Copyright 1997-2005 American Society of Exercise Physiologists. All Rights Reserved.


June 5, 2005
Vol. 9 No. 6.
 Editor: Dr. Lonnie Lowery

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June BOD Editorial
"There is a Need and the Need is Great!"
Criffield, A.
Comparison of Body Composition Measures to Dual X-ray Absorptiometry (First on page)
Bowden R., et al. 
The New Marketing of ASEP"
(MS Word doc)
Pittsley, J.


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with Dr. Don Diboll

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"There is a need and the need is great!"
Aliisa Criffield, MA, EPC, ATC

I was glad to see in PEPonline the article entitled Entrepreneuring as an Exercise Physiologist by Steve Daugherty. I thought it gave some good ideas to get a person thinking about starting your own business. One thing that stuck out to me was the list of jobs that an exercise physiologist might do.

The ASEP leadership [2] states that, exercise physiologists work in health promotion, fitness development, colleges and universities, clinical rehabilitation, and sport and athletic programs. The website also lists some of the specific positions that are filled by exercise physiologists:
sports and wellness program instructors and directors
strength coaches for college, university and professional sports programs
teachers at institutions of higher learning (i.e., if they have a PhD)
researchers in sports medicine and adult fitness programs
managers and exercise leaders in corporate wellness programs
instructors in health and fitness clubs
supervisors of specialized health, fitness, wellness, or lifestyle programs in correctional services, police, fire, and emergency response organizations
fitness instructors in YMCAs, spa and resort centers
exercise specialists in cardiopulmonary rehabilitation programs
fitness directors and managers in the military (such as the air force and army)
exercise technologists in cardiology suites
exercise program designers for special need children
fitness instructors and supervisors at the state, regional, and national levels in sports and athletic programs including
sports management
sports psychology
sports biomechanics
nutritional consultation

Nowhere on that list did it mention working as an exercise physiologist. The question that I would pose is, What about working as an exercise physiologist? What might that specifically look like? I know there are professionals out there with their actual job title being exercise physiologist. I am one of them.

I think about the dietitian profession. Everyone knows exactly what a dietitian would do. Dietitians counsel individuals on nutrition. They may also teach and do other things, but that is what you primarily think of.

I work along side a dietitian in my department. I saw referral after referral from doctors for her to see patients with diabetes. It got me thinking that all those patients she is seeing should be seeing me, also, to get started on an exercise program. Not only is nutrition important for diabetes, but exercise is equally important in managing the disease.
Then I got to thinking about all the other diseases/health conditions out there that exercise has been shown to have a positive effect on: osteopenia /osteoporosis, cancer, high blood pressure, high cholesterol, obesity, fibromyalgia, multiple sclerosis, etc There could be a huge market here for my services. I know some, if not most, physicians are telling people they need to exercise but they do not have the time or know how to show the specifics of what that means.

So my question is, Why not have a practice set up like a dietitian where one would receive referrals from doctors to work with patients who are in need of an exercise program that will positively affect their disease or health condition? Theoretically there should not be a shortage of referrals because of the numerous conditions that exercise benefits. The roadblock comes with reimbursement. Because exercise physiologists are not licensed we dont stand a chance of getting reimbursement. That is one of the first things physicians askis this service covered by insurance? It is not that they dont support my initiative. It is just that many people are not willing or cant afford to pay out of pocket for their health.

We have a hugely untapped resource in a large area of need. Many people need to learn how to exercise to benefit their health. Just think about the people you know that have diabetes. Are they exercising? Most likely they know they should exercise but do they know how to exercise to most affectively benefit their specific disease and what things to watch out for? If you open your eyes you will see the need and the need is great. But our hands are significantly tied without reimbursement to tap into this need.

Ask the Professor: Your Inside Scoop on Tough Questions

with Dr. Don Diboll 
Note: Ask the Professor is intended for informational purposes only. It is not to be taken as healthcare advice. Please do not submit questions of a personal nature (e.g. fitness programs, nutrition advice solicitation, etc.) Thanks.

Q.)  I have been trying to figure out if there is a real difference between my heart rate and whether I am loosing weight or burning fat and loosing weight. I understand "calories in - calories out", but can the exertion level actually determine what my body uses for fuel?


A.) Dear George,

The exertion level (exercise intensity), which heart rate is a good indicator of, can influence whether you are using a greater percentage of fat or carbohydrate to fuel your exercise. In general, the higher the exercise intensity, the more carbohydrate compared to fat used for fuel. Lower exercise intensities tend to use a greater percentage of fat compared to carbohydrate. At best, we use approximately 70% fat to fuel our metabolism, but that is during the resting state. For these reasons, some individuals incorrectly advocate low-intensity aerobic exercise to burn more fat, even if a person is capable of maintaining a higher-intensity exercise for a reasonable period of time (e.g., 20 30 minutes).

The question to ask is how many total calories of fat are being used during exercise, not the percentage of fat calories. The reason is simple. Although a greater percentage of fat calories is used during each minute of low-intensity exercise, the total number of calories used is small; therefore the total number of fat calories used is also small. However, for exercise that is moderate or higher in intensity, the total number of calories used each minute is greater. Even with a lower percentage of fat being used, since the total number of calories is greater, then the total number of fat calories used each minute is potentially greater. Additionally, as a person improves cardiovascular (i.e., aerobic) fitness, they can exercise at a higher intensity for a longer period of time, thus expending even more total calories and fat calories. So as people improve their fitness, their bodies become better at using fat for fuel.


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Copyright ©1997-2005 American Society of Exercise Physiologists. All Rights Reserved.  All materials posted on this site are subject to copyrights owned by the American Society of Exercise Physiologists (ASEP). Any reproduction, retransmission, or republication (in whole or in part) of any document or information found on this site is expressly prohibited, unless otherwise agreed to by ASEP and expressly granted in writing to consent to reproduce, retransmit, or republish the material. All other rights reserved. 



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