ACSM International Conference 2017 Notes

From May 31st until June 3rd in Denver Colorado was the American College of Sports Medicine international conference. Presentations on a myriad of topics involving health, exercise, nutrition, and more occurred over those four days. It is a great time to see what other researchers throughout the world are doing, to catch up with old friends who are at different institutions, and to present some of the work we are doing in the lab I am working in. Below are the notes that I took during a number of different presentations. Unfortunately, I did a poor job of writing down the name of the presenters, but I think if you are interested you might be able to access this information online. Also, I’m throwing in the notes that I took from various side conversations with friends and colleagues in-between sessions, at meals, and at poster presentations.

Day 1)

Gatorade future of sports nutrition talk: The presenters had interest in how science could better personalize nutrition for the elite athletes. How genetics had their contribution to both health and performance with the interaction that nutrition gives.

The major issue they see is most people get the basics wrong but focus on supplementation too soon. Also the gut microbiome is not going to impact indigestion and other negative GI events that can occur during long duration aerobic events. (Normal to have issues when doing an iron man or tour de France).

Side conversation: I asked a researcher I greatly respect about why he never went in to administration and his comment to me was: the further you get from the students the less impact he feels he has. He enjoys the interaction and wants to keep that alive as long as he can. (awesome)

Day 2)

Exercise and the brain:

The hippocampus has various portions that are related to face recognition, one for area and location memory and so on. These are independently effects during Alzheimer’s disease. Chronic exercise of 4 weeks increased perfusion (blood flow) in this area and improves function. Aerobic exercise in mice with PTSD (yes it can happen to them also) can improve symptoms with them. Also with mice, sleep deprivation decreases short term memory, but exercise moderates this effect. Exercise increase brain derived neutropic factory (BDNF, which grows brain cells) along with seems to mediate chemically induced Alzheimer’s and stops the feed forward mechanism of enzyme concentrations that are related increasing tau accumulation in Alzheimer’s.

Exercise helps block fear learning in rats, which helps with fear extinction along with avoiding possible fear relapses (writing this while flying on a plane and I’m trying to get over my fear of flying (how fitting and slightly meta)). The DRN (structure in the brain which I’m sure I didn’t spell the full name correctly in my notes) interacts with the amygdala ?haberlua? (not sure on the spelling here), which is associated with stress and punishment. Exercise over 6 weeks in rates decreased the activity of this area. This could mean that long periods of time are required to get someone habituated with exercise so that the pain perception decreases.

There seems to be a gender difference in the animal model for how their brains react to chronic training.

Dopamine (a neurotransmitter) is important in prediction error, also reward value for the pathways associated. This is linked in turn to brain plasticity and plays in to the fear network and specifically the D1 receptors require high levels of dopamine to be activated and exercise seems to help this occur.

Brain gets more efficient with time in that high level athletes actually have quieter brains when performing tasks than a novice. This also seems to be why novices make more mistakes when people are watching them than the elite. The noisy brain of the novice can also make you too tight (adding to the errors you make). Training increase stress resilience in the brain and high level athletes have less amygdala activation along with better frontal lobe function (which can help activate the amygdala).

Cognitive reappraisal is important since this allows you to reinterpret what a situation means. For high level athletes it allows them to be optimistic which in turn help performance and mental state. Aim to think about how things are improving with time.

Vertical jump performance – look at an athlete’s testing battery for eccentric Rate of force development (RFD), relative concentric mean force, and relative concentric impulse on takeoff for how balanced an athlete is and what needs to be performed.

Fitness overcomes brain decline with age, even decreases the risk the Apoe4 trait risk for Alzheimer’s to a high degree. The gene for BDNF met carrier has an effect on cognitive performance and exercise mediates this effect.

Hormone replacement therapy, omega 3 fatty acid intake, and physical activity all mediate brain health.

Flow chart of how training influences the brain:

Physical activity (PA) > cell and molecular changes > structure and function changes > psychological and social changes > cognitive changes

Diet can mitigate the positive changes from exercise (you can’t out eat a bad diet).

There might be lean body mass maximum levels that can be obtained in collegiate athletes and this can be important for coaches to understand so that they don’t force an athlete to move up a weight class at the expense of their own health and are simply gaining fat.

Back squat speed seems to follow a second order polynomial relationship (a line with a turn in it) and as the loads increase it tends to change with greater hip recruitment.

Exercise increases the number of neurons in the hippocampus and BDNF increases the connectivity in the brain.

Still not sure what type of exercise, duration, and frequency is optimal for brain functioning and further research in this area must be pursued.

Brain still has plasticity (ability to change) later on in life and exercise truly helps this occur.

Microbiome notes: (microbiome is the bacteria, viruses, and fungi that naturally live on your body but more specifically inside your digestive system) the microbiome is important for survival, where the bacteria are competing for survival, it helps with the development and maturation of the immune system. It is important for detoxification in the body and can be both a source of and cause removal of inflammation in the body.

There are a number of phyla of bacteria in the microbiome. The top three are firmicutes (breakdown more simple sugars), bacteroidetes (breakdown complex carbs). There are many more families and a lot of different species in the GI. They give off a number of metabolites like acetate, propionate, butyrate, and lactate.

Most of your bacteria is in your colon (10^12/g), then small intestine (10^3-7/g), and finally the stomach of about 10^1/g.

Fiber is important for the function of this system.

Butyrate is a 4 carbon fat which decrease inflammation and tumor formation along with increases the barrier in the GI between your cells and the bacteria. This is made naturally by some bacteria in your GI and fiber helps this happen.

There is a difference in energy extraction of food due to the microbiome between obese and normal weight mice.

The mucus layer between epithelial cells and the bacteria in the digestion system. Some bacteria can eat away and this and cause negative health outcomes. Having a diverse bacterial population in the GI will help maintain tight junctions and avoid leaky gut syndrome. If you have a breach this causes lots of inflammation.

Physical activity decreases your risk of colon cancer and gall bladder disease. Also helps with Crohns, Irritable bowel disease, and ulcerative colitis by improving quality of life. Extreme exercise causes GI health issues through leaky gut. Most likely to occur when exercising in the heat. Lipopolysaccharides from gram negative bacteria can be found in the blood after hard training (which is a toxin).

Dexatron sodium sulfate causes colitis in the animal model (real bad). Forced training in animals cause more body weight loss with colitis, but voluntary exercise caused better health outcomes then sedentary. Each of those groups had different microbiomes at the end of the study. There was more butyrate in the exercise groups than in the sedentary groups.

Differences with human GI from mouse, we have more villi but less folds (might have this backwards).

Acetate (2 carbon), proponate (3 carbon), and butyrate all play in to increased energy extraction and cardiovascular health. Naturally lean and obese animals have different microbiomes but training tends to make them quite similar. Lean though still had a greater increase in those metabolites being produced.

After training increased the amount of butyrate taxa. This correlated to changes in lean body mass (very interesting).

Humans that eat a plant based diet had the most diverse microbiome and those that ate a high sugar refined and processed diet had the least.

Concussion information: little is known of what is the true return to play and recovery timeline in athletes or regular people. Concussions are considered an epidemic by the CDC. Some sports have high as a 15.3% incidence rate and the common cause in regular people are falls and car accidents.

Creatine and DHA supplementation for concussions are important. Aim for two grams of DHA per day. When athletes were post concussion the TCU protocol was 9g DHA for 3 days, then 6, 3, and back to 2. Creatine aim for 5 grams per day, it is a cheap, effective, and safe supplement and nearly everyone you meet should be on it. Excess consumption of DHA causes retrograde conversion to EPA (not a bad thing just interesting to me). Magnesium, curcumin, and vitamin D might help with concussion, but more research must be performed. There also is a need for daily brain concussion screening in athletes just like their other performance metrics are tracked. Really needs to be an app for this. Youth concussion is still a major factor, though kids don’t hit each other with as much force the acceleration on the brain is quite similar to that in adults but they tend to not hit each other as hard as frequently (interesting point I was straightened out on)

Training: using a single leg clean pull and then machine based work to look at the bilateral deficit in athletes (how much one limb is used over the other).

Muscle biopsies do not change the firing strategies in the muscle (don’t confuse this with performance).

When sleep is cut to less than six hours there was a 4X increase in risk for an upper respiratory tract infection in the military.

ACSM strength and conditioning is about working with disease populations and most of America is diseased (supposedly 60% of people simply aren’t diagnosed yet).

Day 3)

Regardless of risk factor low fitness people have a 2x risk of cardiovascular mortality.

Walking velocity indicates your health (never want to be walking at less than 2mph).

The most positive effect of cardiovascular training on heart health is probably the antiarrhythmic effects.

Very intense exercise might cause plaque ruptures which in turn cause MI or strokes. Very intense being running a marathon, hence why people die each year doing them.

Well trained individuals have larger coronary arteries. Might be a training effect, might just be genetics.

Very large volumes of training might cause cardiac scaring which starts to take away the cardio protective effects of exercise. This comes out to being more than 7.2 MET hours per day for having the negative effects. There seems to be a j shaped curve here where moderate training really is the best method for long term health.

Lowest risk people tend to train 2-4 times per week (aerobically). Running at 7-7.5 mph might be the optimal speed for long term health. Individuals that did less than 51 minutes, 6miles, or 1-2 times per week had a decrease in health risk factors. So doing something is better than nothing.

Best outcomes in light joggers (1-2.4 hours per week).

If you are obese, sedentary, and old don’t shovel your snow. That shit can kill you especially if you live in Detroit. But seriously, people die from that each year. Also hunters die each year from the major sympathetic nervous system response that occurs when they kill a deer.

There are new exercise screening guidelines that I need to familiarize myself with.

Even healthy people can have a heart attack so know the symptoms especially since this increases when you are training. A warm up avoids negative effects on HR and EKG, not warming up can cause arrhythmias. There should be an AED in every single gym.

Big take home here is the issue in most developed countries isn’t too much exercise, but none at all.

Micro RNAs –  miRNA 122 inhibits hep C when the levels of that miRNA is decreased.

They bind to the a 3’ UTR of the gene of interest. There are 1,200 identified in humans, and they target often multiple mRNA. This is up and coming stuff that is not easy to understand or parse all of the effects that they have on the body. Efforts to map the effects are ongoing.

miR 1 helps with hypertrophy

miR 133a/b building mitochondria in the cell

miR 206 helps with muscle hypertrophy and maintaining the quality of the neuromuscular junction

miR 486 stops muscle wasting

miR 499 expressed in the slow muscle fiber phenotype

Currently, there is only 80 primary articles on miRNA expression in humans, but 40 review articles (lol, killing it in this area).

High vs. low responders to exercise have difference profiles. The expression of these miRNAs seems to be different with age.

pGC-1 alpha, and COX IV

The Harvard athlete initiative tracks a lot of metrics and keeps the training logs on the athletes. They get baseline number and have posttest on the athletes. The Baggish article in the journal of physiology comes up with the miRNA profiles that changed in the Harvard rowers

profile 1: 148 and 22, responded both acute and chronically

profile 2: 21, 221 acute

profile 3: 20z, 328 chronic

profile 4: 210, 328 no response

miR 146a related to inflammation

208a cardiac muscle miRNA

Still not sure how trainable the miRNA are much less what causes the clearance of them in the cell.

29-92% of physical activity behavior related to genetics. miRNAs also seem to be related here.

Crossfit: it seems that pull up speed is the biggest limiting factor in a number of workouts and if an athlete wants to be successful this is where they should start working first. Seems to be some more fun research in this area for how to game it more effectively along with the training effects.

Teaching:

Begin class, assignment, review, student-student interaction, discussion, conclude class.

Check out socrative.com for quizzes, assignments, feedback, and question services for classes.

SWIVL is another app that might work well with video performance review.

Know your style, meet students where they are, make it active, use tech but know your limits, create tech limits with students.

Dynamome, look at hemodynamics of the athletes and how they change with time. Take the resting BP and HR of your athletes so you have the information to start.

Also some learning on HRV and ways to hopefully track it with athletes, and how heat shock protein is related to muscle anabolism/catabolism balance in humans.

Summary

So that was just the notes that I wrote down. There was way more going and I probably only attended what would amount to 1% of the total possible sessions. If you have any questions or want the long form of some of the points please let me know. To my students that read this, this is why you always have a pen and notebook or some other method to take notes at conferences. You can always learn something as long as you have your eyes open, ear perked up, and mouth shut (well the last part isn’t necessary, but stay present and interact with the people you meet). Thanks for reading and have a great one.

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