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040-444 - ACSM Registered Clinical Exercise Physiologist - Dump Information

Vendor : ACSM
Exam Code : 040-444
Exam Name : ACSM Registered Clinical Exercise Physiologist
Questions and Answers : 370 Q & A
Updated On : April 24, 2019
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040-444 ACSM Registered Clinical Exercise Physiologist

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040-444 exam Dumps Source : ACSM Registered Clinical Exercise Physiologist

Test Code : 040-444
Test Name : ACSM Registered Clinical Exercise Physiologist
Vendor Name : ACSM
Q&A : 370 Real Questions

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ACSM ACSM Registered Clinical Exercise

Wolters Kluwer health and ACSM accomplice on ACSM'S BEHAVIORAL points OF physical exercise AND undertaking

PHILADELPHIA, Dec.16, 2013 /PRNewswire/ Wolters Kluwer fitness, in partnership with the American college of sports drugs has published ACSM's Behavioral elements of physical activity and undertaking, which explores the latest scientific findings on eliciting the habits alterations needed to in reality make and remain dedicated to a fit culture.

Written by means of a group of main experts led by way of Dr. Claudio Nigg, the new book provides particular thoughts, equipment, and techniques that health and fitness experts can use to inspire and encourage shoppers to be energetic, undertaking, and reside match. The book is the latest providing from an ongoing publishing partnership between Wolters Kluwer health, a number one provider of suggestions for the health care industry, and the American college of activities medicine, which gives lots of private coach, health health expert, clinical activity specialist and registered scientific activity physiologist NCCA-permitted certifications every year.

"we're excited to present a tremendously useful yet scientifically sound discovering tool that provides step-via-step assistance on what is definitely probably the most essential job of health specialists - assisting consumers adhere to a health application," saidKatie Feltman, Director of Publishing for ACSM."Our partnership with Wolters Kluwer health helps extend access for both students and authorities to the definitive science and evidence within the activities drugs box."

Claudio Nigg, PhD., is an authority on healthy habits exchange and motivation. A professor on the tuition of Hawaii, Dr. Nigg additionally leads that colleges' fitness behavior change research workgroup. This, in addition to other event in this area, ended in ACSM's option of Dr. Nigg for lead editor on this title.

attainable now on LWW.com and thru Amazon, ACSM's Behavioral points of actual activity and activity offers step-via-step guidelines to help fitness/fitness gurus and college students grasp motivation suggestions that aid valued clientele adhere to an activity program, together with using checklists and worksheets, entry to new research findings, motivation concepts, and case scenarios.

concerning the American school of sports MedicineACSM is the largest activities drugs and exercise science corporation on this planet. With greater than 50,000 contributors and certified professionals international, ACSM is committed to advancing and integrating scientific analysis to provide academic and useful purposes of activity science and activities drugs.

About Wolters Kluwer HealthWolters Kluwer fitness is a number one global provider of guidance, enterprise intelligence and point-of-care options for the healthcare industry. Serving greater than one hundred fifty international locations and territories worldwide, Wolters Kluwer health's shoppers encompass gurus, institutions and students in medication, nursing, allied fitness and pharmacy. major manufacturers consist of fitness Language , Lexicomp , Lippincott Williams & Wilkins, Medicom , Medknow, Ovid , Pharmacy OneSource , ProVation clinical and UpToDate .

Wolters Kluwer fitness is part of Wolters Kluwer, a market-main global information capabilities company with annual revenues (2012) of three.6 billion ($4.6 billion), about 19,000 employees global and operations in over 40 international locations throughout Europe, North america, Asia Pacific, and Latin the united states. observe our official Twitter tackle: @WKHealth.

source Wolters Kluwer health

connected Articles View greater Books reviews extra hot experiences For You

leading activities medicine and pastime science company implements ACSM licensed very own coach

Dec 20 2004

ACSM considers the implementation of the brand new ACSM licensed very own trainer™ software to be a key method in addressing the rising cost of obesity in the U.S. and other nations as neatly as the colossal number of people who no longer interact in a satisfactory level of physical undertaking. via this new certification, ACSM additionally hopes to enhance public safeguard, as many individuals depend on own trainers as a primary source of fitness and fitness information. The influx of ACSM specialists will help alleviate existing confusion among the public and employers about what constitutes a high quality/credible certification.

To develop into an ACSM licensed own trainer™, knowledgeable must demonstrate vital capabilities akin to the necessities for ACSM’s existing certifications. these certifications are according to essentially the most rigorous examinations that exist, and people who pass are among the many top-rated-organized gurus within the box. the new certification, although, will enable specialists who have not attained a bachelor’s diploma to be certified by using ACSM.

"One third or greater of the own trainers at the moment interacting with the accepted public haven't earned a university diploma,” stated Steven J. Keteyian, Ph.D., FACSM, Chair of ACSM’s committee answerable for certification courses. “This, coupled with the trade’s mind-blowing expertise for boom, represents an important probability to enhance the public’s health. We should make sure that these individuals have the knowledge as a way to allow them to give now not best safe instruction however also tremendously beneficial advice to consumers and the general public.”

The additional certification will enhance and complement ACSM’s latest product line, which comprises the ACSM health/health instructor, ACSM exercise specialist, and ACSM Registered scientific pastime Physiologist. ACSM will now be able to place neatly-knowledgeable and appropriately organized gurus along the whole continuum of the health and health trade, from fitness clubs to outpatient clinical clinics.

“people who develop into ACSM certified very own Trainers™ will now not handiest possess, however demonstrate mastery of the core expertise so that it will allow them to carry exercise counsel safely and effectively within a neatly-defined scope of observe,” stated Mike Niederpruem, ACSM country wide Director of Certification and Registry classes. “they'll no longer hesitate to refer people to other endeavor specialists whose practising and education have fitted them to take care of extra complicated fitness considerations and dangers.”

ACSM comprises the realm’s best consultants in undertaking physiology, cardiology, activities nutrients, biomechanics, public health, and all clinical and scientific disciplines central to the health expert. ACSM should be organizing an array of services and suggestions to help very own trainers in their schooling and persisted professional boom.

through an unique partnership with the digital checking out business Pearson VUE, ACSM will deliver computing device-based trying out for the brand new ACSM certified personal trainer exam. The examination might be the primary in the trade to present “on-demand” trying out and immediate results notification. Candidates will also be examined at a date and time of their determining at any of Pearson VUE's three,700 licensed trying out facilities around the globe. Candidates will get hold of a printout of their exam consequences, damaged down via content material enviornment, which comprises their move/fail fame.


growth for ACSM Certifications: 2015 and beyond

Simpson, William F. Ph.D., FACSM

as the American school of sports medicine (ACSM) transitions into a brand new 12 months, the Committee for Certification and Registry Boards (CCRB) has its share of alterations. The CCRB, at first named the Prevention and Rehabilitation Committee, changed into fashioned in 1975, along with the primary version of the instructions for endeavor testing and Prescription. So just believe of it, ACSM certification will turn 40 this coming yr. there has been plenty development in these 40 brief years.

the first three certifications (application Director, undertaking expert, and exercise examine Technologist) focused on the medical expert and had been groundbreaking at the time as a result of there were no credentials or certifications for endeavor authorities. ACSM in reality became leading the style and forging ahead and not using a landmarks in addition to no competitors. a number of years later, health fitness Director, fitness fitness teacher, and recreation chief were developed to reflect the wants of the nonclinical exercise experts.

throughout time, we’ve accompanied the cessation of probably the most long-established certifications, the addition of the Registered scientific exercise Physiologist, adjustments to some titles (clinical recreation expert, fitness fitness specialist), and the offering of certifications for the nondegreed pastime specialists (certified very own coach and community pastime instructor). ACSM at present certifies three,900 clinical professionals, 10,500 health health experts, and simply greater than 13,000 nondegreed endeavor authorities. The closing 3 years has seen continued increase in certification despite the fact often within the nonclinical credentials.

we've accomplished plenty in forty years and have seen the blossoming of many different corporations in the undertaking certification box. In live performance with the competition, we additionally need to struggle with our occupation’s identification within the public sector, medical community, and eventually how the activity occupation progresses towards state law/licensure.

pastime specialists are compared with different fitness care professions reminiscent of dieticians, athletic trainers, and actual therapists to name just a few. however we share ordinary disciplines and beginnings, the endeavor knowledgeable is distinct. First, we are the “new youngster” on the block only on the age of forty. In point of view, we are only approaching formative years. however, all of the professions mentioned have one distinctive change from us. they all developed to enter into patient/client care professions. We developed from a physique of advantage with roots in physical education and physiology. We advanced into “practicing” our profession. Given this contrast, it is a major hurdle as we circulate the occupation forward.

therefore, a few of our challenges in the imminent 3 years might be to return to agreement on our knowledgeable id. The U.S. Bureau of Labor and records lists the bachelor-degreed endeavor professional as an endeavor physiologist. The fitness and health trade at present is essentially hiring three styles of people: neighborhood pastime instructors, very own trainers, and recreation physiologists. Given the market and how we're identified by way of others, the discussion surrounding altering the identify of the degreed ACSM-certified activity authorities is a credible dialogue. as a result, the CCRB has carried out wide analysis earlier than updating the titles of its certifications, surveying licensed specialists, health business employers, health and scientific companions, and the everyday public. The proposed name adjustments the place to exchange the ACSM certified fitness health SpecialistSM to ACSM licensed activity Physiologist and the ACSM certified medical pastime SpecialistSM to ACSM certified medical endeavor Physiologist. this could provide us three “pastime physiologist” titles from the bachelor-degreed endeavor physiologist and clinical exercise physiologist to the grasp-degreed registered medical undertaking physiologist. The survey statistics showed the new names resonated with audiences throughout the board, with more than 70% of all people surveyed agreeing with the new titles.

The CCRB proposed the identify adjustments to the ACSM Board of Trustees at its November meeting. The ACSM board voted in guide of both adjustments according to the proof presented by using the CCRB. The changes had been introduced this month that the names of two ACSM fitness certifications might be revised to greater signify the scope of observe and potential of the health experts holding these titles. the brand new titles, ACSM licensed activity Physiologist and ACSM certified clinical Physiologist, will exchange ACSM certified health fitness SpecialistSM and ACSM licensed medical endeavor SpecialistSM, respectively (table).

recreation authorities preserving an academic diploma have further talents that is not duplicated in different health-connected professions. Naming these certifications “activity physiologist” helps the general public superior remember and recognize the excessive level of coaching and training these activity authorities have attained. The CCRB looks forward to carrying on with its efforts in moving the career forward.


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ACSM Registered Clinical Exercise Physiologist

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Exercise can help people prevent or manage heart problems.

Exercise can help people prevent or manage heart problems.

ULTRA F/Photodisc/Getty Images

Clinical exercise specialists work in heart health clinics, cardiovascular rehabilitation facilities, fitness centers and doctor's offices to help people avoid or recover from heart health or metabolic problems through exercise. Exercise specialists design individualized exercise programs to help their clients change established patterns of behavior, improve their health and enhance their lives.


Know the Risks: Lifestyle Management of Dyslipidemia

Abnormal blood lipids, known as dyslipidemia, are an increasing health problem in the United States and the world. Approximately 107 million American adults have borderline or high total cholesterol (1) (see Table 1 for cholesterol guidelines). Dyslipidemia is one of the major risk factors for heart disease (1-4). Excess cholesterol builds up in the walls of the arteries. Over time, this buildup contributes to atherosclerosis, a disease process in which arteries become narrowed and blood flow is impaired. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.

There are a number of different forms of dyslipidemia. Hypercholesterolemia indicates elevated blood cholesterol levels (2). Hypertriglyceridemia implies elevated triglycerides (TGs). Hyperlipidemia indicates elevated cholesterol and TGs. Hyperlipoproteinemia is defined as elevated lipoproteins (2). Hypoalphalipoprotein syndrome denotes low high-density lipoprotein (HDL) cholesterol (2). Postprandial lipemia (PPL), discussed in greater detail later, is characterized by a postprandial rise in TG-rich lipoproteins after eating.

One of the first steps in atherogenesis is the infiltration and entrapment of low-density lipoproteins (LDLs) in the blood vessel wall. This leads to a series of events (e.g., oxidation of LDLs, monocyte migration, macrophage uptake of modified LDLs, foam cells, fatty streaks, etc.) that result in the development of fibrous plaques within the walls of the intima.

Dyslipidemia is caused by genetic and environmental factors that lead to problems with enzyme deficiencies, apolipoproteins, or lipoprotein particles. There are a number of factors that contribute to dyslipidemia (see Table 2 for a partial listing).

Dyslipidemia also is a characteristic of the recently defined metabolic syndrome. The metabolic syndrome consists of a group of coronary heart disease (CHD) risk factors which includes glucose intolerance (fasting plasma glucose of 100-125 mg/dL), atherogenic dyslipidemia (TGs ≥150mg/dL and HDL cholesterol <40 mg/dL in men and <50 mg/dL in women), increased blood pressure (≥130/85 mm Hg), abdominal obesity (waist circumference of 102 cm or greater in men and 88 cm or greater in women), a prothrombotic state, and a proinflammatory state (5). A prothrombotic state is a condition that predisposes to venous or arterial thrombosis. A proinflammatory state is the presence of low-grade generalized inflammation within the body that increases cardiac risk.

Lipoproteins are the carriers of lipids (primarily cholesterol and TGs) in the blood. Because fat and water do not mix, the body combines protein plus lipid so that the lipid substance can be transported in plasma. There are several lipoproteins in the body, with different functions (see Table 3). Some contribute to cardiovascular disease (e.g., LDLs) and some help prevent it (e.g., HDLs). In summary, dyslipidemia refers to an abnormality of lipoproteins, covering a variety of disorders relating to abnormal levels of total cholesterol, LDL cholesterol, HDL cholesterol, and/or TGs.

Table 3

Table 3

Figure

Figure

Postprandial Lipemia

Postprandial lipemia (PPL) refers to the rise in TG-rich lipoproteins (e.g., very low density lipoproteins [VLDLs]) after a meal. It is a dynamic condition in which humans spend the majority of their time (7). PPL reflects a combined measure of an individual's capacity to metabolize TGs. Elevated/prolonged PPL, defined as a delayed clearance of TGs after a high-fat meal, is a significant risk factor for the development of atherosclerosis (7, 8). The exchange of core lipids between postprandial lipoproteins and LDLs/HDLs increases during prolonged PPL in susceptible persons, resulting in elevated TGs; the production of small, dense LDL particles; and reduced HDLs (7). Smaller, denser LDLs are more atherogenic than the larger, less dense LDLs. Other atherogenic factors including clotting factors, platelet reactivity, and monocyte and cytokine expression, all of which contribute to endothelial dysfunction, may increase during PPL (7).

Testing for PPL involves a 12-hour fast and initial blood collection. Subjects then ingest a high-fat beverage, and blood samples are collected every 2 hours for 8 hours. Triglyceride concentrations are measured by colorimetry (quantitative chemical analysis by color), and values are plotted over time. PPL is assessed using total area under the curve (AUC). A large value for TG area AUC indicates that the TGs were maintained in the blood longer than expected.

Exercise Effects on Lipid Metabolism

The lowering of TGs is the most consistent effect exercise has on lipoproteins. HDLs often are increased with sustained aerobic exercise that results in an expenditure of >1,200 calories/week, but this effect is less consistent and may be genetically predetermined (9). The greater the exercise volume (and caloric expenditure), the more likely an exerciser will achieve a significant increase in HDL cholesterol. Lower TGs are typically observed with both acute exercise and sustained aerobic exercise training (3). TGs are used as energy by skeletal muscles during endurance exercise. The enzyme lipoprotein lipase (LPL) splits TGs from VLDLs, making them available for uptake by skeletal muscles. Chronic exercise training also increases hepatic HDL production and the conversion of HDL3 to HDL2 in the blood, both of which protect against heart disease (3).

The evidence for exercise alone reducing LDLs and total cholesterol is less conclusive. It appears that weight loss/fat loss is required for significant reductions in LDLs and total cholesterol (3, 10). Regular aerobic exercise does, however, produce favorable changes in LDL subfractions, which will reduce the risk of CHD. For example, aerobic exercise has been shown to convert smaller LDLs to larger LDLs, reducing cardiac risk (3, 11).

Exercise training also favorably alters lipid enzyme activity, resulting in improved lipid profiles. Table 4 lists and defines the major enzymes involved in lipid metabolism. LPL and lecithin-cholesterol acyltransferase are increased with aerobic exercise, whereas hepatic lipase is usually decreased (3). The effects of exercise training on cholesterol ester transport protein are inconclusive at this time (3). Genetic deficiencies can alter the exercise response for some individuals. For example, LPL activity will not be increased in those who have a LPL deficiency (2). It was recently demonstrated in 35 pairs of monozygotic twins (active twins ran a mean of 63 km/week vs. a mean of 7 km/week in the inactive twins) that low HDL cholesterol may be largely determined by genetic factors and is less effectively treated with vigorous exercise (12).

Figure

Figure

Table 4

Table 4

Lifestyle Effects on Dyslipidemia

National Cholesterol Education Program III recommends nutritional intervention, increased exercise/physical activity, and weight loss for many individuals with dyslipidemia (5). There is substantial evidence to support the profound beneficial effects of lifestyle changes on dyslipidemia (3, 4, 10, 11). Although there are a number of medications (e.g., statins) that are effective for treating dyslipidemia, lifestyle changes alone can often normalize lipid profiles. Lipid lowering typically results in modest plaque regression and stabilization, reducing the risk of a cardiac event (3).

Regular aerobic exercise is an essential lifestyle component for improving/controlling blood lipids. The total amount of physical activity seems to be more important than the intensity to induce beneficial effects on lipoproteins (10, 11). Significant daily and weekly energy expenditures are recommended to produce notable changes in individuals with dyslipidemia (3, 4, 10). Cross-sectional studies have shown that lipids continue to improve across weekly running distances from <10 to >40 miles in a direct dose-response relationship (13).

The effect of exercise on PPL also is significant. Individuals who regularly perform aerobic exercise typically display low levels of PPL (14). Vigorous aerobic exercise has been shown to reduce PPL in men with elevated TGs, even when performed 12 hours before a high-fat meal (15). In a recent study, intermittent exercise in young, normolipidemic men and women was shown to improve PPL significantly more than continuous exercise (16). The breakdown of blood TGs (and some TG-rich lipoproteins) is increased during exercise and continues well into the recovery phase. Exercise that stimulates fat use as a substrate during and after the activity helps clear TG from the blood. In addition, exercise stimulates the enzyme LPL and this enzyme may remain active for several hours. Thus, moderate intensity exercise attenuates PPL (17, 18). It is important to note that the favorable effects (e.g., TG lowering) of endurance exercise on PPL seem to be a result of acute metabolic changes as opposed to chronic exercise effects (14, 15). This encourages daily or near daily aerobic exercise to treat elevated PPL. Possible mechanisms for the exercise-induced TG reductions include increased muscle LPL activity and reduced hepatic TG secretion (14, 17).

There only have been a couple of studies on resistance training and PPL, and the results were inconsistent (19, 20). Thus, there are no specific guidelines to recommend at the present time.

Weight loss is another lifestyle factor that significantly improves dyslipidemia. Obesity typically elevates VLDL and LDL fractions, increases TG levels, lowers HDL cholesterol, increases blood pressure, and promotes insulin resistance. Weight loss typically lowers LDLs, TGs, and total cholesterol (2, 3). HDLs may increase, decrease, or remain the same (2, 3). If weight loss is combined with aerobic exercise, HDLs are more likely to be sustained or increase following training. Weight loss also lowers blood pressure, improves glycemic control, and reduces inflammation linked to metabolic and cardiac diseases (3, 5, 21, 22).

Exercise training can improve lipid profiles either directly (without weight loss) by increased lipid enzymatic activity or indirectly (reduced body weight) (2). When weight loss occurs in conjunction with exercise, LDL and total cholesterol are usually lowered (2, 3). Weight loss also has beneficial effects on lowering PPL, as obesity increases PPL. When weight loss is indicated, a loss of 5% to 10% body weight from baseline is a starting goal (4). This amount of weight loss can significantly improve blood lipids. However, even when there is minimal or no weight loss, an improved lipid profile can still be achieved with adequate exercise (11).

Exercise/Physical Activity Guidelines

It is prudent that the fitness professional check with the individual's physician if he or she is taking lipid-lowering medications or other medications for any coexisting diseases (e.g., obesity, hypertension, type 2 diabetes) that may require medical clearance. Statins, for example, can cause muscle damage (myopathy) and this should be considered (4). Table 5 summarizes general exercise guidelines for dyslipidemia. The emphasis should be on aerobic exercise and total weekly caloric expenditure. A good initial goal is to perform aerobic exercise three to five times per week for 20 to 60 minutes, expending ≥1,200 calories/week. Ideally, aerobic exercise for dyslipidemia should gradually progress, as tolerated, to five to seven times per week for 40 to 60 minutes, creating an energy expenditure of >2,000 calories/week (4). A gradual increase in aerobic exercise intensity should also occur. Exercise programs with higher volumes and intensities have been shown to be most effective for increasing HDL cholesterol (11). These guidelines may also need adjusting based on coexisting diseases, current fitness level, and time constraints that may be present. The aerobic training may need to be performed intermittently throughout the day. It is important to remember that lifestyle physical activity (e.g., climbing stairs, lunchtime walks, housework) contributes to the total weekly energy expenditure. Also, for a well-rounded exercise program, resistance and flexibility training should be incorporated (see Table 5 for guidelines).

Nutritional Guidelines

Dietary modification is a powerful nonpharmacological strategy for improving blood lipids. Diets that are high in saturated and trans-fat and cholesterol increase TGs, LDL, and total blood cholesterol. Polyunsaturated fats (e.g., corn oil) seem to have a neutral effect on blood cholesterol, whereas monounsaturated fats (e.g., olive oil) seem to sustain HDLs and lower LDLs and TGs. Reducing saturated and trans-fats and cholesterol intake will usually improve blood lipids. Even though there is variability in individual responses to dietary changes, reducing total calories consumed, particularly saturated fat calories, which results in weight loss, typically lowers total and LDL cholesterol. HDL cholesterol is sometimes lowered as well, but when dieting is coupled with exercise, HDL cholesterol can be maintained (2, 3, 23, 24).

High-carbohydrate diets can increase TG levels and decrease HDL cholesterol, but again, this effect is negated with aerobic exercise (2, 3, 23, 24). Dietary fiber, particularly soluble fiber, helps to lower blood cholesterol levels. Omega-3 fatty acids lower blood TG levels (3). Plant sterols also have been shown to favorably alter lipid profiles, particularly when combined with aerobic exercise (25). Moderate alcohol consumption (no more than one drink per day in women and lighter persons and no more than two drinks per day in most men) (4) may raise HDL cholesterol levels. It may also increase TGs, but its effect on LDL cholesterol appears to be minimal.

Table 6 summarizes the key components of a diet to help lower blood lipids. The emphasis should be on restricting fat, particularly saturated fats, and cholesterol intake while increasing intake of soluble fiber and other foods such as soy, almonds, walnuts, plant sterols and stanols, cold water fish (e.g., salmon), etc., which have been shown to have a beneficial effect on blood lipids. Here are some nutrition tips that favorably help impact blood lipids:

  • Eat fish two to three times per week. The fish should be baked, not fried.
  • Use healthy oils for cooking, such as olive oil and walnut oil.
  • Eat whole grain products. Avoid or limit starchy white pasta and bread.
  • Add or increase oats and oatmeal intake.
  • Increase consumption of green vegetables. Broccoli, spinach, lettuce, and green beans are all examples of healthy carbohydrate, low-calorie green vegetables.
  • Eat whole fruits and berries.
  • Avoid/reduce rich, fattening desserts.
  • The amount of each type of fiber varies in different plant foods. To receive the greatest health benefit, eat a wide variety of high-fiber foods.
  • Case Study

    In December of 2003, a 75-year-old man was referred for lifestyle management to lose body weight and manage cardiovascular risk factors. On medical history and physical fitness, he was found to have had a recent surgical repair of a left quadriceps muscle rupture and had gained 45 lbs over six to eight months of recovery and rehabilitation. He had a history of dyslipidemia and overweight but was not diabetic nor hypertensive. He was a nonsmoker, and his mother and father died of cardiovascular disease at age 78 and 84, respectively. He has been an avid golfer since retirement in 1995, walking nine holes, three days/week. He also has been very active in his daily life but had not been following a regular exercise program. His dyslipidemia was being treated only with Altaprev, 20 mg/day, started in April of 2001. He had had no advice in regard to weight loss, exercise, or other therapeutic lifestyle changes. He was enrolled in the INTERXVENTUSA Cardiovascular Risk Reduction Program (www.interventusa.com). After one year, he had lost 43 lbs (from 244 to 201 lbs). He was eating a low-fat, high-fiber diet (22% fat calories and 45 g of fiber per day by seven day food recall) and exercising 260 minutes/week on average (walking 200 minutes and Airdyne bicycle ergometer 60 minutes). Lipid changes with indicated therapy from 04/01 through 01/05 are summarized below:

    Summary

    Dyslipidemia is a condition that promotes the genesis and progression of atherosclerosis. Dyslipidemia and PPL can often be prevented or treated with lifestyle management of exercise/physical activity, proper nutrition, and weight loss (if needed). Having a sound knowledge of lipid disorders, their associated risks, guidelines for treatment, and understanding how lifestyle management can prevent/improve dyslipidemia will better enable the fitness professional to coach individuals to live healthier lives.

    Condensed Version and Bottom Line

    A large body of evidence suggests that dyslipidemia is directly related to the progression of coronary artery disease. Lifestyle changes, which include increased exercise/physical activity, dietary modifications, and weight loss (if needed) have profound effects on improving dyslipidemia and other lipid disorders such as PPL. This will result in a lower rate of coronary artery disease.

    Recommended Readings Durstine, J. Larry, Ph.D. ACSM Action Plan for High Cholesterol. Human Kinetics, 2006. ACSM Fitness Book. 3rd ed. Human Kinetics, 2003. Cooper, Kenneth H., M.D., MPH. Controlling Cholesterol the Natural Way: Eat Your Way to Better Health With New Breakthrough Food Discoveries. Bantam, 1999. References 2. Durstine, J.L., and G.E. Moore. ACSM's Exercise Management for Persons with Chronic Diseases and Disabilities. 2nd ed. Human Kinetics, 2003, pp. 142-148. 3. Roitman J.L. (Senior Editor). ACSM's Resource Manual for the Guidelines for Exercise Testing and Prescription. 4th ed. Baltimore: Lippincott Williams & Wilkins, 2001, pp. 263-276, 308-318. 4. Whaley, M.H., P.H. Brubaker, and R.M. Otto (Editors). ACSM's Guidelines for Exercise Testing and Prescription. 7th ed. Baltimore: Lippincott Williams & Wilkins, 2005, pp. 211-212, 217. 5. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). The Journal of the American Medical Association 285(19):2486-2497, May 16, 2001. 6. Grundy S.M., J.I. Cleeman, C.N.B. Merz, et al., for the Coordinating Committee of the National Cholesterol Education Program, Endorsed by the National Heart, Lung, and Blood Institute, American College of Cardiology Foundation, and American Heart Association. Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation 110:227-239, 2004. 7. Hyson D.C., J.C. Rutledge, and L. Berglund. Postprandial Lipemia and Cardiovascular Disease. Current Atherosclerosis Reports 5:437-444, 2003. 8. Parks E.J. Recent findings in the study of postprandial lipemia. Current Atherosclerosis Reports 3(6):462-470, November 2001. 9. Williams P.T., P.J. Blanche, R. Rawlings, et al. Concordant lipoprotein and weight responses to dietary fat change in identical twins with divergent exercise levels 1. American Journal of Clinical Nutrition 82(1):181-187, 2005. 10. Durstine J.L., P.W. Grandjean, C.A. Cox, et al. Lipids, lipoproteins, and exercise. Journal of Cardiopulmonary Rehabilitation 22(6):385-398, 2002. 11. Kraus W.E., J.A. Houmard, B.D. Duscha, et al. Effects of the amount and intensity of exercise on plasma lipoproteins. The New England Journal of Medicine 347(19):1483-1492, 2002. 12. William P.T., P.J. Blanche, and R.M. Krauss. Behavioral versus genetic correlates of lipoproteins and adiposity in identical twins discordant for exercise. Circulation 112(3):350-356, 2005. 13. Williams P.T. High density lipoprotein cholesterol and other risk factors for coronary heart disease in female runners. The New England Journal of Medicine 334:1298-1303, 1996. 14. Gill J.M., and A.E Hardman. Exercise and postprandial lipid metabolism: an update on potential mechanisms and interactions with high-carbohydrate diets (review). The Journal of Nutritional Biochemistry 14(3):122-32, 2003. 15. Zhang J.Q., L.L. Ji, G. Nunez, et al. Effect of exercise timing on postprandial lipemia in hypertriglyceridemic men. Canadian Journal of Applied Physiology 29(5):590-603, 2004. 16. Altena T.S., J.L. Michaelson, S.D. Ball, et al. Single sessions of intermittent and continuous exercise and postprandial lipemia. Medicine & Science in Sports & Exercise ® 36(8):1364-71, 2004. 17. Herd S.L., B. Kiens, L.H. Boobis, et al. Moderate exercise, postprandial lipemia, and skeletal muscle lipoprotein lipase activity. Metabolism 50(7):756-762, 2001. 18. Zhang J.Q., T.R. Thomas, and S.D. Ball. Effect of exercise timing on postprandial lipemia and HDL cholesterol subfractions. Journal of Applied Physiology 85:1516-1522, 1998. 19. Petitt D.S., S.A. Arngrimsson, and K.J. Cureton. Effect of resistance exercise on postprandial lipemia. Journal of Applied Physiology 94(2):694-700, 2003. 20. Shannon K.A., R.M. Shannon, J.N. Clore, et al. Resistance exercise and postprandial lipemia: the dose effect of differing volumes of acute resistance exercise bouts. Metabolism 54(6):756-63, 2005. 21. Ryan A.S., and B.J. Nicklas. Reductions in plasma cytokine levels with weight loss improve insulin sensitivity in overweight and obese postmenopausal women. Diabetes Care 27:1699-1705, 2004. 22. Esposito K., A. Pontillo, C. DiPalo, et al. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. The Journal of the American Medical Association 289:1799-1804, 2003. 23. Koutsari C., F. Karpe, S.M. Humphreys, et al. Exercise prevents the accumulation of triglyceride-rich lipoproteins and their remnants seen when changing to a high-carbohydrate diet. Arteriosclerosis, Thrombosis, and Vascular Biology 21(9):1520-1525, 2001. 24. Koutsari C., and A.E. Hardman. Exercise prevents the augmentation of postprandial lipaemia attributable to a low-fat high-carbohydrate diet. British Journal of Nutrition 86(2):197-205, 2001. 25. Varady K.A., N. Ebine, C.A. Vanstone, et al. Plant sterols and endurance training combine to favorably alter plasma lipid profiles in previously sedentary hypercholesterolemic adults after 8 wk. The American Journal of Clinical Nutrition 80(5):1159-66, 2004. Keywords:

    Cholesterol; Dyslipidemia; Postprandial Lipemia; Exercise; Physical Fitness

    © 2006 American College of Sports Medicine Source

    ACSM's Health & Fitness Journal10(4):18-25, July-August 2006.

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    ACSM 040-444 Exam (ACSM Registered Clinical Exercise Physiologist) Detailed Information



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