Each Tuesday afternoon ACSM members receive ACSM's Sports Medicine Bulletin (SMB) in their inbox. Featured at the top of each issue is an Active Voice commentary. The Active Voice commentary is written by authors of articles published in ACSM's journals. We present the Top 10 most read Active Voice Commentaries of 2019.

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1. Evening Vs. Morning Aerobic Training - Which Is Better for Hypertension Treatment?

By John R. Halliwill, Ph.D., FACSM; Leando C. Brito, Ph.D.; Cláudia L. M. Forjaz, Ph.D.

From June 25: High or elevated blood pressure (hypertension) affects one billion people worldwide and is one of the most important risk factors for development of cardiovascular disease. Current clinical guidelines highlight the use of aerobic training as a useful intervention, either alone or in combination with antihypertensive medication and other lifestyle changes to treat hypertension. However, benefits of exercise training, such as its ability to reduce blood pressure, appear to vary across studies and across individuals. Thus, an important research focus is to discover ways to potentiate exercise's hypotensive effect. Read more. 

2. You Might Want to Sit Down for This!

By Gregg Afman, Ed.D., and James A. Betts, Ph.D., FACSM

From May 14: The colloquial phrase “take a load off your feet” reflects the universal recognition that sitting requires less effort than standing. This makes perfect sense when considering the active musculature required in each posture. We were aware of recent campaigns and technologies to promote standing on the basis that prolonged sitting is closely linked to obesity and poor health. Yet, we also were surprised to find that the fundamental difference in energy cost between sitting and standing naturally had never been measured. Read more.

3. Lighting Up the Brain During Exercise

By Gavin D. Tempest, Ph.D. 

From July 2: The cognitive and behavioral benefits of exercise are well known. What is less known are the direct effects of exercise on the brain. Common neuroimaging technologies are not suitable for use during exercise. However, near infrared spectroscopy (NIRS) is relatively robust in reducing motion artifacts and can be used in less restrictive and natural settings. Read more. 

4. Does Statin-Associated Muscle Pain Affect Physical Performance?

By Thomas Morville, M.D., Ph.D. 

From Aug. 27: Statins are cholesterol-lowering medications and, currently, some of the most prescribed drugs worldwide. By now, the benefits of reduced cardiovascular mortality and morbidity are well established, yet great debate remains concerning the reports of possible side effects. These include increased risk of diabetes and, most commonly, increased risk of muscle pain. Despite many attempts to explain this phenomenon of statin-associated muscle pain, no consensus presently exists on the matter. Unfortunately, discontinuation of statin treatment may be the only way to alleviate the muscle symptoms, and this clearly presents a dilemma for both patients and physicians. Read more.

5. Exercise is NOT a Single Medicine - Targeted Prescription Ameliorates Muscle and Bone Loss in Patients with Prostate Cancer

By Robert U. Newton, Ph.D., AEP, CSCS*D, FESSA, FNSCA 

From June 4: As a profession, we must become much more sophisticated in the way we prescribe exercise for the management of various chronic diseases. While any physical activity is likely to be beneficial, patients experiencing considerable morbidity and potential mortality from chronic diseases such as cancer need, and certainly deserve, access to the optimal exercise prescription. It should be tailored to provide the greatest physical and psychological health benefits. Exercise is not a single medicine — instead it ought to be viewed as a medical intervention with a myriad of mode and dosage combinations having highly differentiated effects on the body systems. Read more.

6. Can HIIT Training Improve Function of the Diabetic Heart?

By J. Chris Baldi, Ph.D., FACSM

From July 16: The incidence of type 2 diabetes continues to increase. Moreover, the prolonged management of the disease is crippling health care systems worldwide. Large prospective trials show that improved glycemic control and lifestyle changes result in reduced symptoms of neuropathy, retinopathy and nephropathy, thus improving outcomes for people with diabetes. Unfortunately, reductions in cardiovascular morbidity/mortality have not been realized in these patients, and their cardiovascular disease risk factors remain elevated. Read more.

7. Is Weightlifting Good for Your Heart? If Yes, How Much Is Enough?

By Duck-chul Lee, Ph.D., FACSM

From April 16: It is well documented that aerobic exercise, such as running, is good for the heart and prevents cardiovascular disease (e.g., heart attack or stroke); thus, it is commonly called “cardio” exercise. In contrast, resistance exercise has been traditionally considered beneficial for improving sports performance in athletes. More recent studies have suggested potential benefits with resistance exercise for type 2 diabetes, bone health and functional capacity in older adults.However, there is still limited evidence to demonstrate whether weightlifting is good for the heart and prevents heart attack or stroke ̶ a major cause of death in the general population. Read more.

8. Endocannabinoids and Feeling Differently Post-Exercise — Uncovering Relationships in Depressed Women

By Jacob D. Meyer, Ph.D., and Kevin M. Crombie, M.S.

From Oct. 15: It’s a common phenomenon: After walking, jogging or running, people typically report mood improvements for minutes-to-hours after the exercise has ended. Although popular culture has ascribed this “feel-good” effect of exercise to endorphins, studies that experimentally blocked endorphins from binding to their receptors have led to mixed results. Some still showed mood improvements, even when endorphins were blocked. Despite considerable research examining endorphins and other neuromolecular systems, the mechanisms responsible for positive feelings following exercise remain largely unknown. Recent research suggests that a neuromodulatory system known as the endocannabinoid (eCB) system may play a significant role. Read more.

9. Activity Trackers to Promote and Monitor Physical Activity in Research — Is It Too Good to Be True?

By Jessica McNeil, Ph.D., FACSM, CSEP-CEP 

From June 11: Commercially available activity trackers have become increasingly popular for use as intervention and assessment tools in health promotion and chronic disease prevention research. As an intervention tool, these devices offer prompt and automated feedback on sedentary time and physical activity (PA) participation directly to the consumer. Research teams and fitness professionals can also use these devices and some of their features (e.g., heart rate monitoring) to educate and prescribe PA of various intensities to study participants or clients, allowing the exercise prescription to be personalized. As an assessment tool, these devices allow the research team to monitor PA participation more accurately within a home-based setting throughout an entire intervention, instead of relying on self-reported diaries or “snap shots” of activity monitoring pre- and post-intervention. Read more.

10. Do Skillful and Fit Kids Have Smarter Brains?

By Eero A. Haapala, Ph.D., and Timo A. Lakka, M.D., Ph.D. 

From May 7: In a Systematic Review published in 2016, ACSM suggested a positive association between physical fitness, cognitive functions and academic achievement in children. Although interest has increased in whether improving movement skills, increasing aerobic fitness and decreasing body fat percentage may enhance cognitive functions, most studies on this topic have been cross-sectional and do not allow firm conclusions about cause and effect regarding these relationships. Read more.