I am truly honored to give the upcoming Joseph B. Wolffe Memorial Lecture at the 73rd ACSM Annual Meeting. However, contemplating what to talk about after almost half a century spent researching the interactions between exercise training, nutrition, and their impact on human health and performance required careful reflection! As a former competitive athlete and lifelong exerciser, I knew there were many ‘take-home’ messages that could be learned from the practices of elite performers and translated into the everyday lives of countless individuals. Furthermore, with the application of molecular techniques to exercise biology, we now have compelling mechanistic evidence to underpin many of the practices of top athletes. Recent discoveries have also provided novel insights into the mechanisms by which muscle communicates with other tissues and organs to mediate the beneficial effects of exercise on health, while the adoption of novel digital technologies for exercise across multiple platforms (e.g., cardiometabolic health, neurological and cognitive disorders, musculoskeletal and orthopaedic rehabilitation) should usher a new age of personalized medicine. I hope this gives you a ‘sneak-peak’ of what’s to come in my lecture!
From medals to molecules: High-intensity interval training
Pioneered by athletes since the early 1900’s, HIIT has now entered the popular lexicon of everyday conversation among health practitioners and the public alike. Made popular and validated by the comprehensive studies of Canadian and Norwegian researchers, high-intensity interval training (HIIT) is a time efficient, potent intervention to increase cardiometabolic fitness. But why is HIIT such an effective means of exercise? To answer this question, we recently mapped human muscle kinases, substrates, and signaling pathways in response to a work-matched bout of HIIT and moderate-intensity continuous exercise (MICE). Muscle biopsies taken after just five minutes exercise revealed a rapid activation of a complex network of intensity-specific kinases, substrates, and pathways, with HIIT differentially regulating almost twice the number of phosphosites compared to MICE. This early activation of almost 2,000 phosphorylation sites after HIIT persisted and was increased further at the completion of exercise. Such intensity-specific regulation of signaling pathways in human skeletal muscle may contribute to many of HIIT’s health-promoting effects and show why this method of training yields a great return for a modest time investment.
From molecules to medicine: Exercise ‘mimetics’ and precision health
In February 2001, a new era of genetic medicine was heralded with the announcement of the mapping of the human genome. A new initiative on precision medicine was proudly announced, with promises that genomic science would reveal the mysteries of hereditary factors underlying heart disease, cancer, diabetes and mental illness. However, a quarter-of-a-century later, advances in gene sequencing and their translation to improve patient health outcomes have been slow to arise and seem unlikely to materialize in the manner predicted and heavily promoted by the enthusiasts. Drugs that target known exercise-activated metabolic pathways that enhance endurance, fat metabolism and mitochondrial biogenesis, (i.e., so-called ‘exercise mimetics’ such as the AMP-activated protein kinase and/or the peroxisome proliferator-activated receptors), while showing promise in pre-clinical models, have failed to make it past the start line in large-scale human trials. Such pharmacological efforts have typically targeted skeletal muscle to stimulate some of the adaptations to exercise induced by endurance training. As such, they fail to impart many of the broad health protecting effects of exercise that are seen in tissues and organs other than skeletal muscle. Indeed, perhaps we should be looking for a ‘mimetic’ that works on the brain to motivate people to undertake real exercise!
Maximizing human potential through digital technology
Fewer than a third of adults meet the ACSM recommendations and guidelines for physical activity and exercise required to maintain or improve cardiorespiratory health. The primary reasons for low uptake and adherence include a perceived lack of time, low motivation, family/work commitments, and physical constraints such as injury/illness. The uptake and implementation of exercise interventions remain further constrained by its fragmented and episodic delivery, limited personalization, and challenges in scalability for diverse population groups. Finding novel incentives for people to exercise remains a major issue in developed countries where an increasing sedentary lifestyle, combined with round-the-clock access to energy dense food underlies the current obesity epidemic. Advances in digital technologies including wearable sensors, extended reality, and artificial intelligence-enabled systems, should bring about more personalized, adaptive, and evidence-driven exercise interventions. This is because digital technologies can support real-time monitoring and feedback for customized exercise intervention. Digital technologies should also enable remote care and sustained patient engagement across cardiometabolic, musculoskeletal, neurological, oncologic, and geriatric disease domains. However, advances in digital exercise provision will hinge on successful collaborations between health professionals with a knowledge of exercise prescription, computational modelling, and the behavioral sciences. It is hoped that such a multifaceted approach will help increase levels of physical activity at both the individual and populations level.
More to come in Salt Lake City… See you at the 2026 Annual Meeting!
John A. Hawley, PhD, is a MacKillop Distinguished Professor, and director of the Centre for Human Metabolism and Performance at the Australian Catholic University in Melbourne, Australia. The focus of his lab’s work includes the interaction of exercise and diet on skeletal muscle metabolism, the molecular bases of exercise training adaptation and the cellular bases underlying exercise-induced improvements in cardiometabolic health. He has published over 360 peer-reviewed manuscripts and sits on the editorial boards of many major journals. He is a frequently invited speaker at both National and International scientific meetings and trains daily to keep his maximal VO2max close to his age. He will be giving the Joseph B. Wolffe Memorial Lecture at the upcoming 2026 ACSM Annual Meeting in Salt Lake City.
