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Thompson, Walter R. Ph.D., FACSM, FAACVPR

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ACSM's Health & Fitness Journal 12(6):p 7-14, November 2008. | DOI: 10.1249/01.FIT.0000312432.13689.a4
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A trend has been described as "a general development or change in a situation or in the way that people are behaving" ( It would not be unusual, then, to see the same trends appearing for multiple years in a trends survey. After all, the definition of trend includes the phrase "general development" as opposed to "a fashion that is taken up with great enthusiasm for a brief period" which is the definition of a fad ( For 3 years, the editors of ACSM's Health & Fitness Journal® have developed a survey to determine trends in the fitness industry that might help to guide health and fitness programming efforts for the New Year. The first survey (1) conducted in 2006 was the initial effort to develop a systematic way to predict the future in the health and fitness industry for 2007. A second survey (2) followed for the year 2008.

This third survey of trends in the commercial, clinical, community, and corporate health and fitness industries confirmed several of the trends revealed in previous surveys. Several of the trends first identified for 2007 have moved into the top 10, and some new trends appear to be emerging for 2009. Future surveys will either confirm these new trends, or they will fall short of making an impact on the health and fitness industry.

This annual survey of trends is sometimes confused with estimating the impact of certain pieces of equipment or some new exercise device on the bottom line in for-profit clubs. These survey results do not evaluate equipment, gear, tools, apparatus, or other paraphernalia that may appear at clubs or during late-night infomercials. The survey was designed to confirm or to introduce trends (not fads) that have been sustained by having a proven impact on the industry. Readers of this survey can take this information and apply it to their own settings that include commercial health clubs (for-profit), community settings (not-for-profit), corporate wellness programs, and medical fitness centers (clinical programs). The benefit to commercial settings is the establishment (or justification) of new markets, resulting in increased and sustainable revenue. Community programs can use the results to continue to justify an investment in their unique market by providing sustainable programs serving families and youth. Corporate programs and medical fitness centers will find these results useful in providing increased service to their members and patients.

There were 35 possible trends in the 2009 survey. The top 25 trends from the previous year were included in the survey as were some emerging trends identified for the past 2 years by the editors of ACSM's Health & Fitness Journal®. The editors represent all four sectors of the health and fitness industry (corporate, clinical, community, and commercial) as well as members of academia. Once the potential trends were identified, short explanations were developed to offer the respondent some details without burdening them with too much reading. The survey was designed to be completed in less than 15 minutes. As an incentive to complete the survey, the editors made available a 1-year subscription to ACSM's Health & Fitness Journal® and several ACSM books published by Wolters Kluwer/Lippincott Williams & Wilkins.

As was the case for past ACSM fitness trends surveys, the 35 items were constructed using a Likert-type scale ranging from a low score of 1 to a high score of 10 (i.e., least likely to be a trend to most likely to be a trend). In addition, space was created for the respondent to add any comments. At the end of the survey, additional space was left for the respondent to add any fitness trends left off the list to be considered for future surveys. The next step was to send the survey electronically to a select list of fitness professionals. Using "Survey Monkey" (, the online survey was sent to 9,801 ACSM certified professionals. This list included all currently certified ACSM Certified Personal TrainersSM, ACSM Health/Fitness Instructors® (presently known as ACSM Health Fitness Specialists), ACSM Exercise Specialists® (now ACSM Clinical Exercise Specialists), ACSM Health/Fitness Directors®, and ACSM Program DirectorsSM. Of these, 1,800 were returned for bad e-mail addresses, leaving 8,001 possible participants. After the 2-week window of opportunity had been completed, 1,540 responses were received, an outstanding 19.2% return rate. Responses were received from just about every continent including Asia, Europe, Australia, Africa, North America, and South America.

The first step in the analysis was to collate the responses and then rank-order them from highest to lowest. Only the top 20 are reported here. After rank-ordering them, we asked internationally recognized experts in the health and fitness field representing all sectors to comment on the findings. Their analysis and comments are included at the conclusion of this report. Table 1 provides the results of the two previous surveys (1,2). Although there were some similarities, several of the top 10 trends identified for 2008 did not appear in the top 10 in 2007. However, the 2009 survey (Table 2) reinforced those findings of 2008 as 7 of the top 10 not only appeared on the list but also held the exact same positions. Educated and experienced fitness professionals again topped the list.

Top 20 Worldwide Fitness Trends for 2007 and 2008
Top 20 Worldwide Fitness Trends for 2009

1. Educated and Experienced Fitness Professionals

This is a trend that continues from 2008-to have more educational programs and certification programs that are fully accredited for health/fitness and clinical professionals. More educational programs will become accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), and more certification programs will become accredited by the National Commission for Certifying Agencies (NCCA).

It has become increasingly clear that as the market for fitness professionals becomes even more crowded, some degree of regulation seems to be in order. Commission on Accreditation of Allied Health Education Programs and NCCA are both third-party accrediting agencies-CAAHEP for academic programs and NCCA for certification programs. Because of their independence, neither organization is influenced by the health and fitness industry. In 2007, CAAHEP added a Personal Fitness Trainer accreditation for certificate and associate degree programs. Accreditation for the Personal Fitness Trainer joins academic program accreditation for Exercise Science (baccalaureate) and Exercise Physiology (graduate programs in either applied exercise physiology or clinical exercise physiology). A brand new collaboration has started within the fitness industry to address the issue of standardized practices. Coordinated by NSF International (, this soon-to-be-announced collaboration (known as the NSF Joint Committee on Health Fitness Facilities Standards) will bring various sectors of the industry together to determine facility standards.

2. Children and Obesity

This is a trend toward more programs to attack the ever-growing problem of childhood obesity.


For the third year, childhood obesity programming is on the top of the fitness trends list. It should be no surprise that health/fitness practitioners see the problem of childhood obesity and its comorbidities as an opportunity to make a significant impact on a growing health problem that not only is making an impact in the health care industry today but also will have an even greater impact on the health of adults in the future. For the first time in history, the next generation of young people may not live as long as their parents or grandparents. The health and fitness industry has recognized this problem. All sectors of the health and fitness industry can benefit (as will their clients or patients) by developing health and fitness programs for children at risk for being overweight or obese.

3. Personal Training

This trend continues as the profession of personal training becomes more of a reality and becomes accessible to more people in all aspects of the health/fitness industry.

Personal training climbed to No. 3 from No. 7 between 2007 and 2008 and remains at No. 3 for 2009. In recent years, much attention has been paid to the education and certification of personal trainers. In at least two states (Massachusetts and Georgia), legislation has been introduced to license personal trainers. Although there may be some minor variations of personal training (e.g., small groups), respondents to this survey believe that personal trainers are here to stay and will continue to be an important part of the professional staff of health and fitness centers.

4. Strength Training

This is a trend for both men and women to incorporate strength training into their exercise routines. The health benefits of strength training will be emphasized even more than previously.

Strength training rose from No. 6 on the list in 2007 to greater prominence as No. 4 in 2008 and remains at that spot for 2009. It has again been demonstrated that the central theme of many health clubs remains strength training. There are still those clients who train exclusively using weights, and there are still those who lift weights for body building and what has been commonly referred to as body sculpting. However, today, there are many others (both men and women) whose main focus is on using weight training to simply increase or maintain strength as they get older. Most health and fitness professionals today will incorporate some form of strength training into the exercise routine of both clients and patients. It is common for cardiac rehabilitation, pulmonary rehabilitation, or metabolic disease management programs to include some form of weight training in the exercise prescription.

5. Core Training

This is a trend that emphasizes strength and conditioning of the stabilizing muscles of the abdomen and back. Core training continues to use stability balls, BOSU balls, wobble boards, and foam rollers.


Once considered a fad by many, core training seems to have stood the test of time. Core training typically includes the muscles of the pelvis, lower back, hips, and abdomen-all of which provide much needed support for the spine. Exercising the core muscles may enable the client or patient to improve overall stability of the spine and transfer that to the arms and legs, thus enabling the individual to meet the demands of activities of daily living and for the performance of various sports.

6. Special Fitness Programs for Older Adults

This is a trend that emphasizes and caters to the older adult. As the baby boom generation becomes grayer, and because they may have more discretionary money than their younger counterparts, fitness clubs will capitalize on this growing market.

Falling from No. 2 in 2007 to No. 6 in 2008, fitness programs for the older adult remain a strong trend for 2009. Falling to No. 6 between 2007 and 2008 was a bit of a surprise, considering all the talk about the baby boom generation now rapidly approaching retirement age. Keep in mind, however, that this trend continues to be strong, making the top 10 three years in a row. Retired people typically have greater discretionary money and tend to spend it wisely. Health and fitness professionals can take advantage of the growing population of retired individuals by providing age-appropriate exercise programs. The frail elderly can improve their ability to perform activities of daily living. The more active older adult can enjoy golf and an inspirational game of pickle ball. The highly active older adult (the athletic old) can be targeted by commercial and community organizations to participate in more rigorous exercise programs.

7. Pilates

Pilates is a form of exercise that targets the core of the body (i.e., the abdomen, back, and hips) while using the entire body. It also increases flexibility and improves posture. The exercises are typically done lying on a mat and involve a series of controlled movements of the arm and leg that strengthen the abdominal muscles, hips, and back. Pilates also can be done on special Pilates equipment. Pilates done on a mat is more popular because the similar results can be achieved by just working out on a mat instead of investing in equipment, which can be quite expensive.

8. Stability Ball

Stability balls can vary in diameter from 55 to 85 cm (22 to 34 inches), allowing for a wide range of activities to be performed. The stability ball also is known by other names, including exercise ball, gym ball, Pilates ball, Swiss ball, sports ball, fit or fitness ball, therapy ball, yoga ball, balance ball, or body ball.

A surprise in the top 10 continues to be the stability ball. This type of exercise did not make the top 20 in 2007. In its first introduction into the health and fitness market, most professionals believed that this was a fad, and with most fads, it would disappear. Interestingly, the original stability ball has morphed into a number of new and exciting directions for children, young adults, and even older adults. It teaches stability, balance, and strength. For the much more advanced, a person can stand on the ball while doing strength-training exercise-not something the average person should even attempt!

9. Sport-Specific Training

This is a trend that incorporates sport-specific training especially for young athletes. For example, a high school athlete might join a commercial- or community-based fitness organization to help develop skills during the off-season and to increase strength and endurance.

Sport-specific training has made the top 10 for the first time in this survey. It jumped from No. 13 in the 2008 survey after falling from No. 11 in 2007. It has always been a contender in the survey for a top 10 spot, but this is the first time it has gained so much traction. This is an interesting trend for the health/fitness industry to watch over the next few years. The combination of possibly attracting a new market to commercial clubs and offering a different kind of service could lead to increased revenues.


10. Balance Training

Activities that promote balance include tai chi, yoga, and Pilates as well as exercise balls, wobble boards, BOSU balls, and foam rollers. People work out in this unstable environment predictably increasing balance and stability.

Two years ago, balance training was not even in the top 20 in the trends survey. It first emerged at No. 14 in last year's survey and now appears at No. 10. There may be several reasons for balance training gaining in popularity including the recognition that this kind of exercise program is important for the elderly, as well as for sport-specific training of younger people engaged in competitive athletics. Clearly, balance training is an activity worthy of special attention in the health club industry.


11. Functional Fitness

This is a trend toward using strength training to improve balance, coordination, strength, and endurance to improve one's ability to do activities of daily living. Exercise programs reflect actual activities someone might do during the day.

12. Comprehensive Health Promotion Programming at the Worksite

This is a trend toward a range of programs and services provided to improve the health of workers integrated with systems to support the evaluation and reporting of their impact on health, costs, and productivity.

13. Wellness Coaching

This is a trend to incorporate behavioral science into health promotion programs. Wellness coaching uses a one-on-one approach, with the coach providing support, guidance, and encouragement. The wellness coach focuses on the client's values, needs, vision, and goals.

14. Worker Incentive Programs

This is a trend toward creating incentive programs to stimulate health behavior change as part of employer-based health promotion programming and health care benefit design.

15. Outcome Measurements

This is a trend toward accountability. After many years of just talking about outcomes, there will be efforts to define and track outcomes. Measurements are necessary to determine the benefits of health and fitness programs in disease management and to document success in changing negative lifestyle habits. The proliferation of technology will aid in data collection to support these efforts.

16. Spinning (Indoor Cycling)

As an instructor describes the terrain, this group fitness program has been described as pedaling outdoors without changes in temperature, humidity, or other environmental changes. The pedal tension on the stationary bike is like riding uphill or through valleys. Often, upbeat background music helps to motivate people through this relatively high intensity workout.

17. Physician Referrals to Fitness Professionals

This is a trend toward a growing emphasis being placed on partnerships with the medical community, resulting in seamless referrals to the health and fitness facility.

18. Exercise and Weight Loss

This is a trend toward incorporating a sensible exercise program in all weight loss programs. Most sensationalized diet programs incorporate some kind of exercise program into their daily routine. However, in 2009, the coupling of a diet (or diet pill) and exercise will become more important.

19. Group Personal Training

This trend expands the personal trainer's role from strictly one-on-one training to small group training. The personal trainer works with two or more people (but in a small group) and offers discounts for the group.

20. Reaching New Markets

This is a trend that identifies new markets in all aspects of the health/fitness industry. With an estimated 80% of Americans not having a regular exercise program or a place to exercise, commercial, clinical, corporate, and community programs will reach out to tap this huge market.


Unlike in previous years, there was a clear separation between the fitness trends appearing in the top 10. In last year's survey, the top three trends were only separated by 0.02 points when averaged. In this year's survey, at least 0.10 separated each of the trends. In fact, a whole point separated trend No. 1 from trend No. 10. A notable absence from this year's top 20 was yoga (No. 10 in 2007). Yoga fell to No. 21 in 2009. Two very important trends to watch in the future are wellness coaching (moving from No. 20 last year to No. 13 this year) and physician referrals, appearing this year at No. 17. It would appear as though ACSM's Exercise is MedicineTM program has taken a foothold in the health fitness industry.


Franz X. Schweiger, M.Sc., chairman of the German Association of Exercise and Movement Therapy (DVGS), Germany. "Due to the systematic approach of the survey ACSM is able to predict the development and consequently the future of the international health and fitness market quite precisely. Because the responses were received from professionals of many countries these trends truly reveal a worldwide point of view. Since 7 of the top 10 from 2008 reappeared on the list of the 2009 survey, reinforcing the findings of 2008, the third survey of fitness trends confirmed several of the trends revealed in previous surveys. Hence, there seems to be a reliable tendency in ACSM's trend predictions.


Most encouraging from my perspective as chairmen of the German Association of Exercise and Movement Therapy is the ranking of the item 'educated and experienced fitness professionals' as No. 1 in 2008 and 2009. It reinforces the perception that as the market for health and fitness professionals grows the necessity for regulation and credentials increases proportionally. Accordingly, there will be a rising call for higher professional standards in the field of exercise, health, and fitness. It was very heartening to see the items 'comprehensive health promotion programming at the worksite,' and 'worker incentive programs,' rise in the rankings from No. 17 to 12 and No. 19 to 14, respectively, reflecting the international need for innovative evidence based programs, which should be practically implemented into the future health/fitness and health promotion market. I am also positively surprised that the item 'balance training' made it into the top ten-two years ago it was not even in the top 20. This confirms the German initiative 'fall prevention training for older adults' to reduce the falls of elderly people in order to increase the quality of life in the elderly population and at the same time to decrease the economical burden of the German health care system. The need and consequently the opportunity for health and fitness programs has never been so vast-therefore Carpe Diem."

Joy Prouty, Fitness Programming, Inc. "Just how strong is the connection between the 2009 ACSM worldwide survey and our slogan 'Bridging the Gap Between Science and Practice®'? Very strong! Even a brief look at survey highlights show this as well as the ACSM initiative-Exercise is MedicineTM, to be true.


While it comes as no surprise, the call for education and accountability is a clear message to all health and fitness professionals. Formal education and specific training programs aimed at teaching professionals how to apply information are keys to longevity and success.

Still spotlighted in 2009 trends are education, certification, and experience, as well as meeting the special needs of youth and an aging population. Physician referrals, wellness coaching, and accountability make an important showing, too.

The continued focus on broad-based programs, such as personal training, strength, and balance, and specific programs, such as Pilates, stability ball, spinning, and sport-specific workouts, sends a clear message. Tried-and-true programs based on research and application will remain in the top trends, retaining their importance as long as fitness professionals have the focus, interest, and skills, to make them inviting to the general population as well as fit individuals.

The broad range represented in these trends-childhood obesity to older adults-also provides tremendous job opportunities for health and fitness professionals. After assessing their own strengths and interests, they can find their niche. Professionals who work to create and deliver well-designed programs and classes specific to each group can expect to sow enjoyment and reap success!

The directive to bring health and fitness to the masses worldwide is overwhelming. Yet we can take it a step at a time, bringing together health care providers, government agencies, and fitness professionals to work as a team. Identifying trends in exercise is a significant step that offers us valuable information. Often, it serves as a wake up call that tells us whether we are on the right track, providing the best vehicles to meet the needs of those we are trying to reach."

Madeline Paternstro-Bayles, Ph.D., FACSM, Indiana University of Pennsylvania. "Results of this survey reinforce the trends in employment for students graduating from undergraduate exercise science programs. In addition, the results provide justification for the credentialing of health and fitness professionals (ACSM certification), academic programs (COAES) as well as facilities (NSF). Clearly, while many undergraduate students seeking employment can easily find positions as personal trainers, it is vital to not only discuss but provide documentation for other broader opportunities in the health and fitness industry. Physical activity programs for obese children and teens, group exercise leaders, sport specific trainers and specialty exercise leaders in Pilates and core training programs are ranked high in the survey and can be confirmed by academics as expanding areas for employment for exercise science students. Documentation of these trends, particularly those that are persistent from year to year also can serve to guide the coursework used in the academic preparation of exercise science students. The rankings from fitness professionals appear to represent trends domestically as well as internationally and mirror many global public health concerns. The results of this survey are an excellent informational resource for students and their instructors."


Richard Cotton, M.A., national director of Certification, American College of Sports Medicine. "These are exciting times for our industry and this survey provides support to my experience. First and foremost the number one trend toward educated and experienced fitness professionals is impressive. Even though the majority of the respondents are ACSM-certified fitness professionals, it is still quite impressive that this group so highly values education and experience. It certainly bodes well for the continued professionalization of our profession.


I am quite impressed with the consistency of the trend list from last year to this year. This provides support to the quality of the research and also provides further evidence of the maturation of the industry. With 19 of the top 20 consistent from 2008 to 2009 we can see that our industry is settling into providing value for both public health and sports performance.

It also is encouraging to see that wellness coaching has progressed from number 20 in 2008 to 13 on the 2009 list. This also is evidence of the deepening values of fitness professionals and our field as a whole. We can provide incredibly specific and effective programs to any number of populations, but it begs the question, if our customers cannot ultimately exercise independently how much value are we truly providing?

Additionally I am impressed that outcome measurements continue into 2009. Once again it is an indication of value. The bottom line in both health care and corporate health promotion is outcomes. Without measurable outcomes we certainly cannot prove our value proposition.

Sticking with the value theme, 'physician referral to fitness professionals' has appeared on our trends list for the first time. ACSM is leading the way with our Exercise is MedicineTM initiative by encouraging physicians to consider patient physical activity frequency as a vital sign. A primary goal of this initiative is to connect physicians with fitness professionals to ultimately enhance the health and quality of life of their patients. This is the first year for this initiative, with physician referrals making it on our trend list it appears that we are well on our way to making a difference in this area.

It is very encouraging to be part of both an organization and maturing field that provides such value to the public good. I would especially like to offer acknowledgment to Walter R. Thompson, Ph.D., FACSM, FAACVPR, and the ACSM volunteers and staff who conducted and published this research."


The author thanks Editor-in-Chief Ed Howley, Ph.D., FACSM, for considering this project important enough to include in the year-end edition of ACSM's Health & Fitness Journal®. The author also thanks the ACSM's Health & Fitness Journal® editorial team, especially Paul Couzelis, Ph.D.; John Jakicic, Ph.D., FACSM; Nico Pronk, Ph.D., FACSM; Mike Spezzano, M.S.; Neal Pire, M.A., FACSM; Jim Peterson, Ph.D., FACSM; Melinda Manore, Ph.D., R.D., FACSM; Cary Wing, Ed.D.; Reed Humphrey, Ph.D., P.T., FACSM; and Steve Tharrett, M.S., for their very important input into the construction of the original and subsequent surveys. Finally, the author also thanks the ACSM staff that supported this study by assisting in the construction, formatting, and delivery of the survey to thousands of fitness professionals around the world. In particular, the author recognizes the important contributions of D.Mark Robertson, Lori Tish, Richard Cotton, Hope Wood, and Beth Muhlenkamp.


The 2009 worldwide survey of fitness trends helps the health and fitness industry make critical programming decisions. The results are applicable to commercial, clinical, corporate, and community fitness programs. Although no one has been able to accurately predict the future, this survey helps to track trends in the field that will help program directors and personal trainers make important business decisions.



1. Thompson, W.R. Worldwide survey reveals fitness trends for 2007. ACSM's Health & Fitness Journal® 10(6):8-14, 2006.
2. Thompson, W.R. Worldwide survey reveals fitness trends for 2008. ACSM's Health & Fitness Journal® 11(6):7-13, 2007.

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