To a varying extent, most human characteristics are heritable. The genetic component of physical activity behavior and many related physiological phenotypes has been established as polygenic. This means that variation in these phenotypes is explained by the contributions of hundreds or thousands of genetic variants, each of which has a small effect size. Advances in high-throughput genotyping and statistical genetics have made it possible to estimate the contribution of genetic variation to polygenic traits using measured genotypes. Previously, genetic effects were estimated indirectly from family and twin studies. The measured genetic variation can be summarized into a single score based on variation in multiple genetic loci and their associated effect size weights. This score, usually called a polygenic risk score or a polygenic score, describes an individual’s genetic liability to a trait or disease. Polygenic scoring has recently become a standard method in evaluating inherited risk for common diseases, but these scores have rarely been used in exercise science.

In the July 2020 issue of Medicine & Science in Sports & Exercise_® (MSSE), we published polygenic scores for both self-reported and monitored physical activity. We showed their predictive value in independent cohorts and several physical activity phenotypes. The overall predictive value of these scores, although statistically significant, was rather low, thus limiting their use to research purposes only at this time. Polygenic scores for physical activity describe an individual’s genetic liability to be physically active.

Our recent study, published in the February 2022 issue of MSSE, investigated associations between a polygenic score for monitored physical activity and cardiometabolic diseases. In this study, we used the novel Finnish biobank study FinnGen, which will soon combine the genome information of 500,000 individuals with digital health care data. At the time of our analyses, data from over 200,000 individuals were available. We simultaneously investigated dozens of validated clinical endpoints, including mortality and prescription medication use. We found that genetically less physically active persons are at a higher risk of being obese and developing several cardiometabolic diseases. In addition, genetically active persons tend to live longer, and, perhaps due to longer lifespan, it was observed that they are at higher risk of developing Alzheimer’s disease. Based on our results, it appears that the same genes affect both physical activity behavior and cardiometabolic disease risk. This result may partially explain the frequently reported associations between higher levels of physical activity and lower risk of common diseases.

Polygenic scores provide new tools for genetic studies in exercise science. The scores may be used to study gene-environment interactions and individual responses to exercise interventions with respect to disease prevention. They can also be used to control for underlying genetics in cohort studies. The scoring methods and standards are constantly evolving and currently have substantial practical limitations. The construction of polygenic scores requires large datasets and high-quality phenotypes and genotypes. To achieve powerful scores that are useful also outside research settings, exercise scientists should work together to standardize main measurements. These collaborations with pooled data would provide large-cohort datasets representing different genetic ancestries for future investigations.

Elina Sillanpää is an Academy of Finland research fellow working in the faculty of sport and health sciences at the University of Jyväskylä, Finland. She has a Ph.D. in sport sciences and a background in randomized controlled endurance and strength training interventions. Dr. Sillanpää leads a research group that focuses on genetic and molecular studies of physical activity and exercise in relation to biological aging, functional disabilities and ageing-associated diseases, using advanced statistical methods and novel bioinformatics to analyze gene-environment interactions. Dr. Sillanpää is an active member of large consortiums, including the Interplay of Genes and Environment Across Multiple Studies (IGEMS) and the Genomics and Biology of Physical Activity Consortium (GenBioPAC). Dr. Sillanpää is a member of ACSM.


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

In 2009 our team published the Australian guidelines on exercise and physical activity for people with cancer emphasizing the imperative that clinicians should reject the rest strategy. Rather, patients should be physically active most days using a combination of aerobic and resistance training aiming to accumulate 75 to 150 minutes of moderate to vigorous exercise and two or more strength training sessions each week.

This recommendation was based on a growing number of clinical trials in oncology that evaluated exercise training in patients with cancer and was practically identical to the ACSM recommendations for healthy adults. Over the subsequent decade, research in exercise oncology has exponentially expanded. In 2019 we updated the Australian position statement on exercise medicine in cancer management, recommending a more precise exercise prescription tailored to the individual patient.

The benefits of “exercise is medicine” to improve quality of life, physical function, body structure and mental health are well established and accepted. However, there is a separate imperative to understand why there is a relationship between physical activity and cancer-specific survival and recurrence. This has driven a plethora of pre-clinical (bench-top) research investigating a range of potential mechanisms whereby exercise influences tumor biology.

While multiple hypotheses exist to explain the tumor-suppressive mechanisms of exercise, our study published in the February 2022 issue of Medicine & Science in Sports & Exercise_® focused on the endocrine function of skeletal muscle. The skeletal muscle system is now recognized as the largest endocrine organ in the body, acutely and chronically producing and releasing a range of molecules, including cytokines, termed “myokines,” originating from muscle tissue. We found that a three-month combined (resistance + aerobic) exercise intervention significantly increased resting serum myokine levels (especially oncostatin M and SPARC) in prostate cancer patients with localized disease. Furthermore, the changes in oncostatin M were positively correlated with changes in lean mass, indicating that training-induced muscle hypertrophy may be a key factor driving serum myokine levels. In addition, we applied serum from the study participants sampled before and after the exercise intervention to prostate cancer cells in vitro. We observed a 21% reduction of prostate cancer cell growth. This exercise training/myokine expression mechanism may partly explain previous epidemiological findings of a positive association between increased physical activity and progression-free survival of prostate cancer patients.

This study provided exciting translational data for optimizing exercise prescription. Previous studies have demonstrated a tumor-suppressive role of altered serological factors after exercise in multiple cancer cell lines, including prostate cancer. However, such studies have limited clinical relevance since the serum applied to the cancer cells was obtained from young, healthy individuals. Our study is the first to report elevated levels of muscle-induced serological factors (myokines) in prostate cancer patients and demonstrated a growth-suppressive effect, providing much higher clinical relevance.

From bench-top to bedside is an important paradigm by which we should investigate current issues in optimizing exercise prescription for cancer patients. Translational research to evaluate different exercise modes, intensities, dosages and timing across cancer types and treatments to elicit tumor-suppressive biological mechanisms is required to determine the optimal exercise prescription for each individual patient with cancer and establish exercise as a cancer medicine.



Jin-Soo Kim, M.Sc., is a Ph.D. candidate in exercise oncology at the Exercise Medicine Research Institute, Edith Cowan University, Australia. His research interest is the role of exercise-induced biological factors in tumor suppression to enhance the understanding of exercise prescription for optimization. Kim also focuses on developing an experimental design involving exercise that translates pre-clinical outcomes to clinical observations.

Robert U. Newton, Ph.D., D.Sc., FACSM, is a professor at the Exercise Medicine Research Institute, Edith Cowan University, Australia. His current research interest is the influence of targeted exercise medicine on tumor biology and exercise medicine for reducing the decline in quality of life, strength, body composition and functional ability in cancer patients.


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

In the wake of the 2022 Winter Games, interest has increased in learning about cold-weather sports and athlete care. ACSM is happy to share the following resources developed by our members and published in ACSM's journals.

The Science of Figure Skating: Jumps | Blog

Deborah King, Ph.D., discusses her extensive research into one of the most anticipated events of every Winter Games, figure skating! Learn about the biomechanics of the impressive jumps performed by the athletes.

Biomechanics of Figure Skating | Video

Want to go even more in-depth on the biomechanics of figure skaters’ impressive feats? Dr. King presents a full talk and answers questions in this early installment of ACSM’s Brown Bag Series in Science.

How to Get Started with a New Winter Sport | Blog

Laura Young, Ph.D., shares insights for aspiring skiers and snowboarders gleaned from her years of experience as a ski instructor with Professional Ski Instructors of America. She breaks down the need-to-know information like how to plan for your first excursion, making the sport cost effective and defining the popular phrase après-ski.

Exercising in the Cold: Chilled, not Shaking! | Blog

Being active outdoors in the cold can be invigorating, but it’s important to know the risks and protect yourself from cold-related injury. Laura Young, Ph.D., and ACSM’s Chief Science Office Lynette Craft Ph.D., FACSM, break down the key takeaways from ACSM’s recent consensus statement, “Injury Prevention and Exercise performance during Cold-Weather Exercise.” You can check out the full consensus statement here.

Exercise in Hot and Cold Environments | Handout

Micah Zuhl, Ph.D., provides more tips for keepings yourself safe while being active in extreme temperatures. This convenient handout can easily be downloaded and shared with others.

Exercising in the Cold | Infographic

Dr. Zuhl also put together this hand infographic that outlines proper layering techniques to keep yourself protected based on the temperature and your desired activity.

High Altitude and Cold Weather Sport: Are There Nutritional Concerns? | Blog

How can an athlete ensure that they are properly fueled for performance in cold and/or high-altitude conditions? Dan Benardot, Ph.D., R.D., FACSM, has worked with many professional and Olympic athletes through out his career, and provides insights into potential issues and how they can be avoided. (Dr. Benardot is also the author of ACSM’s Nutrition for Exercise Science).

Doping Control in PyeongChang – Fighting for Clean Sport at the Winter Games | Blog

Ahead of the previous Winter Games, Matthew Fedoruk, Ph.D., shared insights into the doping control programs that the organizing committee put into place following the doping scandal at the 2014 Sochi Winter Games.

Anabolic-Androgenic Steroid Use in Sports, Health and Society: A New Consensus Statement from ACSM | Blog

If you want to learn more about steroid use both in sports and by recreational athletes, check out ACSM’s recent consensus statement on the topic. Michele LaBotz, M.D., share a summary in this blog post. You can read the full consensus statement here.

Relevant articles published in ACSM’s journals:

Incidence of exercise-induced bronchospasm in Olympic winter sport athletes | MSSE 2000

Winter Sport Athletes: Nutrition Issues during Preparation for the 2002 Olympic Winter Games in Salt Lake City, USA | MSSE 2002

A Biomechanical Analysis Quadruple Figure Skating Jumps | MSSE 2002

Altitude Training, Erythropoietin, and Blood Doping | ESSR 2002

Bone Mineral Density of Olympic-Level Female Winter Sport Athletes | MSSE 2004

Prevention and Treatment of Foot and Ankle Injuries in Figure Skaters | CSMR 2006

Medical Coverage of Winter Nordic Sports, An Overview From the Field | CSMR 2010

Common Injuries and Medical Problems in Singles Figure Skaters | CSMR 2013

The Physiological Capacity of the World’s Highest Ranked Female Cross-country Skiers | MSSE 2016

In developed countries, the life expectancy of adults has increased dramatically over the past century. This is largely due to decreases in smoking and reductions in infectious disease and cardiovascular disease brought about by modern medicine. However, due to a rise in labor-saving devices and electronic entertainment, many have suggested that we have engineered much of the physical activity (PA) out of our lives. In fact, reductions in PA are believed to have led to deteriorations in both cardiorespiratory and muscular fitness and contributed to high rates of diabetes and obesity in recent decades. PA is an important human behavior that has a tremendous influence on health and well-being.

With traditional instruments for assessing PA, such as questionnaires and time-use diaries, it has been difficult to track time trends in habitual PA. However, the advent of small, wearable activity monitors has greatly improved our ability to track time trends in PA. Our study, published in the February 2022 issue of Medicine & Science in Sports & Exercise_®, investigated these trends. Using a systematic review and meta-analytic approach, we analyzed time trends of PA in research studies that used wearable devices. We identified 16 studies from participant populations from eight different European, Asian and North American countries. All studies reported a snapshot of PA during at least two different time points, separated by at least one year, between 1995 and 2017.

Overall, these studies reported a significant decline in PA that equated to a decrease of around 1,100 steps per day over the entire duration of the studies. While the decrease in PA was apparent in all age groups, the decrease in children and adults were considerably smaller than the decrease of about 2,300 steps per day observed in adolescents (11-19 years). When expressed as a rate of decline over time, studies of adolescents demonstrated a dramatic rate of decline: nearly 1,500 steps per day per decade. Rates of decline were similar among both adolescent boys and girls.

While we anticipated that we would find a decrease in PA across the duration of the studies, the large decrease in PA among adolescents was unexpected. We should not interpret the small decrease in adults as “a job well done.” The decrease in PA in adults has probably been occurring for more than a century, with the largest decreases occurring prior to 1995. However, the decrease in PA in adolescents appears to be a more recent development. There are many factors that have contributed to the decrease in PA among adolescents, including reductions in physical education and active commuting to school. However, the decrease in adolescent PA also occurred at around the same time as the increase in smartphone technology, social media use, and electronic entertainment. It is likely that these factors have played a role in the decreases in PA among all age groups, but especially among adolescents.

The results of this study suggest that we still have some work to do in the promotion of PA across all age groups. In particular, more focus should be placed on increasing PA in adolescent boys and girls.

Scott A. Conger, Ph.D., FACSM, is an exercise physiologist and an associate professor in the Department of Kinesiology at Boise State University. His research focuses primarily on the monitoring and assessment of physical activity. He has been an active member of ACSM for more than 20 years.





David R. Bassett Jr., Ph.D, FACSM, is a professor and head of the Department of Kinesiology, Recreation, and Sport Studies at the University of Tennessee, Knoxville. His current research focuses on physical activity measurement and the importance of ambulatory activity in preventing chronic diseases.

Viewpoints presented in SMB 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 SMB.

During the Olympics, we gather around our screens and watch in suspense as our favorite athletes battle it out for a spot on the podium. We say things like “that McTwist was insane!” or “I wish I could try that!” Some of us leap off the couch eager to practice. But for others, trying one of these sports can be daunting. How do I get started? Where do I go to try this? How should I prepare?

Here are some common questions and answers to ease the early jitters of the novice winter sport enthusiast.

How do I get started?

• Take it slow. If winter sports are really “out of the box” for you, begin gradually. Starting with activities such as sledding and tubing can be a fun introduction for everyone.
• Make your first attempt on a sunny day! Whatever activity you decide, make sure you try it on a warm, nice day. If your first attempt is on a dark, windy, -10° blizzard day, chances are you won’t last long. Nice sunny weather is key to enjoying your first experience.
• Look for a winter sport complex (even if you live in the South). Did you know there is an indoor snow park in Florida? You can try activities like skiing and snowboarding indoors! Many winter sport complexes have skating rinks, cross-country/snowshoe/snow biking trail systems, curling and luging facilities with staff, rentals and lessons to get you started.
• Take a lesson. There are a variety of lesson types: beginners only, adults only, women or men only, group lessons, private lessons. You can also request a female or male instructor or specific personality type, age, etc. to help you feel more comfortable. And you don’t need to sign up in advance — you can request a lesson on the spot.
• Join a club. Most clubs have beginner groups. Look for local groups on social media for meet-ups or first-timer events.

How do I make it cost effective?

• Ski swaps. These events in fall or early winter sell used and new gear. Manufactures and retailers often sell overstock or unsold merchandise, allowing you to snag new equipment or clothing for all sports (not just winter gear) at discounts. Ski swaps are often fundraisers, so check your local listings for dates and times.
• Used sporting goods stores. Look into trade-in programs of outdoor gear toward store credit or cash.
• Daily vs. seasonal rentals. Some resorts will offer rentals for the entire season. This is a great way to learn and practice with the same piece of equipment.
• Discounts. Many places offer specific beginner packages. A lesson and gear-rental combo is usually cheaper than purchasing individually. Many area hotels have “ski and stay” offers with discounts on food and lodging.

I’ve started — now what?

• Consistency. This is key. You probably won’t be able to go down a black diamond your first time on snowboard, but practice makes progress.
• Take more lessons. I took a women’s only group lesson that met every week, and it was one of the best decisions I’ve ever made. I had a no-judgement environment to learn in while gaining a supportive group of peers to keep me going.
• Get a buddy. You’ve heard the phrase “get a workout partner.” The same is true for your new winter sport. A friend or group makes you accountable.
• Use your other skills to advance. Most people have skills from other activities that can transfer to their new winter sport. Do you have great balance from your yoga practice? This is an important skill in skating. Do you hike or backpack in the summer? Those boots and hiking poles you already own provide a similar feeling to the one you get with ski boots and ski poles! Take the skills you already have and put them to use in a new way.

What should I know as beginner?

• Costs lower over time. Once you have the gear, the costs decrease dramatically.
• Get strong beforehand. Physical conditioning does help, especially if you are traveling to higher elevations for the first time. It will also help you recover faster.
• Training inside can help you outside. Strengthen your body for your new winter sport. Sport-specific exercises can help you advance and keep you motivated.
• The myth: This is only for kids. There are lots of programs and resources solely for adult beginners. I work as a part-time ski instructor, and I have taught people in their 70s how to ski. You can learn at any age.
• The myth: It is easier if you start young. As an adult you are stronger, fully developed and have a lot more mental experience. Most likely you have gone through a learning process before, so use that to help you advance.
• You won’t be a beginner forever. Be patient. It is easy to get frustrated because you are not advancing as quickly as you hope. Keep trying. You will get off the bunny hill. I promise. The joy of activities that we can do well into our 90s is worth it.

And lastly — what does “après-ski” mean?

One of the best aspects of any winter activity is “après” time, which translates to “the social activities and entertainment following a day’s skiing.” This means coming inside, taking off your outdoor clothing, sipping on a beverage (think hot toddy or hot chocolate) and warming up by a cozy fire. This one is by far the easiest to learn!

These activities are wonderful avenues to maintaining our physical, social and mental health during the darkest times of the year. So go on — try a new sport and release your inner Olympian!

Additional resources:
Blog (includes tips on what to wear) | Exercising in the Cold: Chilled, not Shaking!
Handout | Exercising in Hot and Cold Environments
Blog | High Altitude and Cold Weather Sport: Are There Nutritional Concerns?

Laura Young holds a Ph.D. in health and kinesiology from the University of Utah and is a part-time ski instructor with the Professional Ski Instructors of America.