ACSM Health & Fitness Summit 2009

The American College of Sports Medicine brought their annual Health & Fitness Summit to Atlanta and I felt that I had to attend. About 1200 others thought the same way and an informative time was had.

I did feel sorry for the people coming from the northern states - this was an opportunity to enjoy some sun and warmth. Would you believe it but Atlanta was under a perpetual deluge for the entire conference.


The first session for me was 1pm Wednesday "Follow the evidence" with Chuck Thigpen talking about preventing & rehabing shoulder injuries and ended Saturday lunch time with Len Kravitz giving a wonderful presentation.


There were many highlights but the presenter that stuck in my mind was Ralph LaForge talking about Managing the Metabolic Syndrome and the related topic of Managing Dyslipidemia.


What did I learn from Ralph LaForge and how much of that is relevant to my clients ?

• The first objective of managing metabolic syndrome is to delay and maybe prevent diabetes. If a client moves on from pre-diabetic to diabetic then all the health issues and health costs escalate severely. Then after diabetes, heart issues will eventually arrive. If diabetes can be delayed then the heart issues will also be delayed - possibly prevented altogether.
• When looking at Lab Test results, total cholesterol is nowadays seen as not so important. Total Non-HDLC cholesterol is a very important number. However the ratio of Total Cholesterol to HDLC is important. One wants this ratio below 4. Ralph said that if a person has had a heart attack and then gets the ratio of Total Cholesterol to HDLC below 3 then there has not been a single incidence ever of a second heart attack.
• Tri-glycerides are also very important. Exercise makes the body oxidized i.e. use, tri-glycerides and thus their concentraion in the blood reduces. This is not true for cholesterol. High tri-glycerides are a concern because if they are really high, above 1,000, then pancreatitis can result.
• Exercise can reduce the bad affects of a heavy meal. If one gets about 400 calories of exercise [for instance by walking about 4 miles] within 8 to 12 hours of the meal then the tri-glyceride peak from the meal is reduced by about half.
• Exercise is the way to deal with the Metabolic Syndrome. Get at least 1,500 calories of exercise a week. This means walking 15 miles a week - 2 or 3 miles a week or do it all at the week-end with a couple of long walks. It's the total calorie burn that has a healthy impact.
• Use a pedometer - Ralph recommends a simple yet robust design such as Accusplit Eage 120 XLM. Walking 2,000 steps will burn 1,000 calories. Ralph recommends buying in bulk because in his experience clients are going to lose 2 or 3 pedometers a year.
• Exercise reduces the risk even if there is no weight loss. Exercise reduces the number of cholesterol particles in the blood, and even if the total cholesterol number does not come down, reducing the number of particles in the blood guards against the development od diabetes.
• Ralph said that a soda with sugar (around 100 grams) and caffeine, spikes blood triglycerides faster than anything - faster than anything containing fat. This is not at all intuitive. As a result Ralph asks his clients (patients) how many 'encounters' they have had with fast food. He said that a typical American has 25 to 35 'encounters' with fast food a week (including sodas).

There were many other great sessions which I'll have to pick up on in future posts:

• Ellen Coleman talking about Muscle Building Supplements (very sceptically) was lovely
• Annette Lang presenting on training the pregnant client was a total delight and very informative.
  
• Nanette Wenger, Chief of Cardiology at Grady Hospital, Atlanta (plus working at Emory) made an important presentation about womens' heart health
  
• Then there were the three Clinical Exercise Specialists (Paul Sorace, James Churilla, Peter Ronai) who presented on the benefits of resistance training for heart disease and diabetes.