIEND has been involved with an effort to develop global reference standards for CRF

    Finally, the recognition of the importance of CRF was summarized in the 2016 scientific statement by the AHA entitled “Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign.” This statement concludes that “the addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and to encourage lifestyle-based strategies designed to reduce cardiovascular risk.” 

    ACSM has been a leader in advancing the importance of physical fitness. It is now clearly understood that CRF is one of the most important markers of health and should be regularly assessed in the clinical setting. Exercise professionals are well positioned to advance this message and are the key personnel that provide the measurement of CRF. 

    Do you know your CRF level? If not, it is time to seek out a facility that can provide this vital information for you.

    Related CEC Courses:
    POLAR and ACSM Presents: Heart Rate Monitoring Assessment Course (6 CECs)
    Industry Presented Webinar: Essential Elements of Heart Rate Based Training – Key Concepts & Practical Applications for Training (2 CECs)

    Lenny KaminskyDr. Lenny Kaminsky directed the Clinical Exercise Physiology Program and Laboratory and the Adult Physical Fitness Program at Ball State University (BSU) for over 25 years and is currently the director emeritus of BSU’s Fisher Institute of Health and Well-Being. He is one of the primary collaborators of the Ball State Longitudinal Lifestyle Study (BALLST) and one of the co-founders of the Fitness Registry for the Importance of Exercise National Database (FRIEND) Registry for Cardiorespiratory Fitness. He has served as editor of multiple ACSM publications and regularly contributes to scientific writing groups including the American Heart Association’s (AHA) scientific statement supporting cardiorespiratory fitness as a vital sign and the American Association of Cardiovascular and Pulmonary Rehabilitation’s (AACVPR) Statement on Progression of Exercise Training. He is the Editor-in-Chief of AACVPR’s Journal of Cardiopulmonary Rehabilitation and Prevention and the commentary editor of the ACSM Bulletin. 

    Viewpoints presented in ACSM Bulletin commentaries reflect opinions of the authors and do not necessarily represent positions or policies of ACSM. 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 the ACSM Bulletin.  

  • Dietary Nitrate and Women’s Athletic Performance: A Call for Further Research

    by Caitlin Kinser | Nov 16, 2023

    Nitrate supplementation has consistently been shown to benefit exercise performance due to its capacity to increase nitric oxide (NO), a signaling molecule that plays an important role in skeletal muscle function during exercise. Once ingested, nitrate is converted to nitrite via anaerobic bacteria in the oral cavity and nitrite is converted to NO especially under conditions of low oxygen availability and low pH, such as those that may be found in skeletal muscle during exercise. Inorganic nitrate is considered by the International Olympic Committee as one of only five dietary supplements with sufficient evidence to improve exercise performance in specific scenarios. Despite this, improved exercise performance with nitrate intake is not a universal finding among studies. Importantly, while nitrate appears to be effective in men, most studies conducted in women have not shown performance improvements with its supplementation. Although a logical interpretation of this is that nitrate is not performance-enhancing for the female athlete, we believe it is important to recognize that the literature on nitrate supplementation and women is small and limited, and more research is needed before drawing definitive conclusions.  

    Female representation in research on nitrate supplementation and exercise is severely lacking, with only eleven studies to date conducted exclusively with women, while almost 100 investigations have been performed with men. Of those studies with women, most (8/11) of these did not find an improvement in exercise performance with nitrate, although there are some data to the contrary. A closer look at the results of a recent systematic review and meta-analysis may explain why many of the studies in women showed no benefit from nitrate supplementation. This meta-analysis suggested that the performance-enhancing benefit from nitrate ingestion may not occur when there is no control for antibacterial mouthwash use (since this can eliminate important bacteria that converts the nitrate to nitrite); with acute doses ≤4.9 mmol or ≥15 mmol and chronic doses ≤4.9 mmol or ≥10 mmol; when nitrate is ingested <150 min before exercise; for exercises with duration ≤120 s or >600 s. Accordingly, all studies to date that have demonstrated a lack of a performance-enhancing effect of nitrate in women possess at least one of these characteristics that may potentially compromise benefits from nitrate supplementation. Additionally, several of the nitrate studies in women did not control for the menstrual cycle phase and/or did not consider the use of oral contraceptives. This is important given that menstrual cycle phase and oral contraceptive use may influence exercise performance and the response to nitrate supplementation. 

    Our recently published article in the Translational Journal of the American College of Sports Medicine aimed to highlight this discrepancy in the literature, namely that there is currently insufficient evidence to draw strong conclusions about the efficacy of nitrate supplementation for female athletes. There is a clear need for well-designed studies to determine whether women can benefit or not from this dietary supplement. This is especially important at a time when the number of female athletes at the Olympic Games is equal to that of male athletes and given the fact that even the smallest performance gains can make the difference between winning gold and failing to achieve the podium. To help researchers interested in this field, we have provided suggestions for studies investigating the effectiveness of dietary nitrate in female performance:  

    1. Use a placebo-controlled, crossover, double-blind, and randomized study designs, due to the short duration of nitrate supplementation and its short washout period.  

    1. To increase performance-enhancing effects (as based upon studies using predominantly males), studies should employ a 5-9.9 mmol dose of nitrate, using beetroot juice as a vehicle, ingested ≥150 min prior exercise lasting 120-600 s (e.g.: 4-km cycling time-trial, 1500 m and 3000 m running time-trial and 2000 m rowing) and avoid antibacterial mouthwash. 

    1. Compare monophasic oral contraceptives users and a men-only group to determine if inherent physiological differences may lead to distinct performance responses to nitrate supplementation between women and men.  

    1. Consider whether menstrual cycle phase alters the response to nitrate supplementation through comparisons of the effects observed between two or more phases.  

    Women seeking to gain a competitive advantage from nitrate: 

    We suggest that female athletes consult with a registered dietitian to determine the need for nitrate supplementation. If the decision to trial nitrate is taken, we suggest that female athletes rigorously and systematically test nitrate supplementation in, preferably in repeated competition simulations and compare it to their performance without nitrate, to verify if this strategy can enhance exercise performance and does not lead to side effects (e.g., mild gastrointestinal problems). If dietary nitrate proves to be consistently effective in improving performance during simulations and side effects are not observed, the athlete could consider its use in competition.   

    For more detailed recommendations and explanations about the topic, please read the paper “Directions for Future Studies to Determine Dietary Nitrate Efficacy in Female Athletes." 

     

    Arthur Carvalho, B.Sc., is a master’s student at the Faculty of Medicine of the University of São Paulo and a member of the Applied Physiology and Nutrition Research Group at the University of São Paulo, where he researches sex differences in exercise performance response to inorganic nitrate supplementation. 

    Breno Duarte, MSc, is a Ph.D student at the Faculty of Medicine of the University of São Paulo and a member of the Applied Physiology and Nutrition Research Group at the University of São Paulo, where he researches physiological and performance responses to different sources of dietary nitrate supplementation. 

    Bryan Saunders, Ph.D., is a researcher and lecturer in sport and exercise science at the Faculty of Medicine of the University of São Paulo, Brazil and a senior member of the Applied Physiology and Nutrition Research Group at the University of São Paulo. His main areas of research include nutritional supplementation to improve exercise performance, determination of the mechanisms through which these supplements act and what factors might moderate these effects. Bryan has applied sport science experience having provided performance analysis and physiology support to several UK-based football teams, has worked with elite cycling in Brazil and was previously a member of the São Paulo Cycling Federation. He currently serves on the editorial board of Frontiers in Nutrition and the Translational Journal of the American College of Sports Medicine

  • Do Sports Medicine Physicians Exercise More Regularly than Primary Care Physicians?

    by Greg Margason | Nov 08, 2023
    Do Sports Medicine Physicians Exercise More Regularly than Primary Care Physicians

    It is well established that regular physical activity is beneficial for the human body and mind. Many studies have outlined the effects of aerobic exercise and resistance training for longevity and optimization of the health span. There are well-established guidelines for physical activity, such as Physical Activity Guidelines for Americans by the U.S. Department of Health and Human Services. Unfortunately, only 24.2% of the American adult population meet the daily and weekly requirements for both aerobic and muscular-strengthening activity. 

    Patients traditionally are asked to turn to their primary care physicians or other members of their health care team for guidance on how to best implement these physical activity recommendations. It is well established that physicians who are more physically active themselves are more likely to discuss exercise with their patients. However, is there a difference in recommendation between those physicians with general primary care training vs. those with specialty training in sports medicine? 

    Our study, published in the November issue of Current Sports Medicine Reports, sought to answer this question by asking 649 participants about their personal exercise habits and counseling practices for their patients. We specifically compared primary care physicians with those who had received one extra year of specialty training in sports medicine; 72% of the respondents had previously or were currently completing a sports medicine fellowship training program. We found that those with sports medicine training were more likely to personally meet the physical activity guidelines than those without. 

    A thought-provoking conclusion from the study was that physicians with more sports medicine training felt a personal obligation to meet the physical activity guidelines themselves. Additionally, almost a quarter of our study population felt uncomfortable counseling patients on their physical activity or exercise habits if they didn’t meet the guidelines themselves. 

    Interestingly, we found that many providers felt limited for implementation of Exercise is Medicine® (EIM) in their practice, whether because they themselves felt inadequately trained in the subject or due to lack of resources. Therefore, we believe that the addition of more education on physical activity, such as EIM, and the implementation of such practices would benefit all levels of medical training. Hopefully, this additional training will help medical professionals combat the epidemic of decreased physical activity across the globe. A complimentary approach would be for physicians to directly work with exercise professionals, who can provide support and guidance for patients related to developing and maintaining a physically active lifestyle. The American College of Sports Medicine® has been a leader in providing resources, training, and certification programs for exercise professionals

    Tyler Slayman

    Tyler Slayman, M.D.
    , is a family medicine and primary care sports medicine physician at the University of Iowa Hospitals and Clinics and member of ACSM. As a marathoner himself, he serves as the director of the Endurance Athlete Program at UI Sports Medicine in Iowa City, Iowa. 


    Viewpoints presented in ACSM Bulletin commentaries reflect opinions of the authors and do not necessarily represent positions or policies of ACSM. 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 the ACSM Bulletin. 

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