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Home   About ACSM   Join ACSM   Meetings   Continuing Education   Get Certified   Access Public Information Dec. 25, 2012


Happy Holidays from the American College of Sports Medicine!

The American College of Sports Medicine wishes you a happy and healthy holiday and new year! View a special holiday message from ACSM.

January Issue ESSR Available Online
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The first issue for 2013 of Exercise and Sport Sciences Reviews is available online now! Go to the Web site to view the articles*, which cover a variety of topics, and to view the online-only content. The Journal Club questions by editor Roger Enoka are posted so make sure to download and review them after reading the covered article, “Origin and Development of Muscle Cramps” by Marco Alessandro Minetto, Aleš Holobar, Alberto Botter, and Dario Farina. The article is available for download FREE for a limited time!

*ACSM Professional members must login at the ACSM Web site first. Then click on the “Access My Journals” link.

Revisiting the Top 10 SMB Articles from 2012

From energy drinks to preventing triathlon swim deaths, this year Sports Medicine Bulletin has featured commentaries from some of the brightest minds in sports medicine and exercise science in our weekly “Active Voice” columns. As the year comes to a close, we’d like to take this issue to revisit the 10 most popular “Active Voice” commentaries from 2012.

Energy Drinks —What You Need to Know!
Marathon Running: Healthy or Harmful?
Is High-Intensity Interval Training a Time-Efficient Exercise Strategy to Promote Health?
How Much Exercise is Needed to Improve Insulin Resistance?
Does Acute Static Stretch Compromise Muscle Force?
Does Cardiorespiratory Fitness Level Trump LDL-Cholesterol Level for Predicting CHD Mortality?
The Role of Vigorous-Intensity Exercise in Preventing Chronic Disease
Exercise Your Pain Away
Triathlon Swim Deaths: Initial Steps Toward Prevention
Q&A — The Exercise is Medicine® Credential

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Energy Drinks —What You Need to Know!
By Amy Eichner, Ph.D. and Erin Hannan    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Amy Eichner, Ph.D., is Special Advisor on Drugs and Supplements at the U.S. Anti-Doping Agency, where her responsibilities include their dietary supplement policy and providing related education to their stakeholders. Dr. Eichner previously led USADA’s Drug Reference Department. Prior to joining USADA, she conducted medical research at Harvard University and Massachusetts General Hospital. During the period immediately before coming to USADA, she directed an accredited calibration and testing laboratory dedicated to biocompatibility testing of medical devices for the Therapeutic Goods Administration in Australia.

Erin Hannan is Communications and Outreach Director for the U.S. Anti-Doping Agency. Her work focuses on ensuring that competing athletes and our nation’s youth are equipped with tools and skills for making healthy, informed and ethical choices for their lives. With a background in enterprise marketing, branding, communications and outreach initiatives, her responsibilities at USADA include facilitating communications with competing athletes to foster ethical, healthy and informed behaviors, as well as developing comprehensive educational resources to promote these aims.

This article first appeared in the April 2012 e-newsletter of the Professionals Against Doping in Sports. The PADS initiative is jointly led by ACSM and USADA. This topic has broad relevance to many exercise and sports settings, so it is also being presented here for our SMB readers. For more about PADS and to become a subscriber to the PADS newsletter, see the website at: professionalsagainstdopinginsports.org.

You may already know this, but there are significant differences between sports/electrolyte drinks (those that contain carbohydrates and electrolytes) and the "Energy” drinks that are now all the rage. But what you may not know is just how significant, and potentially serious, these differences can be. All of these names for drinks can be confusing – don’t be fooled. The ingredients can be deceiving. If your patients are drinking something that advertises itself as an “Energy Drink,” they are probably helping themselves to a healthy (or more likely unhealthy) dose of stimulants. A more proper name for this class of drinks could be “Stimulant Drinks.”


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Marathon Running: Healthy or Harmful?
By Johannes Scherr, M.D.    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Johannes Scherr, M.D., graduated from the University of Freiburg Medical School, Freiburg i. Br., Germany. He performed residencies in internal medicine and sports medicine at the Heart Center in Freiburg-Bad Krozingen and at the University Hospital ´Klinikum rechts der Isar´ of the Technische Universitaet Muenchen, Germany. His research activities relate to biochemical and physiological effects of prolonged and vigorous exercise, with special focus on the cardiovascular system. He has published several research articles on the effects of marathon running. He is chief team physician of the German National Alpine Ski Team. This commentary presents Dr. Scherr’s views associated with the research article he and his colleagues published in the September 2012 issue of ACSM’s Medicine and Science in Sports and Exercise® (MSSE).

Regular moderate physical activity is an important strategy to improve risk factors for heart disease and prevent myocardial infarction and stroke. In addition, exercise is an effective tool in patients with disease such as diabetes, high blood pressure, cancer or heart failure. To distribute this information, the American College of Sports Medicine has launched the global initiative Exercise is Medicine®.

Is High-Intensity Interval Training a Time-Efficient Exercise Strategy to Promote Health?
By Martin Gibala, Ph.D.    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Martin Gibala, Ph.D., is Professor and Chair of the Department of Kinesiology at McMaster University. He studies the regulation of energy metabolism from the molecular to whole-body level and also conducts applied research that examines the impact of nutrition and training on exercise performance. He and his colleagues published a research article related to this commentary that appeared in the Oct. 2011 issue of Medicine & Science in Sports & Exercise® (MSSE). For more on the topic, see Dr. Gibala’s review in the April 2008 issue of ACSM’s Exercise and Sports Sciences Reviews (ESSR), titled “Metabolic adaptations to short-term high-intensity interval training: a little pain for a lot of gain?

High-intensity interval training (HIT) describes exercise that is characterized by brief, intermittent bursts of vigorous activity, interspersed by periods of rest or low-intensity exercise. HIT is infinitely variable, with the specific physiological adaptations induced by this form of training determined by various factors including the precise nature of the exercise stimulus (i.e., the intensity, duration and number of intervals performed, as well as the duration and activity patterns during recovery). When compared on a matched-work basis, or when estimated energy expenditure is equivalent, HIT can serve as an effective alternative to traditional endurance training, inducing similar or even superior changes in a range of physiological, performance and health-related markers in both healthy individuals and diseased populations.

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How Much Exercise is Needed to Improve Insulin Resistance?
By Francesca Amati, M.D., Ph.D.    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Dr. Amati is a research group leader in the Department of Physiology at the University of Lausanne, Switzerland. Specialized in internal medicine with a research background in exercise physiology, her main research focuses on insulin resistance and the mechanisms by which physical activity prevents or treats chronic diseases such as diabetes. This commentary presents Dr. Amati’s views associated with the research article she and her colleagues published in the May 2012 issue of ACSM’s Medicine and Science in Sports and Exercise® (MSSE).

Regular exercise is one of the first lines of defense against type 2 diabetes (T2D). Insulin resistance is a key component of T2D and is often present for many decades before the onset of T2DM. While some cross-sectional and prospective intervention studies have demonstrated the beneficial effect of endurance exercise on the improvements of insulin resistance in healthy and pre-diabetic states (such as impaired glucose tolerance), other studies report contradictory results with either no effect of exercise on insulin sensitivity or the observation of an effect only if performed at relatively high intensity.

Beyond the current recommendations to engage in at least 150 minutes of moderate-intensity endurance exercise each week (see ACSM Position Stand, for example), unanswered questions with important clinical and practical questions remain. Some examples are: “Will a sedentary person obtain improvements in insulin sensitivity if exercising less then 150 min/week?”, “Will the gain be proportionally greater if exercising more?”, and “Will someone with a high degree of insulin resistance respond better then someone with a relatively lower insulin resistance?” Our recent study in MSSE was conducted to examine the dose-response effect of exercise on improvements in insulin sensitivity during physical training in previously sedentary adults.

Does Acute Static Stretch Compromise Muscle Force?
Anthony D. Kay, Ph.D.    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Anthony D. Kay, Ph.D., is a senior lecturer in the Department of Sport, Exercise & Life Sciences at The University of Northampton in the U.K. His research focus includes examining musculotendinous mechanics, neuromuscular activity and force production. See the Jan. 2012 issue of ACSM's Medicine & Science in Sports & Exercise® (MSSE) for a related research review he co-authored, titled "The Effect of Acute Static Stretch on Maximal Muscle Performance: A Systematic Review."

Static stretching is a common physical activity conducted by athletic, recreational and clinical populations, employed primarily for the short-term benefits of increased flexibility and decreased muscle tension. It often induces feelings of exercise readiness and is thought to reduce the risk of muscle strain injury. However, over the past decade, a growing body of research has reported that muscular force can be compromised after acute stretching, which may negatively influence exercise performance. Position statements and exercise prescription guidelines from governing bodies including ACSM have continued to reflect this interpretation. However, before changing exercise recommendations, I believe it is our role as researchers to objectively, critically and systematically evaluate the literature, and to ask: do we really know whether stretching is or is not detrimental to muscular performance, and should we recommend or oppose its use?


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Does Cardiorespiratory Fitness Level Trump LDL-Cholesterol Level for Predicting CHD Mortality?
By Steve Farrell, Ph.D.    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Dr. Farrell is the science officer for the Division of Education at The Cooper Institute in Dallas. He and his colleagues have delivered health and fitness workshops around the globe for the past 30 years. His main area of research focuses on the associations among cardiorespiratory fitness, adiposity, and various health outcomes. This commentary presents Dr. Farrell’s views associated with the research article he and his colleagues published in the November issue of ACSM’s Medicine and Science in Sports and Exercise® (MSSE).

There is broad consensus that elevated levels of LDL cholesterol and low levels of cardiorespiratory fitness (CRF) are powerful independent risk factors for coronary heart disease (CHD). Is it possible that one might be a stronger predictor of CHD mortality than the other? My colleagues and I designed a study that would look at all possible combinations of CRF and LDL and the subsequent risk of CHD mortality. In this study, recently reported in MSSE, we followed 40,718 apparently healthy men who underwent a comprehensive baseline physical exam at the Cooper Clinic during 1978-2006. All men had a maximal treadmill stress test and blood work at the time of their exam. We divided the group into three categories of CRF:

Low fit: the bottom 20% (1st quintile) compared to other men in their age group.
Moderate fit: the next 40% (2nd and 3rd quintile) compared to other men in their age group.
High fit: the top 40% (4th and 5th quintile) compared to other men in their age group.

The Role of Vigorous-Intensity Exercise in Preventing Chronic Disease
By Andrea K. Chomistek, Sc.D. and Eric B. Rimm, Sc.D.    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Dr. Andrea Chomistek is a research fellow in the Department of Nutrition at the Harvard School of Public Health and an ACSM member. Her research background is in physical activity and the epidemiology of cardiovascular disease. Her current research interests include developing better definitions of physical activity and inactivity in order to improve our understanding of how to maximize the health benefits of regular exercise, particularly as related to cardiovascular disease, obesity, and diabetes.

Dr. Eric Rimm is an associate professor of epidemiology and nutrition at the Harvard School of Public Health and an associate professor of medicine at the Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School. He is the director of the Program in Cardiovascular Epidemiology at the Harvard School of Public Health. Dr. Rimm’s main research interests include studying associations between diet and other lifestyle characteristics in relation to risk of obesity, diabetes, heart disease, and stroke.

The following commentary reflects Dr. Chomistek’s and Dr. Rimm’s views relating to their and colleague’s research article, which appeared in the October 2012 issue of
Medicine and Science in Sports and Exercise® (MSSE).

The importance of physical activity in disease prevention has been widely studied and is generally well accepted. Regular physical activity has been shown to lower the risk of diabetes, coronary heart disease, stroke, some types of cancer, and all-cause mortality. Greater physical activity provides greater health benefit but the shape of the dose-response curve specifically for vigorous-intensity activity is not well defined.
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Exercise Your Pain Away
By Dane B. Cook, PhD, FACSM and Laura D. Ellingson, PhD    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Dane B. Cook, Ph.D., FACSM, is an Associate Professor in the Department of Kinesiology and co-director of the Exercise Psychology Laboratory at the University of Wisconsin – Madison. His research focuses on determining the psychobiological mechanisms of pain and fatigue and learning how exercise can be used to better understand and treat these phenomena in healthy adults and those suffering from chronic pain and fatigue.

Laura D. Ellingson, Ph.D., is a Post-Doctoral Research Scientist in the Department of Kinesiology at the University of Wisconsin – Madison. Her research focuses on the influence of exercise and physical activity behaviors on central nervous system processing of pain in patients with chronic pain conditions and healthy individuals.

See the July, 2012 issue of ACSM's Medicine & Science in Sports & Exercise® (MSSE) for the research report they authored with colleagues, entitled “Physical Activity is Related to Pain Sensitivity in Healthy Women.”

Pain is an increasing public health concern. At any given time up to 50% of adults are affected by various acute pain conditions (ranging from everyday aches and pains to serious injuries). Roughly 20% of the population suffers from chronic musculoskeletal pain. The consequences of living with pain are dire. Pain interferes with activities of daily living, negatively impacts personal relationships, decreases work productivity and increases health care utilization. Unfortunately, aside from drugs, there are few evidence-based options for dealing with either acute or chronic pain.

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Triathlon Swim Deaths: Initial Steps Toward Prevention
By Rudy Dressendorfer, P.T., Ph.D., FACSM    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Rudy Dressendorfer, P.T., Ph.D., FACSM is an accomplished scientist, educator and clinician with a career focused on clinical exercise physiology. He is an ACSM Program Director and has served on ACSM’s certification and education committee. He retired as full professor of human performance and sport at New Mexico Highlands University and subsequently taught exercise physiology and did collaborative research with faculty at the University of Alberta in Canada. Currently, he practices sports medicine as a licensed physical therapist in California. Rudy has published extensively on physical conditions, injuries and related prevention strategies for endurance athletes. He also has direct experiences with these issues, as he is a highly successful amateur triathlete.

A disturbing number of drownings have occurred during triathlon swims in recent years: 14 deaths were reported between 2006 and 2008, and nine more in the summer of 2011. Prevention is indicated, but there is little certainty about the causes of these unexplained deaths. Drowning due to water inhalation could occur, given that physical contact during mass starts and pack swimming is the norm in triathlon races. However, rescue craft are typically close by, and trained swimmers usually tolerate catching a mouthful of water or missing a breath or two without the need for emergency help. In the absence of other limitations to breathing, ordinary drowning seems an unlikely cause for most triathlon swim deaths. Sudden cardiac death remains a possibility to be ruled out.

Q&A — The Exercise is Medicine® Credential
By Deborah Riebe, Ph.D., FACSM    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Deborah Riebe is a professor and chair of the Department of Kinesiology at the University of Rhode Island. She currently serves as chair of ACSM’s board of certification, the Committee on Certification and Registry Boards. Dr. Riebe is an associate editor of the upcoming 9th edition of ACSM’s Guidelines for Exercise Testing and Prescription.

SMB: Why was the Exercise is Medicine (EIM) credential program created?

Physical activity plays an important role in the prevention and treatment of many chronic diseases. Physicians and other health care providers often don’t have the time to go beyond the simple recommendation of “exercise more” and many do not have the training necessary to develop an appropriate exercise prescription. Since there is no licensure in our field (except in Louisiana for clinical exercise specialists) and because there are more than 300 certifications available, it is often difficult for health care providers to identify exercise professionals with demonstrated competence to work with patient populations. The EIM credential helps physicians navigate this challenge and provides the opportunity for the medical community to work closely with exercise professionals.


Sports Medicine Bulletin
Sports Medicine Bulletin is a membership benefit of the American College of Sports Medicine. There is no commercial involvement in the development of content or in the editorial decision-making process for this weekly e-newsletter. The appearance of advertising in Sports Medicine Bulletin does not constitute ACSM endorsement of any product, service or company or of any claims made in such advertising. ACSM does not control where the advertisements appear or any coincidental alignment with content topic.

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