Exam Day

My test date to take the exam is August 11, 2011. I feel that utilizing the ACSM text books and consulting some sources on the internet have helped me to adequately prepare for the exam. I hope to do well the first time around and successfully gain my certification.

It should be noted again that once someone is certified that it is not the end of learning about exercise physiology and fitness, but rather the beginning. Having certification opens up the doors for job opportunities, as well as continuing learning opportunities (which is in fact a requirement for keeping your certification valid; refer to the “Overview of the ACSM” section on this blog for details or visit their website at http://www.acsm.org for complete information). Also research in the scientific community continues to help fitness professionals learn more about improving the field of the fitness industry and healthcare.

As an aspiring wellness manager and proponent of health education, I hope to complement my current graduate education (I am currently a candidate of the M.S. in Wellness Management at Ball State University) with the fitness certification to contribute to the well being of healthcare and health education in the United States.

References

The following is a list of references used throughout this entire blog:

1. http://www.acsm.org
2. American College of Sports Medicine (ACSM). ACSM’s resource for the personal trainer third edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2010.
3. American College of Sports Medicine (ACSM). ACSM’s certification review third edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2010.
4. American College of Sports Medicine (ACSM). ACSM’s guidelines for exercise testing and prescription eighth edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2010.
5. http://www.topendsports.com/
6. U.S. Department of Health Agriculture. USDA national nutrient database for standard reference, release 20 nutrient lists. Washington, DC; 2009. Retrieved from world wide web at: http://www.ars.usda.gov/Main/docs.htm?docid=15869

Flexibility Fitness

Inadequate flexibility is associated with decreased performance of activities of independent living and decreased ability to engage in specific physical movements. One of the most common flexibility testing procedures is the Sit and Reach Test.

Sit and Reach Test: This test involves sitting on the floor with legs stretched out straight ahead. Shoes should be removed. The soles of the feet are placed flat against the box. Both knees should be locked and pressed flat to the floor – the tester may assist by holding them down. With the palms facing downwards, and the hands on top of each other or side by side, the subject reaches forward along the measuring line as far as possible. Ensure that the hands remain at the same level, not one reaching further forward than the other. After some practice reaches, the subject reaches out and holds that position for at one-two seconds while the distance is recorded. Make sure there are no jerky movements.

The score is recorded to the nearest centimeter or half inch as the distance reached by the hand. Some test versions use the level of the feet as the zero mark, while others have the zero mark 9 inches before the feet. Below is a table with normative values:

	men		women
	cm	inches	cm	inches
super	> +27	> +10.5	> +30	> +11.5
excellent	+17 to +27	+6.5 to +10.5	+21 to +30	+8.0 to +11.5
good	+6 to +16	+2.5 to +6.0	+11 to +20	+4.5 to +7.5
average	0 to +5	0 to +2.0	+1 to +10	+0.5 to +4.0
fair	-8 to -1	-3.0 to -0.5	-7 to 0	-2.5 to 0
poor	-20 to -9	-7.5 to -3.5	-15 to -8	-6.0 to -3.0
very poor	< -20	< -7.5	< -15	< -6.0

Muscular Fitness

The purpose of testing muscular fitness is to assess an individual’s maximal strength and endurance in order to create an effective strength training program.

Muscular Strength Tests:

Handgrip Dynamoeter: The purpose of this test is to measure the maximum isometric strength of the hand and forearm muscles. The subject holds the dynamometer in the hand to be tested, with the arm at right angles and the elbow by the side of the body queezes the dynamometer with maximum isometric effort, which is maintained for about 5 seconds. No other body movement is allowed. The subject should be strongly encouraged to give a maximum effort.

One Repetition Max Bench Press: This is suited for the athletic population and not recommended for individuals that are de-conditioned in a strength training program.  The subject performs the barbell bench press by lifting weight that he or she can only perform with good form for one repetition. This might take several trial and error attempts, thus it is important subjects get adequate rest between sets if he or she feels they can lift more weight with good form. This test measures the strength of the chest, shoulder and arm muscles.

Note: One repetition max attempts can be performed with other exercises such as the squat or dead lift. It is important to have a spotter for safety and supervision of maximal lifts.

Here are the estimated norms of the 1-rep max bench press:

1 Rep Max Bench Press Table for adults  (weight lifted per bodyweight)
Rating	Score (per body weight)
Excellent	> 1.60
Good	1.30 – 1.60
Average	1.15 – 1.29
Below Average	1.00 – 1.14
Poor	0.91 – 0.99
Very Poor	< 0.90

Muscular Endurance Tests:

Push-up Test: Males start in the standard “down” position (hands pointing forward and under the shoulder, back straight, head up, using the toes as the pivot point). Females start in the modified down position of the “knee push up” (legs together, lower legs in contact with mat with ankles plantar-flexed, back straight, hand shoulder width apart, head up using the knees as the pivot point). The subject must raise the body by straightening the elbows and return to the “down” position, until the chin touches the mat. The stomach should touch the mat. The subject’s back must be straight at all times and the subject must push up to a straight arm position.

The maximal number of push ups performed consecutively without rest is counted as the score. The test is stopped when the client strains forcibly or is unable to maintain the appropriate technique within two repetitions.

Here is a reference chart for standard norms of the level of fitness regarding the push up test:

Curl-Up (Crunch) Test: The participant assumes a supine position on a mat with knees bent at 90 degrees. The arms are at the side, palms facing down with the middle fingers touching a piece of masking tape. A second piece of tape is placed 1o cm away.

A metronome is set to 50 bpm and the individual does slow controlled curl-ups to lift shoulder blade off the mat (trunk makes 30-degree angle with the mat), in time with the metronome at a rate of 25 per minute. The test is performed for 1 minute. The lower back should be flattened before each curl-up.

The individual performs as many curl ups as possible without pausing to a maximum of 25. The maximum number of repetitions is counted and compared to standard norms:

YMCA Bench Press Test: The barbell load for men is 80 pounds and for women is 35 pounds. A metronome of 60 bpm (30 repetitions per minute). The participant lies on the bench, feet on floor, with a spotter ready. The bar is started in the down position (the weight is on the subject’s chest) and the subjects perform full repetitions until fatigue or until the subject breaks the cadence. The number of consecutive repetitions recorded and compared to norms:

Body Composition

Body composition assessment measures the relative proportions of fat versus fat-free/lean tissue in the body. This is commonly reported as a percent of body fat. Having a healthy body fat percentage is essential for optimum health and sports performance. There are several procedures for measuring body composition and each procedure’s accuracy is relative to the equipment and skill of the tester:

Hydrostatic (Underwater) Weighing:

This is regarded as the “gold standard” for measuring body composition because it is the most accurate if the tester is skilled at performing the procedure. It involves weighing a person in the air (to get their weight), then weighing the person underwater (air weight – underwater weight = volume). From these, body density is calculated (weight/volume).  Because lean body mass (muscle, organs, bones, etc.) is more dense than fat, body density is directly related to proportion of body fat.

Subjects are seated in the water in a seat suspended from a scale. The subject must exhale as much air as possible (down to residual volume), submerge their body completely under water, and remain as motionless as possible until an accurate scale weight (underwater weight) can be determined. To ensure consistent results, 5 to 10 measurements are required.

The measurements of the subject’s body weight and density are plugged into a regression equation to calculate their estimated body fat percentage.

As stated before, the advantage of this method is that it is the most accurate method (relative error of ~2-3%). The disadvantages however is that the procedure takes long and the subject may feel uncomfortable with having to hold their breath under the water. Additionally if the tester is not skilled at taking the readings then the results may not be as accurate. Also the equipment is very large and expensive. It is unlikely that hydrostatic weighing would be performed at a routine fitness club. This methodology of body composition testing is usually performed in an exercise physiology laboratory or a university lab.

Skinfold Measurements:

The thickness of the fold of skin is determined with calipers on predetermined locations on the body. A more detailed discussion of skinfold measurements was covered in a previous model here.

• Skinfold sites (males):
• Chest (pectoralis): Midpoint between anterior axillary fold and the nipple
• Triceps: midpoint from olecranen process to the acromion process (tip of scapula)
• Subscapular: 1cm below the lowest angle of the scapula
• Suprailiac: just above the iliac crest
• Abdomen: 3cm to the right and 1cm below the umbilicus
• Thigh: Midpoint of quads

The measurements of these sites are plugged into a regression equation to determine the client’s body fat.

Skinfolds can be done using a 3-site measurement, 7-site, or 9-site (9 different anatmoical positions).  Typically, the more sites measured, the more accurate the estimate of body fat. The  advantages of skinfold measurements include relatively low cost equipment that is portable and the relative error in estimating body fat percentage is low ( relative error of ~3.5-4.0%).  A disadvantage is that it can be highly inaccurate unless performed by a well-trained individual.

Anthropometry:

Measurements of the client’s height, weight, and girths at standard, appropriate anatomical sites are taken (refer to page 17 of the ACSM’s Certification Review Third Edition for the sites) to predict the relative body fatness. The advantages of this method is that the equipment is cheap since it only requires measurement tape and a scale for body weight. However the disadvantages are that this method is not very accurate (relative error of ~3-8%), inaccurate location of the circumference sites will result in a greater margin of error, and this method may not be appropriate for all athletes (e.g. this would be inaccurate for body builders that have large circumference sites due to having a lot of muscle mass).

Body Mass Index:

This method involves a basic height to waist ratio to estimate an individual’s relative body fat percentage. The ratio is the person’s weight in kilograms (kg) divided by their height in meters squared (m^2). BMI has been used for years for large populations and is often used in public health settings. It has been found to correlate with incidence of certain chronic diseases, such as hyperlipidemia. However this method is NOT recommended to be used for athletes because it fails to distinguish between muscle mass and fat free mass. Thus many athletes would have a “high BMI” because of they posses a lot of muscle mass for their relative height. Below is an example of a BMI chart:

Waist-to-Hip Ratio:

The individual’s waist circumference and hip circumference are measured; then, the waist-to-hip ratio is calculated from a equation and compared with available standards (see Table 6.6 on page 111 from the ACSM’s Certification Review Third Edition). This method is not highly recommended either, even though it is convenient, because it might not be appropriate nor accurate for all athletes, like body builders.

Bio-Electrical Impedance Analysis:

This is a quick, noninvasive method for estimating body fat. A low level electrical current (not harmful) is sent through the body.  The current moves easily through electrolyte-containing lean body mass and with difficulty (resistance) through fat.  The level of electrical resistance is directly related to the percentage of body fat.  Advantages of this method include relatively low cost equipment, portable, and limited training. However the disadvantages are that the hydration status of an individual greatly skews the results of this method and it is one of the less accurate methods for estimating body fat (relative error of ~4-7%).

For the ACSM CPT exam it is crucial to learn the skinfold sites. Look over the images and tables in your text.

Exercise Testing

Purpose:

The purpose of exercise testing is to provide  information to current and potential exercisers about the various aspects of health-related fitness. Testing is also used for risk stratification (assessing an individual’s risk for a particular chronic disease or health condition, particularly for heart disease), which will influence the exercise prescription and development of a program based on the individual’s overall health status. Data collected from various fitness tests allows the instructor to develop a safe and effective exercise program for the client.

Order of Exercise Tests:

When a battery of fitness assessments are being conducted in a single session, the following order of tests is recommended:

1. Resting Measurements: Measurements such as heart rate, blood pressure, blood analysis.
2. Body Composition: Some methods of assessing body composition are sensitive to hydration status. Because cardiorespiratory or muscular fitness tests may have an acute effect on hydration, it is appropriate to conduct an individual’s body composition before any of these test measures.
3. Cardiorespiratory Fitness: VO2 Max testing.
4. Muscular Fitness: One rep max test or muscular endurance tests.
5. Flexibility: Stretching activities, such as the sit and reach test, are best conducted after the person has warmed up from the other strenuous activities.

Cardiorespiratory Fitness

Cardiorespiratory Fitness:

An individual’s heart rate, blood pressure, and aerobic capacity/V02 Max can be tested to assess an individual’s overall cardiorespiratory fitness.

V02 Max: Aerobic Capacity is defined as the maximum amount of oxygen that can be utilized during maximal or exhaustive exercise. The terms V02 max, aerobic power, and aerobic capacity are all used interchangeably. Aerobic Capacity is measured in units of milliliters of oxygen per kilogram of body weight per minute (ml/kg.min^-1) because it is relative to an individual’s body weight, and oxygen and energy needs differ relative to size. This measurement is generally considered to be the best indicator of an athlete’s cardiovascular fitness and aerobic endurance. Theoretically, the more oxygen utilized and consumed at a high exercise intensity, the more ATP will be produced; which is the case with many elite endurance athletes. Aerobic capacity is also useful as a stress test to determine how much stress a patient’s heart can tolerate from exercise. There is a linear relationship with exercise intensity and oxygen consumption. The oxygen consumed during exercise will increase with intensity, but after a certain point the oxygen consumed will plateau even with an increasing intensity. This plateau marks the V02 max.

 

V02 Estimation from Submaximal Tests:

There are a variety of methods to estimate an individual’s V02 max. These methods are not as accurate as direct testing, but they are relatively inexpensive and less taxing on an individual’s body compared to the direct test. The direct test requires a relatively high pain tolerance from the individual, since the individual’s metabolism moves from an aerobic to anaerobic state. Individuals that have a heart condition or low fitness levels should not do a direct test since it requires maximal exertion.

The Rockport Walk Test: A pre-measured one mine course or route and a stop watch are required to conduct this test. This testing procedure estimates an individual’s aerobic capacity from his or her heart rate response to walking a measured 1 mile route at a brisk walking pace. Subjects are required to walk a mile as fast as possible, record the time taken to complete the walk, and to immediately measure their heart rates after completing the 1 mile walk. The individual’s age, body weight in pounds, time taken to complete the 1 mile walk and post-exercise heart rate is plugged into a progression equation to estimate his or her V02 max in units of ml/kg.min^-1. The advantages about this procedure are that minimal equipment is required, it is relatively inexpensive, it can be self-administered, and individuals with low levels of fitness may be able to do this procedure. The disadvantages of this procedure are that it may be ineffective for athletes with a high level of fitness or individuals that have a low cardiac output since their heart rate responses would be minimal. An individual could get a false reading with a low cardiac output since his or her rate is low, a high V02 max could result when he or she actually has a low level of fitness.

Cycle Ergometer Test: A cycle egrometer and a stop watch are required to conduct this test. This testing procedure estimates an individual’s aerobic capacity from his or her heart rate response to a graded exercise test protocol. The test requires subjects to cycle on the cycle ergometer at a constant workload by having the subjects initially start at an adjusted resistance and speed of 25 watts (0.5 kp) for 3 minutes. Depending on how much the subject’s heart rate has increased at the end of the initial protocol will depend on how much the workload will increase in the next stage. If the subject’s heart rate increased to 85 beats per minute or less than the subject will cycle at 2.0 kp in the second protocol for 3 minutes, if the subject’s heart rate increased between 86-100 beats per minute than the subject will cycle at 1.5 kp in the second protocol for 3 minutes, and if the subject’s heart rate increased by over a 100 beats per minute than the subject will cycle at 1.0 kp in the second protocol for 3 minutes. Subjects will then increase each protocol by 0.5 kp following the second protocol for two more protocols for 3 minutes each (2). After the fourth protocol is completed subjects measure their heart rate, and based on that heart rate subjects use the Astrand-Nomogram to see where their estimated V02 value correlates in liters per minute (see your textbook for charts). The advantages of this procedure are that it is favorable procedure for cyclists, it is simple to administer, and the ergometer cycle is portable in most testing felicities. The disadvantages of this procedure are similar to the Rockport test that it would underestimate the fitness of an individual with a high maximal heart rate and overstate the fitness of an individual with a low maximal heart rate.

Step Test: This procedure requires a stable step (33cm in height for females and 40 cm in height for males) that is wide enough for subjects to step up and down one foot at a time, a metronome to regulate the pace, and a stop watch. This testing procedure requires subjects to step up and down one foot at a time onto the step for two minutes at the beat of 90 beats per minute; the metronome is used to regulate the pace. The subjects repeat the same procedure but at an increased metronome of 96 beats per minute and then 102 beats per minute. The subjects will have their heart rates measured for 15 seconds between each of the three protocols and the three values are graphed in order to estimate each subject’s maximal heart rate. A best fit line is drawn from the graph to estimate each subject’s maximal heart rate and the step rate based on the subsequent heart rate (2). The step rate obtained from the graph and the height of step is plugged into a progression equation to estimate each subject’s V02 max. The advantages of this procedure are that it is simple to administer, the test is quick, and individuals with low fitness levels may be able to participate in this procedure. The disadvantages are that the reliability and validity of this test are similar to the other submaximal estimations in that the fitness of an individual with a low maximal heart rate would be overestimated, while the fitness of an individual with a high maximal heart rate would be underestimated. Also the standardized height measurement for the steps do not account for differences in individual heights which may be give shorter individuals a slight disadvantage for stepping up and down the step.

Direct Test: The direct testing for V02 max requires a controlled, strict and rigorous protocol in an exercise physiology lab or sports medicine clinic. The equipment required for the test includes oxygen and carbon dioxide analyzers, an ergometer (usually a treadmill or bicycle) on which workload can be modified, a Douglas bag that the subject wears in order to measure the amount of air being expired per minute, a stopwatch to adjust the workload during each stage of testing, an electrocardiogram (ECG) to monitor the subject’s heart rate, and trained health professionals to take blood pressure and blood lactate readings during the test (at the end of each stage). For the purpose of this blog, the treadmill protocol will be discussed. The subject places the Douglas bag over his or her face and the mouthpiece into his or her mouth, it is important that the device fits the subject properly in order to effective measure expired air. The subject is instructed to run at a moderate and comfortable pace on the treadmill and every 3 minutes the incline on the treadmill is increased by 2.5%. The increase in the incline will gradually progress in order to transition the subject from a moderate intensity to maximal exertion; this allows the researcher to examine the increase in oxygen consumption and determine when the subject has reached his or her V02 max. The subject’s heart rate is monitored through the ECG readings and his or her blood lactate and blood pressure is taken at the end of each change during the actual test. The subject is considered to reach his or her V02 max when the amount of oxygen consumed has reached a plateau and no longer increases with an increasing workload, maximal heart rate was reached, the subject’s respiratory exchange ratio has reached 1.00 and above (this indicates anaerobic metabolism), or the subject has reached volitional exhaustion. The advantages of the direct test are an exact measurement of a subject’s V02 max, maximal heart rate can be measured, and the test is standardized so values for subjects’ can be compared in any clinical felicity. The disadvantages of the direct testing are the test is time consuming, expensive, and extremely taxing on the subject’s body (patients with health conditions or a low level of fitness may be unable to do the direct test).

Here are the normative values of VO2 Max values:

Maximal oxygen uptake norms for men (ml/kg/min)

	Age (years)
rating	18-25	26-35	36-45	46-55	56-65	65+
excellent	> 60	> 56	> 51	> 45	> 41	> 37
good	52-60	49-56	43-51	39-45	36-41	33-37
above average	47-51	43-48	39-42	35-38	32-35	29-32
average	42-46	40-42	35-38	32-35	30-31	26-28
below average	37-41	35-39	31-34	29-31	26-29	22-25
poor	30-36	30-34	26-30	25-28	22-25	20-21
very poor	< 30	< 30	< 26	< 25	< 22	< 20

Maximal oxygen uptake norms for women (ml/kg/min)

	Age (years)
rating	18-25	26-35	36-45	46-55	56-65	65+
excellent	> 56	> 52	> 45	> 40	> 37	> 32
good	47-56	45-52	38-45	34-40	32-37	28-32
above average	42-46	39-44	34-37	31-33	28-31	25-27
average	38-41	35-38	31-33	28-30	25-27	22-24
below average	33-37	31-34	27-30	25-27	22-24	19-22
poor	28-32	26-30	22-26	20-24	18-21	17-18
very poor	< 28	< 26	< 22	< 20	< 18	< 17

Exercise Guidelines for Special Populations

 

These guidelines are based on the ACSM’s Guidelines for Exercise Testing and Prescription Eighth Edition. Note this does not cover the scope of the text, as it only includes the FITT principles, but not specific conditions or chronic diseases. Consult the text book for more details.

 

Children and Adolescents:

 

• Frequency: At least 3-4 days a week.
• Intensity: Moderate (activity that noticeably increases breathing, sweating, and heart rate) to vigorous intensity (activity that substantially increases breathing, sweating, and heart rate).
• Time: 30 – 60 minutes a day.
• Type: A variety of activities that are enjoyable and developmentally appropriate; these may include walking, active play/games, dance, team sports, and muscle and bone strengthening.

 

Pregnancy:

 

 

 

• Frequency: At least 3 days a week, preferably all days of the week.
• Intensity: Moderate intensity (40-60% of VO2 Reserve). Because of heart rate variability during pregnancy, use of a perceived exertion scale or the “talk test” (being able to maintain conversation during activity) may be more appropriate to monitor exercise intensity.
• Time: At least 15 minutes a day, gradually increasing to at least 30 minutes a day to total an accumulation of a 150 minutes per week.
• Type: Dynamic, rhythmic physical activities that use large muscle groups, such as walking or cycling.

 

Older Adults:

 

 

 

Aerobic Activity:

 

• Frequency: At least 5 days a week of moderate intensity activities or 3 days a week of vigorous intensity activities. Or a combination of both moderate and vigorous intensity activities 3-5 days a week.
• Intensity: Use a perceived exertion scale of 0 – 10, where 5 – 6 is moderate activity and 7 -8 is vigorous activity.
• Time: At least 30 minutes for moderate activity, up to 60 minutes for greater fitness benefits. For vigorous intensity activities, 20-30 minute sessions. Total accumulation of weekly activity should be between 75 – 100 minutes of activity per week.
• Type: Any modality that does not impose excessive orthopedic stress, such as walking, swimming, or stationary biking activities. Individuals my engage in weight bearing activities like running if they have the tolerance for weight-bearing activities.

 

Muscle-Strengthening Activity:

 

• Frequency: At least 2 days a week.
• Intensity: Use a perceived exertion scale of 0 – 10, where 5 – 6 is moderate activity and 7 -8 is vigorous activity.
• Type: Progressive weight training program or weight bearing calisthenics (8-10 exercises involving all major muscle groups or 10-15 repetitions each ), stair climbing, or other strengthening activities that involve all major muscle groups.

 

Flexibility Activity:

 

• Frequency: At least 2 days a week.
• Intensity: Use a perceived exertion scale of 0 – 10, where 5 – 6 is moderate activity and 7 -8 is vigorous activity.
• Type: Any activities that maintain or increase flexibility using sustained stretches for each muscle group and static, rather than ballistic movements.

 

Balance Exercises:

 

There are no specific recommendations for exercises that incorporate balance, but general recommendations include: a frequency of 2-3 days per week and activities that involve progressively difficult postures that reduce the base of support (e.g. two-legged stand, semi tandem stand, tandem stand, one-legged stand) or tai chai.

 

 

 

 

 

 

 

 

Sample Endurance Running Nutrition Guidelines

Nutrient	Recommended Amount
Carbohydrates	8 – 10g per kg of body weight daily.   Before Exercise: 1g per kg of body weight 1 hour before exercise, 2g per kg of body weight 2 hours before exercise, 3g per kg of body weight 3 hours before exercise, and 4 – 4.5 g per kg of body weight 4 hours to exercise.   During Exercise: 15-20g every 15 minutes if running is one hour or more.   After Exercise: 1-1.5g per kg of body weight immediately after exercise and again 2 hours later for about 4-6 hours.
Protein	1.2 – 1.4g per kg of body weight daily.   Slightly >1.4g per kg of body weight for ultra-endurance runners.
Fat	20 – 35% of total calories daily.
Vitamins and Minerals	Not necessary unless there is a clinical deficiency (runners can get daily vitamins and minerals from a well-balanced diet that helps them maintain their body weight).   Iron deficiency and calcium deficiency could be a problem for some endurance runners, particularly female athletes and runners that consume a vegetarian diet.   If an individual has an iron deficiency is he or she should aim for iron values greater than the RDA values (>18 mg a day for men and >8 mg a day for women).   Current recommendations for athletes with disordered eating, amenorrhea, and risk for early osteoporosis are 1500 mg of elemental calcium and 400-800 IU of vitamin D per day.
Fluid/Hydration	DRI Values: 2.7 liters a day for women and 3.7 liters a day for men.   Before Exercise: 5 -7 ml of fluids per kg of body weight 4 hours before exercise to allow enough time to optimize hydration status and for excretion of any excess fluid as urine.   During Exercise: 6-12 ounces (177.44 – 354.88 ml) every 15 minutes. Athlete should assess tolerance and adjust amount that will not cause GI stress.   After Exercise: At least 600 ml after exercise or 450-675 mL of fluid for every pound (0.5 kg) of body weight lost during exercise.   If running is greater than one hour then athletes should consume sports beverages that contain electrolytes and 6-8% carbohydrates per serving.   If the running is less than an hour than consuming water should be fine. However environmental conditions, such as heat and humidity, may warrant the need of a carbohydrate beverage.
Dietary Supplements	Ergogenic aids, or supplements marketed to enhance athletic performance, for the most part have proven to offer minimal benefits to athletes. The ACSM recommends that athletes should be counseled regarding the appropriate use of ergogenic aids.   Some ergogenic aids that may of interest to an endurance runner are caffeine and sports drinks, gels and energy bars.   Caffeine acts as a central nervous stimulant, which has been shown to improve an endurance runner’s time to exhaustion and recovery.   Sports drinks, gels, and energy bars may be convenient options for runners that need to meet their daily nutritional needs for macronutrients, particularly carbohydrates, during a race or event and during times of travel when food options are limited

Sample Food Sources

The following information was taken from the U.S. Department of Agriculture’s website at: http://www.usda.gov/wps/portal/usda/usdahome

The purpose of these tables is to given an idea of food sources for a particular macro-nutrient.

Carbohydrates:

Protein:

Fats: