This year's attention to nationwide health care reform has cemented the health and fitness industry's emphasis on the need for proper accreditation and certification, according to an American College of Sports Medicine (ACSM) survey of fitness trends published in the November/December issue of ACSM's Health & Fitness Journal®. The growing demand for educated and experienced fitness professionals claimed the top spot in the survey for the fourth consecutive year.

"As the market in this sluggish economy becomes even more crowded and competitive, the need for regulation, either from within the industry or from external sources, is growing," said the lead author of the survey, Walter R. Thompson, Ph.D., FACSM. "For example, a number of states and the District of Columbia are considering legislation to regulate personal trainers just as it does physicians, lawyers and pharmacists." Thompson, an exercise physiologist at Georgia State University and a Fellow of ACSM, is also spokesperson for the ACSM American Fitness IndexTM.

The survey, now in its fifth year, was distributed to ACSM-certified health and fitness professionals worldwide and was designed to reveal trends in various fitness environments. Respondents around the world returned more than 2,200 completed surveys. Thirty-one potential trends were given as choices, and the top 20 were ranked and published by ACSM.

The most surprising findings, experts say, are the trends that have fallen off the list for 2011 - balance training, stability balls and Pilates. Pilates suffered the worst fall, disappearing after a ninth place ranking in 2010.

"It appears from this survey that Pilates may not have been a trend at all but may be considered a fad in the health and fitness industry," said Thompson. "Next year's survey will either embrace Pilates as a trend or will answer this question."

New trends to the list include worker incentive programs, clinical integration and reaching new markets. These additions directly reflect some of the work ACSM is doing to globalize the Exercise is Medicine® initiative.

"Interest in medical fitness, worker incentive programs, and worksite wellness programs may be a direct result of health care reform measures and Exercise is Medicine," said Thompson. "With an estimated 80 percent of Americans not having a regular exercise program or a place to exercise, health and fitness professionals must search for news ways to deliver their services to people who need them."

The top ten fitness trends predicted for 2011 are:

1. Educated and experienced fitness professionals. Due to increases in the number of organizations offering health and fitness certifications, it's important that consumers choose professionals certified through programs that are accredited by the National Commission for Certifying Agencies, such as those offered by ACSM.

2. Fitness programs for older adults. As the baby boom generation ages into retirement, some of these people have more discretionary money than their younger counterparts. Therefore, many health and fitness professionals are taking the time to create age-appropriate fitness programs to keep older adults healthy and active.

3. Strength training. Strength training remains a central emphasis for many health clubs. Incorporating strength training is an essential part of a complete physical activity program for all physical activity levels and genders.

4. Children and obesity. With childhood obesity growing at an alarming rate, health and fitness professionals see the epidemic as an opportunity to create programs tailored to overweight and obese children. Solving the problem of childhood obesity will have an impact on the health care industry today and for years to come.

5. Personal training. More and more students are majoring in kinesiology, which indicates that students are preparing themselves for careers in allied health fields such as personal training. Education, training and proper credentialing for personal trainers have become increasingly important to the health and fitness facilities that employ them.

6. Core training. Distinct from strength training, core training specifically emphasizes conditioning of the middle-body muscles, including the pelvis, lower back, hips and abdomen - all of which provide needed support for the spine.

7. Exercise and weight loss. In addition to nutrition, exercise is a key component of a proper weight loss program. Health and fitness professionals who provide weight loss programs are increasingly incorporating regular exercise and caloric restriction for better weight control in their clients.

8. Boot camp. Boot camp is a high-intensity structured activity program modeled after military style training and led by an instructor. Boot camp incorporates cardiovascular, strength, endurance and flexibility drills in both indoor and outdoor settings.

9. Functional fitness. This is a trend toward using strength training to improve balance and ease of daily living. Functional fitness and special fitness programs for older adults are closely related.

10. Physician referrals. Physician referrals, a key component of the Exercise is Medicine initiative, partner medical professionals with heath and fitness professionals to seamlessly integrate exercise into their patients' lives.