American College of Sports Medicine 2018 Conference Review Part 1
June 23 2018
The 2018 annual American College of Sports Medicine (ACSM) conference was held at Minneapolis from March 28-June 2. For people who are not aware, ACSM conference is the largest conference in the exercise and sports medicine area. I stayed at the Normandy Inn, which is a 15-minute walk from the Minneapolis convention center.
The conference officially started on Wednesday although there were pre-conference talks on Tuesday. They had 5 different tracks to choose and each track had number of talks going on at the same time.
Physical Activity for Cancer Prevention and Treatment: State of Evidence
The first highlight talk in the morning essentially summarized the evidence from the, yet to be officially released, federal physical activity guidelines for cancer prevention by Dr. Anne McTiernan at Fred Hutchinson Cancer Research Center, Seattle. The last physical activity guidelines came out in 2008, so this is a major update that everyone was eagerly waiting for. The new guidelines will be officially released by the end of 2018.
Some of the main highlights of the talk:
- On average, 40% of people will be diagnosed with cancer in their lifetime
- Although several cancers are genetical, most of them are due to environment and lifestyle
- The committee reviewed almost 45 reviews, meta-analysis and pooled studies
- Strongest evidence linked highest versus lowest exercise levels to reduced risks of bladder, breast, colon, and other common cancers (by 10-20 percent)
- Limited or moderate evidence exist for other cancers
- Not clear about brain cancer
- Some evidence for sedentary time (or sitting time) associated with cancers risk
- Limited evidence to show exercise reduces mortality in cancer survivors (people who had cancer and survived)
- Currently, large studies going on to see if exercise has an effect in cancer survivor’s (ex., CHALLENGE trial)
- There is a dose response relation, but exact dose of exercise not clear, varying age groups, and so forth?
What about areas for future research:
- All these results from observational trials. So we need some large RCT’s
- We need to know more about the dose response or whether moderate intensity activities such as walking are sufficient and whether resistance training has a role too.
In short, please exercise if you want to reduce cancer risk. We all know the “Relay for life” runs to raise awareness and money for cancer research. But I seriously don’t think a lot of people think they are doing a lot more in preventing cancers for themselves by just participating in these charity runs. And this is why it kills me when people talk about exercise just merely in terms of losing weight and looking good. So remember this next time you exercise.
Hypertrophy: The Extrinsic Variables
This symposium was on the topic of muscle growth. I could never find the rooms where the talks were held and always got lost in that big convention center.
The first talk was by Dr. Michael Roberts from Auburn University. The talk was about how muscle mass is measured and how it is defined. DEXA which is commonly used to measure muscle mass counts extracellular water as muscle too. He showed a slide where subtracting extracellular water measured using Bioimpedance spectroscopy drastically reduced muscle mass measured using DEXA. And he was just talking about,extracellular water, but remember that muscle is 70% water. He concluded by saying estimating changes in extracellular water is important when assessing muscle hypertophy and we need to address “what hypertrophy is”. In fact, my recent grant was on this same topic but in older adults. It may sound academic, but it has a lot of implications on defining clinical cut-points for sarcopenia.
The next talk is from our very own Dr. Brad Schoenfeld - a.k.a Dr. Muscle from Lehman College. Brad talked about the myth of an optimum repetition range for muscle hypertrophy. He started off by talking about studies on protein synthesis showing that high reps and low reps producing similar results. He then talked about results in untrained individuals which didn’t really convince him and how it prompted to do his own study on trained (I have written about this study in another article). And finally he did a meta-analysis (collection of studies) showing high reps and low reps to be both effective in increasing muscle. Interestingly, he also said there is some evidence to show higher reps might be targeting more of the Type 1 and lower reps the type 2 fibers. I thought Brad had a nice progression in his talk - from basic science to single studies to finish off with a meta-analysis. Can’t argue with that logic, can you?
The next speakers were Jeremy Loeneke and Jeremy Steele. But I had to leave since my poster session time was up. My poster was on the energy cost of walking in older adults. We know the energy cost for walking in old people is low. But we wanted to see this in low functioning old people. This was part of a big NIH study that I am involved in. Briefly, low functioning older adults walk slowly compared to healthy older adults, but they tend to burn similar calories. And this partly due to their lower cardiorespiratory fitness (vo2peak). So they are walking very slow, but still struggling and burning more to do that even. It could also be due to compensations, neurological, muscular and so forth too.
Supplements to Promote Hypertrophy and Combat Atrophy
Creatine
I was a bit late for this talk since I was at the poster presentation. I walked in to the presentation on creatine by Dr. Eric Rawson from Bloomsburg University. If I heard him right, he said most of the effects of creatine were due to people working harder than the direct effects of creatine per se. He also mentioned that creatine do not exacerbate muscle damage, even with intense damaging protocols, and helps reduce inflammation and improve recovery. Creatine monohydrate is nearly absorbed 100% so increased absorption with other creatine formulations are just outright scams. Creatine upregulates or expresses a number of growth related genes, GLUT-4 and improves carbohydrate metabolism and such. One of the audience comments was the role of creatine in increasing water content through improved glycogen stores is under appreciated. Mind you, one gram of gylcogen stores around 3-4 gms of water along with it.
Fish Oil
Dr. Bettina Mittendorfer from Washington University in St. Louis talked about the effect of fish oils on muscle hypertrophy. She talked about how fish oils have showed increase in protein synthesis in both old and young adults. And how fish oil supplementation have shown to increase muscle mass and physical performance in older adults. I thought she could have mentioned some of the negative studies too because there exist a few. For the Q&A session, I asked what is driving this increase in protein synthesis. She replied that she is not really sure and the increase in protein synthesis was independent of the anti-inflammatory effects of fish oils. Fish oil is getting a lot of flack these days due to the null effects on cardiovascular outcomes. But the effects of fish oil on the muscular system are very novel and interesting. And on a related note, I just submitted a fish oil paper to one of the major medical journals.
Now for some closing thoughts: The more I learn about research and the more I attend these conferences, especially being in the midst of a replication crisis, I think presenters should spare some time to talk a bit about study quality and limitations. I always tend to enjoy poster sessions at conferences; it is just one of those rare occasions where you can learn about the study and have the study author to answer your questions right in front of you. It was also so nice to see all these students from so many far away countries talking about their little study with so much passion and confidence. That always puts a smile on my face.
That’s all for the first part. In the second part, I will review some of the other interesting talks and posters that I came across. Thank you for reading.
