What are the major changes to the new food label?

It has been almost 20 years since the U.S. Food and Drug Administration (FDA) has updated the Food Label¹. With updated scientific information, new nutrition research, and input from the public the FDA has made design and content changes to the food nutrition labels seen on packaged foods and drinks¹.

As a health care professional, educator, or consumer learning the details of the new nutrition facts label is key to making informed nutrition choices.

1. 
   Serving sizes have been updated to better reflect the amount people typically eat or drink today. The serving size is not a recommendation of how much to eat but a realistic reflection of what many Americans actually eat and drink. For instance, the serving size for ice cream was previously ½ cup and now it is ¾ cup.


2. 
   This change to the food label should make the information easier to find and use.


3. 
   Research shows the type of fat consumed is more important than the amount³.


4. 
   The %DV is how much a nutrient in a serving of food contributes to a total daily diet. This explanation also has been updated to better explain the %DV at the bottom of the new food label in a footnote. For example, the Daily Value (DV) for sodium is 2,300 milligrams (mg).
   If one serving of a pasta dish contains 1,150 mg of sodium, the %DV for sodium would be 50%.
   

   When deciding if a food has a high or low percentage of a nutrient, many nutrition professionals use the 5 and 20 rule.  A product with 5% DV or less is considered low, and 20% DV or more of a nutrient per serving is considered high. This can be of assistance when comparing food products.  Going back to the above pasta example, a single serving of pasta with a 50% DV for sodium would indicate the pasta dish is high in sodium, as it is above 20% DV according to the 5 and 20 rule.  

5. 
   The amount of Added Sugars are now required on the new food label. Consuming too much added sugars can make it difficult to meet nutrient needs while staying within calorie limits. Added sugars include sugars that are added during the processing of foods (such as sucrose or dextrose), foods packaged as sweeteners (such as table sugar), sugars from syrups and honey and sugars from concentrated fruit or vegetable juices. They do not include naturally occurring sugars that are found in milk, fruits and vegetables. The Daily Value for added sugars is 50 grams per day based on a 2,000 calorie daily diet.
   
   

   Total sugars include naturally present sugars in many foods and beverages such as the sugar in milk and fruits as well as any added sugars that may be present in the product.  There is no Daily Value for total sugars because no recommendation has been made for the total amounts to each in a day.



6. 

Vitamin D and Potassium are now required on the new food label.  This is because Americans often fall short of the recommended amounts.   Diets higher in vitamin D and potassium can reduce the risk of osteoporosis and high blood pressure, respectively.

Vitamin A and Vitamin C are no longer required. Deficiencies of these nutrients are rare today so they will no longer be displayed on food labels⁴.

What has stayed the same? 

Calcium and iron will continue to be listed on the label because the majority of Americans do not meet the recommended daily amounts. Diets higher in calcium and iron can reduce the risk of osteoporosis and anemia, respectively.

How to use the new information on the food label?

Use the new food label to promote and choose foods that are high in:

• Dietary fiber, vitamin D, calcium, iron and potassium

  Use the new food label to discourage and avoid foods that are:

• Higher in saturated fat, sodium and added sugars

Food choices are directly linked to higher risks for developing certain health conditions such as high blood pressure, cardiovascular disease, various cancers, osteoporosis and anemia³. Making informed nutrition choices promotes a healthier lifestyle, longevity and lowers disease risk.

The FDA also has an education campaign to raise awareness about changes to the new food label.  Additional education resources such as adverts, video and consumer friendly downloadable materials are available at: fda.gov.

Author:  Laura Young, MS, ACSM-CPT, is currently a doctoral student at the University of Utah. She is also the science assistant at ACSM, under Lynette Craft Ph.D., Chief Science Officer.

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Nutrition Resources

References:

1.  Food and Drug Administration. (2020). The New Nutrition Facts Label.  Center for Food Safety and Applied Nutrition. [cited 2021 January 20]. Available from: https://www.fda.gov/food/nutrition-education-resources-materials/new-nutrition-facts-label

2.  U.S. Centers for Disease Control and Prevention. (2012, April).  Second National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2012. National Center for Environmental Health, Division of Laboratory Sciences.

3. U.S. Department of Agriculture. (December 2015). 2015-2020 Dietary Guidelines for Americans. 8th Edition. U.S. Department of Health and Human Services. [cited 2021 January 20]. Available from: https://health.gov/our-work/food-and-nutrition/2015-2020-dietary-guidelines/.

4.  U.S. Centers for Disease Control and Prevention. (2012, April 2). CDC’s Second Nutrition Report: A comprehensive biochemical assessment of the nutrition status of the U.S. population. National Center for Environmental Health/Division of Laboratory Sciences. [cited 2021 January 20]. Available from: https://www.cdc.gov/nutritionreport/pdf/4page_%202nd%20nutrition%20report_508_032912.pdf

For the past 25 years ACSM’s Health & Fitness Journal® has strived to provide health and fitness professionals with accurate, unbiased and authoritative practical information that will enhance their day-to-day work with clients and patients. Since 1997 the journal has published six issues per year covering a wide variety of exercise, nutrition, health behavior-change and other topics that are of interest to the health and fitness industry. Each issue consists of two to six feature articles that have undergone a peer review process, special columns written by the journal’s associate editors and a number of continuing education (CEC) opportunities.

For the sixth consecutive year the September/October issue of ACSM’s Health & Fitness Journal^® was a  themed issue focusing on a current hot topic for the fitness industry. The 2020 themed issue was exceptional and zeroed in on the timely theme of: “Refocusing Life Span to Health Span, Making Every Age Count.” Beginning with our Health & Fitness From A to Z column and an excellent review of “Aging in America” written by Madelyn Byra, B.S., M.S., the issue provided six feature articles that collectively covered the life span and shared critical information regarding health behaviors that affect an individual’s health span. This was a timely issue in light of the COVID-19 pandemic and the impact it has had on people with preventable chronic conditions.

Historically the November/December issue has presented ACSM’s Worldwide Survey of Fitness Trends, always one of our most popular publications. Beginning in 2018 we highlighted the survey in a themed issue published in November/December. In 2019 the trends themed issue was expanded to include survey results from international regions that included Europe, China, Argentina/Brazil and Spain. With continued expansion of the surveys in other international regions, the publication of this comprehensive themed issue has been moved to the January/February 2021 issue. This change allows for additional time for all of the survey data to be analyzed and compared, and also corresponds with the beginning of the calendar year.

In 2020 the journal published 23 feature articles and a total of 50 columns penned by the journal’s exceptional associate editors. The relative interest in these 73 articles can be quantified by comparing the number of times the online version of the article is viewed and/or referred to through social media platforms and the mainstream media.

Perhaps connected to experiences with the pandemic, the most popular 2020 article referred to by social media platforms and mainstream media was “Promoting Physical Activity for Mental Well-being,” written by Stephanie L. Cooper, Ph.D., FACSM. The altmetric score (which is derived from those online conversations about the article) for this article was closely followed by an article written by Avery D. Faigenbaum, Ed.D., FACSM; James P. MacDonald, M.D., FACSM; Carlos Carvalho, Ph.D. and Tamara Rial Rebullido, Ph.D., CSPS, titled “The Pediatric Inactivity Triad: A Triple Jeopardy for Modern Day Youth.”

Both articles also were the two most accessed articles on the journal’s website that were published in 2020 along with an article from our September/October themed issue, “Exercise during Pregnancy: A Prescription for Improved Maternal/Fetal Well-being,” written by Margie H. Davenport, Ph.D. Interestingly, the two most assessed articles in 2020 were from prior year publications. These were ACSM’s Worldwide Survey of Fitness Trends 2020 and an article from the May/June 2013 issue titled “High-Intensity Circuit Training Using Body Weight: Maximum Results with Minimal Investment.” While the trends issue has historically been one of the most popular articles, one must wonder if the pandemic influenced the popularity of the high-intensity training article, as exercise professionals have been searching for activities that clients can do away from fitness facilities, many of which have been closed or had access limitations.

Outlook for 2021

The journal content scheduled for 2021 is exceptional and will continue to represent topics and practical applications that will be of interest to health and fitness professionals and supportive of the important work they undertake with their clients and patients. Launching 2021, the January/February issue presents the journal’s themed issue highlighting “ACSM’s Worldwide Survey of Fitness Trends 2021.” Content includes and survey results from six additional international regions. It is a stellar issue and provides interesting insight into the effects of the pandemic on fitness services around the globe.

The March/April issue corresponds with the release of the 11^th edition of ACSM’s Guidelines for Exercise Testing and Prescription and will feature an article by Barry Franklin, Ph.D., FACSM covering the evolution of the guidelines. Once again, the journal will publish a themed issue in the September/October publication. Overseen by our Associate Editor-in-Chief Gary Liguori, Ph.D., FACSM and guest editor Yuri Feito, Ph.D., FACSM, the issue will focus on High Intensity Interval Training and Chronic Disease. An exceptional group of feature authors have been confirmed to share their expertise covering the utilization of HIIT within a range of health conditions. Other upcoming feature articles will include topics on virtual fitness, tips for live-streaming exercise sessions, wearable technology, autism, exercise for obstructive sleep apnea and a broad range of other pertinent topics. Overseen by our Digital Content Editor, Vanessa Kercher, Ph.D., the journal’s digital web content continues to expand along with utilization of a variety of social media platforms. The supplemental digital content posted on the journal website supports many of the feature articles and columns, providing additional information and video content for journal readers.

Journal submissions remain strong, and we appreciate each health and fitness professional who has submitted their work for publication and encourage you to consider sharing your expertise as well. It has been refreshing to see articles penned by young professionals and graduate students within the submissions this past year, and the journal is deeply indebted to our editorial board for shepherding these articles through the review process. If you are interested in submitting an article to ACSM’s Health & Fitness Journal®, you can learn how to write and submit a feature article here.

Additionally, the journal’s associate editors have an exceptional slate of content planned for 2021 that will continue to provide practical information to guide our work with clients and patients.  Following is a list of our regular columns and their respective associate editors.

Most Read Articles in 2020

1. High Intensity Circuit Training using Body Weight (2013 article)
2. ACSM’s Worldwide Survey of Fitness Trends for 2020
3. Promoting Physical Activity for Mental Well-being
4. The Pediatric Inactivity Triad: A Triple Jeopardy for Modern Day Youth
5. Exercise During Pregnancy: A Prescription for Improved Maternal/Fetal Well-being
6. Using a Health Promotion Program Planning Model to Promote Physical Activity and Exercise (Clinical Applications column)

Conversation Starters: Top Altmetric Scores

Altmetric calculates a score based on the online attention an article receives. The score is calculated based on two primary sources of online attention: social media and mainstream news media.

1. Promoting Physical Activity for Mental Well-being
2. The Pediatric Inactivity Triad: A Triple Jeopardy for Modern Day Youth
3. Benefits of Incorporating HIIT Programs for Individuals with Down Syndrome
4. Aging in America (Health & Fitness from A to Z column)
5. Long-Term Athletic Development as a Framework to Influence Wellness during Childhood and Adolescence
6. The Deadlift (Do it Right column)
7. Exercise for Prevention of Chronic Disease (Wouldn’t You Like to Know column)

Brad A. Roy, Ph.D., FACSM, ACSM-CEP, is an executive director at Logan Health. He is responsible for The Summit Medical Fitness Center, a 114,800 sq ft medically integrated fitness center in Kalispell, Montana, the Westshore Medical Fitness Center in Lakeside, Montana, the Polson Medical Fitness Center in Polson, Montana, and a number of other hospital departments. He is the editor-in-chief of ACSM’s Health & Fitness Journal^®. 

I was an undergraduate student at the University of Massachusetts, Amherst when I attended my first ACSM meeting. The year was 2005. I was a research assistant in the Physical Activity and Health Lab of Patty Freedson, Ph.D., FACSM, and the Muscle Biology and Imaging Lab of Priscilla Clarkson, Ph.D., FACSM. During my senior year, my lab mates and I volunteered to represent UMass at the New England ACSM Annual Student Bowl (this is a jeopardy-style competition). We got crushed! It was my fault. I got more than my fair share of questions wrong. On the bus ride home, I apologized to my teammates for making so many errors, but nobody was mad. We were all elated. The experience left us dreaming of possible futures at the intersections of sport, exercise and science.

A few years later, I was studying for my Ph.D. in Kinesiology and Nutrition with David X. Marquez, Ph.D., FACSM, at the University of Illinois at Chicago. Dr. Marquez took me to my first ACSM National Meeting in 2008, where I saw him participate in the first cohort of the ACSM Leadership & Diversity Training Program (LDTP). The LDTP was established to mentor and retain members from backgrounds underrepresented in medicine and science (nationally, this includes some racial/ethnic minority groups, individuals with disabilities and individuals from disadvantaged backgrounds at all levels; and women at the doctoral level) to ACSM Fellowship over a five-to-10-year period. The LDTP was launched following the diversity-focused presidential platform of ACSM past-President W. Larry Kenney, Ph.D., FACSM. I wasn’t in the room for the 2003 ACSM presidential reception, but the legend goes that Dr. Kenney (a white man who raised three African American children) brought his children on stage during his address and told the crowd, “I want to tell my children that they too can one day be president of ACSM but looking at our history I can’t tell them that. I think it’s time for that to change.” He followed through by establishing the Task Force on Diversity Action.

I pause here to acknowledge the courage Dr. Kenney displayed in that moment. At a reception to honor his rare achievement—Dr. Kenney served as ACSM’s 46th president—he deflected the attention away from himself (sacrificing hard-earned adulation) to do something uncomfortable for everyone in attendance. He recognized publicly that the opportunity he had to compete for the honor of leading the college had not been made available to everyone. At the time of Dr. Kenney’s address, this was indisputable, all 45 of his predecessors had been white and all but four were men. What Dr. Kenney delivered that day was not just a call for racial integration at ACSM, it was also a call for meritocracy; a call for structural and cultural barriers that exclude some groups to be stripped away; a call for our most talented to be extended the opportunity to compete, regardless of their background. In my view, we should embrace large variability in achievement between individuals based on talent and enterprise, but we should be deeply troubled where variability in achievement neatly follows sociodemographic lines.

The way ACSM responded to Dr. Kenney is nothing short of inspirational. We did not run from it. We did not sweep it under the rug. We did not make excuses. We faced it and got busy working. Isn’t that what exercisers do? We put in the work, day-after-day, year-after-year.

In 2020, I had the honor of leading a writing team to catalogue ACSM’s gains in diversity, equity and inclusion (DEI) over the past decade for a special issue of the Journal of Best Practices in Health Professions Diversity (JBPH), which was edited by ACSM Fellow Melicia Whitt-Glover, Ph.D. The article provides a comprehensive overview of ACSMs past and ongoing DEI efforts. It dives into the empirical basis for connections between diversity and organizational performance and lays out how our DEI efforts have been designed to help ACSM advance its primary goal of “helping people worldwide live longer, healthier lives.”

So, what have decades of courage and commitment yielded for ACSM? Here are a few highlights:  

• Since Dr. Kenney made DEI the focus of his presidential platform, at least four other ACSM presidents have followed suit.
• ACSM has operated more than a dozen distinct, large-scale DEI-focused efforts at the national level alone; among these are three mentorship programs that combine to pair more than 100 proteges with mentors each year.
• The ACSM LDTP has had 102 unique participants, one-third of whom have been mentored by past ACSM presidents and vice presidents. Among alumni of the program, 71% remain active ACSM members, 16 have achieved Fellowship status and six have been elected to the Board of Trustees.
• Since 2008, both the overall number of ACSM members and overall number of ACSM Fellows has risen by 10%; the number of female Fellows has skyrocketed by 33%; and the proportion of members identifying as Asian (from 8% to 10%), Hispanic (from 5% to 7%) and African American (from 4% to 7%) have all risen substantially.

I can attest to the personal aspect of these efforts. I applied to be a protégé in the ACSM LDTP in 2010 when I was a Ph.D. student. Today, I am an ACSM Fellow, an ACSM Trustee, a tenure-track faculty member at a research I university, a National Institutes of Health (NIH) funded researcher and the beneficiary of some of the most outstanding mentorship and support imaginable. From 2014-18, I served as chair of the ACSM Diversity Action Committee and as director of two of its mentorship programs. During that period, I met protégés that were flat out brilliant—full stop, no hedging, no equivocation—and witnessed ACSM volunteers and staff go above and beyond time and again. Last year, David Garcia, Ph.D.—LDTP alumni, ACSM Fellow, tenure-track assistant professor at the University of Arizona, and all-around great guy—and his stellar long-time LDTP mentor, Stella Volpe, Ph.D., RD, LDN, FACSM, publicly shared their ACSM LDTP experience, which included that Dr. Garcia named his first daughter Stella Garcia after Dr. Volpe.

The world needs more trainers, more coaches, more clinicians and more scientists. DEI in the context of ACSM is not a zero-sum game. The challenges we face are so daunting that we need to compete for talent everywhere that we see it.

How can you contribute?

• Students, get in the game. Consider a career in health and physical activity. You can find info about some of ACSM’s mentorship programs here, here and here. There are many worthy professions, but none has greater potential to contribute to human health and well-being than ours.
• Researchers, clinicians and practitioners, recruit talent everywhere you see it. I am here because somebody invited me to play jeopardy and consider a career in science. Sometimes a nudge is all it takes. Consider also volunteering as an ACSM mentor (applications here). Don’t forget to check with your ACSM regional chapter as many already have excellent mentorship programs; and if they don’t, I think you should start one.

This past decade has shown us that where we pursue goals with courage and commitment, we can have great success. 

Eduardo Esteban Bustamante, Ph.D., FACSM, is an assistant professor of Kinesiology and Nutrition at the University of Illinois at Chicago (UIC), where he directs the UIC Healthy Kids Lab. He is an ACSM Leadership & Diversity Training Program alumnus and has been an ACSM Fellow since 2017. Dr. Bustamante served as chair of the ACSM Diversity Action Committee and director of the ACSM LDTP from 2014-18. Currently, Dr. Bustamante serves on the ACSM Board of Trustees as the Appointee of ACSM President Dr. NiCole Keith.

Translational research is designed to bridge the gap from basic science to practice, and it is not surprising that this research often resonates with a wide audience. Despite this, I was shocked by the response to a paper by Michaelson and colleagues, which has dwarfed the reaction to any previous article in the Translational Journal of the American College of Sports Medicine (TJACSM). It was a relatively simple experiment on the best recovery posture following high intensity exercise – hands on your knees or hands above your head. The data revealed a benefit to hands on knees. While published in 2019, the article and its impact continued to reverberate throughout the athletic community in 2020.  It has been met with a tremendous response from athletes around the world who felt vindicated by these data. Apparently, there was near universal preference among athletes to recover with hands on their knees only to be thwarted by coaches who required hands to remain above their head. While this does not address an especially critical public health or performance issue, its reception suggests that it will have a lasting impact. This paper reached the top 5% of articles in Altmetric attention scores (that are derived from the online conversations about the article). This score was largely due to these findings being tweeted by nearly 1,500 users including MC Hammer and Houston Texans athlete JJ Watt– reaching over five million people! It also was shared on group Facebook and Reddit pages and picked up by more traditional media. Even my teenage daughter and her high school friends knew the results!

The social media response raises an interesting question regarding the role of journals in supporting broad dissemination of research: to what extent should journals support this kind of distribution? While many scholars have adopted social media to share and discuss findings, there are those who dismiss engagement with social media as beneath the academic, with the potential to undermine the integrity of research. I would agree that there are concerns if the study is designed solely to seek this wide audience – science should not be conceived to be click bait. But, translational research should be relevant to people’s lives, and I am thrilled to see such engagement with our journal and our field of sport science. At the end of the day, athletes now have the data to counter their coach’s assertions that were based only on tradition. This is, after all, exactly the kind of science-informed practice – if on a small scale – that we hope research plays in our society. We can only fulfill this role to the extent that people are widely informed of our work. Social media provides the most effective means of this kind of dissemination and already has been broadly embraced by most researchers. The challenge is to share our findings in a format that allows for understanding in a condensed form.  

These issues are particularly relevant for an online journal like TJACSM. In response, we have begun to feature one article a quarter with an infographic to ease sharing across social media platforms. We also leave open the option for supplemental content (e.g., video abstract or an author’s own infographic) for the same purpose. We are just beginning and have barely scratched the surface of what is possible. As we move into 2021, TJACSM will continue to work to find ways to improve our journal as author-centered and work to ease the publication process and support multiple avenues for sharing research. Read more about the exciting changes happening in this recent blog.

John Bartholomew, Ph.D., FACSM, currently serves as professor and chair of the Department of Kinesiology and Health Education at The University of Texas at Austin. His research centers on the development of school-based interventions to increase physical activity and the benefits of such interventions for academic performance. Dr. Bartholomew is editor-in-chief of the Translational Journal of the American College of Sports Medicine.

In December 2017, the call was put out for applications for the Senior Editor role of ACSM’s Guidelines for Exercise Testing and Prescription, 11^th Edition. ACSM’s Guidelines for Exercise Testing and Prescription is the lead title in the American College of Sports Medicine (ACSM) book portfolio. The first edition of Guidelines was published in 1975, and it maintains its status as the most widely circulated set of guidelines for exercise professionals. The book is a definitive resource in the industry and is used in the classroom, for certification preparation and in practice. Guidelines is published by ACSM’s publishing partner Wolters Kluwer and is updated every four to six years by leading experts in the field to ensure the content is up-to-date and meeting the needs of the dedicated individuals within the exercise science environment.

The process for selecting the Senior Editor included preliminary reviews, phone interviews and voting through the ACSM governance process. Upon completion of this rigorous selection process, ACSM was delighted to announce Gary Liguori, Ph.D., FACSM, as the senior editor of the 11^th edition of Guidelines. Dr. Liguori has been a member of ACSM since 1994 and a fellow since 2011. Dr. Liguori is also an ACSM-Certified Clinical Exercise Physiologist. In his time as an ACSM member, Dr. Liguori has served as an associate editor of the A-to-Z column and as Associate Editor-in-Chief for ACSM’s Health & Fitness Journal^®. Additionally, Dr. Liguori acted as the senior editor of ACSM’s Health-Related Physical Fitness Assessment, 5^th Edition, the senior editor of the first edition of ACSM’s Resources for the Exercise Physiologist, and as an associate editor on ACSM’s Guidelines for Exercise Testing and Prescription, 10^th edition. As Senior Editor, Dr. Liguori selected Yuri Feito, Ph.D., MPH, FACSM, Charles Fountaine, Ph.D., FACSM, and Brad A. Roy, Ph.D., FACSM, as associate editors for the text.

We sat down with Dr. Liguori to discuss some of the changes that readers can expect to see in the 11^th edition of ACSM’s Guidelines for Exercise Testing and Prescription. Don’t forget to check out more information on the 11^th edition!

What can you tell us about how your team integrated industry updates in the text?

As with every new edition, the editors and contributors for the 11th edition integrated the most up-to-date recommendations available from ACSM position stands and other relevant professional organizations’ scientific statements, making Guidelines the most current, primary resource for exercise testing and prescription. Additionally, the most recent guidelines and recommendations available, including the 2018 Physical Activity Guidelines for Americans, were integrated throughout the text.

What’s one of the biggest changes in terms of content included?

This edition of Guidelines presents an entirely new chapter focused on the role of exercise in conditions that affect the brain. Chapter 11 includes Cerebral Palsy, Parkinson’s Disease and Intellectual Disability and Down Syndrome, which were in the 10th edition, and now also includes brand new coverage on the conditions of Attention-Deficit/Hyperactivity Disorder, Alzheimer’s Disease, Anxiety and Depression and Autism Spectrum Disorder. The goal of adding this chapter is to bring forth the most current evidence and specific strategies for these ever more present conditions, thereby providing timely and relevant preparation for engaging with individuals with these conditions.

Are there any organizational changes readers will see?

Chapters 2 (Exercise Preparticipation Health Screening) and 3 (Preexercise Evaluation) from the previous edition were merged into one chapter titled Preexercise Evaluation. In this 11th edition of Guidelines, what is now chapter 2 clarifies the recommended order in which to conduct the preexerccise evaluation screenings. This chapter also includes specific guidance for informed consent, preparticipation health screening, the ACSM Preparticipation Screening Process and Algorithm and Medical History and Cardiovascular Disease Risk Factor Assessment. The CV risk factor analysis is separate from the algorithm screening as the former is for client education and the latter is for initiating an exercise program.

Are there broader guideline updates that were incorporated into the recommendations in the new edition?

For Cardiovascular coverage we made changes within two chapters; specifically, within Chapter 8, Exercise Prescription for Individuals with Cardiovascular and Pulmonary Diseases, we include updated guidance for the post-CABG patient in regard to fewer restrictions on arm movement, encouraging the vast majority of individuals to initiative arm movement immediately after surgery, within reason of course. We also made revisions to Chapter 9, Exercise Prescription for Individuals with Metabolic Disease and Cardiovascular Disease Risk Factors, to include updated hypertension guidelines. We know how important it is for the exercise professional to be familiar with both the ACC/AHA and JNC7 blood pressure thresholds and classifications, and therefore have included both sets of guidelines with equal importance. Both of these blood pressure guidelines are also presented in Chapter 2.

What other input did you use to help guide what we’ll see in the upcoming edition?

Based on feedback from students and faculty during the 2018 ACSM focus group we realized we wanted to make significant revisions to the appendices. We decided to integrate the information from the Common Medications appendix directly into the chapter text wherever appropriate and we also consulted with numerous practicing clinicians to understand which were the most common medications exercise professionals were likely to encounter in routine practice. This resulted in a significantly shorter Medication section in the final appendix, which will be much easier for students to reference. Our ACSM Facebook study groups also shared that ECG and metabolic calculations are topics of significant importance, so we decided to update the appendices on electrocardiogram interpretation with a greater emphasis on the ‘normal’ ECG. An entirely new appendix was created to house all of the most critical metabolic calculations, along with numerous examples of how to use them. Our focus groups felt they were awkwardly placed within the text, so we anticipate this new appendix to be a much handier student and practitioner reference. And finally, we shortened the appendix on ACSM certifications, as the most up-to-date information lives on the certification section of the ACSM website.

Anything you would like to add?

Overall, I am extremely proud of the work that our team has put into this new edition and believe the updates will be exceedingly useful to students, instructors and practitioners in every stage of their career. We hope you find them as useful as we do.

Order ACSM's Guidelines for Exercise Testing and Prescription 11th Edition


Gary Liguori, Ph.D., FACSM, is the dean of the College of Health Sciences and a professor of kinesiology at the University of Rhode Island in Kingston, Rhode Island. He is the Senior Editor of the 11^th edition of ACSM's Guidelines for Exercise Testing and Prescription (GETP11).