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  • August Updates on NIH Reform and Appropriations

    by Caitlin Kinser | Aug 19, 2024
    Policy Corner cover: Post title and image of the US Capitol Building

    NIH Reform

    House and Senate Republicans have proposed separate plans to reorganize the National Institutes of Health (NIH), but these efforts are expected to face significant hurdles this Congress. Before the COVID-19 pandemic, the NIH received bipartisan support and consistent funding increases. However, the pandemic highlighted issues such as gain-of-function research and allegations of sexual harassment, prompting renewed scrutiny and calls for reform. 

    House Republicans, led by retiring Energy and Commerce Chair Cathy McMorris Rodgers, have introduced a comprehensive plan to consolidate the NIH’s 27 institutes and centers into 15, among other changes. This proposal was included in the fiscal 2025 funding bill, though it has been criticized by some in the scientific community as lacking a scientific basis. 

    In contrast, Senate Health, Education, Labor and Pensions Committee ranking member Bill Cassidy is advocating for improvements in the NIH’s grant approval processes and biomedical workforce. Cassidy’s proposals are seen as more collaborative and have not yet been formalized into legislation. 

    Despite these proposed changes, both the House and Senate are maintaining or slightly increasing NIH funding levels for the upcoming fiscal year. The House bill proposes steady funding at $48 billion, while the Senate bill includes a modest increase to $50.2 billion, with additional funds for cancer research and new authorities related to addressing sexual harassment. Smaller reforms proposed in the Senate are considered more likely to advance this Congress compared to broader overhauls. 

    Appropriations

    Congress adjourned for August recess with minimal progress on the 12 annual spending bills necessary to fund government agencies and programs. Federal financing is set to expire on September 30, which could lead to significant disruptions within federal agencies important to ACSM members. 

    The Republican-controlled House has passed five appropriations bills, but these include deep budget cuts and contentious cultural provisions, making them unlikely to become law. Meanwhile, the Democratic-controlled Senate has passed seven bills through committee with broad bipartisan support but has yet to vote on them in the full Senate. 

    Given the August recess, Congress is expected to rely on a “continuing resolution” (CR) to avoid a government shutdown. The need for such a stopgap measure is anticipated as lawmakers return just before the deadline.  

    Key negotiators agree on potentially adding disaster relief funding for areas impacted by recent crises, but significant disagreements remain. Democrats favor a short-term CR extending past the November elections but ending before the year's end, allowing for reevaluation of priorities. House Republicans are open to a longer CR extending into 2025, which could align with hopes of a Republican presidential win and increased conservative control. Both parties are cautious about extending funding too far into the next year, potentially complicating the next president’s budget negotiations. 

  • What Can I Do to Improve Pedestrian Safety in My Community?

    by Caitlin Kinser | Aug 19, 2024

    Pedestrian deaths in the United States are declining, but there is still a long way to go to protect the safety of those who are walking, rolling and cycling in American cities.

    In 2023, 7,318 pedestrian fatalities occurred in the U.S., a 5.4% decrease from 2022, which saw the highest number of pedestrian deaths in four decades, according to a report from the Governors Highway Safety Association. Although improvements have been made, pedestrian fatalities are still 14.1% higher than pre-pandemic levels (2019 and earlier).

    The ACSM American Fitness Index monitors pedestrian fatalities in the 100 most-populous U.S. cities. The average for all cities monitored is 3.2 deaths per 100,000 residents. The cities with the lowest rate of pedestrian fatalities are:

    • Irvine, CA (0)
    • Lincoln, NE (0.3)
    • Plano, TX (0.3)
    • North Las Vegas, NV (0.4)
    • Garland, TX (0.4)
    • Arlington, VA (0.4)
    • Henderson, NV (0.6)
    • Gilbert, AZ (0.7)
    • Reno, NV (0.7)
    • Omaha, NE (0.8)

    While some cities are excelling in pedestrian safety, others are tragically failing. The cities with the highest rate of pedestrian fatalities are:

    • Memphis, TN (8.8)
    • Albuquerque, NM (8.7)
    • St. Louis, MO (7.5)
    • Tucson, AZ (7.2)
    • Detroit, MI (7.0)
    • Tampa, FL (6.9)
    • Orlando, FL (6.8)
    • Atlanta, GA (6.5)
    • Miami, FL (6.1)
    • Phoenix, AZ (6.0)

    “A decline in pedestrian deaths offers hope that after years of rising fatalities a new trend is starting,” said GHSA Chief Executive Officer Jonathan Adkins. “Each death is tragic and preventable. We know how to improve safety for people walking – more infrastructure, vehicles designed to protect people walking, lower speeds and equitable traffic enforcement. It will take all this, and more, to keep the numbers going in the right direction.”

    According to the same report from the Governors Highway Safety Association, two-thirds of pedestrian fatalities occurred in locations where no sidewalk was noted in the incident report.

    One way that cities can help to improve safety for pedestrians is to incorporate a Complete Streets Policy. Complete Streets are designed and built to ensure the safety of street users (pedestrians, cyclists, transit riders and motorists) of all ages and abilities. Complete Streets is a process and approach to increasing safety, and there is not a one-size-fits-all model. A Complete Streets system may include sidewalks, bike lanes, designated bus lanes, crosswalks, median islands, protected public transportation stops, enforced speed limits, lighting and more.

    The ACSM American Fitness Index also monitors adoption of Complete Street’s policies across the 100 cities. According to the 2024 report, only 28 of America’s largest cities have Complete Street policies that are both officially adopted at the city or county level and include enforcement mechanisms. Fifty of the cities have some level of policy without enforcement, and while the remaining 22 have no policy at all.

    What can I do to improve pedestrian safety in my community?

    If you want to take action to improve pedestrian safety where you live, focus on these actions:

    • Advocate for improved planning, funding, and infrastructure, such as the adoption of Complete Streets and/or a Safe System Approach in your community
    • Hold yourself accountable as a driver by following all traffic regulations and speed limits, and eliminate driving distractions such as texting while driving
    • Support safe routes for active transportation and school-zone safety
    • Help educate your community about safety, including joining public campaigns and sharing credible information on social media
  • ACSM’s Old Headquarters: A Sunset Leads to a Sunrise

    by Greg Margason | Aug 13, 2024

    When I view the picture that accompanies this blog post, it reminds me of the old adage “Is the glass half full, or is it half empty?”

    In the first week of July, I was able to fly out to Indianapolis to meet up with the ACSM Office of Museum, History and Archives’ liasons, Creative Services Manger David Brewer and Vice President of Operations Katherine Schowengerdt, as well as Interim CEO Katie Feltman. As many of you know, ACSM is selling the building that it has called home since the groundbreaking ceremony that occurred on Dec. 15, 1983. And now ACSM is looking to the future some 40+ years after the ground was broken in 1983. So it was my role, along with the ACSM staff, to go into the building and to secure the history of our organization collected since 1954 — some 70+ years!

    I flew into Indianapolis on Monday, July 1, in preparation for our task. On Tuesday I was picked up by Katherine, and we were on our way to 401 West Michigan Street, our former headquarters. For those of you who may not know, the building has not been highly used since the pandemic started in early 2020, and on this hot summer day, the air conditioning wasn’t working either. There were two main aspects of the buidling that we were mainly focused on: the basement, where a number of our historical files have been kept throughout the years, and the room that was known as the ACSM Library. Our chief goal while there was to secure and preserve our history, mainly to be boxed up for storage, as ACSM begins to plan for our future.

    The great thing about this visit is that it allowed multiple eyes to view what we had and what needed to be preserved. In large part, all of the historically relevant files and boxes in the basement were brought upstairs to be prepared for storage. And then, as we went through the ACSM Library, anything that referred to ACSM in any form was boxed up to be stored and reviewed at a later date. The task was not easy, and thankfully water was provided by Katherine on day one and by Dave on day two, for the heat rose to a very high level throughout each day. But all in all, we were able to stay relatively hydrated and felt confident that we were securing our organization’s history.

    On that Tuesday evening, I was fortunate to have dinner with both Katherine and Dave as well as Katie. As a volunteer leader, one of the the common themes I thought about during this trip was just how invested ACSM leadership and its staff were in the preservation of our history — which there is a lot of! This was perhaps one of the highlights of my trip, leaving thinking about how highly invested our ACSM leaders are in the preservation of our history. Approximately 70+ years of ACSM history was secured and will be on its way to storage, if it isn’t there already. Our future task will be to go through this vast pile of history, or what I would call “historical gems,” such as the picture of a young Dr. Josephine Rathbone that I came across, or the picture of Drs. D.B. Dill and Per-Olof Åstrand conducting an aerobic performance assessment with a female subject on a treadmill.

    It is the hope of our office, now that the securing of our history from the building has occurred, that with the help of an archivist in the future, we will be able to comb through all of it, organize and digitize it, and then develop a plan for how to best share it with the most important part of our organization: our membership.

    Now, back to the picture at the top of this blog. Is the sun setting, or is it rising? Well, the sun is setting on this current ACSM property: I took this picture on the morning of my second day, and as I was getting in my Uber back to the airport to fly home, I honestly felt a little sad about the sale of our former headquarters. But then quickly after, I had feelings of excitement and hope thinking about ACSM as it moves forward. Because ACSM is more than just a building. It is a collection of people — staff, volunteer leaders and members. And as ACSM President Dr. Stella Volpe stated at the 2024 annual meeting held in Boston this year, “We are ACSM.”

    So, the place ACSM calls home may change, but the “we” of ACSM is only growing. The sun is rising, and the glass is just not half full — it’s filling.

     

    Sean Walsh, Ph.D., FACSM, is a professor in the Department of Physical Education, Recreation, and Dance at Central Connecticut State University. He is a past president of the New England Chapter of the American College of Sports Medicine (NEACSM) and serves as the historian to both ACSM and NEACSM.

  • Active Voice | Is Healthy Weight Gain in Athletes Realistic?

    by Greg Margason | Aug 07, 2024

    As a dietitian in the United States Army, many soldiers have sought nutritional advice from me with the goal of gaining muscle or bulking up before going to Ranger School. Many professional and recreational athletes likewise want to intentionally gain weight for reasons that include increased strength or power or being at a heavier body weight than the opponent to gain a competitive edge.  

    But current sports nutrition guidelines for intentional weight gain are based more on estimates and assumptions than evidence, as very little research has been conducted in this area. The commonly recommended starting point for an energy surplus is an additional 500 kcal per day, which may be incorporated by adding one or two additional energy-dense snacks or beverages. This additional energy may be from whole foods that have been minimally processed in consideration of both the health (short and long term) and performance of the athletic individual. 

    For our study, “A Randomized Trial of Healthy Weight Gain in Athletic Individuals,” recently published in Medicine & Science in Sport & Exercise®, we explored whether current performance nutrition guidelines of a ~500 kcal/day surplus along with rigorous resistance training promoted healthy weight gain, which we define as being mostly lean with minimal gains in adiposity and no ill health effects. We included 32 athletes (19 men, 13 women) from a variety of athletic backgrounds, as this accurately represents the reality of a sports dietitian’s work. Of note, we were able to recruit a number of female participants, an understudied population in this area of research. 

    Instead of providing participants with ultra-processed snacks, high-energy supplements or mass gainers, we prepared our 500 kcal snacks each week from minimally processed foods. To investigate a possible difference in healthy weight gain between the two commonly discussed macronutrients in sports nutrition, we randomized our participants to a protein-dominant or carbohydrate-dominant snack group. Two examples of our protein-dominant snacks include a smoothie (natural peanut butter, banana and whole milk) and a handful of peanuts, raisins and spicy cheese. Examples of our carbohydrate-dominant snacks include a smoothie (frozen blueberries, strawberries, fresh spinach, orange juice, avocado, extra-virgin olive oil and sugar) and a handful of dried mango, dried cranberries and butter crackers. 

    The key takeaway of our study is that current performance nutrition guidelines for healthy weight gain worked for about half of our participants by the end of our 10-week intervention, with no adverse health outcomes (fasting blood lipids, blood glucose and blood pressure). Furthermore, the total weight gain was about ~70% lean mass. A surprising result was that our carbohydrate-dominant snack group gained more weight than the protein-dominant snack group, though lean mass gain was not statistically different between groups. 

    We must continue to investigate what factors contributed to a more or less efficient weight gain among our participants, or in other words, what factors help explain why some athletes gain weight and others seem to be hard gainers. These factors likely include individual characteristics such as age, sex, resistance training history, hormonal profile and changes in metabolism or appetite that occur in response to energy surplus. 

    We hope nutrition and exercise professionals will use the results of our study to help their clients with healthy weight gain and may recommend the whole food approach. Because we found a wide range of weight gain among our participants (-0.9 to 4.4 kg), we also recommend frequently analyzing client progress to ensure the right energy surplus for optimal healthy weight gain. 

    This study was funded by a grant from the Peanut Institute Foundation. 

    The views and information presented are those of the author and do not represent the official position of the U.S. Army Medical Center of Excellence, the U.S. Army Training and Doctrine Command, or the Department of the Army, Department of Defense, or U.S. Government. 

    Allison Sanchez, Ph.D., recently earned her doctorate in clinical physiology and metabolism from Virginia Polytechnic Institute and State University. Her dissertation work focused on evaluating nutrition recommendations and identifying predictors to promote healthy weight gain through whole foods in athletic individuals. She has been a registered dietitian in the United States Army since 2011 and a board-certified specialist in sports dietetics since 2014. She is a member of the American College of Sports Medicine®. 

  • Anti-Doping Efforts in Paris 2024

    by Caitlin Kinser | Aug 05, 2024
    Drug test on a black background, purple diagonal lines, ACSM logo and

    After years of waiting, the summer Olympics are finally here. All attention will turn to the amazing feats of athletes from all over the world. Spectators, media and fans will witness the highs and lows as dreams are made (and broken) against the spectacular backdrop of Paris. Many friends and family will debrief after the performances they have witnessed and inevitably the topic of performance enhancing drugs will be raised by someone. It’s usually a topic only talked about if there is a big scandal but anti-doping is a global sporting movement with not only a crucial role at the Games but every day of the Olympic cycle.

    Olympic and paralympic hopefuls are bound by the World Anti-doping Code which sets out rules to ensure a level playing field across all sports and countries. A number of important areas of the Code relate to Testing and Whereabouts. Day to day, athletes may be tested by their National Anti-doping organization of their International Sport Federation both in or out of competition tests. Many of us associate drug testing with those that occur immediately after a sporting event, known as in-competition or IC testing. These tests are of course very important to verify a “clean podium” at the time of the event, but the majority of anti-doping tests that are conducted around the world actually occur during an athlete’s everyday life – known as out-of-competition (OOC) testing. Elite athletes who are part of a registered testing pool are required to submit “Whereabouts” information to anti-doping authorities which provides information on where they are staying as well as known locations and times for training, work and study. On top of this, athletes must provide a daily one-hour window where they can be located. Failure to update or be where the athlete says they will be in the one-hour window can have significant consequences for athletes under the Code, but it is obvious that this is a big responsibility and a fair burden on athletes, especially those with busy travel and competition schedules.

    Athletes may be required to provide any or all of the following approved sample types – urine, blood or dried blood spots (DBS). Sample must be collected by an accredited Doping Control Officer (DCO) who must follow strict international standards for sample collection and transport, not only to ensure the integrity of the sample but also to protect the Athlete’s rights. Samples must analyzed at a World Anti-doping Agency (WADA) Accredited Laboratory, again following the International Standard for analysis. Anti-doping authorities will determine the sample type and analysis according to the sport and type of athlete being tested. Very simply, specialized testing for anabolic steroids may be more common in sports where muscle size and strength is advantageous, whereas testing for erythropoietic stimulating agents such as EPO may be more common in endurance sports. However, since the substances named on WADA’s Prohibited List of substances apply to all sports (with a few exceptions), any substances can be tested for regardless of the athlete’s sport. In addition to direct testing, longitudinal monitoring of certain biomarkers in blood and urine has also been adopted in anti-doping, resulting in the concept of the Athlete’s Biological Passport (ABP).

    Anti-doping testing has been “part of the job” for the most of the athletes here at the Olympics for the past three years, or more for the seasoned campaigners, with out of competition testing a necessary feature as well as IC testing at trials and qualifying events. Here in Paris, this doesn’t stop! Under the jurisdiction of the International Olympic Committee, anti-doping testing continues from the opening of the Olympic Village and at every competition venue. All being well, anti-doping will continue its hard work in the background without scandal and the dinner conversations can be more focused on the athlete’s performances.

     

    Laura Lewis Headshot

    Laura Lewis, Ph.D., Born in the UK, Laura moved to Australia in 2005 to begin a graduate training position in the Physiology department at the Australian Institute of Sport. She began a sports-based Ph.D. in 2007, examining in the role of hemoglobin mass on cycling performance, with her research taking her to Europe and the US with the Australian National cycling team. Graduating in 2011, Laura continued to work as an applied sports scientist with Australia’s aspiring Olympians from a range of sports including water polo, soccer and track and field. She maintained her research interests, particularly in Altitude and anti-doping, combining the two in 2014 during a challenging project at the Tour of Qinghai Lake in northern China. Laura worked as a Research Fellow at the Australian Institute of Sport and Australian Catholic University and was awarded a PCC grant in 2015 to study the combined effects of altitude and iron supplementation on the Athlete Biological Passport. In 2020, Laura joined the U.S. Anti-Doping Agency as Director of Science, where she works alongside the testing, education and legal teams, advocating for clean sport and Athlete’s rights to fair competition.

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