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WORLDWIDE SURVEY REVEALS FITNESS TRENDS FOR 2010

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

doi: 10.1249/FIT.0b013e3181bcd89b
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LEARNING OBJECTIVES From this article, the reader should understand the following concepts:

• The difference between a fad and a trend

• Worldwide trends in the commercial, corporate, clinical, and community health and fitness industry

Expert opinions about identified fitness trends for 2010

Learn what leading experts are predicting to be the top health and fitness trends of 2010! The results were based on an international survey and the article includes commentary from fitness experts. You won't want to miss this valuable insight.

Walter R. Thompson, Ph.D., FACSM, FAACVPR, is a regents professor of exercise science in the Department of Kinesiology and Health (College of Education) at Georgia State University, where he has a second academic appointment in the Division of Nutrition (School of Health Professions, College of Health and Human Sciences). He has lectured on health promotion and fitness topics in 22 countries on five continents. He has recently served on the ACSM Board of Trustees and was twice elected a member of its Administrative Council. He is a past chairman of the ACSM Committee on Certification and Registry Boards, past chairman of the CAAHEP Committee on Accreditation for the Exercise Sciences, and he is currently serving as the chairman of the ACSM American Fitness Index™ Advisory Board and chairman of the NSF International Joint Committee on Health Fitness Facilities Standards.

Respondents to and readers of this survey must make the important distinction between a fad and a trend. A trend has been described as "a general development or change in a situation or in the way that people are behaving" (http://dictionary.cambridge.org). It would totally be expected, then, to see the same trends appearing for multiple years in a trends survey. The definition of trend, after all, 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 (http://dictionary.reference.com). For the past 4 years, the editors of ACSM's Health & Fitness Journal® have developed and widely disseminated an electronic survey to determine trends in the health and fitness industry that might help guide health and fitness programming efforts for 2010 and beyond. The first survey (1) conducted in 2006 for 2007 trends was the initial effort to develop a systematic way to predict the future in the health and fitness industry. A second survey (2) followed for the year 2008, and then a third survey followed for 2009 (3).

This fourth in a series of annual surveys of health and fitness trends in the commercial, clinical, community, and corporate sectors of the industry confirmed several of the trends revealed in previous surveys. Some of the trends first identified for 2007 have moved up and stayed in the top 10 in 2008 and 2009, whereas some new trends seem to be emerging for 2010. Because this is a survey of trends, and not fads, future surveys will either confirm these new trends or they will fall short of making an impact on the health and fitness industry and drop out of the survey.

The ACSM annual worldwide survey of health and fitness trends is sometimes confused with estimating the potential impact of new equipment or some emerging exercise device on the bottom line in for-profit clubs. These results do not attempt to evaluate equipment, gear, tools, apparatus, or other paraphernalia that may suddenly appear at clubs or during late-night infomercials. The survey has been designed to confirm or to introduce trends (not fads) that have been sustained by having a proven impact on the industry. It is understandable that some of the trends revealed in earlier surveys would appear again (and perhaps for several years). It is as important for the health and fitness industry to pay attention to not only those new trends appearing for the first time, but also for those trends that do not appear this year or have been replaced on the list by other trends.

Readers of this survey should consider taking this information and applying it to their own settings that may include commercial health clubs (for-profit), community settings (not-for-profit), corporate wellness programs, and medical fitness centers (clinical programs). The benefit to commercial health clubs 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 protracted programs serving families and youth. Corporate programs and medical fitness centers will find these results useful through an increased service to their members and patients.

There were 37 possible trends in the 2010 survey (two more than in 2009). The top 25 trends from the previous year were included in the survey as were some emerging trends identified during the past couple of 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, commercial), as well as members of academia. Potential trends were first identified, and then short explanations were written 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 seven newly released ACSM books published either by Wolters Kluwer/Lippincott Williams & Wilkins or Human Kinetics for a random drawing of all responders. In the end, this proved to be a huge incentive to increase participation in the survey.

As in past ACSM worldwide fitness trends surveys, the 37 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). After each scoring opportunity, space was created for the respondent to add any comments (these comments were very helpful in the identification of emerging trends appearing in this year's survey). At the conclusion of the survey, additional space was left for the respondent to add any comments or potential 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 (www.surveymonkey.com), the online survey was sent to 9,989 ACSM-certified professionals (188 more than last year). 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, 239 were returned for bad addresses or the recipient opted out, leaving 9,750 possible participants. After the 3-week window of opportunity had been completed, 1,477 responses were received, which represents a very good return rate of 15%. 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 the responses, we asked internationally recognized experts representing all sectors of the health and fitness field to comment on the findings. Their analysis and comments are included at the conclusion of this report. Table 1 provides the top 10 results of the three previous surveys (1-3). Interestingly, the same top six trends identified in 2008 and 2009 appear in the top 6 trends for 2010, just in a different order. Therefore, the 2010 survey (Table 2) reinforces those findings of 2008 and 2009, and even 2007. Functional fitness appearing as no. 4 in 2007 and no. 8 in 2008 did not reappear in the top 10 until this survey, where it now stands at no. 7. Educated and experienced fitness professionals once again topped the list. Stability ball (which showed remarkable strength as a trend for the past 2 years) dropped to no. 18 in 2010. It is very interesting to note that the issue of children's obesity and specialized programs for older adults continues to show strength in the survey results.

TABLE 1

TABLE 1

TABLE 2

TABLE 2

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1. Educated and Experienced Fitness Professionals

This is a trend that continues with education and certification programs that are fully accredited by national third-party accrediting organizations for health/fitness and clinical professionals. More educational programs at community colleges, undergraduate programs, and graduate programs at colleges and universities 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 and more competitive, some degree of regulation either from within the industry or from external sources (i.e., government) seems to be in order. The CAAHEP and NCCA are both third-party accrediting agencies; CAAHEP for academic programs and NCCA for certification programs. Because of their independence, neither organization is directly influenced by the health and fitness industry. In 2007, CAAHEP added a Personal Fitness Trainer accreditation for certificate (1-year) and associate (2-year) 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 new collaboration has started within the fitness industry to address the issue of standardized facility practices. Coordinated by NSF International (www.nsf.org), this collaboration (known as the NSF Joint Committee on Health Fitness Facilities Standards) brings various sectors of the industry and the public together to determine facility standards.

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2. Strength Training

This is a trend for both men and women to incorporate strength training into their exercise routines. Strength training moved from no. 6 on the list in 2007 and rose to greater prominence to no. 4 in 2008 and remained in that position in 2009. For 2010, strength training moved up to the no. 2 position on the list. It has been once again demonstrated that the central theme of many health clubs remains strength training. There are still many clients who train exclusively using weights, and there are still those who lift weights for bodybuilding 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 age. Most health and fitness professionals today will incorporate some form of strength training into the exercise routine for both apparently healthy clients and for patients with controlled disease. It is not uncommon for cardiac rehabilitation, pulmonary rehabilitation, or metabolic disease management programs to include some form of weight training in the exercise prescription.

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3. Children and Obesity

This is a trend toward more programs addressing the ever-growing problem of childhood obesity and a potential new market for commercial- and community-based organizations. Although slipping slightly to no. 3 for 2010, for the fourth year, childhood obesity programming is on the top of the worldwide 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. The health care industry is already feeling the effect of rising obesity rates as the cost of its care continues to escalate. The obese kids of today will become the obese adults of tomorrow. For the first time since these predictions were made, 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.

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4. Personal Training

This trend continues as personal training is recognized as a profession not just for young people starting out, but as a long-term (if not lifelong) occupation. As more professional personal trainers are educated and certified, they become more accessible to more people in all aspects of the health/fitness industry. In 2008, personal training climbed to no. 3 from no. 7 in 2007 and remained at no. 3 for 2009. In 2010, personal training fell slightly to no. 4. In recent years, much attention has been paid to the education and certification of personal trainers. In a number of states (Massachusetts, Georgia, and several others), 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.

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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, among many other pieces of equipment. Core training seems to have stood the test of time as it again appears at no. 5, just as it has for the past 4 years. 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.

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6. Special Fitness Programs for Older Adults

This is a trend that emphasizes and caters to the older adult. As the baby boom generation ages into retirement 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 and 2009, fitness programs for older adults remain a strong trend for 2010. Falling to no. 6 between 2007 and 2008 was a bit of a surprise considering all the discussion about the baby boom generation rapidly approaching retirement age. This trend, however, continues to be strong, making the top 10 four years in a row, once again appearing at no. 6 for 2010. Health and fitness professionals can take advantage of this growing population of retired individuals by providing age-appropriate exercise programs. 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 including strength training. Even the frail elderly can improve his or her ability to perform activities of daily living.

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7. 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. Functional fitness first appeared on the survey as no. 4 in 2007 but fell to no. 8 in 2008 and no. 11 in 2009. It has reappeared in the top 10 for 2010 at no. 7. There may be some relationship between functional fitness and special fitness programs for older adults because many exercise programs for this age group are composed of these kinds of activities.

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8. 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. Breaking into the top 10 for the first time in the survey in 2009 (no. 9), sport-specific training jumped from no. 13 in 2008 after falling from no. 11 in 2007. It has always been a contender in the survey for recognition, but this is only its second time in the top 10, improving one position to no. 8. 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 as well as offering a different kind of service could lead to increased revenues.

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9. 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 during a training session. It also increases flexibility and improves posture. The exercises are typically done lying down on a mat and involve a series of controlled movements of the arms and legs that strengthen the abdominal muscles, hips, and back. Pilates also can be done on special Pilates equipment, which may prove to be a secondary source of income for commercial- and community-based organizations. Pilates done on a mat is more popular because the same results can be achieved without investing in equipment, which can be quite expensive. Pilates first appeared in the top 10 on the survey in 2008 and has remained strong through 2010 (although dropping from a consistent no. 7 position to no. 9).

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10. 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. This is the surprise of the 2010 worldwide survey. Group personal training has always hovered around the bottom of the top 20 list until this year. In 2007, group personal training was no. 19 on the list. In 2008, it rose slightly to no. 15 but dropped again in 2009 to no. 19. In these tough economic times when personal income seems to be decreasing, personal trainers need to be creative in the way they package personal training sessions. Training two or three people simultaneously seems to make great economic sense for both the trainer and the client. As the economy improves, it will be interesting to see if this trend continues.

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ROUNDING OUT THE TOP 20

11. 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. Outcome measurements have appeared in the top 20 list for all 4 years of the survey but have increased in importance in recent years.

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12. Exercise and Weight Loss

This is a trend toward incorporating all weight loss programs with a sensible exercise regimen. Most sensationalized diet programs incorporate some kind of exercise program into their daily routine. However, in 2010, the coupling of a diet and exercise will become more important.

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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. Wellness coaching continues to show strong support within the health and fitness industry as it maintains the no. 13 position for the second year in a row.

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14. Yoga

Yoga has taken on a variety of forms within the past couple of years (including Power Yoga, Yogalates, and others including yoga in hot environments). Instructional tapes and books are plentiful as are certifications in the many yoga formats. Yoga can be taught in many forms, each with its own special emphasis. Some of these forms are known as Iyengar Yoga, Ashtanga, Bikram Yoga (that's the hot and humid one), Vinyasa Yoga, Kripalu Yoga, Anuara Yoga, Kundalini Yoga, and Sivananda Yoga. Yoga made a surprising comeback in 2010 after falling out of the top 20 in 2009 (in 2008, yoga appeared in the top 10).

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15. Spinning (Indoor Cycling)

As an instructor explains 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.

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16. Boot Camp

This is a high-intensity structured activity that is patterned after military-style training. It includes cardiovascular, strength, endurance, and flexibility drills and usually involves both indoor and outdoor exercises. Boot camps also combine sports drills and calisthenics. This is the first time boot camp has appeared in the top 20 of this worldwide survey.

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17. Physician Referrals

This is a trend toward a growing emphasis being placed on partnerships with the medical community resulting in seamless referrals to a health and fitness facility. Physician referrals to fitness professionals first appeared in the top 20 in last year's survey and could find additional traction because of ACSM's Exercise is Medicine™ initiative and health care reform measures being considered around the world.

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18. Stability Ball

A stability ball is a durable rubber ball with a variable diameter of between 55 and 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 for 2008 and 2009, the stability ball fell to no. 18 for 2010. This type of exercise did not make the top 20 in 2007. In its first introduction into the health and fitness market, many 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 directions for children, young adults, and even older adults. It is used to teach stability, balance, and strength. If the stability ball disappears from the top 20 list in 2011, it could very well have been a fad but with some longevity.

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19. 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. In 2007, balance training was not in the top 20 in the trends survey. It first emerged at no. 14 in 2008 and gained strength in 2009 in the no. 10 position. There may be several reasons for balance training gaining in popularity, including the recognition of this kind of exercise program for the elderly as well as for sport-specific training of younger people engaged in competitive athletics. In 2010, balance training not only fell out of the top 10 fitness trends but went to no. 19. Could balance training follow the stability ball as a fad that had some longevity?

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20. 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. Worksite health promotion programming fell to no. 20 in 2010 from no. 12 in 2009.

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SUMMARY

There were a number of surprises in this year's worldwide trends survey. First, group personal training went from the bottom of the top 20 list for the previous 3 years to no. 10 in 2010, perhaps reflecting on the worldwide economic downturn, forcing personal trainers to become more creative with how they deliver services. Functional fitness reappeared in the top 10 list for 2010 after failing to make the list in 2009, but having been no. 4 in 2007 and no. 8 in 2008. Sport-specific training continues to be strong as does Pilates. Stability ball and balance training fell out of the top 10 to no. 18 and no. 19, respectively. A notable improvement in this year's top 20 was yoga (no. 14 in 2007, no. 10 in 2008, no. 21 in 2009, and no. 14 in 2010). Two very important trends to watch in the future continue to be wellness coaching (no. 20 in 2008, no. 13 in 2009 and 2010) and, appearing on the list of top 20 in 2009 and at no. 17 in 2010, physician referrals. It would appear as though ACSM's Exercise is Medicine™ program has some traction in the health and fitness industry.

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INTERNATIONAL EXPERTS COMMENT ON 2010 TRENDS

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Len Kravitz, Ph.D., Department of Health, Exercise & Sport Sciences, University of New Mexico. "The results of the 2010 worldwide fitness trends survey demonstrate that fitness professionals prioritize continuing education highly and recognize that advancing our knowledge is essential for the industry to continue expanding and developing. Fitness professionals recognize there must be more unification in our accreditation and qualification standards. The 'spurt' of group personal training is splendid. This direction brings forward many novel opportunities for personal trainers to enhance their professional services while directly attending to the economic challenges people are facing in our worldwide economy. The comprehensive survey that Dr. Thompson has summarized imparts a meaningful inference with respect to 'exercise and weight loss' (no. 12). Perhaps there can be greater collaboration of exercise professionals, nutritionists, and clinical specialists in developing exercise and weight loss programs that can be readily implemented to combat this growing epidemic. And if our successes continue in helping people improve the quality of their lives through exercise, wellness, and lifestyle changes, it is hoped that physicians throughout the nation and world will seek out our expertise via programs such as ACSM's Exercise is Medicine™."

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Margaret Moore, M.B.A., B.S., founder and CEO, Wellcoaches Corporation and co-director, Institute of Coaching, McLean Hospital/Harvard Medical School. "While the fitness and personal training fields and related research have exploded in the past decade, much remains to be done to facilitate and sustain the lifestyle change needed to help people optimize health and well-being. The coaching industry has moved into health and fitness over the past 5 years, unleashing a new profession - the wellness coach - to bring to consumers the psychological processes of change and a holistic or integrated wellness approach. I was happy to see wellness coaching first appear in the top 20 in the 2007 survey, and now in 2010, it has moved up to no. 13 on the list. Coaches are experts in what it takes for people to decide to change and make a space for the work of change, the nature of the motivation that is the jet fuel for change, the resources, capacity, positivity, and confidence needed to navigate the journey of change, and the kinds of things that derail the change journey and how to deal with them. Coaches have a large toolbox to facilitate change, all leading our clients to a place where they say 'I accomplished more than I thought was possible and I will never go back to the way I was. My new way of living is nonnegotiable.'"

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Jonathan Patricios, M.D., FACSM, sports physician and president-elect of the South African Sports Medicine Association, Johannesburg, South Africa. "ACSM's Health & Fitness Journal® worldwide survey on trends in fitness should be of particular interest to clinicians. As physicians, we should be somewhat ashamed that 'physician referrals' only made it into the top 20 last year and is currently positioned at 17. Exercise is and always has been a convenient and cost-effective (if not free!) interventional and preventative strategy in dealing with diseases of lifestyle. Perhaps the global economic downturn will force us to prescribe exercise more often, and the international reach of ACSM's Exercise is Medicine™ campaign should hopefully see this trend permanently establishing itself in the top 10. As for the other trends, South Africa appears to reflect the emphasis on core, Pilates, and strength training, better-educated and more accessible personal trainers, and the use of stabilizing and balancing techniques. As a third-world country, we face the dichotomy of inadequate food resources for many and a growing obesity problem in a population exposed to Western junk food. Exercise intervention in the obese child does not receive as much attention but is a trend we certainly need to emulate. Clinicians need to be aware of trends in fitness as we should all be determining which forms of exercise are in the best interests of every patient's health."

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Erica M. Jackson, Ph.D., FACSM, Department of Kinesiology, College of William & Mary. "It is very exciting to see educated and experienced fitness professionals top the list for the third year in a row. This finding is promising for those entering the fitness workforce and it supports the move toward greater regulation of academic programs and certifications. There are fitness trends that reflect all of the health-related fitness components in the top 20, indicating the recognition of comprehensive fitness programs for maximal health. These findings also indicate that ACSM's Exercise is Medicine™ message is being supported by a range of fitness professionals. Personal training, group training, and wellness coaching making the top 20 further supports ACSM's Exercise is Medicine™ message. It is encouraging that in a difficult economy, people are willing to make an investment in health and disease prevention through health-promoting behaviors. These items in the top 20 also support lifestyle change to improve health and fitness. Childhood obesity, weight loss for adults, and fitness programming for older adults are consistent with health objectives for the United States. Overall, the findings from ACSM's international survey are exciting because they show ACSM's Exercise is Medicine™ message has been well received by educators and fitness professionals and that research is translating to practice."

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Acknowledgments

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 is indebted to the ACSM staff that supported this study by assisting in the construction, formatting, and delivery of it to thousands of fitness professionals around the world. In particular, the author recognizes the important contributions of Dick Cotton, Hope Wood, and especially Lori Tish.

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CONDENSED VERSION AND BOTTOM LINE

The 2010 worldwide survey of fitness trends helps the health and fitness industry make critical programming and business 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 assist owners, operators, program directors, and personal trainers make important business decisions.

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References

1. Thompson WR. Worldwide survey reveals fitness trends for 2007. ACSM's Health & Fitness Journal. 2006;10(6):8-14.
2. Thompson WR. Worldwide survey reveals fitness trends for 2008. ACSM's Health & Fitness Journal. 2007;11(6):7-13.
3. Thompson WR. Worldwide survey reveals fitness trends for 2009. ACSM's Health & Fitness Journal. 2008;12(6):7-14.
Keywords:

Commercial; Clinical; Corporate; Community; Expert opinions; Future programs

© 2009 American College of Sports Medicine