I was double checking something re: health risk factors and noticed that for "impaired fasting glucose" there was a discrepancy between the text (table 5.1 on page 157) and the flashcards.
The table says > 110, the flashcard says >100. I did some research online and also spoke with someone from ACE today (who was very helpful) to confirm it and she said it's > 100 NOT >110.
Also, she said re: the TC/HDL ratio, that ACSM doesn't actually even go by ratio (I mentioned that I was puzzled why they had that on the diagnostic exam since it's not something we're supposed to worry about anyway) but in spite of the fact that they don't really use it she said that typically 3.5 or better (which I believe means LOWER) is considered good.
HDL >60 is treated separately as a negative risk factor which cancels out a positive risk factor (rather than being treated as part of a ratio).
I made a page on the Health Risk Factors w/ all the updated info which I'll post as a reply to this if you want to print it out (w/o all this stuff above :)).
- Waist circumference > 40 inches men (102 cm)/> 35 inches women (89cm)
-Percent body fat: 25% and higher-men/32% and higher-women);
4. Sedentary lifestyle
5, Diabetes or impaired fasting glucose (> 100 mg/dl)
6. Family history of heart disease (before age 55 in father, or 65 in mother)
7. Elevated total cholesterol (> 200 mg/dL) or low HDL (less than 40 mg/dL)
Note: HDL > 60 mg/dL is negative risk factor which cancels a positive risk factor.
LDL: Optimal: less than 100 (160-189 is high) or 130-159 combined w/ high risk status should see a physician. --------------------------------------------------------------------------------- TC/HDL ratio (which apparently we actually DON'T need to know for the test but I'll put it here as part of this anyway for the sake of being thorough).
It is generally desirable to have a TC (Total Cholesterol) reading of below 200 mg/dl.
Borderline is between 200-239 and high is 240 or greater.
When TC is divided by HDL a number called the TC/HDL ratio is derived.
An ideal value is less than 3.5 though a range of 3.5-4.5 is commonly cited as acceptable.
(Note: When I called ACE I was told that 3.5 or better (which I believe means lower) is considered acceptable)
---------------------------------------------------------------------------------- Note: on pg 158 it says that ANY client with two or more risk factors should be referred to a physician before beginning a vigorous exercise program.
then it goes on to say: In addition, ACSM recommends that males over age 45 and females over age 55 have a medical evaluation, including a maximal exercise test, before beginning vigorous exercise programs. (so these would be folks that ALSO have 2 or more risk factors in ADDITION to their age).
On page 170 it says: ACSM (2000) recommends that men over 45 and women over 55 with two or more cardiovascular risk factors have a physician-supervised maximal graded exercise test before taking part in any vigorous exercise (i.e. greater than 60% of capacity).
So just to make sure I have this clear....
If a man is 45 or a women over 55 but does NOT have 2 or more risk factors then they are okay to go ahead w/ vigorous exercise and don't even need a medical evaluation (in other words it's not just the age that's a factor). BUT if they have 2 or more risk factors IN ADDITION to their age then they need to have a medical evaluation plus the GXT before doing a vigorous exercise program.
However, if they are only doing low-moderate exercise as the goal, only if they are diagnosed w/ cardiopulmonary disease or have one or more MAJOR signs or symptoms suggestive of cardiopulmonary disease do they need to have a medical exam and clinical exercise test prior to beginning an exercise program (ACSM 2000).
I wanted to share something in case something else might confuse folks (as it did me) regarding cholesterol. I was sure the exercise etc. disc was wrong and wrote to Guy Andrews over at the company. This is what I wrote (minus the pleasantries :)). --------------------------------------------------------------------------------- one of the questions was:
During a health screen you discover that your client has a total cholesterol of 206 and and HDL of 32. According to ACSM:
A. You client has two risk factors (this is the answer I believe is correct and is verified in the ACE manual)
B. You client has ONE risk factor (this is the answer the test gives as correct.
According to page 157 of the ACE manual under Risk Factors : Hypercholesterolemia: Total serum Cholesterol of greater than 200 mg/dL or HDL of less than 40 mg/dL.
Also according to one of the other questions on the test it is verified as well.
the question is:
The NCEP recommends which of the following:
the correct answer is:
Keeping total cholesterol below 200 mg/dL and HDL greater than 35 mg/dL
Please confirm, I just want to make sure I have this correct for the benefit of my own knowledge.
Thanks and take care,
Scott
Here's what Guy Andrews Wrote:
The CD rom is correct. Even though the total cholesterol is 206 & the HDL is 32 that counts as only 1 risk factor: "Poor cholesterol profile." To count it as 2 risk factors is, in effect, double jeopardy. For example, it's not unusual to have a client with high total cholesterol, low "good" cholesterol & high "bad" cholesterol -- but in that case it is still 1 risk factor. (not 3)
The NCEP recommendation is just that a recommendation, but that is not counting risk factors as ACSM does.
Best wishes!
Guy Andrews, MA, CSCS Executive Director Exercise ETC Inc 1-800-244-1344
Scott, Thanks again for your time and effort in getting to the bottom of these annoying inconsistencies! Hang in there with the studying~
Hi Vonni,
I'm glad this stuff is helpful, I have a hard time keeping it all straight just by reading it so I need to organize it (and often reorganize it). :)
Thanks for the good wishes w/ the studying, I wish you the best also! I feel like I've run a mental (and physical) marathon since October and I'm looking forward to reaching the finish line of this phase. I want to move on to phase 2, actually using all I've learned w/ clients! :)
I also hope that you're feeling better w/ the exercise etc. disc. I think it's gotta be helpful getting in all that practice at analyzing and then answering questions.
