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Training For Gains: High Intensity, Low Volume Strength Gains Stick. Low Intensity, High Volume Gains Don't, But They Come With Significant Improvements in Body Comp

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It's one thing to make strength and mass gains, it's a whole different story to make them last - if possible, for the rest of your life! Study suggests: Training intense, may help.
Thank God for the Internet. Otherwise we would hardly be able to get our hands on papers that are written by Iranian scientists and published in the Turkish Journal of Sport and Exercise; and that, my dear (mostly) American friends, would be a real pity!

"Effect of acute detraining following two types of resistance training on strength performance and body composition in trained athletes"- that's the title of a paper that was published late last year but popped up in the major databases, only recently. In spite of the delay, the results Vahid Tadibi and his colleagues from the Razi University, the  University of Kordestan and the Islamic Azad University present in this 5-pages paper are unquestionably well worth being covered.
Don't forget to feed your muscles and learn more about protein intake at the SuppVersity

Are You Protein Wheysting?

Spread or waste your protein?

Protein requ. of athletes

High EAA intra-workout fat loss

Fast vs. slow protein

Too much ado about protein?
In view of the limited evidence available for the effect of detraining on strength training with different intensity and volume, Tadibi et al. set out to
"determine the influences of short term detraining after two kinds of resistance training on strength performance and body composition in trained athletes."  (Tadibi. 2013)
To this ends, the Iranian researchers recruited 30 healthy men students recruited from
Razi University of Kermanshah. The subjects were divided into two experimental groups as follows:
  • group (I) who performed resistance training with low intensity and high volume (GRI: n=15), weight 73.7±10.3 kg, height 174.5±7.5 m and age 24.7±1.4 years old and 
  • group (II) who performed low volume and high intensity (GRII: n=25), weight 63.2±6.2, height 175.8±5.5 and age 25.4±1 (years old). 
The participants attended physical education classes for six weeks/three times a week, with duration of 45-60 min each session. Each training session involved three phases in both groups and lasted 50–60minutes:
  • warm up, specific or related training and cool down. 
Warm up and cool down phases were similar in both groups included 7 min running with intensity sufficient to raise breath rate, 3 min stretching training.
Learn more about the effects of circuit training: When you build a circuit training routine, don't forget: There are lot's of metabolically demanding kettle- bell exercises to spice things up. There are probably a dozen of reasons why people train. Many of them are really good: Wanting to stay healthy, to live longer, or to excel in your sports. Of others, however, I am not so sure whether they are actually worth pursuing, or do you think" - suggested read: "Circuit vs. Classic Strength Training, Which System is More Metabolically Demanding? What are the Energetic Costs and Where Does the Energy Come From, Fat or Glucose?" | read more.
The actual intervention, i.e. the specific training part consisted of fast-paced circuit training workouts with 60 to 90 seconds rest between the following exercises:
  • Figure 1: Graphical overview of the two training regimen
    bench press, 
  • squat, 
  • biceps curls, 
  • triceps extensions, 
  • shoulder press
What? No, I have no idea, if they forgot to list the back exercises, or if the subjects actually didn't do any. What I do know, though is that the
"[s]ubjects performed 12– 15 maximal repetitions/set (55–60% 1RM) in group I, low intensity and high volume (LIHV protocol), and 5 maximal repetitions/set (85–90% 1RM) in the group II, low volume and high intensity (HILV protocol)" (Tadibi. 2013)
In order to establish optimal progression the "1RM was retested in the end of every week so that resistance could be adjusted properly" (Tadibi. 2013).

TRAINING ➲ DETRAINING ➰ RESULTS?

Apropos progress, you will probably remember that the actual intention of the researchers was not to compare the muscle and strength gains during the six-week training program, but their persistence. Accordingly, the all-important question was what would happen, when the subjects resumed their normal active, but not necessarily resistance trained lifestyle after a 2-week lay-off of any type of systematic (training stoppage).
Figure 1: Relative changes in max strength (left) and body comp (right) from pre- to post-detraining (Tadibi. 2013)
Well, you can see the results of this type of realistic 6-weeks on 2-weeks of regimen in Figure 1 - a result based on which you should be able to confirm the following conclusions:
  • Contrary to what common wisdom would predict, the low intensity, high volume (LIHV) and the high intensity, low volume (HILV) regimen produce statistically identical strength gains over the course of the six-weeks training phased (not shown in Figure 1)
  • The gains on the high intensity, low volume (HILV) regimen were - albeit not significantly - but visibly more persistent than those that were brought about by the high volume low intensity regimen.
  • The high volume training turned out to have significant fat burning effects of the initially significant relative reduction in body fat % of 18% (from  12.15% to 9.73 in LIHV vs.   11.91% to 10.59% in the HILV group), there were yet only 7% left after 2 weeks of detraining (the BF% went back up from 9.73±3.12% to 11.27±3.37%).
As the researchers point out, this result may look different, if the study population was older or sick. In less-conditioned individuals (Hakkinen. 1994), which is - in my humble opinion - a very important hint for both, the young and old SuppVersity readers, as it confirms (once again), that the optimal training routine is a very individual thing and cannot be cookie cut based on a single study.
In the end the study at hand confirms the usefulness of periodization! At first it may seem as if the lasting effects of the high intensity, low volume training would suggest that this is the way to train. We must not forget, though that both "regular hypertrophy" as in protein synthesis and the architectual changes the muscle undergoes are two sided of the same coin. The goal should thus always be to have both come into their own.
Don't forget, you can learn more about periodization, here at the SuppVersity.
Let's go beyond the results and get to the underlying mechanisms and practical implications: In the absence of corresponding data, it's obviously difficult to tell, whether the following hypothesis is accurate. Based on the research I have done for the Intermittent Thoughts on Building Muscle (read the article series), I would yet speculate that the persistence of the gains in the high intensity, low volume group reflects a difference in structural (muscle + nerves) vs. non-structural adaptations.

The latter has been observed previously with increased satellite cell recruitement, IFG-1 + MGF activity and corresponding changes in the structural architecture of the muscle (improved firing of motor units, incorporation of new satellite cells...) in response to high or even super-maximal intensity training & eccentrics and would speak in favor of "structural gains" vs. the mere "ballooning up" in response to the protein synthetic response of high volume strength training.

On the other hand, we all want the muscle to show, right? And if you look at the reduction in BF% after the 2 weeks of detraining it's hard to argue in favor of high intensity training, when it comes to fat loss.
References:
  • Häkkinen, K. "Neuromuscular adaptation during strength training, aging, detraining, and immobilization." Critical Reviews in Physical and Rehabilitation Medicine 6 (1994): 161-161.
  • Tadibi, Vahid, et al. "Effect of acute detraining following two types of resistance training on strength performance and body composition in trained athletes." (2013).

2-3g of Betaine Per Day Double Your IGF-1 & Reduce Your Body Fat-% By 19%!? Plus: Spermine Gets Fat Rodents Lean in 4 Weeks + 29 Common(!) High Spermine Foods.

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They "take" spermine everyday!
This may not look like it, but today's SuppVersity post contains a hell lot of information about an amino acid you do know and a polyamine you probably don't know yet.

When you'll be done with the article, the latter will change and one or the other will probably start googling the words "spermine bulk powder" or "spermine buy" and thus disregard the advice I have to give in the bottom line of this fat loss-oriented compilation of short news right from the labs of international research teams...

Well, I guess before I start sounding even more pathetic, I will just begin with study #1 - the study that covers the amino acid you all know - betaine!
  • Double Your IGF-1 & Reduce Your Body Fat By 19% W/ Betaine!? I have to admit, the evidence I have to support this hilarious claim is not conclusive, but it's interesting. That's for sure.
➲ IMPORTANT REMINDER - This is "betaine" as in trimethylglycine aka TMG,not"betaine" as in betaine HCL, which may help you if you have serious problems with your digestive system, but is otherwise (i.e. for 99% of the healthy population) a complete waste of money and will have NO effect whatsoever on your IGF-1 and body fat levels.
  • The data was published in a not exactly totally recent paper from the Department of Veterinary Medicine at the Faculty of Veterinary Science of the Chulalongkorn University in Thailand. The subjects were pigs and the objective of the present study was, therefore, to evaluate the effect of betaine supplementation (at 0.125% of the total diet) on carcass quality, growth performance and changes in serum IGF-1 and TG concentrations of finishing pigs.
    Figure 1: Relative IGF-1 & triglyceride levels, as well as thickness of back fat (Lothong. 2013)
    Aside from the previously mentioned improvements in body fat and IGF-1, the pigs on the "high" betaine diet (my calculation would suggest that we are talking about a human equivalent of only 2-3g per day) did also lead to significant reductions in serum triglyceride and could thus also help people with high blood lipids. 
  • The Unknown Fat Loss Power of Spermine - You don't even know what spermine is? That's funny, 'cause you all have plenty of it in your body. It's after all a polyamine that's involved in cellular metabolism found in all eukaryotic cells.
➲ Additional Info: Spermine and allergies, heart disease & diabetes: According to Peulen et al. (1998) 5.02 nmol ml−1 of spermine is a critical value for the spermine content of human breast milk. If there is less spermine in it, the likelihood of your children developing allergies will increase. A high spermine / generally high polyamine intake has also been suggested to protect against heart disease (Soda. 2010) and help with diabetes (Jafarnejad. 2008).
  • On the other hand, if you google it, you will soon realize that not just you, but also we (as in we as humans) know relatively little about Aethylenimin, as Spermin has previously been called. Thus, it took me a brief excursion into the archives the scientific journals of the world to come up with some information about its distribution in the mammalian body (see Figure 2) and following information (Tabor. 1976).
    Figure 2: Spermidine content of various tissues (left; Tabor. 1976); effects of 4 weeks of spermidine supplementation on body weight (g) of pre-fattened (high fat group) mice (Sadasivan. 2014)
    With respect to its functions, Anthony E. Pegg, a researcher from the Pennsylvania State University writes in his latest review published in January 2014:
    Table 1: Spermine-rich foods (data in mg/100g calc. based on Nishimura et al. 2006)
    "Polyamines play important roles in cell physiology including effects on the structure of cellular macromolecules, gene expression, protein function, nucleic acid and protein synthesis, regulation of ion channels, and providing protection from oxidative damage.

    Vertebrates contain two polyamines, spermidine and spermine, as well as their precursor, the diamine putrescine. Although spermidine has an essential and unique role as the precursor of hypusine a post-translational modification of the elongation factor eIF5A, which is necessary for this protein to function in protein synthesis, no unique role for spermine has been identified unequivocally. The existence of a discrete spermine synthase enzyme that converts spermidine to spermine suggest that spermine must be needed and this is confirmed by studies with Gy mice and human patients with Snyder-Robinson syndrome in which spermine synthase is absent or greatly reduced. In both cases, this leads to a severe phenotype with multiple effects among which are intellectual disability, other neurological changes, hypotonia, and reduced growth of muscle and bone." (my emphasis in Pegg. 2014)
    In other words, we know that we know... well, very little ;-) What we do know from a very recent study that was conducted (red alert!) by scientists working for Connexios Life Sciences Private Limited and is about to be published in one of the future issues of European Journal of Pharmacology is that spermine has the ability to bring diet-induced obese rodents back to a normal weight within four weeks! At least if it's dosed at a human equivalent of ~60-75mg per day.

    Aside from the profound reduction in body weight (-24%), the Connexios researchers observed in their fattened up mice, the spermine treatment did also reduce the fasting blood glucose levels by -18%. The corresponding improvements in glucose metabolism came hand in hand with the increases in fatty acid oxidation that were responsible for the rapid loss of white adipose tissue mass. 
As SuppVersity reader you know that betaine's IGF boosting effects occur in humans as well | learn more
Bottom line: Contrary to the use of spermidine supplements, which is still pie in the sky, betaine aka TMG (trimethylglicine) is a readily available amino acid of which you, as an avid SuppVersity reader know that it has also been shown to increase size and strength gains in athletes (learn more), to sooth the negative inflammation in your adipose organs (learn more), to set the anabolic stage for muscle growth by increasing IGF-1 and decreasing cortisol (evidence, more evidence) and to have a mild yet possibly overblown effect on the purported cardiovascular disease (CVD) marker homocysteine (learn more).

If you asked me, my money would thus be on betaine, not spermine on the moment, if I had to bet which of those could make a valuable addition to your supplement routine. Why? That's a question you shouldn't be asking if this ain't your first visit to the SuppVersity. With one sponsored rodent study supporting its efficiacy, spermine may qualify as the "new go to supplement" for the supplement industry, but for you as a critical thinker, it will obviously take independent human trials before you throw your money at Connexios and possible copycats.
References:
  • Jafarnejad, A., et al. "Effect of spermine on lipid profile and HDL functionality in the streptozotocin-induced diabetic rat model." Life sciences 82.5 (2008): 301-307.
  • Lothong, Muttarin, Pornchalit Assavacheep, and Kittipong Tachampa. "Effects of Dietary Betaine Supplementation on Growth Performance, Carcass Quality and Serum IGF-1 and Triglyceride of Finishing Pigs." (2013). 
  • Nishimura, Kazuhiro, et al. "Decrease in polyamines with aging and their ingestion from food and drink." Journal of biochemistry 139.1 (2006): 81-90.
  • Pegg, Anthony E. "The function of spermine." IUBMB life (2014). 
  • Soda, Kuniyasu. "Polyamine intake, dietary pattern, and cardiovascular disease." Medical hypotheses 75.3 (2010): 299-301. 
  • Sadasivan, SK et al. "Exogenous administration of Q2 spermine results in improved glucose utilization and decrease in bodyweight of mice." European Journal of Pharmacology (2014). Accepted article.
  • Tabor, Celia White, and Herbert Tabor. "1, 4-Diaminobutane (putrescine), spermidine, and spermine." Annual review of biochemistry 45.1 (1976): 285-306.

    Double Your Gains With Plain Creatine Monohydrate: Up to 2.6x Greater Strength Gains on the Bench With 5g of Plain Creatine Monohydrate per Day in Trained Rookies

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    No pain... ah no creatine, no gain ;-)
    There have been so many articles about creatine on the Internet that I usually hesitate to add another one to the (mostly accurate) praise of creatine monohydrate. The reason I still want to address the issue today, is a quantitative one: The data Kebrit and Rani present in their recent paper in the Turkish Journal of Sport and Exercise is simply too impressive not to (ab?)use it as a plug to remind you that you are missing out if you don't use 3-5g of creatine to speed up your strength gains - if you are a beginner by a whopping 100%!
    You can learn more about creatine at the SuppVersity

    Pharmacokinetics of Creatine PI & PII

    Supercharge Creatine W/ Baking Soda

    Creatine & the Brain

    Creatine + ALA = Better Uptake?

    Creatine Before or After Workouts?

    Creatine, DHT & Hairloss?
    The study design Daniel Kebrit and Sangeeta Rani, two scientists from the Debre Markos University and the Haramaya University in Ethiopia used in their study is easy to explain. 20 Ethopian sprinters (no master athletes) who competed to represent Haramaya Universityin 6th Ethiopian Higher Education Institutions sport festival completed a 12 weeks of resistance training program with or without provision of 5g of creatine per day.
    "After two weeks of conditioning, the groups were begun performing resistance training (both weight bearing and weight free exercises). Weight exercises include deadlift, barbell squat, bench press, etc. Push up, curl up and brisk walking were some of the weight free exercises which were performed by both groups.

    The duration of exercise was 45 minutes with the frequency of 3 days per week. Efforts were put to control the subjects. They were advised, not to participate in any other physical activity." (Kebrit. 2013)
    If you take a look at the type of exercises, the workout frequency an the total volume (in minutes), you may be surprised that this was enough to elicit the strength gains I plotted for you in Figure 1.
    Figure 1: Strength gains after 6 (left) and 12 weeks of resistance training with and without the provision of 5g of creatine monohydrate per day (Kebrit. 2013)
    It goes without saying that the total strength gains in athletes with years of training experience under their belt may be less pronounced, but when I saw the 2.6x higher increase in bench press performance within 3 months and 2x higher gains after only 6 weeks, I thought that the 14-year old kids at the gym who talk about creatine as if it was "gear" can't be so far off...
    Figure 2: comparison of the relative increase in bench press strength in response to creatine supplementation (Kebrit. 2013) and testosterone enanthate (Bhasin. 1996) both in conjunction w/ exercise.
    I am not kiddin't this is steroid like! I know it sounds hilarious, but if you look at the results of the often cited study Bhasin et al.  published in the New England Journal of Medicine on the 4th of July in 1996, you will see that the even a supra-physiological dose of injectable testosterone enanthate did not double the gains of the young, healthy study participants in the said study.

    It's an apples vs. oranges comparison, I know, but it's still impressive, right? Well, I thought so and that's why I did include this study in the SuppVersity news, although each of you should know that creatine and protein are the only two "must have supplements" for strength trainees.
    Reference: 
    • Bhasin, Shalender, et al. "The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men." New England Journal of Medicine 335.1 (1996): 1-7.
    • Kebrit, Daniel, and Sangeeta Rani. "Muscle strength and muscle endurance: with and without creatine supplementation." Turkish Journal of Sport and Exercise (2013).

    High Protein Diets Don't Counter Anti-Anabolic Effects of Low Energy Intake: 29% Reduction in Free Testosterone, -16% IGF-1 With 40% Energy Deficit Despite 2.4g/kg Protein

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    Melt the belly, keep the muscle - a decent amount of protein is key, but more ain't more and as a recent study shows: This has nothing to do with hormones.
    If you are no newbie to the SuppVersity you will be aware that there is no way to escape the "anti-anabolic" effects of suboptimal energy intakes. You will also know that protein catabolism cannot be countered by the ingestion of extra protein (see "Protein Intake & Muscle Catabolism: Fasting Gnaws on Your Muscle Tissue and Abundance Causes Wastefulness" | read more).

    And, last but not least, you will be aware of the fact that the best you can do is to eat enough protein to keep the protein synthetic machinery running by consuming mTOR-promoting fast-absorbing high BCAA (leucine) protein sources such as whey protein (learn more about whey protein).
    The data from the Pasiokos study shows: 1.6g/kg and not 2.4g/kg allows for the optimal balance of fat loss and lean mass retention (Pasiakos. 2013)
    I guess, I have to warn you again! More protein is not a solution - even if some gurus want to make you believe it was. While the study at hand will only confirm that it does not help, a previous study by Pasiakos et al. (2013) revealed that eating too much protein (in this case 3x the RDA, i.e. 2.4g/kg) and thus necessarily too few carbohydrates and fats (learn more in " Evidence From the Metabolic Ward: 1.6-2.4g/kg Protein Turn Short Term Weight Loss Intervention into a Fat Loss Diet" | go back)
    The fact that protein cannot save your testosterone and IGF-1 levels from plummeting, on the other hand, is something you may only have have gathered based on the data I presented in my March 2013 article about the contest prep of natural bodybuilder Chris Fahs (see "Scientific BB Contest Prep Coverage: Six Months of Dieting, Daily Workouts & Hormonal + Metabolic Shutdown Pave the Natural Way to the Sub 5% Body Fat Zone" | read more). A sufficiently powered study that would determine what Henning et al. call "the anabolic hormonal response to habitual consumption of high protein diets during short-term ED [energy deficit]" as well as the downstream effects of the "modulations in testosterone and IGF-I" on the well-documented preservation of fat free mass "subsequent to consuming high protein diets" (Henning. 2014).

    Are effects of protein on IGF-1 and testosterone responsible for the preservation of lean mass

    To this ends, Paul C. Henning, Lee M. Margolis, James P. McClung, Andrew J. Young, and Stefan M. Pasiakos (you know him from the dark blue infobox ;-) from the U.S. Army Research Institute of Environmental Medicine recruited 33 adults. The perfectly healthy subjects were assigned to diets providing protein
    • 0.8g/kg protein per day (RDA),
    • 1.6g/kg protein per day (2X-RDA), and
    • 2.4g/kg protein per day (3X-RDA)
    for 31 days. The testosterone, sex-hormone binding globulin (SHBG) and IGF-I levels of the 20-22-year old men were assessed after a 10-day period of weight-maintenance (WM) and after 21 days of consuming a calorically reduced (-40%) diet.
    Warning, there is a methodological "glitch" here: Actually it's no glitch for us, because we will achieve our "caloric deficit" by the very same combination of working out and eating less as the subjects in the study at hand. Unfortunately, we all know that simple calculations like "run for an hour and eat those three cups of rice less equals 1000kcal" are notoriously unreliable. This does not diminish the overall significance of the study, but I sill want you to keep that in mind, before you overgeneralize the results to "diet only" or "exercise only" scenarios.
    In view of the previously cited results from Lindy Rossow's natural bodybuilding study (Rossow. 2013; see corresponding SuppVersity article) it's actually not surprising that the scientists hypothesis that "high protein diets would attenuate decrements in testosterone and IGF-I components" is flawed.
    Figure 1:  Relative pre vs. post changes in testosterone and IGF-1 & its binding proteins (Henning. 2014)
    The testosterone and IGF-1 levels of the volunteers who resided on the metabolic ward at the USDA Grand Forks Human Nutrition Research Center to ensure experimental control, plummeted and the acid-labile subunit decreased (Note: The ostensibly high decrease in total testosterone in the 1xRA is a result of surprisingly high total testosterone levels 668.9ng/dL after the accommodation phase on the 1xRDA diet). This alone is not exactly what you would call "muscle preserving". In conjunction with the concomitant increases in the respective binding proteins, i.e. SHBG and all three IGF binding proteins (P < 0.05), the short (21 day) diet phase led to an utter deterioration of two important components of what I would like to the "anabolic milieu" that's necessary for optimal skeletal hypertrophy.

    This leaves us with an interesting side-finding in the higher protein groups where the changes in fat free mass were directly and negatively (r = − 0.62, P < 0.05) associated with a molecule the scientists call "acid-labile subunit (ALS)". In view of the fact that this protein is also known insulin-like growth factor binding protein this observation provides further evidence for the direct involvement of IGF-1 in the accrual and maintenance of muscle mass.
    It takes some profound changes in T-levels to see real-world effects on lean and/or fat mass | learn more
    Bottom line: Protein helps, but it's effect are non-hormonal and mediated via the activation of the p-AKT/mTOR protein synthetic cascade. Put simply: A higher protein intake can help you keep the protein synthetic machinery running. In conjunction with exercise (s. red box), the unquestionably the most powerful anti-catabolic, a higher protein intake helps to preserve lean mass on a diet. What (additional) protein cannot do, though is to ameliorate the diet-induced reductions in testosterone and IGF-1 that occur, whenever you consume significantly less energy than you need.

    Whether you consider it surprising or even unbelievable or simply natural that this doesn't mean that you will "fall apart", is probably a matter of how deeply rooted your (from a science perspective) unwarranted believe in the effects of reductions / increases in testosterone within the normal range is (with 420ng/dL even the men in the 3xRDA group who had the lowest T-levels were still "in range"). If you've read my previous dissertations in "Quantifiying the Big T" (read more), you shouldn't be all too surprised, though (suggested read: "IGF-1 and its Splice Variants MGF, IGF-IEa & Co - Master Regulators or a Bunch of Cogs in the Wheel of Muscle Hypertrophy?" | more).
    References:
    • Henning, et al. "High protein diets do not attenuate decrements in testosterone and IGF-I
      during energy deficit." Metabolism (2014). Accepted Paper - 14. February 2014
    • Pasiakos SM, Cao JJ, Margolis LM, Sauter ER, Whigham LD, McClung JP, Rood JC, Carbone JW, Combs GF Jr, Young AJ. Effects of high-protein diets on fat-free mass and muscle protein synthesis following weight loss: a randomized controlled trial. FASEB J. 2013 Jun 5. [previous SuppVersity article]
    • Rossow LM, Fukuda DH, Fahs CA, Loenneke JP, Stout JR. Natural Bodybuilding Competition Preparation and Recovery: A 12-Month Case Study. Int J Sports Physiol Perform. 2013 Feb 14 [previous SuppVersity article]

    There is More To Glucose Control Than Carbohydrates (1/?): Non-Carbohydrate Nutrients And Their Effects On Blood Glucose Management ➲ Amino Acids, Proteins, Peptides

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    This is part I of a multipart series, you will be able to navigate by clicking on the pictures in the box below.
    While it appears to be obvious that eating a low-to-no-carbohydrate diet would be the easiest way to manage your blood glucose levels, carbs are by far not the only nutrient that will have an effect on your blood glucose levels. In a recent overview article, Martina Heer and Sarah Egert from the Department of Nutrition and Food Science at the University of Bonn provide a decent overview of the multiple ways by which "other nutrients, such as dietary protein and amino acids, the supply of  fat, vitamin D, and vitamin K, and sodium intake seem to affect glucose homeostasis." (Heer. 2014).

    In the coming weeks I will use their review as a starting point for my own overview of the effects of non-carbohydrate and "almost cabohydrate"nutrients  on glucose metabolism. And for today, I decided, to conclude this week that was full of exciting protein news on Monday ("Protein Power" | read more) and Saturday ("Dieting, High Protein, Testosterone & IGF-1" | read more) with - what else could it be - a summary of a the anti-diabetic effects of peptides, proteins and amino acids.
    You can learn more about this topic at the SuppVersity

    Amino Acids, Proteins, Peptides

    Read these ➲ while waiting

    Are You Protein Wheysting?

    Spread or waste your protein?

    Protein requ. of athletes

    High EAA intra-workout fat loss
    Protein, the glucose repartitioner?! Due to its insulinogenic effects protein increases the non-oxidative glucose disposal. In contrast to whey proteins, turkey, beef, eggs and co., i.e. "slow digesting proteins", will induce a significantly reduced insulin surge and have a correspondingly less pronounced effect on blood glucose.

    It does not even take whole proteins. Single amino acids and dipeptides (=2-amino acids) can have glucose repoartitioning trick, too | learn more
    Insulin is yet probably not the major, or primary agent behind these effects. More recent studies appear to suggest that the mechanism of the blood glucose lowering-effect of whey protein seems to be mediated primarily via increases in glucagon-like peptide 1 (GLP-1). This "satiety hormone" will then, in turn, lead to increased insulin secretion (Lan-Pidhainy. 2010; Maier. 2012). Combined with its ability to decrease gastric emptying and the correspondingly reduced influx of glucose through / from the portal vein (Maier. 2012; Bendtsen. 2013), GLP-1 makes the perfect anti-diabetes "drug" - no wonder that Ligratude, a synthetic analogue is already used very successfully in diabetes and obesity treatment (Astrup. 2012).

    In its effects on GLP-1 whey is pretty unique. Even similarly fast absorbing protein sources, such as soy, or other dairy proteins such as casein, do not cause such a pronounced effect on GLP-1 and insulin secretion. A recent study from the Iran University of Medical Sciences and Health Services, for example, compared the effects of the pre-ingestion of additional 65/60g of whey protein concentrate (WPC) and soy protein isolate (ISP) before a meal on a hole host of metabolic markers in 45 healthy overweight and obese men.
    Hypoglycemia warning: If experience fatigue, agitation, sweating, shivering, feeling cold, a having really bad temper and/or other symptoms of low blood sugar, after having a bolus of whey protein, it may be a good idea to (a) check your blood glucose levels and (b) consume your whey with a source of readily available carbohydrates in the future.
    The first improvements in a hole host of parameters were observed after only two weeks and at the end of the 12-week study period, the consumption of additional 65 gr WPC or 60 gr ISP in 500 ml water 30 min before lunch in a non-restricted diet scenario had brought about significant improvements in
    Figure 1: Effects of 12 week of WPC vs. ISP supplementation on fasting blood glucose (Tahavorgar. 2014)
    • systolic and diastolic blood pressure
      ⤷ improved heart health, 
    • apo lipoprotein A-I and apo B
      ⤷ improved cholesterol metabolism, 
    • malondialdehyde
      ⤷ reduced lipid oxidation,
    • HDL, LDL and triglycerides
      ⤷ improved lipid metabolism,
    • high sensitive C- reactive protein
      ⤷ reduced inflammation
    What the scientists did not observe, though, was an improvement in fasting blood glucose levels in the subjects in the soy protein group. The latter was - and that's in line with what we've said before about the effects of different protein sources on GLP-1 - "whey exclusive".
    Figure 2: Glucose and insulin release levels after 50g glucose load w/ 30g whey or 30g canola oil (Lan-Pidhainy. 2010)
    Similar beneficial effects have been observed, among others, by Lan-Pidhainy, whose study was the first to prove that the insulinotropic effects of whey protein are not attenuated by insulin resistance (Lan-Pidhainy. 2010). In contrast to Tahavorgar et al., the researchers from the University of Toronto measured the acute effects on co-ingesting 30g of whey protein with a standardized 50g glucose load - a study that's obviously of lower real-world significance than the chronic administration scheme in the more recent study by Tahavorgar et al. (2014) or the 60-day bedrest study Martin Heer et al. conducted for the NASA. In this tightly controlled study, the provision of a high protein diet (1.45g/kg body mass/d dietary protein plus 7.2g branched chain amino acids per day) with an "animal:vegetable protein ratio" of 60:40, almost fully compensated for the bed rest-induced 35% reduction in insulin sensitivity during 60-day bed rest.

    How does protein work?

    The ameliorative, yet not significant effect of soy protein isolate on the blood sugar levels of the subjects in Tahavorgar study, as well as the observations the researchers from University of Bonn made when they studied the effect of bed-rest, confirm that it does not always have to be whey protein to benefit from the anti-diabetic effects of  the chains of amino acid residues we know as "proteins".

    Ok, the GLP-1 inducing effects of whey protein appears to be particularly pronounced, and partly related to the presence of certain functional dairy peptides, which may, as the data from a 2009 study by Chen et al. suggests, be even more pronounced for casein than whey (see Figure 3).
    Figure 3: Relative GLP-1 production in intestinal cell culture exposed to BCAAs, skim milk or casein (Chen. 2009)
    The Chen clearly supports a hypothesis Heer & Egert form in their previously cited review of the contemporary evidence of the involvement of nutrients other than carbohydrates in blood glucose management. Interestingly, though, the evidence the German researchers cite involves yet another non-BCAA amino acid - alanine, which is also the #1 substrate for hepatic de novo glucogenesis:
    "Although the mechanism is not well understood, some in vitro studies show how the insulinotropic effect might be induced (Dunne, 1990; Brennan. 2005; Cunningham. 2005). In cell experiments with the application of L-alanine, the increase in insulin secretion might be caused by an increased intracellular oxidation of amino acids, which raises the ATP content of the cell. Increase in intracellular ATP content leads to closure of the ATP-sensitive potassium channels, and this channel closure leads to depolarization of the cell membrane and activation of the calcium channels. Activation of the calcium channels then causes an exocytosis of insulin from the cells (Brennan. 2005; Cunningham. 2005)." (Heer. 2014)
    Another possibility could be that amino acids are co-transported into the cell together with
    sodium, as shown in further cell experiments [26]. This could also lead to a depolarization of
    the plasma membrane in the pancreas and finally to an exocytosis (=pumping process) of insulin.
    While 200mcg of chromium are essential, consuming way more can have pro-diabetic effects | learn more.
    You can learn more about the other nutrients in the next installment(s): I know that this is not exactly fair, but let's be honest - Aren't there better ways to spend a Sunday afternoon than writing SuppVersity articles? I personally feel the answer is "YES!" The discussion of the effects of dietary fat, in general, (one of the things that's going to be mentioned may already be inferred from Figure 2) and individual fatty acids in particular, as well as the influence of vitamin D, vitamin K, calcium, magnesium, chromium, zinc, sodium, and a couple of other nutrients will thus have to wait until next week (some even longer ;-).
    References:
    • Astrup, Arne, et al. "Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide." International journal of obesity 36.6 (2012): 843-854. 
    • Bendtsen, Line Q., et al. "Effect of dairy proteins on appetite, energy expenditure, body weight, and composition: A review of the evidence from controlled clinical trials." Advances in Nutrition: An International Review Journal 4.4 (2013): 418-438.
    • Brennan, Lorraine, et al. "A nuclear magnetic resonance-based demonstration of substantial oxidative L-alanine metabolism and L-alanine-enhanced glucose metabolism in a clonal pancreatic β-cell line metabolism of L-alanine is important to the regulation of insulin secretion." Diabetes 51.6 (2002): 1714-1721.
    • Chen, Qixuan, and Raylene A. Reimer. "Dairy protein and leucine alter GLP-1 release and mRNA of genes involved in intestinal lipid metabolism in vitro." Nutrition 25.3 (2009): 340-349. 
    • Cunningham, GA, et al. "L-Alanine induces changes in metabolic and signal transduction gene expression in a clonal rat pancreatic β-cell line and protects from pro-inflammatory cytokine-induced apoptosis." Clinical science 109 (2005): 447-455.
    • Dunne, M. J., et al. "Effects of alanine on insulin-secreting cells: Patch-clamp and single cell intracellular Ca 2+ measurements." Biochimica et Biophysica Acta (BBA)-Molecular Cell Research 1055.2 (1990): 157-164.
    • Heer, Martina, et al. "High Protein Intake Improves Insulin Sensitivity but Exacerbates Bone Resorption in Immobility (WISE Study)." (2012).
    • Lan-Pidhainy, Xiaomiao, and Thomas MS Wolever. "The hypoglycemic effect of fat and protein is not attenuated by insulin resistance." The American journal of clinical nutrition 91.1 (2010): 98-105.
    • Meier, Juris J. "GLP-1 receptor agonists for individualized treatment of type 2 diabetes mellitus." Nature Reviews Endocrinology 8.12 (2012): 728-742.
    • Tahavorgar, Atefeh, et al. "Effects of whey protein concentrate consumption compared with isolated soy protein on metabolic indices, inflammatory and oxidative stress factors in healthy overweight and obese men." Razi Journal of Medical Sciences 20.115 (2014): 17-30.

    Fish Oil or GLA to Treat Acne Vulgaris? Controlled Human Trial Confirms: 2g EPA + DHA or 400mg GLA do the Trick!

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    If you want to know how to get of pubertal acne, you got to ask professional pubescents ;-)
    The study at hand is not only the first experimental verification of the efficacy of omega-3 + gamma linoleic acid supplementation in acne treatment, it's also "paleo approved", because it cites a study by no one else but Loraine Cordaine himself ;-) Don't worry, I am just kiddin' around. In spite of the fact that Cordain's study "Acne vulgaris: a disease of Western civilization" (Cordain. 2002) is in fact the #1 on the reference list, the scientists from the Seoul National University College of Medicine refrain from (paleolithic) dairy bashing in their evaluation of "the clinical efficacy and safety of omega-3 fatty acids and of GLA for the treatment of mild to moderate facial acne." (Jung. 2014)

    If you google "natural acne treatment" it will usually not take long until you find a reference to fish oil and gamma linoleic acid (as in borage or starflower oil). Against that background it is surprising that the Korean scientist are obviously the first to scrutinize the efficacy of 2,000 mg of eicosapentaenoic acid and docosahexaenoic acid and 400 mg γ-linoleic acid (from borage oil) in a parallel design dietary intervention study.

    Long-standing "natural acne cure" now scientifically proven

    The 45 participants with mild to moderate acne, were allocated to either of the intervention groups for 10 weeks, after which the effect on their skin was evaluated visually and via heamatoxylin, eosin and immunohistochemical staining of the lesions.
    DHA + EPA vs. GLA + X: I am not sure if this may have skewed the results, but it is imho worth mentioning that the DHA + EPA group received their 2g of long-chain omega-3s in form of two caps of pure EPA + DHA. The GLA group, on the other hand, had to take 2 caps with 1,000mg of borage oil, which contains 200mg GLA per gram, but also up to 420mg of "regular" linoleic acid, of which scientists believe that it is an acne vulgaris promoter (Wolf. 2004).
    And what the scientists observed was ... positive, at least in the omega-3 group, the mean inflammatory acne lesion count was significantly reduced (from 10.1 ± 3.2 in week 0 to 5.8 ± 3.4 in week 10; p < 0.05).
    Figure 1: Changes in inflammatory acne lesion counts with time (left, top), noninflammatory acne lesion counts with time (left, bottom), and changes in patients' subjective assessment (VAS) with time (right; Jung. 2014)
    As you can see in Figure 1, a similar change was observed in the GLA (9.8 ± 5.2 before vs. 8.0 ± 4.6 after 5 weeks vs. 6.6 ± 3.7 after 10 weeks, p < 0.05), but not in the control group (9.9 ± 4.3 before to 10.2 ± 6.2 after 10 weeks).
    Figure 2: Before (top) and after (bottom) photos (Jung. 2014)
    "Mean non-inflammatory acne lesion counts were also reduced by omega-3 and GLA supplementation (23.5 ± 9.2 to 18.9 ± 8.3, p < 0.05, and 22.8 ± 8.4 to 19.2 ± 7.2, p < 0.05, respectively) at final visits, whereas mean lesion count in the control group was unchanged (from 21.8 ± 9.7 to 22.0 ± 8.6). Significant differences were evident between the treatment groups and the control group after 10 weeks (p < 0.05)." (Jung. 2014)
    In the end, there was no no significant difference between the two treatments for any of the measured parameters, so that it is probably up to you, whether you try to control the "fire within your skin" with GLA or DHA + EPA supplements.
    GLA, EPA & Co play an important role in thyroid disorders, as well | learn more
    "Where Bro- and Pro-Science Unite in the Spirit of True Wisdom": The study at hand exemplifies this simple principle almost perfectly. DHA + EPA and GLA have been used to manage acne vulgaris for years.

    It was thus high time for the "pro-science" to catch up with what "bro-scientists" all around the world knew all along. Fish oil and borage oil help with acne vulgaris.

    Why? Well, in both cases it's probably the reduction of the production of arachidonic acid-derived pro-inflammatory eicosanoids.
    References:
    • Cordain, Loren, et al. "Acne vulgaris: a disease of Western civilization." Archives of Dermatology 138.12 (2002): 1584-1590.
    • Jung, Jae Yoon, et al. "Effect of Dietary Supplementation with Omega-3 Fatty Acid and gamma-linolenic Acid on Acne Vulgaris: A Randomised, Double-blind, Controlled Trial." (2014).
    • Wolf, Ronni, Hagit Matz, and Edith Orion. "Acne and diet." Clinics in dermatology 22.5 (2004): 387-393.

    Saturated Fat Makes You Fat! You Read the Press Release - Here is the Whole Story: A Story of Muffins, SFA, MUFA, PUFA, Body, Liver & Visceral Fat and N6s & Lean Mass

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    I have to admit: Whether a conclusion as general at this is warranted based on the data from a recent study is questionable.
    Somehow I knew that people would freak out, about a press release I reposted on the SuppVersity Facebook page earlier today (read it!). Next to saying that you can eat fructose and not get obese saying that you can eat PUFAs without getting fat is probably as heretic as saying that saturated fat makes you fat... what? Oh yes! You're right, it can be even worse. I mean, imagine you'd say that unsaturated fatty acids are less obesogenic than saturated fats.

    Ah, come on! That's so mainstream it must be propaganda from the "pharmaceutical enteprise/ cholesterol lowering drug entreprise" [sic!], right?

    Well, I am just looking at the acknowledgements of the study the press release refers. Let's see: "None of the authors have any conflicts of interest to disclose" and "This study was funded by the Swedish Research Council (project K2012-55X-22081-01-3)." No, I wouldn't say this sounds like there had been a "pharmaceutical enteprise/ cholesterol lowering drug entreprise" funding the study
    Just as an aside: Discarding the results, because the results are not inline with your own indoctrictinat like the guys who sponsored it, is pretty pathetic. If you want to argue that the results Fredrik Rosqvist and his colleagues from the Uppsala University, and the Center for Clinical Research Dalarna are b*s*, you better take a look at the study design to identify flaws and shortcomings - and guess what?! That's what we are about to do now.
    Now that we have all calmed down a bit, let's see what exactly we could freak out about - or, to put it differently, let's take a closer look atthe study design, the results, and their interpretation.

    I - The Research Question

    I know that many of you don't care about questions. That's a mistake. In science, questions are everything. Answers are secondary. The motto of a true researcher is thus - just as the Greek philosopher Euripides had it -  "Question everything. Learn something. Answer nothing." In the end, we've already made a very good start by questioning the scientists' conclusion that
    "[...] overeating SFA promotes hepatic and visceral fat storage whereas excess energy from PUFA may instead promote lean tissue in healthy humans." (Rosqvist. 2014)
    What we are interested in part I of our analysis are not our questions, though. What we want to look at now, is the question that worried the researchers, the questions, whether ...
    "[...]liver fat accumulation during moderate weight gain could be counteracted if the excess energy originate mainly from PUFA rather than from SFA." (Rosquist. 2014)
    This question, as logical as it may seem for the average individual who has been sucking up the "good fat (PUFA) vs. bad fat (SFA)" mantra with his PUFA-enriched formula ever since he was born, is obvious a reason to freak out for the meanwhile almost as average black-and-white thinking inhabitant of the blogosphere.

    Don't interpret this article as incentive to follow all dietary recommendations to the "T" before you've read my 2012 article on the effects of an allegedly heart healthy low fat diet on the LDL particle profile of healthy volunteers | read more
    What this question is not, though, is pure invention. The idea to investigate whether liver fat accumulation during moderate weight gain could be counteracted if the excess energy originate mainly from PUFA rather than from SFA was born, when the researchers observed an isocaloric diet rich in PUFA given for 10 weeks reduced liver fat content and tended to reduce insulin resistance compared with a diet rich in SFA in individuals with abdominal obesity and type 2 diabetes (Bjermo. 2012) - the differences were not earth-shattering, but statistically significant (-1% total fat in PUFA vs, +0.6% body fat in SFA); and the "improvements" in the visceral fat to subcutaneous fat ratio (a marker of a healthier fat distribution) in the PUFA group of the Bjermo study were brought about (mainly) by increases in subcutaneous body fat in the PUFA group.

    In view of the fact that the alleged improvements (in many cases the values simply worsened less) of the blood lipids, glucose and insulin levels, the hypothesis that "liver fat accumulation during moderate weight gain could be counteracted if the excess energy originate mainly from PUFA rather than from SFA" (Rosquist. 2014) is legitimate, but probably optimistic.

    II - Study Design

    So, if the underlying hypothesis is valid, the next thing we could target to debunk the claim that saturated fats are more fattening / unhealthier than unsaturated fats would be to have a closer look at the design of the LIPOGAIN study:
    • Figure 1: Rel. changes in liver, visceral and subcutaneous fat in subjects over-consuming a high vs. low (white) saturated fat diet.
      the subjects were randomly allocated to the two intervention groups
    • the scientists made sure that the subjects gained weight at identical rates (3%) (the amount of muffins consumed per day was individually adjusted weekly, i.e. altered by +/- 1 muffin/day depending on the rate of weight gain of the individual)
    • the dietary intervention was based on highly standardized food items 
    • muffins containing sunflower oil (high in the major dietary PUFA, linoleic acid, 18:2 n-6) or 
    • muffins containing palm oil (high in the major SFA, palmitic acid, 16:0). 
    • the muffing were baked in large batches under standardized conditions in a metabolic
      kitchen at Uppsala University
    • except  for  the type of fat, the  muffins  were  identical  with  regard  to  energy,  fat (51%),  protein (5%), carbohydrate (44%; sugar to starch ratio 55:45), and cholesterol content, as well as taste and structure.
    I guess you will agree that there are no major design flaws, here. If anything, you could speculate that the changes in SFA and PUFA intake (-1.6% and +4.9% SFA intake and +7.9% and +0.3% PUFA intake in the PUFA and SFA group, respectively) were pretty pathetic and insufficient to produce significant results.
    Figure 2: Relative contribution of saturated (SFA), monounsaturated (MUFA) and polyunsaturated (PUFA) fatty acids to the total energy intake of the subject before and after the study (Rosquist. 2014)
    If you take a look at my plot of these differences (you should be aware that they are expressed in terms of the total energy intake), you will have to concede, though, that the difference between SFA/PUFA ratios, i.e. 0.9 and 3.6, is pretty significant.
    Figure 3: There is a distinct correlation between the relative amount of omega-6 fatty acids in the blood and the change in lean mass - a beneficial one!
    More or less flawless, but still questionable: Whether that's enough for you to accept that the Rosquist et al. used their results to make a general statements about the effects of saturated vs. unsaturated fat intake is up to you. The same goes for the real-world significance of the different body and liver fat trajectories in Figure 1.

    In view of non-negligible increases in total, liver and visceral body fat and the absence of the often-touted pro-anabolic effects of saturated fats (mind the proportionality of an increase in the allegedly bad omega-6 concentration in the blood and the lean mass increases / decreases in Figure 3), it's difficult to keep nibbling on a chunk of bacon without at least taking into consideration that the "bad PUFAs" may not be as bad after all.

    "Whut?" Calm down, I am not suggesting that you have to go back to the "saturated fat is bad for you" mantra, but I would like to invite you to take a parting look at Figure 2 (right) and note that the main characteristic of the "PUFA" diet is not its high PUFA content, but it's balanced fat content. Maybe the sentence "The optimal diet is characterized by a balanced intake of all three main types of dietary fat" would thus be a conclusion we can agree on - ha?
    References:
    • Bjermo, Helena, et al. "Effects of n− 6 PUFAs compared with SFAs on liver fat, lipoproteins, and inflammation in abdominal obesity: a randomized controlled trial." The American journal of clinical nutrition 95.5 (2012): 1003-1012.
    • Rosqvist, Fredrik, et al. "Overfeeding Polyunsaturated and Saturated Fat Causes Distinct Effects on Liver and Visceral Fat Accumulation in Humans." Diabetes (2014): DB_131622.

    Exercise Threesome: The EPO-Effect of Oxygen Shortage ☆ The Training Effects Of Eccentric Flywheel Squats ☆ The Time You'd Have to Work Out If You Wouldn't Watch TV

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    YoYo flywheel device similar to the one used in the study from the Karolinska Institute in Stockholm.
    There is a lot to learn about exercise today! About the blood building effects of intermediate hypoxia, about the impressive effects on strength and power you can elicit, if you do your squats on a flywheel device such as the one to the right, and - let's not forget that - the indisputable evidence that you just have to cut back on your screen time to make room ... ah, I mean "time" to turn from a sedentary slob to an active individual.

    Apropos screen time! Let's  not prolong your screen time more than necessary with this lengthy introduction, but get straight to the point - I mean, the news, of course!
    • The EPO-Effect of Oxygen Shortage : A study from the University of Western Australia shows athletes who train in a low-oxygen environment (simulated high altitude training) have significantly higher hepcidin (a protein that inhibits iron transport from the gut into the portal vein)and erythropoietin (EPO) levels in the early hours after the workout.
      Figure 1: Changes in serum IL-6 (pre vs. post), hepcidin and EPO levels (pre vs. 3h post; Badenhorst. 2014)
      As Claire E. Badenhorst and her colleagues point out, this would lead to an immediate increase in dietary iron absorption and formation of red blood cells that may be partly responsible for the well-known ergogenic effects of altitude training.

      Whether the decreased IL-6 levels immediately after the 8 × 3 min interval running sessions at 85 % of the subject's maximal aerobic capacity are likewise something to celebrate is yet questionable in view of the most recent research on the involvement of this allegedly "bad" inflammatory cytokine (Knudsen. 2014) - I mean, if, as Knudsen et al. argue, the IL-6 increase is responsible for the increase oxidation of fat after a workout you would not necessarily want to decrease it... correct?! The improvements in maximal strength and power, researchers from the Karolinska Institute in Sweden have observed in their latest experiments have been "slightly greater" in the male vs. female subjects. In view of the overall effect size, it is obvious, though that eccentric-overload resistance training is a training technique, both men and women should not forget about prematurely (Fernandez‑Gonzalo. 2014).
    • Eccentric Overload Training for Him and Her - While you are looking at the data in Figure 2 you do have to keep in mind, thought, that doing 6 weeks (15 sessions) of flywheel supine squat RE training is probably not what you had in mind, when you read about "eccentric overload training for him and her" - right?
      Figure 2: Pre vs. post changes after 6-weeks of eccentric flyhweel training (Fernandez‑Gonzalo. 2014)
      Well, in view of the fact that the subjects in the study at hand were not obese couch-potatoes, but science undergraduate students (16 men;  and 16 women) who engaged in 4–6 h of recreational exercise per week, it may be worth to convince the owner of your gym to head over to "yoyotechnology.com" and buy one of these funky devices ;-)
    • A Little Less TV, a Little More Sports! I must say, I was not surprised when I hit on a recent study by Sjaan R. Gomersall, Kevin Norton, Carol Maher, Coralie English, and Tim S.
      "In search of lost time: When people undertake a new exercise program, where does the time come from? A randomised controlled trial." (Gomersall. 2014)
      That's the title of the paper that was published in the Journal of Science and Medicine in Sport. And if we are honest it's also a paper with unsurprising results. It does after all tell us, what most of you will probably already have expected: Reducing their screen time (=TV watching) is the #1 setscrew that will allow previously sedentary individuals to make room for exercise in their lives.
      Figure 3: Changes Physical Activity Level (PAL, in METs) and time (min/day) in front of the computer, for active transport, self-care, quite time and work and study activities (Gomersall. 2014).
      Likewise on the list of reduced activities are the time spent in front of the computer and the time that's wasted on video games (not shown) - wasted unless it's Tetris, of which you've learned only recently that it will help you lose weight; see "An Effective Appetite Suppressant From the 90s" (learn more).

      What's interesting and actually in line with previous research is the fact that the increased activity levels did not reduce the time spent with friends (socio-cultural) or at work. In other words: Working out will not turn you into a lonely jobless person ;-)
    Figure 4: Relative risk of obesity according to sedentary behaviours (in h); adj. for Relative risk of obesity according to sedentary behaviours and physical activity (Banks. 2011)
    Bottom line: Whether you manage to exercise in a hypoxic environment or on a flyhweel machine is unquestionably negligible, as long as you decide to exercise instead of sitting in front of computer and television for a couple of hours, everyday.

    Why you would possible want to do that? Well, what about the 23% increase in obesity risk that comes with 2h of additional screen time per day of which Banks et al. observed in the 91 266 participants of the 45 and Up Study that it cannot be compensated by extra physical activity (see Figure 4; Banks. 2011)?
    References: 
    • Badenhorst, C.E. et al. "Influence of post‑exercise hypoxic exposure on hepcidin response
      in athletes."  European Journal of Applied Physiology (2014). 
    • Banks, Emily, et al. "Screen-time, obesity, ageing and disability: findings from 91 266 participants in the 45 and Up Study." Public health nutrition 14.01 (2011): 34-43.
    • Fernandez‑Gonzalo, R et al. "Muscle damage responses and adaptations to eccentric-overload resistance exercise in men and women." European Journal of Applied Physiology (2014).
    • Knudsen, Jakob G., et al. "Role of IL-6 in Exercise Training-and Cold-Induced UCP1 Expression in Subcutaneous White Adipose Tissue." PloS one 9.1 (2014): e84910.
    • Gomersall, Sjaan R., et al. "In search of lost time: When people start an exercise program, where does the time come from? A randomised controlled trial." Journal of Science and Medicine in Sport (2014).

    Study Confirms: Acute Post-Exercise Myofibrillar Protein Synthesis Is Not Correlated with Resistance Training-Induced Muscle Hypertrophy in Young Men

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    FSR ≠ more muscle = no news for ya!
    For the average SuppVersity reader the sentence "Acute Post-Exercise Myofibrillar Protein Synthesis Is Not Correlated with Resistance Training-Induced Muscle Hypertrophy in Young Men" is not just the title of a recent paper in the open access journal PLOS|ONE, it's also the experimental verification of a claim I've made in almost all my articles about the acute effects of certain training modalities and/or supplements on myofibrillar protein synthesis and the corresponding increases in muscle size some people appear to expect from a 2h-long 10% increase in fractional protein synthesis (learn more).

    And yes, practically speaking these findings imply that we have to question the real world significance of all the neat studies on the "superior muscle building effects" of whey protein, BCAAs and even more so leucine, in which the authors base their recommendations on acute increases in post-exercise protein synthesis.
    Don't worry, you have not been "wheysting" your money: While there is a paucity of data to confirm the long(er) term muscle building effects of isolated amino acids (EAA, BCAA and leucine), there is plenty of data from 6-12 week human trials to support the pro-anabolic effects of whey protein. What we don't have, though is evidence to support the notion that the long-term muscle building effects are as superior to those of other protein sources (e.g. casein) as the increases in acute protein synthesis would suggest.
    In the corresponding experiment that was funded by the National Science and Engineering Research Council (NSERC) of Canada Cameron J. Mitchell et al. determined whether the acute myofibrillar protein synthesis measured acutely in training-naive subjects after their first bout of resistance exercise with protein consumption would correlate with the actual increase in muscle size after 16 weeks of resistance training.

    Suggested read: "Protein Intake & Muscle Catabolism: Fasting Gnaws on Your Muscle Tissue and Abundance Causes Wastefulness " | more
    Before the actual experiment began, the subjects, healthy young recreationally active normal-weight men (177 cm; body mass index = 26.4 kg/m²; men age 22 years) without previous strength training experience, underwent a magnetic resonance imagining (MRI) scans of their right thigh to determine muscle volume, a dual, energy x-ray absorptiometry (DXA) scan to assess whole body fat and bone-free mass (lean mass) and standardized strength tests to determine their maximal isotonic strength (often labeled the 1RM) for all training exercises.

    After all baseline measurements (including baseline muscle protein synthesis) were recorded, the subjects completed 16 weeks of RT while ingesting a protein rich beverage (30g of the same whey protein of which Burd et al. showed in 2012 that it elicits a higher increase in MPS than casein) immediately after their exercise session and with breakfast on non-training days.
    "Briefly, participants trained four times weekly with two upper and two lower body workouts. Lower body exercises are described above in the acute exercise session. Upper body exercises consisted of chest press, shoulder press, seated row, lat pulldown, bicep curl and tricep extension. The program was progressive in linear manner moving from 3 sets of 12 repetitions to 4 sets of 6  repetitions. At the end of the training period, MRI, DXA scans and strength testing were repeated." (Mitchell. 2014)
    If you look at the above description of the workout (and supplementation regimen) you will probably agree that this is pretty much what the majority of resistance physique oriented gym-goers do.
    Figure 1: Myofibrillar fractional protein synthesis rate (left) measured acutely after a single workout and changes in muscle volume (%) over the whole 16-week study period as a function of the 1-6h post-workout FSR (Mitchell. 2014).
    People who hope that the often reported increases in fractional protein synthesis would pay off and yield increased net muscle gains and thus exactly what Mitchell et al. did not observe in their study, which could not establish the corresponding correlation between the actute increase in post-workout fractional protein synthesis (Figure 1, left) and the chronic change in muscle volume (Figure 1, right).

    Figure 2: Changes in muscle volume (%) expressed relative to acute increases in 4E-BP (Mitchell. 2014).
    If anything, it was the expression of the Eukaryotic translation initiation factor 4E-binding protein 1 aka 4E-BP1 one of the motors of protein synthesis, but not the increase in myofibrillar fractional protein synthesis that looked as if it could have any predictive value with respect to the increase in muscle volume, the young men experienced in the course of the 16-week training period.

    After thinking about the implications of these findings for a minute, I do yet have to admit that the assumption that this would refute the previously invoked recommendations completely, is probably premature.
    SuppVersity Suggested Read: "Protein Wheysting?! No Significant Increase in PWO Protein Synthesis W/ 40g vs. 20g Whey, But 100% Higher Insulin, 340% More Urea & 52x Higher Oxidative Amino Acid "Loss" | more
    "Though shalt not make quantitative predictions about long(er) term muscle gains based on acute FSR measurements!"- This statement is unquestionably correct. It's something I have written about before and it's a statement that is supported (if not confirmed) by the data of the study at hand.

    The statement "though shalt not make qualitative predictions about long(er) term muscle gains based on acute FSR measurements", on the other hand, would yet be unwarranted and is probably incorrect. We do after all have more than enough evidence that increases in post-workout protein synthesis will (sooner or later) result increases in muscle size. The fact that we cannot predict the extent of long(er) term hypertophy effects based on measuring acute changes in FSR does not imply that these changes would not matter at all. It does only mean that we have to be careful about overestimating the real-world effects of differences in protein synthesis between training modalities and supplements, even if they are statistically significant in the hours after a workout.
    Reference:
    • Burd, Nicholas A., et al. "Greater stimulation of myofibrillar protein synthesis with ingestion of whey protein isolate v. micellar casein at rest and after resistance exercise in elderly men." British Journal of Nutrition 108.06 (2012): 958-962.

    Meat-Love: You May Have Pork, Too. Eating More Lean Chicken, Beef & Pork Builds 3.6kg of Lean Mass + Cuts Abdominal Obesity by 7% in Obese Australians

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    It's often cited as the source of all nutritional (and environmental) evil and still: The experimental evidence informs us that the epidemiologically instigated politically subsidized meat hating is unreasonable.
    I wanted to start this article with the words "I actually don't know why" and follow it up with the statement "pork has gotten such a be rep," but that would be incorrect: After giving it a brief thought, I do know why pork has gotten such a bed rep as the unhealthiest meat source there is. It's not a religious question as some of you may believe.

    It's rather a matter of the end-consumer products that are made of pork. sausages & co are not good for your health, but that's not because they are made of pork, but rather because they consist of highly processed waste no one of you would eat, if it was served in its original form - and that in spite of the fact that the unprocessed garbage would probably be healthier than the final hot dog.
    "Meat" and "Pork" are not the problems: That pork per se is not a problem and pork-consumers can - probably to the great astonishment of the average dietitian - improve their body composition without diet and exercise by its regular consumption is the results of a recent 6-months study by researchers from the University of South Australia in Adelaide (Murphy. 2014).
    The participants, , 49 overweight or obese adults were randomly assigned to consume up to 1kg/week of pork, chicken or beef, in an otherwise unrestricted diet for three months. To avoid the "saussages" effect the male and female participants were given seven (men) or five (women) portions of "their" meat per week and told to incorporate it into their habitual diet.

    Table 1: Energy & Nutrient intake at baseline and during the meaty intervention period (Murphy. 2014)
    As the meats were matched on energy per serving, the portion sizes varied slightly (pork 140 g/serve, chicken 150 g/serve, beef (red meat) 150 g/serve).
    "All participants were seen fortnightly to monitor body weight, discuss any issues arising in the intervention and collect a selection of frozen meat products including lean beef or pork steak or chicken breast, stir fry, diced and mince. All participants kept a weekly log of study meat consumption" (Murphy. 2014)
    Next to their food intake, the subjects also had to log their physical activity in three-day logs (2x week + 1x weekend).

    This data was then used by the researchers to calculate the energy expenditure (kcal) for every 15 min period in a 24 h day according to nine categories of different types of activity (e.g., sleeping, playing sports, gardening etc.) and multiplied by the appropriate physical activity level factor for the reported intensity of exercise.
    Just to clarify things: There was no energy restriction and/or exercise regimen involved and the data the scientists gathered confirms that the only meaningful changes that occurred were the intended substitutions / additions of lean pork, beef and chicken meat!
    As it turned out, there were no differences in either the total energy or macronutrient intake between the groups; and on the micronutrient side of things, the only measurable difference was a minimally (but statistically significantly) elevated zinc intake in the beef group.
    Figure 1: Changes in body composition during the 6 months pork, chicken, beef phase (Murphy. 2014)
    Against that background it is not surprising that the main outcome, i.e. the changes in body composition I plotted in Figure 1 were (from a statistical point of view) identical as well. What is surprising (certainly for Colin T. Campbell), though, is that
    • Figure 2: Lean mas at baseline and after the meaty intervention (Murphy. 2014)
      ... the weight loss occured in the absence of prescribed energy reduction and / or increase in activity level or the total protein intake (see Table 1) of  the 50 ± 2 year-old overweight male and female participants , 
    • ... there was an extremely health-relevant 7% increase in lean mass (that's +3.5 ± 0.1kg (!); see Figure 2) in and all women
    • ... the researchers did not observe any negative side effects in either of the groups.
    In other words: Simply eating more - not less - lean and mostly "clean" (=unprocessed) meat lead to a significant and unquestionably health-relevant reduction in abdominal fat and corresponding increases in lean mass.
    Bottom line: The significance of the decrease in fat and increase in lean mass, the researcher observed in the study at hand can hardly be overestimated. Unfortunately, there are still way too many men and even more women who consider the "weight loss" their main "health goal" - a goal, of which Allison et al. (1999) have been able to show that it increases all-cause mortality, which a loss of body fat, as it occured in the study at hand, lowers all-cause mortality!

    Suggested read: "Reduced Weight Gain, Improved Insulin Sensitivity and No Adverse Side Effects from 'Red Meat Supplementation' Even in Rodents!" | read more.
    In that, it should not be surprising for you as a SuppVersity reader that an increased intake of (mostly) lean + unprocessed red meat can be the driving force of corresponding changes in body composition. I have, after all, written about the unwarranted over-generalized assault on meats repeatedly (" The Meaty Gritty on the Red Meat Debate: A Comprehensive Rebuttal of the Constant Assault On My Beloved Steaks " | read more); and in view of the data German researchers presented in a 2011 paper (Petzke. 2011), it should be clear that similar benefits of meat in general and lean pork in particular will occur in lean women, as well (see "Additional(!) 200g Pork/Day Build Lean Mass + Improve Blood Lipids & Glucose Levels" | read more)
    References:
    • Allison, D. B., et al. "Weight loss increases and fat loss decreases all-cause mortality rate: results from two independent cohort studies." International Journal of Obesity & Related Metabolic Disorders 23.6 (1999).
    • Murphy, Karen J., et al. "A Comparison of Regular Consumption of Fresh Lean Pork, Beef and Chicken on Body Composition: A Randomized Cross-Over Trial." Nutrients 6.2 (2014): 682-696.
    • Petzke, Klaus J., Susen Lemke, and Susanne Klaus. "Increased fat-free body mass and no adverse effects on blood lipid concentrations 4 weeks after additional meat consumption in comparison with an exclusion of meat in the diet of young healthy women." Journal of nutrition and metabolism 2011 (2011).

    Losing Weight Doesn't Have to Ruin Your Metabolism: No Unexpected Reduction in Energy Expenditure With Sane Weight Loss. Plus: 9 Simple Rules Every Dieter Must Follow

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    Weight loss is easy, but doing it fast and without losing muscle is - as of now - more of an art than a science.
    In the past weeks I have received a couple of questions which revolved around the notion of diet and exercise induced metabolic shutdown. Although I'd hope that I did answer all your questions more or less to your personal satisfaction, I hope that taking the publication of two very recent papers as an incentive to write a whole article about this complex topic will spare me future lengthy elaborations on what exactly happens, when an obese, overweight or lean person reduces his body weight.

    ➲ Fast forward to the 9 simple rules if you're in a hurry

    Before we are going to take a look at the ahead-of-press publication of a related review in the Journal of the International Society of Sports Nutrition, though, I want to briefly envoke the results a group of researchers from the Christian Albrechts University in Kiel presents in their latest paper in the American Journal of Clinical Nutrition (Pourhassan. 2014).

    In the corresponding experiment, Maryam Pourhassan, Anja Bosy-Westphal, Britta Schautz, Wiebke Braun, Claus-C Glüer, and Manfred J Müller investigated the changes in body composition that occur, when overweight individuals lose weight and assessed their impact on resting energy expenditure and insulin resistance. As Pourhassan et al. point out,
    Little has previously been known about metabolic effects of changes in the composition of either FM or FFM with weight loss and gain." (Pourhassan. 2014)
    This is problematic. It should after all be self-evident that the changes in fat mass (FM) and fat free mass (FFM) and their ratio alone will have a significant impact on the resting energy expenditure (REE) of the dieter.
    The interaction between "weight loss", energy requirements and health is a very complex issue, one that's unfortunately still "underinvestigated"
    If we also take into consideration that the position of the fat stores, e.g. extremities vs. trunk, will have a major impact on the weight loss related improvements in glucose and lipid metabolism, as well as whole body inflammation, leptin, adiponectin and the production and effects all sorts of other crucially important proteins and hormones, it becomes obvious that the current practice of plugging, body weight, height and age into a formula and hitting the "="-key on your calculator cannot be exactly the ideal solution. And what's more, the fact that the changes in weight and the corresponding metabolic adaptations will recursively influence each other doesn't make the situation simpler, either.
    Figure 1: Changes in glucose and insulin response during oral glucose tolerance test after diet and/or exercise induced weight loss (Dengel. 1996)
    "Metabolic adaptations are a result of changes in body composition and variations in the metabolism of individual body components. Weight loss had a strong effect on improving insulin resistance in overweight and obese individuals (Dengel. 1996; Niskanen. 1996).
    What's still missing, though, is the
    [...] determination of whether metabolic effects of weight loss result from the reduction of specific fat depots (eg, in VAT) or a generalized decline of adipose tissue" (Pourhassan. 2014).
    Studies like the one by Dengel et al. (see Figure 1) also provide initial evidence that exercise and diet induced improvements in body composition will have different effects on glucose metabolism, which is unquestionably one of the contemporarily most important health markers (and most common reasons people are unhealthy). Significant improvements of the blood glucose response to an oral glucose tolerance test, for example cannot be achieved solely by exercise. Only a reduction in body fat (and as I would suspect liver and muscle glycogen stores) as it is brought about by negative energy balances will get this job done.

    In previous studies, the scientists from the Christian Albrechts University in Kiel have already been able to show that weight loss–related changes in FFM were mainly explained by a reduction in skeletal muscle mass (MM), whith a minor contribution of losses of kidney and liver mass. It goes without saying that the latter depends on the original weight of the organ and can be quite pronounced, in obese individuals, with beginning for full-blown NAFLD (Bosy-Westphal. 2013).

    This is what the researchers did

    In the study at hand, in the course of which 83 healthy subjects - 50% of them obese, the rest normal to overweight - were investigated at 2 occasions with weight changes between -11.2 and +6.5 kg (follow-up periods between 23.5 and 43.5 mo). At both visits to the lab, the scientists measured the...
    • body composition by using the 4-component model and whole-body MRI
    • resting energy expenditure (REE),
    • plasma thyroid hormone concentrations, and
    • insulin resistance
    ...by standardized methods to elucidate the associations between the changes in body composition, energy expenditure, thyroid hormone levels and glucose metabolism.
    Yes, there was no dietary control: In the future it would be nice to see whether or not the means by which the study participants gained and lost weight correlate with the changes in body composition, thyroid hormone levels, resting energy expenditure and insulin sensitivity... the costs for an adequately powered study would yet be exorbitant, I guess.
    If we take a look at the amount of muscle the weight losers dropped (-15%) and the -16% reduction in triiodothyronin (T3) and their relation to the accuracy of the calculated vs. measured energy expenditure in Figure 2, it may be surprising to see that the difference between calculated and real energy expenditure of the subjects is comparatively small.
    Figure 1: Changes in body composition, and thyroid hormones (left) corresponding before calculated (unadjusted) and measured REE levels in weight gainers, losers and stable subjects (Pourhassan. 2014).
    In view of a lean-to-fat mass weight loss ratio of 0.26 and body fat reductions of up to 59.5% (not shown in Figure 2) in the particularly nasty trunk area, it is eventually not that surprising as it may initially seem that the ~11kg the "weight losers" dropped did not result in the often-talked about metabolic shutdown, we see so often in relatively lean individuals whose dream of a cover model physique turns into a nightmare of lifelong dieting.
    Figure 3: Resting energy expenditure (x-axes) expressed as function of total body mass (left), and lean body mass of weight losers (middle) and gainers (right), respectively (Pourhassan. 2014).
    The data in Figure 3 confirms what the previous remarks implied: It's the lean mass and not the total body mass (right) that determines the resting energy expenditure before and after weight loss (left) and gain (middle). Moreover, a detailed statistical analysis of the date revealed several in- and interdependent associations between the changes in body composition on the one hand, and those of resting energy expenditure, T3 levels and glucose metabolism on the other hand:
    "In a first analysis, we included changes in FFM and FM as independent variables.
    Changes in FM explained 22.8% of the variance in changes in REE(measured), and changes in FFM explained an additional 7.4% of the variance. In a second analysis, we added changes in individual components of FFM (ie, changes in skeletal muscle, bone mass, adipose tissue, heart mass, kidney mass, liver mass, and brain mass) and changes in FM as independent variables. Changes in skeletal muscle explained 29.8% of the variance in changes in REE(measured), and changes in FM explained additional 4.2%."
    When changes in plasma triiodothyronine were also included in a third model, an additional increase in the proportion of the explained variance was observed (44.7%). Overall, the changes in skeletal muscle and serum triiodothyronine explained 34.9% and 5.3%, respectively, of the variance in changes in measured REE; and the inclusion of the changes in kidney mass brought about another 4.5% increase of the explanatory value of the scientists' mathematical model.

    Significant associations were also observed between HOMA-IR, the classic the marker of insulin resistance, on the one hand, and subcutaneous trunk (r=0.62), and arm and leg fat (r = 0.46). What's quite intriguing, though is that similar correlations for the "bad" visceral fat were observed only in the weight gainers, while "the decrease in SAT of the arms [...]was the only fat depot decrease that was associated with a decrease in the HOMA index with weight loss (r = 0.45, P < 0.012).

    Skinny arms and insulin sensitivity? That sounds strange!

    It does not only sound strange, it should also remind us of the fact that all the previously discussed correlations are statistics based on a more or less (rather more ;-) uncontrolled investigation into the interactions of weight loss, energy expenditure and metabolic health we should not overestimate.

    In fact, this is where paper #2 comes into play. As Eric T Trexler, Abbie E Smith-Ryan, Layne E Norton who focus on in their review of the metabolic adaptation to weight loss on the "implications for athletes point out, there is plenty of good evidence to support the hypothesis that the energy restriction that's necessary for (rapid) weight loss will induce a number of adaptations that serve to prevent further weight loss and conserve energy. Trexler et al. speculate that ...
    "[...i]t is likely that the magnitude of these adaptations are proportional to the size of the energy deficit, so it is recommended to utilize the smallest possible deficit that yields appreciable weight loss." (Trexler. 2014)
    Consequently, they recommend (just like I did in previous articles) to adopt moderate energy deficits (my suggestion: 20-30% of the habitual, not the calculated energy intake), knowing that it will not just decrease the rate of weight loss, but also minimize the unfavorable adaptations that challenge successful reduction of fat mass.  In conjunction with a high(er) protein intake of >25% of the total energy intake and (my suggestion) at least 30g of high EAA protein with every meal (e.g. dairy, eggs, fish, pork, beef, chicken, turkey, and pea-protein for the vegans) this will facilitate stepwise body fat reductions with minimal reductions in lean body mass and a bearable impact on athletic performance.
    There is no "magic macronutrient ratio": Although I do believe that many of you have finally realized that there is no magic weight loss pill, the emails and messages I receive on a daily basis leave no doubt that even SuppVersity readers have been bamboozled by the "magic macro numbers" that are thrown around all over the Internet. If there is a number you should you should remember, it's "30" as in 30g of quality protein with every meal" (make it 20g for "snacks" and read my interview w/ Sean Casey for more information on this issue).
    It is moreover imperative that you keep lifting heavy objects while you're dieting. As I have outlined in my article "Protein Intake & Muscle Catabolism: Fasting Gnaws on Your Muscle Tissue and Abundance Causes Wastefulness" (read it) the increase in dietary protein will keep the protein synthesis elevated. What it won't do, however is to battle the diet induced expression of catabolic muscle proteins (read more) and the inevitable drop in testosterone  and IGF-1, I wrote about only recently in my article "High Protein Diets Don't Counter Anti-Anabolic Effects of Low Energy Intake" (learn more about the hormonal sides of dieting).

    Take home message for the physique oriented dieter

    The following list of rules, which is based on the latest bro- and pro-scientific evidence is going to help you make the most of your next diet,
    • stick to stepwise reductions of total energy intake - start with 15% and increase in 5-10% steps, whenever you hit a plateau
    • if not absolutely necessary limit your energy deficit to max. 40% - if you hit a plateau, take two weeks off and begin dieting again, instead of running yourself into the ground 
    • keep lifting heavy while you're dieting to minimize muscle loss - you can use bot inter- (e.g. 1x powerlifting, 2x higher rep bodybuilding or circuit training routines per week) as well as intra-workout periodization (eg. a heavy compound lift for 5x5 and auxiliary exercises for 3x10 reps and 4x15 reps)
    • Never work out to burn calories | learn why
      use your diet, and only your diet to generate an energy deficit - there is room for both high intensity interval and classic low intensity steady state (walking on an inclined treadmill) exercise, but it must not be done to "burn calories" (learn why) - unless, obviously, you actually want to feel miserable and accelerate the fal loss stalling adaptive reduction in energy expenditure
    • increase in protein intake to >25% of total energy - as long as you stick to the "-40% max"-rule this should leave enough room for the "magic" 2x RDA (1.6g/kg) value of which a study by Pasiakos showed that it produces a better lean-to-fat mass loss ratio than a diet with 2.4g/kg protein (learn more)
    • consume at least 30g of EAA-rich protein per meal - this will bring you up to the magic 10g of EAAs which have been shown to be associated with improved body composition in epidemiological studies (don't use isolated amino acids, instead - they are non-satiating and have inferior metabolic and protein anabolic effects)
    • implement regular refeeds, whenever your total energy deficit is >25% - the refeeds will consist of a single day of 10-15% above maintenance energy intake with a focus on carbohydrates, and should be implemented once or twice a week; they are are believed "to temporarily increase circulating leptin and stimulate the metabolic rate" (Trexler. 2014) and will thus postpone the occurrence of weight loss plateaus 
    • The beneficial metabolic effects of veggies are mediated in parts by stretch receptor <> vagus nerve interactions in your gut (Rolls. 2002; de Graaf. 2011). These are reduced / absent if you juice or powder your veggies.
      fill yourself up with vegetables - except from a few "high energy" exceptions you can and should eat as many veggies as possible; aside from the tons of healthy vitamins and phytonutrients, the mere increase in food volume is going to have a major metabolic impact that goes way beyond an increase in satiety and cannot be achieved with powdered and is significantly reduced with juiced vegetables (you can still "juice", if you insist even waste money on greens supplements, but their benefits will never be up to fresh produce)
    • avoid post-starvation obesity by working your way up to your habitual energy intake progressively - this is particularly important to avoid the formation of new fat cells (=adipocyte hyperplasia), which are currently believed to stick "forever" (=the cells whole life-cycle of ~10 years); neither the pizza and McDonald's diet, nor - and this is something most people tend to overlook - returning to the dietary habits that brought you into a situation, where dietary restriction became obligatory to get (back) in shape are feasible ways of eating after a diet; increase your energy intake in <5% steps every three days and watch the scale and your image in the mirror carefully to minimize fat gains (it's impossible not to gain a minimal amount of fat)
    While all of these recommendations have anecdotal evidence (many of them from generations of fighters, bodybuilders and figure athletes), not all are "scientifically proven" - the procedure of reverse dieting, for example, sounds logical, it appears to work, but a study that would compare the changes in body composition on a slow "on-ramp" to those which occur, when you return to a whole-foods, junk-food free maintenance diet - ie. the litmus test for reverse dieting - has yet to be conducted.
    Bottom line: In spite of the fact that the primary sources (Pourhassan. 2014 & Trexler. 2014) today's SuppVersity article is based on deal with totally different subject populations, i.e. obese sedentary vs. lean and athletic, the rules I formulated towards the end of the article can be used to optimize and sustain fat (not just weight) loss by all dieters from the Biggest Loser candidate, whose life depends on a 50% reduction to the (almost) shredded physique athlete who does not want to sacrifice his / her health and future physique for the one triumph that may bring him / her a pro-card in whatever division he or she may be competing in.
    References:
    • Bosy-Westphal, A., et al. "Effect of weight loss and regain on adipose tissue distribution, composition of lean mass and resting energy expenditure in young overweight and obese adults." International Journal of Obesity 37.10 (2013): 1371-1377.
    • de Graaf, Cees. "Why liquid energy results in overconsumption." Proceedings of the Nutrition Society 70.02 (2011): 162-170.
    • Dengel, Donalald R., et al. "Distinct effects of aerobic exercise training and weight loss on glucose homeostasis in obese sedentary men." Journal of Applied Physiology 81.1 (1996): 318-325.
    • Niskanen, L., et al. "The effects of weight loss on insulin sensitivity, skeletal muscle composition and capillary density in obese non-diabetic subjects." International journal of obesity and related metabolic disorders: journal of the International Association for the Study of Obesity 20.2 (1996): 154-160.
    • Pourhassan, Maryam, et al. "Impact of body composition during weight change on resting energy expenditure and homeostasis model assessment index in overweight nonsmoking adults." The American journal of clinical nutrition (2014): ajcn-071829. 
    • Rolls, Barbara J., and Liane S. Roe. "Effect of the volume of liquid food infused intragastrically on satiety in women." Physiology & behavior 76.4 (2002): 623-631.
    • Trexler et al. Metabolic adaptation to weight loss: implications for the athlete." Journal of the International Society of Sports Nutrition 11 (2014):7.

    "Now You Can Eat All The Crap in The World and Still Lose Weight" Psychological Liberation After Taking a Purported "Fat Burner" is an Overlooked Risk Factor for Obesity

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    Yeah! I am in the active arm of the study! Now I Can Eat All The Crap in The World and Still Lose Weight!
    I have been waiting for this study to be conducted for years and am by no means surprised that a group of scientists from the Tunghai University and the National Sun Yat-sen University in Taiwan found that "[u]sing weight-loss supplements may produce unintended consequences on
    dietary self-regulation." I mean, don't we all know someone who succumbed to the psychological
    liberation when he or she was using a weight-loss supplement? Yes, we do! 

    Is it any wonder that weight loss pills suck, if the experiment Yevvon Y. Chang and Wen-Bin Chiou conducted confirmed what we expected altogether?
    You can learn more about fat burners at the SuppVersity

    Capsaicin as a Thermogenic

    Piperine vs. Silbutramine
    New Ephedra Sources?

    Inflammation = True Fat Burner

    Fat Oxidation ↑↑ w/ Caffeine

    High Calcium Diets = Fat Burner?
    After consuming a purported weight loss pill, the 70 young women who had been recruited for the experiment and were randomized to receive a pill of which half of them was told ...
    • "the test pill will help you to attain weight loss" - active arm of the study
    while the other half was told that the little pills they were supposedly taking in the "Biology Department" and during a functional food test, got the information
    • "the test pill is a placebo that will be used in a future study" - placebo arm
    before they were send to a student restaurant for a lunch buffet - the buffet, where the magic happened and the psychologically liberating effect of the weight loss pills took full effect.
    "The food in this buffet, which remained consistent over the course of the experiment, consisted of six healthy items (e.g., fruit, salad with Japanese dressing, vegetable pizza, steamed bean cu steamed fish, and sugar-free green tea) and six less healthy items (e.g., chocolate cookies, French fries, fried chicken, cheeseburgers, soda, and custard). Healthy and less healthy items were identified by two nutritionists blind to the purposes of the experiment." (Chang. 2014)
    Other than you may have expected, the "heavier" ladies neither ate more, nor less healthy foods. What did have an impact on the number of food items and, more importantly, the type of food (healthy vs. unhealthy) the young women ate was the message the message they'd received, when they had taken the weight loss pill.
    Figure 1: Relative differences in total, unhealthy and healthy food intake in subjects who believed that they consumed the weight loss pill; data expressed relative to control group (Chang. 2014)
    As you can see in my plot of the study results in Figure 1, the women who had been told that the pill the had taken was an effective fat burner, consumed more food and made unhealthier food choices than the control group who believed they had consumed an ineffective placebo supplement.

    Based on a previous analysis of the participants general attitude towards weight loss supplements, the scientists were also able to determine that the "now you can eat all the crap in the world and still lose weight" effect was more pronounced in those young ladies with a positive attitude towards weight loss pills and a firm believe in their efficacy.
    Suggested Read: "Forgotten Dieting Aids: Choline, Carnitine, Caffeine and the Anti-Weight-Loss Plateau Effects of Sugar and Phosphates" | more
    Bottom line: I am not telling you not to support your weight loss efforts by using a stim-based fat burner. These products can keep you going, suppress appetite and will help you function in your everyday life, when your calorie intake drops and the lack of energy takes it's toll.

    NONE of the currently available OTC fat burners will actually "burn" the fat you are to lazy to lose. If you are taking these products to have the occasional slice of pizza every other day, you are doomed to fail. Sales of indulgences like this may work in the confession box, but they don't work on the (body fat) scale.
    References:
    • Chang, Yevvon Y., and Wen-Bin Chiou. "The Liberating Effect of Weight-Loss Supplements on Dietary Control: A Field Experiment." Nutrition (2014).

    There is More To Glucose Control Than Carbohydrates (2/?): Non-Carbohydrate Nutrients And Their Effects On Blood Glucose Management ➲ SFA, MUFA PUFA, TFA & Co - Fats!

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    Some say "fat is a mistake" others say "it was our fattest mistake to believe just that" - who is right? Or are things eventually more complicated than that?
    In the last installment of this series, we've covered the relatively well-known, but rarely well-understood beneficial effects of protein on glucose homeostasis in humans (⤷ go back and read it).

    This week we will make a fat transition (all puns intended) to the 2nd macronutrient that exerts non-carbohydrate dependent effects on glucose homeostasis: FAT!

    We have known for decades that the acute glycemic response is affected by the fat content of the diet.

    As my German "friends", Martina Heer and Sarah Egert, whose recent paper in the scientific journal Diabetes/Metabolism Research and Reviews inspired me to write this article series point out, a recent meta-analysis of the existing literature on low-carbohydrate + high-fat diets suggests that these diets, unlike high-carbohydrate and high glycemic index diets, may be effective in improving glycemic control, weight, and lipid profiles (Schwingshackl. 2011).
    You can learn more about this topic at the SuppVersity

    Proteins, Peptides & Blood Glucose

    SFA, MUFA, PUFA & Blood Glucose

    Read these ➲ while waiting

    Low Fat Advantage on IF

    16 Weeks High Fat Diet

    Fat to Blunt Insulin?
    In view of the fact that I may probably safely assume that you haven't been living under a rock for the past 10 years, I would be impressed if you consider the results Schwingshackl et al. presented in the Annals of Nutrition and Metabolism news.

    We all know that there is hardly a better way to reduce blood glucose levels than not eating carbohydrates, but if you look at the title of this series and my goal to present an analysis of the effects of non-carbohydrate nutrients on blood glucose homeastasis in humans, it should be obvious that low carb diets must be excluded from this overview. What we will focus on in this installment is thus
    • the general effect of dietary fat on the absorption, appearance and clearance of glucose from the bloodstream, and
    • the different effects of saturated, monounsaturated, and polyunsaturated short- and long-chain fatty acids on glucose homeostasis
    Now that you all know our plan of attack, let's get right straight to the facts and our close analysis of the contemporarily available data. There is a myriad of different fatty acids in our diets, but we don't even understand the role of the most abundant ones, which are oleic acid, linoleic acid, palmitic acid, and stearic acid completely.
    Where are the short chains? If you are honest, this is an unwarranted question. We are, after all talking about "non-carbohydrate nurtients" from your diet, here and last time I checked, the production of short chain fatty acids in our guts required dietary carbohydrates. If we discard the 3-4% of butyrate quality butter, you will thus have to consume resistant starches to benefit from the proven anti-diabetic, anti-obesity effects that is brought about by the interaction of gut derived short chain fatty acids with "their" receptor, ie. GPR43 (den Besten. 2013; Kimura. 2013).
    The ratio of these monounsaturated, polyunsaturated and saturated fatty acids in our diet determines our own molecular built, meaning: The dietary acid composition of our diet has both acute mechanistic, and chronic structural effects on our cells, which are mediated by the storage of fatty acids in tissues and cell membranes (Carlson. 1986).
    • 27nmol/L LDL Per 1% Reduction in Trans Fat Intake | learn more
      A high intake of trans-fats for example will lead to an accumulation of trans-isomers of linoleic acid in the heart and a highly significant 50% risk increase for cardiac arrest (Lemaitre. 2002).
    • A high concentration of linoleic acid (n-6) in the erythrocyte membrane has been shown to be negatively, a high palmitic acid content positively associated with incident type 2 diabetes in 1346 Finnish men aged 45–73y researchers from the University of Eastern Finland followed for 5-years in recently conducted a population-based study (note: The researchers detected no protective effect of omega-3 fats; cf. Mahendran. 2014).
    I could easily extend this list, but I assume that you're getting the idea of the significant interactions between the fatty acid composition of cell membranes and the various functions and attributes of the cells (eg. membrane fluidity, ion permeability, and insulin receptor binding or affinity), which can affect both, local as well as systemic insulin sensitivity.
    Fatty acid ⇆ PPAR interaction (Kota. 2005)
    "More recent experimental data also point toward other mechanisms which involve direct regulatory effects on gene expression and enzyme activity.

    For example, in vitro studies and studies in animal models suggest that fatty acids could act directly on insulin-sensitive tissues (Risérus. 2008)." (Heer. 2014)
    In the six years that have passed since the overview by Risérus et al. (2008) Heer and Egert cite in their paper has been published, we have learned much about these direct effects. You all know the effects fish oil, conjugated linoleic acid and co have on the peroxisome proliferator-activated receptors (PPARs) and the corresponding downstream effects on glucose uptake and the storage of superfluous energy in the adipose organ (Kota. 2005. Grygiel-Górniak. 2014).

    PUFAs, PPARs and the key to becoming a healthy obese individual

    According to the most recent review of the literature, the PPAR-gamma receptor which is activated primarily by unsaturated fatty acid and their metabolites (15- hydroxy eicosatetraenoic acid, 9- and 13- hydroxy octadecadienoic acid, 15-deoxy  12,14-prostaglandin J2, and prostaglandin PGJ2), is the master regulator of glucose homeostasis and lipid storage. Against that background it is no wonder that Risérus concludes his previously cited review on the note:
    "Substituting saturated fat with unsaturated fat seems to have beneficial effects on insulin sensitivity, although the clinical significance of modifying fat quality alone is still unclear." (Risérus. 2008)
    It's after all an increase in insulin sensitivity that is - at least in the chronic overfeeding scenario, we call the "standard American diet" - an increase in insulin sensitivity that is paid for with increased adiposity - a phenomenon that's related to the pro-adipogenic effects of PPAR-gamma and one that diminishes the usefulness of  thiazolidinediones like pioglitazone, which are mostly pan(=all) agonists of the peroxisome proliferator-activated receptors, in the battle against diabetes. At least, if you share my opinion and think that treating an already overweight diabetic with a drug that will lead to significant weight gain (Khan. 2002) could do more harm than good in the long run.
    The fact that the anti-diabetes effects of PUFAs are mediated by their adipogenic effects does not mean that you have the choice between pest and cholera, but the PUFA induced increase in insulin will always be a double-edged sword, as long as you are consuming significantly more energy than you're expending.
    Still, if our main concern is blood glucose management in an overfeeding scenario (=the Western real word), the international recommendations to reduce the intake of saturated fatty acids (SFA) to ≤10% of total energy intake (Aranceta. 2012) do appear warranted. And if replacing them with carbohydrates is not an option, because (a) we are talking about the influence of non-carbohydrate nutrients and (b) "[n]o clear association between SFA intake relative to refined carbohydrates and the risk of insulin resistance and diabetes has been shown" (Astrup. 2011), we will probably have to resort to protein (see last installment) or mono- and polyunsaturated fatty acids. Both have been shown to exert beneficial effects on glucose and lipid homeostasis, as well as other important health markers.
    • MUFAs boost resting energy expenditure: Next to its beneficial effects on blood glucose and lipid management, a high intake of monounsaturated fatty acids can also increase the resting energy expenditure in humans by 3% in the fed and 4% in the fasted state, respectively (Kien. 2013).
      Monounsaturated fats - MUFAs -- Gadgil et al. report that 2 weeks on high MUFA diets lead to prompt improvements in insulin sensitivity in 64 individuals with prehypertension or stage 1 hypertension without diabetes (Gadgil. 2013). Two years before Gillinghan et al. wrote in a review of the effect of high mono-unsatuarated fatty acid intakes that the "[c]onsumption of dietary MUFA promotes healthy blood lipid profiles, mediates blood pressure, improves insulin sensitivity and regulates glucose levels" (Gillingham. 2011).
    • Polyunsaturated fats = PUFAs -- Similar beneficial effect on heart health have been reported for the replacement of saturated fat with polyunsaturated fatty acids (both, omega-3 and omega-6; see Flock. 2014). Evidence for the beneficial effects of omega-3 fatty acids, in particular, dates back to the late 1980s, when Popp-Snijders et al. observed that 8 weeks of daily supplementation of 3 g of the omega 3 fatty acids eicosapentaenoic and docosahexaenoic acid improves the insulin sensitivity of subjects with non-insulin-dependent diabetes (Popp-Snijders. 1987).

      Unfortunately, studies like this have triggered an unwarranted euphoria even among healthy individuals, whose hope for further improvements in insulin sensitivity are not just unwarranted (Risérus. 2008), but could actually mislead them to mimic the high-dose fish oil supplementation regimen of the diabetic subjects in a 2006 study by Mostad et al. (1.8 g 20:5n−3, 3.0 g 22:6n−3, and 5.9 g total n−3 fatty acids from fish oil) to end up with a similar negative effect on blood glucose levels and glucose utilization (see Figure 1).
      Figure 1: Blood glucose levels (left), glucose utilization and C-peptide levels (right) of 26 diabetic subjects after 8 weeks of high dose fish oil vs. corn oil supplementation (Mostad. 2006)
      It must be said, though, that the Mostad study is an exception. Most fish oil supplementation studies used lower amounts of fish oil and showed improvements in lipid metabolism, but no effect on insulin sensitivity, similar to those Kabir et al. observed in 2007. Accordingly, reviewers agree fish oil supplementation in moderate dosages (equivalent to 1-2 g/day n-3 LCPUFA) has no significant adverse effects on fasting glucose, HbA1c, fasting insulin, or insulin sensitivity (McManus. 1996; Friedberg. 1998; Montori. 2000; Lombardo. 2006; Akinkuolie. 2011; Lee. 2013) - unfortunately, it does not improve these parameters, either.
    If we take a look at the null-results (=no difference in insulin sensitivity between groups) Lovejoy et al. present in their 2002 study on the effects of "high" MUFA, SFA and trans-fatty acid diets with only 9% of the total energy being based on the corresponding fatty acids, it is yet questionable how "high" the saturated fat intake has to be to elicit negative effects (Lovejoy. 2002).
    Are transfats fat burners? It is certainly counter-intuitive, but in the Lovejoy study, the 9% transfat (elaidic acid) diet did not leave the insulin sensitivity of the 25 healthy men and women who participated in the trial unchanged, they did also increase the oxidation of fatty acids by 21% compared to the high MUFA diet (Lovejoy. 2002).
    If we compare the results of the Lovejoy study to those Vesby et al. present in their 2001 paper, it would appear that the perviously cited 10% of the total energy intake could actually be a realistic upper intake level. With 17% of the total energy the diet in Vesby's 3 months study had a significantly higher saturated fat content - high enough to produce a -10% reduction in insulin sensitivity compared to baseline (-12% compared to high MUFA control). Similar negative effects have been observed in the Rosquist (2014) study, I wrote about only a couple of days ago (see "Saturated Fat Makes You Fat!" | read more).

    This wouldn't be the SuppVersity, though, if I didn't list at least two of the "on the other hands" we haven't discussed yet. Firstly, there are no long-term dietary intervention studies that would support the results of these and other 4-12 week interventions.

    Is palmitic acid the bad guy? If SFAs impair insulin action, are all SFAs equally bad? Possibly not, but there is still insufficient evidence to prove this. Vessby et al. proposed that especially high proportions of palmitic acid may promote insulin resistance, and that a major role of SCD-1 may be to reduce the availability of palmitic acid in body tissues by converting it to palmitoleic acid. And while it appears as if palmitic acid had most significant negative effects on cellular glucose transport, fat oxidation, ceramide synthesis, cellular signalling, apoptosis and lipogenesis, conclusive evidence that "it's just palmitic acid that's the problem", is still missing.
    And secondly, and probably more importantly, none of the studies investigated the interactions between the saturated fat and carbohydrate content of the diets. As I pointed out right at the beginning of this article, there is little doubt that a high fat diet with a minimal carbohydrate content will lower the average blood glucose levels of (pre-)diabetic individuals - in this case, the negative effects of palmitic acid on the insulin sensitivity of skeletal muscle (Sawada. 2012), fat cells (Kennedy. 2009), and the hypothalamus (Benoit. 2011) are irrelevant, anyway. No carbs, no increase in blood glucose, no need for insulin stimulated glucose uptake... ah, and not a topic for this article series, since it is about the influence of "non-carbohydrate" nutrients on blood glucose levels.

    Another of these non-carbohydrate nutrients that got an honorable mention as purported fat burner in a couple of paragraphs before are cis- and transfats. Isomeric fatty acids with the same number of carbon and hydrogen atoms, but very distinct health effects. Transfats include:
    • "unnatural" cis- and trans monounsaturated fatty acids as they occur in partially hydrogenated fats, but also
    • "natural" ones such as vaccenic acid and the conjugated isomers of linoleic acid (CLA) in dairy
    about which Mensink et al. write in their 2005 review of the literature, that "it is [still] not clear if effects of ruminant and industrial trans fatty acids on cardiovascular risk are different" from those of the non-ruminant ones (Mensink. 2005).

    Before we are taking a closer look at how bad the "bad" unnatural transfats actually are, I would thus like to suggest that we remind ourselves of the benefits of their ruminant cousins.

    Contrary to the benefits of supplemental CLA, the beneficial effects of vaccenic acid and other ruminant transfats in dairy are beyond doubt | more
    If you are, as I would hope a SuppVersity fan and follow all the recent events (which means >9 news items per day) on www.facebook.com/SuppVersity, you will that the evidence to suggest that the effects of hydrogenated vs. ruminated transfats are completely different has been accumulating ever since the publication of Mensink's paper.

    Only a couple of days ago, on Friday, to be precise, I posted a blurb about a recent study from the Konkuk University in Korea, which demonstrated direct anti-cancer effects from the "CLA precursor" vaccenic acid (Lim. 2014). The #1 ruminant transfat in full-fat milk and dairy products (read more on the SuppVersity Facebook Page).
    If you wanted to destroy your body fat, you'd have to consume exclusively the prodiabetic, inflammatory tans-10,
    cis-12 isomer | learn more
    Stay away from mixed CLA supplements: Contrary to the health-benefits of their food-borne brethren, the usefulness of the transfats you will find in gel-caps at each and every supplement store are still "controversial" it is clear that "more research is needed before the widely available CLA supplements (racemic mixtures of both isomers with prodiabetic effects; cf. Risérus. 2002) should be advocated as an adjunct to control body weight" (Heer. 2014) - and this is specifically true in view of the opposing effect of cis-9,trans-11 (anti-inflammatory, anti-diabetic | Moloney. 2007)  and trans-10,cis-12 (inflammatory | Poirier. 2006) conjugated linoleic acid on blood lipids and glucose metabolism (Halade. 2010)
    Now, we've (as so often) been talking about weight loss, and blood lipids. Before we go on, I would thus like to point out that, earlier this year, Nestel et al. have been able to show that lysophosphatidylcholine, lyso-platelet-activating factor, and several phospholipid fatty acids did not only correlate with the number of servings of full-fat dairy foods of 86 overweight and obese subjects with metabolic syndrome, but also with their insulin sensitivity (Nestel. 2014).

    Surprise: No evidence to support benefit of reduction of dietary TFA on glucose homeostasis

    If we take a look at the corresponding effects of transfats, the picture that emerges is less clear. A recent meta-analysis ofseven randomized, placebo-controlled clinical trials, for example, has shown that an increase in TFA intake from 2.6% to 7.8% of total energy intake did not lead to any significant change in circulating glucose or insulin concentrations (Aronis. 2012). The meta-regression analysis the researchers from the Harvard Medical School conducted also revealed that there was no dose-response relationship between the amount of transfats their subjects consumed and the corresponding effects on blood glucose and insulin concentrations. In spite of the very real detoriations of the HDL/LDL cholesterol ratio, there is thus, as Aronis et al. rightly point out, "no evidence to support a potential benefit of the reduction of dietary TFA intake on glucose homeostasis." (Aronis. 2012)

    Let's not forget the acute effects!

    I mentioned them right at the beginning of this article: The acute effects dietary fats can and will have on the blood glucose, insulin and incretin (~satiety hormone) response to a meal. 

    Figure 2: Blood glucose (mmol/L, left), GIP (pmol/L, top-right), and insulin (mU/L, bottom-right) response to a standardized mashed potato meal 30min after the ingestion of water, olive oil, or both (Gentilcore. 2006)
    As Figure 2, a compilation of data from a 2006 study by Gentilcore et al. shows, the pre-ingestion of 30ml olive oil 30 min before a standardized mashed potato meal that was prepared based on 65 g powdered potato and reconstituted with 250 ml water and 20 g glucose (total carbohydrate content of the meal was 61 g) lead to a significant reduction of the postprandial glucose surge (see Figure 2, left), significant increases in GIP and a prolonged elevation of insulin (Figure 2, right). As beneficial as the acute reduction in glycemia may seem to a type II diabetic. In the long run it were these prolonged phases of hyperinsulinemia that triggered the development of his diabetes (Marangou. 1996).

    The pro-inflammatory effects of high fat meals, of which a recent paper by Mohammed Herieka and Clett Erridge would suggest that they have been underestimated in the common analyses of plasma borne markers of inflammation, such as cytokines and soluble adhesion molecules (Herieka. 2014), on the other hand depend largely on the type of dietary fat that is consumed. While cooking oils and foods that are high in saturated fats appear to have consistent pro-inflammatory effects (Williams. 1999), high MUFA and or omega-3 enriched meals, walnuts, almonds, pistachios and, obviously, fatty fish will ameliorate the postprandial inflammation and exert beneficial effects on the vascular reactivity (West. 2005).
    Figure 3: Pro-inflammatory dietary fats are only one of the components that drive the contribution of the postprandial inflammatory response to the self-intensifying circle of metabolic inflammation (Margioris. 2009)
    In conjunction with the caloric value, the glycemic index, and the lipid profile, as well as inter-personal parameters such as obesity, adult onset diabetes and a sedentary life-style, the whole issue of high fat induce post-prandial increases in inflammation and their potential effects on glucose metabolism is yet to complex to be addressed, here. In view of the fact that it is only indirectly related to the topic at hand, you will have to read up on this, yourself. In that, the 2009 paper by Andrew N. Margioris, from which I took Figure 3, could serve as a starting point (Margioris. 2009).

    Don't worry if your head feels ready to explode

    It's about time, we sum things up, anyway. While we certainly have a lot to learn, the contemporary scientific evidence would suggest that...
    • the commonly cited negative effects of dietary fat on insulin sensitivity are real - even a high fat, low carb diets will lead to acute reductions in glucose tolerance (Hales. 1963),
    • the negative effects on insulin sensitivity are partially mediated by increases in free fatty acids (Roden. 1996),
    • the ill health effects of the high fat-induced reduction in glucose tolerance depends on the presence and amount of carbohydrates, as well as the total energy intake and -expenditure and other non-nutrient dependent parameters (Margois. 2009),
    • in the postprandial phase, the impaired / slowed influx of glucose and the prolongation of the postprandial hyperinsulinemia may provide an acute relief for people with already elevated blood glucose levels (Gentilcore. 2006), eventually, they will yet promote the development and progression of insulin resistance (Marangou. 1986)
    • Figure 4: Insulin secretion rates in response to isocaloric meals based water (CONT), palm oil (SFA), olive oil (MUFA) and safflower oil (PUFA) in overweight and obese but otherwise health non-diabetic men (Xiao. 2006)
      the postprandial inflammation that occurs after the ingestion of a high fat meal is problematic for individuals with an already high baseline inflammation (Peairs. 2011),
    • based on epidemiological evidence it would appear that the replacement of saturated with mono-unsaturated fats will result in long-term improvements in blood glucose management (Gillingham. 2011),
    • compared to saturated fat, an increase in polyunsaturated fats improves the acute insulin response to an otherwise isocaloric meal (see Figure 4; safflower vs. olive vs. palm oil in Xiao. 2006),
    • the anti-inflammatory effect of omega-3 fatty acids do not produce consistent improvements in blood glucose management (Akinkuolie. 2011),
    • Figure 5: Paleo-lovers listen up! Aside from a higher protein and a sign. lower N6/N3 ratio, the alleged "paleo diet" or rather the diet, Cordain, Eaton & co tell you our ancestors ate had a 50% lower SFA:PUFA ratio (Simopoulos. 2002)
      there are concerns that very high intakes of omega-3 fatty acids (>6g of LCPUFA for months) could lead to reductions in insulin sensitivity similar to those we are seeing with the imbalanced omega-6 intake of the Western diet (Simopoulos. 2002; Mostad. 2006),
    • the anti-diabetes effects of high(er) PUFA intakes come hand in hand with a pro-obesogenic increase in PPAR-gamma activity similar to, but less pronounced than those of thiazolidinedione-based anti-diabetes drugs like pioglitazone - keyword: "obese, but healthy"
    • the existence and even more so the extent of the often-claimed negative effects of transfats on glucose metabolism are dubious (Aronis. 2012); if anything, they occur as long(er) term down-stream effects of more general pro-inflammatory and hyperlipidemic effects of non-ruminate trans fatty acids and the foods that contain them (Remig. 2010), and lastly
    • there is accumulating evidence that the natural blend of ruminant transfats in high fat dairy exerts beneficial effects on glucose metabolims (Mensink. 2005; Lim. 2014)
    As you will have realized by now, there is no definitive answer to the question, whether fats are good or bad. When it comes to diabetes and insulin resistance, it's not even possible to point with a finger on the bad trans-fats without having to ask yourself, if they aren't yet another scapegoat for a problem that's nor nutrient, but rather food related. A problem for which the overabundance of energy dense nutrient-poor foods is a perfect growth medium.
    The superior lean mass and significantly reduced fat gains, Mendes-Netto et al. observed in 2011 with an extreme high carb + low fat diet are a perfect example of the fact you better stay away from fat, when you feel the need to overeat on carbs on a bulk or whenever else | more.
    When it's all said and done, the central message of this extensive analysis is probably that it is simply impossible to look at the effect of dietary fat on glucose homeostasis in man in isolation. In combination with high amounts of 'preferably' fast-digesting carbs dietary fats - specifically saturated ones - are pro-diabetic villains and their sixfold unsaturated cousins are not a tad better.

    In concert with a balanced whole-foods diet, regular physical activity and quality sleep, however, your health and insulin sensitivity are not going to be threatened by the consumption of reasonable amounts of saturated fats and their potentially pro-inflammatory omega-6 cousins whose overabundance and not their inclusion in the modern Western is a highly obesogenic problem (see Figure 5).
    References:
    • Akinkuolie, Akintunde O., et al. "Omega-3 polyunsaturated fatty acid and insulin sensitivity: a meta-analysis of randomized controlled trials." Clinical Nutrition 30.6 (2011): 702-707.
    • Aranceta, Javier, and Carmen Pérez-Rodrigo. "Recommended dietary reference intakes, nutritional goals and dietary guidelines for fat and fatty acids: a systematic review." British Journal of Nutrition 107.S2 (2012): S8-S22. 
    • Astrup, Arne, et al. "The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010?." The American journal of clinical nutrition 93.4 (2011): 684-688. 
    • Benoit, Stephen C., et al. "Palmitic acid mediates hypothalamic insulin resistance by altering PKC-θ subcellular localization in rodents." The Journal of clinical investigation 121.1 (2011): 456.
    • Carlson, Susan E., Jane D. Carver, and Stephen G. House. "High fat diets varying in ratios of polyunsaturated to saturated fatty acid and linoleic to linolenic acid: a comparison of rat neural and red cell membrane phospholipids." The Journal of nutrition 116.5 (1986): 718-725. 
    • den Besten, Gijs, et al. "The role of short-chain fatty acids in the interplay between diet, gut microbiota, and host energy metabolism." Journal of lipid research 54.9 (2013): 2325-2340.
    • Flock, Michael R., Jennifer A. Fleming, and Penny M. Kris-Etherton. "Macronutrient replacement options for saturated fat: effects on cardiovascular health." Current opinion in lipidology 25.1 (2014): 67-74. 
    • Friedberg, Cylla E., et al. "Fish oil and glycemic control in diabetes: a meta-analysis." Diabetes Care 21.4 (1998): 494-500.
    • Gadgil, Meghana D., et al. "The Effects of Carbohydrate, Unsaturated Fat, and Protein Intake on Measures of Insulin Sensitivity Results from the OmniHeart Trial." Diabetes care 36.5 (2013): 1132-1137. 
    • Gentilcore, Diana, et al. "Effects of fat on gastric emptying of and the glycemic, insulin, and incretin responses to a carbohydrate meal in type 2 diabetes." Journal of Clinical Endocrinology & Metabolism 91.6 (2006): 2062-2067.
    • Gillingham, Leah G., Sydney Harris-Janz, and Peter JH Jones. "Dietary monounsaturated fatty acids are protective against metabolic syndrome and cardiovascular disease risk factors." Lipids 46.3 (2011): 209-228.
    • Grygiel-Górniak, Bogna. "Peroxisome proliferator-activated receptors and their ligands: nutritional and clinical implications-a review." Nutrition journal 13.1 (2014): 17. 
    • Halade, Ganesh V., Md M. Rahman, and Gabriel Fernandes. "Differential effects of conjugated linoleic acid isomers in insulin-resistant female C57Bl/6J mice." The Journal of nutritional biochemistry 21.4 (2010): 332-337. 
    • Hales, C. N., and P. J. Randle. "Effects of low-carbohydrate diet and diabetes mellitus on plasma concentrations of glucose, non-esterified fatty acid, and insulin during oral glucose-tolerance tests." The Lancet 281.7285 (1963): 790-794.
    • Harvey, Kevin A., et al. "Long-chain saturated fatty acids induce pro-inflammatory responses and impact endothelial cell growth." Clinical Nutrition 29.4 (2010): 492-500.
    • Herieka, Mohammed, and Clett Erridge. "High‐fat meal induced postprandial inflammation." Molecular nutrition & food research 58.1 (2014): 136-146.
    • Kennedy, Arion, et al. "Saturated fatty acid-mediated inflammation and insulin resistance in adipose tissue: mechanisms of action and implications." The Journal of nutrition 139.1 (2009): 1-4.
    • Khan, Mehmood A., John V. St Peter, and Jay L. Xue. "A prospective, randomized comparison of the metabolic effects of pioglitazone or rosiglitazone in patients with type 2 diabetes who were previously treated with troglitazone." Diabetes Care 25.4 (2002): 708-711.
    • Kien, C. Lawrence, et al. "Substituting dietary monounsaturated fat for saturated fat is associated with increased daily physical activity and resting energy expenditure and with changes in mood." The American journal of clinical nutrition 97.4 (2013): 689-697.
    • Kimura, Ikuo, et al. "The gut microbiota suppresses insulin-mediated fat accumulation via the short-chain fatty acid receptor GPR43." Nature communications 4 (2013): 1829.
    • Kota, Bhavani Prasad, Tom Hsun-Wei Huang, and Basil D. Roufogalis. "An overview on biological mechanisms of PPARs." Pharmacological Research 51.2 (2005): 85-94. 
    • Lombardo, Yolanda B., and Adriana G. Chicco. "Effects of dietary polyunsaturated n-3 fatty acids on dyslipidemia and insulin resistance in rodents and humans. A review." The Journal of nutritional biochemistry 17.1 (2006): 1-13.
    • Lemaitre, Rozenn N., et al. "Cell membrane trans-fatty acids and the risk of primary cardiac arrest." Circulation 105.6 (2002): 697-701.
    • Lovejoy, Jennifer C., et al. "Effects of diets enriched in saturated (palmitic), monounsaturated (oleic), or trans (elaidic) fatty acids on insulin sensitivity and substrate oxidation in healthy adults." Diabetes care 25.8 (2002): 1283-1288. 
    • Marangou, A. G., et al. "Metabolic consequences of prolonged hyperinsulinemia in humans: evidence for induction of insulin insensitivity." Diabetes 35.12 (1986): 1383-1389.
    • Margioris, Andrew N. "Fatty acids and postprandial inflammation." Current Opinion in Clinical Nutrition & Metabolic Care 12.2 (2009): 129-137.
    • McManus, Ruth M., et al. "A comparison of the effects of n-3 fatty acids from linseed oil and fish oil in well-controlled type II diabetes." Diabetes Care 19.5 (1996): 463-467. 
    • Mendes-Netto, R. S., et al. "Effect of the dietary glycid/lipid calorie ratio on the nitrogen balance and body composition of bodybuilders." Nutrire-Revista da Sociedade Brasileira de Alimentação e Nutrição 36.1 (2011): 137-150.
    • Mensink, Ronald P. "Metabolic and health effects of isomeric fatty acids." Current opinion in lipidology 16.1 (2005): 27-30.
    • Kabir, Morvarid, et al. "Treatment for 2 mo with n− 3 polyunsaturated fatty acids reduces adiposity and some atherogenic factors but does not improve insulin sensitivity in women with type 2 diabetes: a randomized controlled study." The American journal of clinical nutrition 86.6 (2007): 1670-1679. 
    • Lee, C., et al. "Fish consumption, insulin sensitivity and beta-cell function in the Insulin Resistance Atherosclerosis Study (IRAS)." Nutrition, Metabolism and Cardiovascular Diseases 23.9 (2013): 829-835.
    • Lim, Ji-Na, et al. "trans-11 18: 1 Vaccenic Acid (TVA) Has a Direct Anti-Carcinogenic Effect on MCF-7 Human Mammary Adenocarcinoma Cells." Nutrients 6.2 (2014): 627-636.
    • Mahendran, Yuvaraj, et al. "Association of erythrocyte membrane fatty acids with changes in glycemia and risk of type 2 diabetes." The American journal of clinical nutrition 99.1 (2014): 79-85.
    • Montori, Victor M., et al. "Fish oil supplementation in type 2 diabetes: a quantitative systematic review." Diabetes Care 23.9 (2000): 1407-1415.
    • Mostad, Ingrid L., et al. "Effects of n− 3 fatty acids in subjects with type 2 diabetes: reduction of insulin sensitivity and time-dependent alteration from carbohydrate to fat oxidation." The American journal of clinical nutrition 84.3 (2006): 540-550. 
    • Peairs, Abigail D., Janet W. Rankin, and Yong Woo Lee. "Effects of acute ingestion of different fats on oxidative stress and inflammation in overweight and obese adults." Nutr J 10.1 (2011): 122.
    • Poirier, Hélène, et al. "Nutritional supplementation with trans-10, cis-12–conjugated linoleic acid induces inflammation of white adipose tissue." Diabetes 55.6 (2006): 1634-1641.
    • Popp-Snijders, C., et al. "Dietary supplementation of omega-3 polyunsaturated fatty acids improves insulin sensitivity in non-insulin-dependent diabetes." Diabetes Research (Edinburgh, Scotland) 4.3 (1987): 141-147. 
    • Remig, Valentina, et al. "Trans Fats in America: A Review of Their Use, Consumption, Health Implications, and Regulation." Journal of the American Dietetic Association 110.4 (2010): 585-592.
    • Risérus, Ulf, et al. "Treatment with dietary trans10cis12 conjugated linoleic acid causes isomer-specific insulin resistance in obese men with the metabolic syndrome." Diabetes care 25.9 (2002): 1516-1521.
    • Risérus, Ulf. "Fatty acids and insulin sensitivity." Current Opinion in Clinical Nutrition & Metabolic Care 11.2 (2008): 100-105.
    • Roden, Michael, et al. "Mechanism of free fatty acid-induced insulin resistance in humans." Journal of Clinical Investigation 97.12 (1996): 2859.
    • Sawada, Keisuke, et al. "Ameliorative effects of polyunsaturated fatty acids against palmitic acid-induced insulin resistance in L6 skeletal muscle cells." Lipids Health Dis 11.1 (2012): 36-44. 
    • Simopoulos, Artemis P. "The importance of the ratio of omega-6/omega-3 essential fatty acids." Biomedicine & pharmacotherapy 56.8 (2002): 365-379.
    • Schwingshackl, L., B. Strasser, and G. Hoffmann. "Effects of monounsaturated fatty acids on glycaemic control in patients with abnormal glucose metabolism: a systematic review and meta-analysis." Annals of Nutrition and Metabolism 58.4 (2011): 290-296. 
    • Vessby, Bengt, et al. "Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU Study." Diabetologia 44.3 (2001): 312-319.
    • Williams, Michael JA, et al. "Impaired endothelial function following a meal rich in used cooking fat." Journal of the American College of Cardiology 33.4 (1999): 1050-1055. 
    • Xiao, C., et al. "Differential effects of monounsaturated, polyunsaturated and saturated fat ingestion on glucose-stimulated insulin secretion, sensitivity and clearance in overweight and obese, non-diabetic humans." Diabetologia 49.6 (2006): 1371-1379.

    Does Your Pre Workout Inhibit Fat Loss? Study Shows Nitrate Supplements Decrease Metabolic Rate By 4.2%

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    If you want other to see your pump, you got to be ripped. If not, why care about reductions in BMR?
    If you remember my posts about the first generation, arginine-based pre-workout products you will be aware that the only pump they produced was the word "pump" in their name or product description. The reason was and still is simple. The mere provision of l-arginine, which is a precursor to nitric oxide does not lead to an increase in nitric oxide production. Why? Well, think of a building a house: Just buying some concrete won't make you a proud home owner, either ;-)

    The bad thing: Arginine didn't work. The good thing: This means it didn't decrease your BMR, either

    Against that background it's quite astonishing that arginine and citrulline based pre-workout products have dominated the top-seller lists of the big supplement vendors for decades. A fact that's probably partly due to other potential benefits of these amino acids, of which one - you as a SuppVersity reader know that - could be fat loss | learn more about the potential fat loss effects.
    On a side note:  I am pretty sure the fact that the other potential benefit is an increase in sexual stamina didn't hamper the sales either (Neuzillet, 2013; Hotta. 2014 ;-)
    With more and more people openly declaring that they would no longer waste money on "good tasting, but expensive and disfunctional products", they industry was yet pressed to develop alternatives. Luckily, our body has two options it can chose from, when producing nitric oxide.

    Fortunately, the industry has developed better alternatives...?

    You know option #1, the arginine ➲ nitric oxide pathway, and - with all the hype and hyperbole that surrounded the introduction of the first nitrate supplements - I am pretty sure, you know the other one as well, the nitrate-nitrite ➲ nitric oxide pathway

    Figure 1: The Arginine- and the Nitrate-Nitrite - NO pathway are the yin and yan of nitric oxide production (Lundberg. 2008).
    As the illustration (Figure 1) I have "borrowed" from a comment by Jon. O. Lundberg et al. (2008) illustrates quite nicely, the arginine and nitrite nitric oxide pathway are the yin and yan of NO production.

    With the "yan", i.e. the nitrate-nitrite ➲ nitric oxide pathway being a relatively "new kid on the NO block", that recycles (=reduces) inorganic anions nitrate and nitrite to form bioactive NO in blood and tissues during physiological hypoxia.

    It goes without saying that there is a bottle neck to this process as well, but the rate limiting availablility of oxygen which hampers the argine-based NO generation by NOS becomes limited as oxygen levels fall is actually a signal for the nitrate–nitrite ➲ nitric oxide to really kick in.

    There is more yin and yan, here

    If you take a closer look at the results of a study in the America Journal of Clinical Nutrition (Figure 2), you will yet have to realize that there is "more yin and yan", here than you'd probably hope for. According to the data scientists from the venerable Karolinska Institutet in Stockholm, Sweden, present in their paper, "[d]ietary inorganic nitrate reduces the RMR." (Larsen. 2014)
    Figure 2: VO2 consumption (marker of fatty acid oxidation) and basal metabolic rate (BMR) relative to means (left), thyroid hormone (T3, T4) levels after 3-d dietary intervention with sodium nitrate (Larsen. 2014)
    Whut? Yes, you read Larsen et al. right: In their randomized, double-blind, crossover study, in the course of which the Swedish scientists measured the resting metabolic rate (RMR) of 13 perfectly healthy 18–49 y olds (17 women) via indirect calorimetry after a 3-d dietary intervention with sodium nitrate (NaNO3 @ 0.1mmol/kg body weight) or a placebo (NaCl), Larsen, Schiffer, Ekblom et al. observed a statistically and (probably) physiologically significant reduction BMR reduction of 4.2% which correlated strongly to the degree of nitrate accumulation in saliva (r²= 0.71) and fits in nicely with the reduced O2 consumption of which Bailey et al. were the first to observe it in response to nitrate supplementation during exercise (Bailey. 2009).

    Interestingly, these effects were not - as you may have been speculated - brought about by changes in thyroid hormone status. And the subjects insulin sensitivity, glucose uptake, plasma concentration of isoprostanes, as well as their total antioxidant capacity were unaffected, as well.
    Suppversity Suggested Read: " The Beat Your Personal Bests W/ Beets 101: How Much? 8.4 mmol Nitrate ~400-1300g Beets! When? 2.5h Pre Workout!" | read more
    Bottom line: If the 0.1mmol/kg were not equivalent to only 200–300 g spinach, beetroot, lettuce, or other vegetable that was rich in nitrate, I would probably say: Here you have it! Another supplement that's not just useless, but actually detrimental to your goals.

    The way things are, I will refrain from ranting and rather suggest you simply skip the supps and consume the spinach, beetroot, lettuce and other high nitrate veggies right away. Most of the human studies which support the ergogenic potential of nitrates have been conducted with beetroot juice instead of capped sodium-nitrate.

    And let's be honest, the weight loss advantage of having green and not so green nitrate containing vegetables in your is eventually beyond doubt. So, if there was a similar reduction in RMR from your daily serving of spinach, you can be more or less certain that it was compensated by the beneficial weight loss effects of the whole spectrum of nutrients that's present in this edible flowering plant in the family of Amaranthacea.
    Reference:
    • Bailey, Stephen J., et al. "Dietary nitrate supplementation reduces the O2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans." Journal of Applied Physiology 107.4 (2009): 1144-1155.
    • Hotta, Yuji, et al. "Oral l‐citrulline supplementation improves erectile function and penile structure in castrated rats." International Journal of Urology (2014).
    • Larsen, Filip J., et al. "Dietary inorganic nitrate improves mitochondrial efficiency in humans." Cell metabolism 13.2 (2011): 149-159.
    • Lundberg, Jon O., Eddie Weitzberg, and Mark T. Gladwin. "The nitrate–nitrite–nitric oxide pathway in physiology and therapeutics." Nature Reviews Drug Discovery 7.2 (2008): 156-167.
    • Neuzillet, Y., et al. "A randomized, double‐blind, crossover, placebo‐controlled comparative clinical trial of arginine aspartate plus adenosine monophosphate for the intermittent treatment of male erectile dysfunction." Andrology 1.2 (2013): 223-228.

    Foods, Not Macros: Isoenergetic Breakfast With Identical Macronutrient Content More Satieting With Eggs vs. Flakes. Plus: Omega-3 Microbiome Obesity Interactions

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    Eggs or Flakes? Not 30% vs. 25% protein! A brief reminder of the fact that the stuff you eat is still food.
    I am not quite sure when or why this happened, but I know that more and more people are thinking in terms of "macros" instead of foods. What I do know, though, is that the recent publication of studies from the Pennington Biomedical Research Center at the Louisiana State University System (Bayham. 2014) and an ostensibly unrelated study that was conducted by researchers from the Alimentary Pharmabiotic Centre, Biosciences Institute in Cork and scientists working at the local university and the University of Pittsburgh School of Medicine (Patterson. 2014) confirms - once again (!) - how futile this ignorant approach to nutrition actually is.

    Eggs vs. cereals - not the best example, but...

    In that, I am well aware that the "battle" between an egg- and a cereal-based breakfast in the Patterson study is not exactly a good model of what's currently going on in the health and fitness community. With cereals being labeled as "the devil" (it's always nice to be "anti", isn't it?), no one would after all consider having ...
    • One-and-a-half cup of Special K® RTE cereal, 200 ml Silk® original soymilk, one slice of Natural Grain “Wheat n’ Fiber”® bread, 13 g of butter, and 10 g of sugar-free strawberry jam (CG)
    ... for breakfast. In view of the fact that the same can be said for the calorie- and mocronutrient matched "high quality protein" breakfast, i.e.
    • Two scrambled eggs, 120 mL skim milk, two slices of Holsum® thin white  bread, 5 g of butter, and 18 g of Smuckers® strawberry jam
    ... I still believe that the consequences of "breaking the fast" (learn why I am calling breakfast thus in "Breakfast or Breaking the Fast" | read more) with eggs vs. Special K are still relevant to the previously introduced context. And if you know that the acetylated form of ghrelin and PYY are "satiety hormones", it does not take a rocket scientists to interpret the data in Figure 1.
    Figure 1: Level(s) of "satiety hormones" after the different breakfasts (Bayham. 2014)
    What is difficult to tell, though, is whether the increased satiety after the egg breakfast would actually lead to a reduced intake at the subsequent meal.
    • On an individual basis, i.e. on just one of the two eating occasions, the higher levels of acetylated ghrelin and PYY did not suppress the 20 healthy overweight or obese subjects energy intake during the subsequent lunch
    • For day 1 and day 7, together, on the other hand, the 64kcal the egg eaters consumed less than the cereal eaters did reach statistical significance.
    If we throw overboard all the things we (believe) we know about the fallacy of calorie counting, this would translate into a ~448kcal difference for one week and a whopping difference of 23,360kcal for a year, which should shed ~3.3kg of body fat a year.
    7000kcal for 1kg of body fat? I know that this is a naive miscalculation, but it should suffice to demonstrate that the protein quality (remember the amount of protein in both breakfast conditions was identical) counts and two eggs (vs. Kellog's Special K) can make the difference between slow, but continuous weight gain on the one and weight stability (or more) on the other hand.
    Whether or not similar concrete weight loss vs. gain effects can be achieved with different types of fat is nothing study #2 in today's science mash-up here at the SuppVersity could answer. What it can tell you though, is that protein and obviously carbohydrates, where even Mr. Average Joe thinks in terms of "low GI" = good and "high GI" = bad carbs, these days, is by no means the only food component, where unspecifically counting macros is not going to cut it (or get you cut, if that's what you want to achieve).

    This is not just about fish oil

    "Of course, the bad omega-6s" ... I know that this is what you're thinking right now, but let's be honest, isn't that a bit narrow-minded?  It sure is and still, the results Ellaine Petterson and her Irish and American colleagues present in their most recent paper demonstrate quite clearly that the ingestion of fish and flax seed oil has pretty unique effects that go beyond its ability to increase the tissue concentrations of DHA to levels way beyond what you'd see in low fat or high fat diets with palm, olive or safflower oil powered high fat diets.
    Increased lipid oxidation in athletes w/ low dose fish oil (Filaire. 2010)
    The health benefits of omega-3s: The often-cited evidence of the benefits of high omega-3 levels in the cells is by far not so conclusive as the laypress and supplement producers would have it. Danthi et al. have shown only recently that fish consumption, but not the omega-3 content of your cells is a reliable predictor of cognitive performance in the elderly. Associations between heart health, mortality, etc. and cellular omega-3 levels could thus be mediated by the whole food source of those omega-3s, i.e. fish consumption, and not by their mere presence in the cells, as well.
    In addition it lead to an increase in the relative abundance of bifidobacteria, a gut tenant that has been linked to all sorts of beneficial health effects, but has recently been outshadowed by various strains of lactobacilli (0.95% vs. more than 2% in all other groups), which - and this is an important information - were the lowest in the rodents who were kept on diets with 45% of the energy from fish and flaxseed oils.

    Whether or not, the negative effects of fish oil on the lactobacillacea count in the guts of the lab animals is also partly responsible for the more or less disappointing effects the fish and flax seed diet had on the body composition (Figure 2) of the wild-type C57BL/6J male mice (21 d old) in the study at hand is questionable.
    Figure 2: Body composition analysis at the end of the study (Patterson. 2014)
    It's not impossible, though. A brief glance at the insulin levels and leptin levels in Figure 3 reveals that neither of them looks anyway close to what someone who's religiously taking his fish oil caps on a daily basis would be expecting. In the end, it is thus not really that surprising that only the palm oil diet group ended up with an inferior lean-to-fat mass ratio of 1.17 (vs. 1.33 in the omega-3 group).
    Figure 3: Changes (%) in relevant metabolic markers in response to the different diets (Patterson. 2014)
    The results of the study at hand, i.e. the effects on body composition (Figure 2), as well as blood glucose and lipid metabolism (Figure 3) are thus clearly not in line with the ubiquitously placated message that "fish oil is good for you" - a message, the indoctrinated average supplement junkie will still discern from the abstract of the study:
    "[...] Ingestion of the HF-flaxseed/fish oil diet for 16 weeks led to significantly increased tissue concentrations of EPA, docosapentaenoic acid and DHA compared with ingestion of all the other diets (P< 0·05); furthermore, the diet significantly increased the intestinal population of Bifidobacterium at the genus level compared with the LF-high-maize starch diet (P< 0·05). These data indicate that both the quantity and quality of fat have an impact on host physiology with further downstream alterations to the intestinal microbiota population, with a HF diet supplemented with flaxseed/fish oil positively shaping the host microbial ecosystem." (Petterson. 2014).
    Neither the "loss" of lactobacilli, nor the - if anything - negative effects of the high omega-3 diet on the lean-to-fat-mass ratio and the amount of insulin that's floating around in the rodents' blood are mentioned in said abstract.


    Fat = Diabetes - A FAT Mistake?
    If you go take a look at the actual study data, we are thus left with the question, whether the purported benefits of having high amounts of omega-3 fatty acids in our cells (see red info box a couple of paragraphs above) are real enough (or really enough - whatever you prefer) to discard the fact that the study at hand would actually suggest that olive and not fish + flaxseed oil should be your go-to source of dietary fat on a high fat diet.

    Moreover, if we abandon any paradigmatic believes, we would even have to concede that - within the current context, i.e. a rodent study and a diet with protein contents of only 19.2% (low fat) and 23% (high fat), the low fat mix of 1.25% of palm, 1.25% olive, 1.25% safflower oil, 0.625% fish and 0.625% flaxseed oil the rodents in the starch and sucrose groups received is superior to any of the high fat variants.

    You may say that this is "rodent shit" (and it is, because this is what the scientists analyzed to access the SFCA metabolism of the mice) and a mere coincidence, but wouldn't you agree that this oil mix looks a little too much like the mixture you'd get on a low-to-moderate fat diet with olive oil as a staple for everything, where you add oils, palm and safflower oil from processed foods on your cheat days and fish oil / omega-3s from your once or twice a week serving of salmon... ?
    Enough of the speculations, though: What I actually wanted was to remind you of the fact that you're still eating food not proteins, carbohydrates and fats and that there are physiological performance-, health- and longevity related, as well as psychological downsides, I can only hint at in the info-box to the right, to any form of "as long as it fits my macros" ignorance.
    References: 
    • Bayham, Brooke E., et al. "A Randomized Trial to Manipulate the Quality Instead of Quantity of Dietary Proteins to Influence the Markers of Satiety." Journal of Diabetes and its Complications (2014).
    • Filaire, Edith, et al. "Effect of 6 Weeks of n-3 fatty-acid supplementation on oxidative stress in Judo athletes." International journal of sport nutrition 20.6 (2010): 496.
    • Danthiir, Vanessa, et al. "Cognitive Performance in Older Adults Is Inversely Associated with Fish Consumption but Not Erythrocyte Membrane n–3 Fatty Acids." The Journal of nutrition (2014): jn-113.
    • Patterson, E., et al. "Impact of dietary fatty acids on metabolic activity and host intestinal microbiota composition in C57BL/6J mice." The British journal of nutrition (2014): 1-13.

    Grazin' Study Shows: Increased Eating Frequency Bad For Obese and Lean Men. Reduced Diet-Induced Thermogenesis and Blunted Lipolysis Could Promote Future Weight Gain

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    Grazing not allowed!
    Usually, I don't do this in the introduction of an article, but in this case, it fits so nicely that I just can't resist to prepend todays SuppVersity article with a citation from the conclusion of a recent paper in Pyschology and Behavior, a journal of which I believe that it covers the true reasons of the obesity pandemic... but I am digressing, here's your quote (Allroit. 2014):
    "Even if subjective and physiological data suggest a beneficial effect of frequent eating on appetite in obese men, no effect was demonstrated on energy intake. Moreover, the decrease in diet induced thermogenesis and lipolysis, reflected by NEFA profiles, could be deleterious on energy balance in the long run."

    What? Grazing ain't good for me? But my doctor (Oz?) said so!

    If you are still in the "I believe every word my doctor" says phase of your development as a free-thinking individual, it's probably a waste of time to read the rest of the article. If you have an open ear and eye for the scientific discoveries that have been made in 25 years that have been passed since the 5th edition of the by then already outdated textbook your doctor used during his studies were published, I'd suggest you take a look at the overview of the study design:
    "[A]fter being included, the subjects had a first visit for a lunch at the experimental restaurant of Institut Paul Bocuse Research Centre (IPB). The aim of this first visit was to familiarize the subjects with the environment and the foods which would be used during the study.

    During this visit, subjects were invited to the experimental restaurant at 12:00 and were asked to taste all of the food items offered at an individual buffet-type meal. A choice of classical hot and cold French food items with varied macronutrient compositions was offered. [...] Subjects were instructed to eat ad libitum. The mean rating of food items, measured on a 100 mm electronic visual analog scale (VAS), varied from 4.4 ± 0.4 (for grated carrots), to 7.5 ± 0.4." (Allriot. 2014)
    After this first visit, the subjects were then invited to four experimental sessions, in a randomized order, each session separated by at least 7 days: two were conducted in IPB for behavioral explorations; the other two took place in Rhône-Alpes Research Centre for Human Nutrition (CRNH) for metabolic explorations.
    Please note: What the scientists observed in the study at hand, as well as in their previous research does not confirm that eating more frequently will make you obese. It does however provide significant evidence against the "eat more frequently to stay lean"-hypothesis that's still rattling around in the mainstream media and certain parts of the fitness community.
    At first this may seem awkward, but by having four sessions in different locations the scientists tried to minimize environmental confounders. Furthermore, the order of the four testing sessions was randomized across the participants to prevent any order effect (the random allocation sequences were generated by a biostatistician using a 2-step randomization).
    • Subjects were requested to avoid vigorous activities and to abstain from alcohol consumption the day before each session. 
    • Subjects were also asked to select a dinner they consume regularly and to eat this same meal the evening before each session. 
    • Subjects were also instructed tofinish eating this dinner by 9:00 pm and to eat nothing else after this time. 
    For the four sessions, the subjects were given each time the same 674.8 kcal breakfast, the sole difference - you probably suspected this already, when you read the quotation in the introduction to this article - was the time they had to consume this meal, i.e.
    • 20 min in  T0 (8:00 am) (F1 condition) or 
    • 4x10 min long (168.7 kcal each) every hour at T0, T60, T120 and T180 min (F4 condition). 
    The breakfast in F1 was composed of white bread (40 g), croissant (80 g), strawberry jam (30 g), unsalted butter (10 g), orange juice (120 g), white sugar (10 g), and black coffee or tea (400 ml). For each of the four eating episodes of F4, these quantities were divided by 4. Subjects were asked to eat all the food provided for breakfast. As mentioned earlier, they received both breakfasts (F1 and F4) on two occasions: once in the IPB, once in the CRN.

    Ok, you know the results, but ....

    ... let's still take the time and check out the quantitative differences between the metabolic response to grazing (F4 condition) vs. regular food consumption (F1) in the 17 obese male study particpants (BMI 31.9kg/m²).
    Figure 1: Subjective satiety and hunger scores in the obese subjects during the 2x2 testing conditions (Allriot. 2014)
    What is certainly interesting, is that even the subjective advantages in hunger and satiety were very transient and, if you take a look at what the subjects ate, you will probably argue that this is no wonder: I mean, you don't believe you can gobble down white bread, a croissant with strawberry jam and unsalted butter and a cup of sugar-sweetened coffee all at once without a significant elevation in insulin of which you as a SuppVersity reader know that its satiety effects are blunted in obese / insulin resistant individuals, do you?
    Figure 2: Insulin (left) and NEFA (right) levels after the test-meals (Allriot. 2014)
    While I am not sure how differences such as those you see in Figure 2 were statistically non-significant, I can tell you that the increase in NEFAs in the "regular eaters" (F1) at T ~ 220min goes hand in hand with the previously reported increase in fatty acid oxidation that was - just as the increase in NEFA - blunted, when the subjects "grazed" their breakfast.
    Bottom line: You want it really short? Don't fu**** graze / eat 10x a day! Despite the beneficial impact on appetite sensations and on ghrelin and GLP-1 concentrations, this study provides evidence that an isocaloric increase of the number of eating episodes does not have a short term positive effect on energy intake in obese men.

    Suggested Read: ""Breakfast Keeps You Lean" Myth or Mystically True? Bias + Unwarranted Causal Implications" | read more
    Contrary to what the authors write in their conclusion, this does eventually stand in line with findings in lean individuals, where a similar reduction in dietary thermogenesis and inhibited lipolysis was observed (Allirot. 2013). This is obviously of paramount importance for us, because it confirms that "the beneficial short-term effect of increasing eating frequency on appetite in lean men considering subjective, physiological and behavioral data" are not worth the anti-weight loss effects due to the reduced thermogenecis and decreases in lipolysis "that could be deleterious on energy balance in the long run." (Allriot. 2013) - for once, I have nothing to add, here ;-)
    References:
    • Allirot, Xavier, et al. "An isocaloric increase of eating episodes in the morning contributes to decrease energy intake at lunch in lean men." Physiology & behavior 110 (2013): 169-178.
    •  Allirot, Xavier, et al. "Effects of a breakfast spread out over time on the food intake at lunch and the hormonal responses in obese men." Physiology & behavior (2014).

    Breakthrough HMB Research: Additional(!) 10% Reduction in Body Fat, 5% Higher Lean Mass + 2x Higher Strength Gains After 12W of Heavy Lifting in Trained Individuals

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    HMB-FA could be for ladies, too - or don't you want to look good naked, girls?
    First, it was "as potent as oxandrolone", then it was "disappointing", "dysfunctional" and "tasted like crap"... you know what I am talking about? Well, then you've been around in the bodybuilding and fitness community for some time. And since you are here, at the SuppVersity, your goto source for the latest information from the realms of nutrition, exercise and supplementation science, you will probably be aware, that HMB, the molecule, I have obviously been referring to in the first sentences of this article, is about to make a comback - in liquid form and without the calcium bond in calcium β-hydroxy-β-methylbutyrate the studies that were presented at the last ISSN conference (read previous article) caused quite sensation in the fitness community.

    Now, more than 6 months later, I got a message from Jacob Wilson that he and his colleagues have "just published the first long term periodized HARDCORE training study using HMB-Free acid." It's, as Jacob says, and I can confirm, the "most controlled study to date" (Wilson, 2014 - Facebook).
    No, soccer mums! HMB is not going to kill your kid: I am nor sure why, but whenever supplements work (best example creatine), it won't take long until the first rumors of potentially hazardous side effects appear (Fuller. 2014). First on the Internet, then on TV (see the WPXI News Item Jose Antonio posted recently on the ISSN Facebook site). Against that background it's good to know that the no-observed-adverse-event-level (NOAEL) for HMB is 2.48 and 2.83 g/kg BW d−1 in male and female rats, respectively. For a human being this would translate to ~70-100g/per day and thus certainly more than you'll be able to afford, when the free acid form of HMB will hit the market.
    And after a brief with Jacob about the study design that revealed that the authors omitted the (imho critically important) information that the subjects received both HMB and a whey protein supplement (the latter is not mentioned in the methodology section), I would even agree that Jacob's conclusion that "his" study shows that HMB "clealy works in trained athletes" (Wilson, J. Facebook Conversation. 2014) is accurate as well.

    Let's first take a look at what Wilson et al. did

    Before we go on with the results, of which I know that they are what intrigues you most, let's briefly take a look at the pretty unique design of the combined exercise training + supplementation regimen the scientists from the University of Tampa, the IMG Acadamy, the University of Central Florida, and the Iowa State University came up with for this experiment:
    • 12 weeks is the study length we are looking at -- plenty of time for muscle growth, you would say, but if you want to use trained athletes, this is probably as short as it may be to make sure that you get measureable results 
    • Table 1: Overview of Phase 1-3 (Wilson. 2014)
      three training phases -- with Phase 1 (Table 1, top) consisting of a daily undulating periodized
      resistance-training program 3 days per week during,  Phase 2 (Table 1, middle) 2-week
      overreaching cycle during weeks 9 and 10, and Phase 3 (Table 1, bottom) tapering (volume) for weeks 11 and 12 - needless to say that this is an intense protocol which will, even without HMB, produce serious gains
    • 20 is the number of resistance trained men who participated in the study -- with 9 guys in the placebo and 11 guys in the HMB group enough to detect statistically significant differences, if those are actually physiologically relevant (in other words: a single outlier, maybe a "non-responder" - if there was such a thing - won't ruin the whole data set)
    • standardized baseline tests for strength & body comp, as well as blood draws and analyses -- this is so basic that I actually thought about even mentioning it
    • 3g of per day that's the dosage of HMB in a free acid form (HMB-FA) -- the free form of HMB has been shown by Fuller et al. in 2011, already, to have a superior bioavailability
    There is more than just a superior bioavailability to HMB-FA! What's in fact more important than the increased relative amount of HMB that makes it into your blood stream, is the speed at which this process takes place. Improved absorption kinetics, ie. faster absorption ➲ greater anabolism - if we apply what we've learned about the difference between 30g of whey protein and a quarter-pounder, this would mean that cannot expect to see the same results with 3g and probably not even with 9g of calcium bound "regular" HMB - even if the total amount of HMB that hits your blood stream would be higher!"
    • 30g of whey protein isolate (Dymatize ISO100, chocolate) that's the dosage of additional whey protein all subjects received -- this information is unfortunately missing from the original paper - a mishap that had me question the value of the data, initially; and if I had not been able to acquire it from Jacob directly, I would probably have torn the study apart, pointing to the possibility that HMB (FA or not) would produce similar non-existent results as the 3g+ of leucine people add to their whey protein shakes, falsely hoping this would increase the protein synthesis "beyond 100%"
    I know the above is more than some of you want to process; so if you don't want to read it just keep in mind that we are dealing with a highly anabolic exercise protocol, which is - if anything - too intense to be considered "what the average fitness enthusiast will do in the gym". This does not change, though, that the results I plotted in Figure 1 are more representative of what the majority of you could achieve on a corresponding regimen (exercise + supplementation), than the albeit impressive results of the myriad of classic HMB studies in elderly patients (Wilson. 2008).
    Figure 1: Changes in strength and body composition over the course of the 12-week study (Wilson. 2014))
    Apropos, "impressive" - I should say that this attribute applies to the results Wilson et al. present in their recent paper, as well; and that's true for both, the supplement and placebo group!
    "HMB-FA resulted in increased total strength (bench press, squat, and deadlift combined) over the 12-week training (77.1  ±  18.4 vs. 25.3  ±  22.0  kg, p  <  0.001); a greater increase in vertical jump power (991 ± 168 vs. 630 ± 167 W, p < 0.001); and increased lean body mass gain (7.4  ±  4.2 vs. 2.1  ±  6.1  kg, p < 0.001) in HMB-FA- and placebo-supplemented groups, respectively." (Wilson. 2014)
    Whether or, the more appropriate question probably is, to which degree the superior lean and strength gains in the HMB group are a result of the blunted increase in creatine kinase (−6 ± 91 vs. 277 ± 229 IU/l, p < 0.001), an (imho) very unreliable marker of muscle damage and cortisol (−0.2 ± 2.9 vs. 4.5 ± 1.7 μg/dl, p  <  0.003), a suspected catabolic, the role of which in the orchestrate of muscle growth does yet remain highly elusive (learn more in "All About Cortisol" | read more), in the HMB-FA group during the overreaching cycle is questionable and imho of corelative, not causal nature.

    Previously, HMB turned out to be particularly useful in scenarios where muscle loss was an issue (the previously mentioned studies in elderly individuals). You also know from a previous article of mine that Wilkinson et al. were able to show that HMB - contrary to leucine, by the way - an excellent inhibitor of protein breakdown. In am overreaching scenario, of which you can see based on the significant strength decreases in the placebo group at the end of the overreaching phase (see Figure 1, left), it is thus possible that the added anti-catabolic effects of HMB are what actually made the difference. In turn, this would yet mean: If you don't train like a maniac, even high amounts of additional HMB may feel to induce changes, as Jacob and his colleagues observed in the study at hand.
    When is HMB-FA going to be available? As of now no supplement company has officially announced a free form HMB product (at least none I know of). Based on the hype the study at hand will certainly generate, I would yet expect that John Rathmacher, John Fuller, Shawn Baier, Steve Nissen, and Naji Abumrad who hold a patent on an "Improved method of administering beta-hydroxy-beta-methylbutyrate (hmb)" (Rathemacher. 2011), which is basically HMB-FA, will already be locked in talks with several companies.
    I am impressed! By both, the study design and the results, by the way. That's the type or dietary research on dietary supplements that's done by exercise enthusiasts instead of office sitters; and it's the kind of science of which I would like to see more in the future.

    That being said, let me tell you something important before you scroll down to the comment area and ask: I don't know when the first HMB-FA products are about to hit the market. All I can tell you is that I personally would not try to emulate the results with regular HMB. As I pointed out in the red box towards the top, chances that you'd see the same benefits, when you're supplementing with calcium-HMB and whey are slim and if you know how "regular" HMB tastes, you will be aware that a "test run" would probably hurt your tastebuds even more than it would hurt your purse ;-)
    Reference:
    • Fuller Jr, John C., et al. "Subchronic toxicity study of β-hydroxy-β-methylbutyric free acid in Sprague-Dawley rats." Food and Chemical Toxicology (2014).
    • Rathemacher, John, et al. "Improved method of administering beta-hydroxy-beta-methylbutyrate (hmb)" WO 2011075741 A1. 2011
    • Wilson, Gabriel J., Jacob M. Wilson, and Anssi H. Manninen. "Effects of beta-hydroxy-beta-methylbutyrate (HMB) on exercise performance and body composition across varying levels of age, sex, and training experience: A review." Nutr Metab (Lond) 5 (2008): 1.
    • Wilson, Gabrial J., et al. "The effects of 12 weeks of beta-hydroxy-beta-methylbutyrate free acid supplementation on muscle mass, strength, and power in resistance-trained individuals: a randomized, double-blind, placebo-controlled study." European Journal of Applied Physiology (2014)

    L-Arginine - 6g/Day Boost Cholesterol- & Non-Esterified Fatty Acid Lowering Effects of Resistance Training. Are Classic Pre-Workouts Actually "Health Supplements"?

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    Lifting will improve your blood lipids, l-arginine will boost the effect.
    In the spirit of Tuesday's post on the potential negative effects of nitrate supplements on weight loss (learn more + see box below for some important clarifications), I would like to invite you to take a look at the effects of "short-term  L-arginine  supplementation  on  lipid  profile  and  inflammatory proteins after acute resistance exercise in overweight men" as they are about to be reported in one of the future issues of e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism by Nascimento et al. (Nascimento. 2014) - it's not essentially new, but actually quite a nice reminder of the fat that what I said about l-arginine in the nitrate article was not all made up.
    An addendum to the nitrate study: Even a persistent 5% reduction in RMR would not necessarily inhibit weight loss + you can argue that your body needs less energy / oxygen, because it works more effectively and contrary to common believe that's what a true ergogenic should do!
    In the introduction to the said article, I already hinted at and linked to the potential weight loss benefits of l-arginine. In spite of the fact that it is literally useless as an NO-booster (remember without increase in NOS, the enzyme that produces NO from arginine, simply piling up more arginine in your blood will only lead to increases in uric acid), previous studies have already shown that L-arg improves the metabolic profile of people with suboptimal health status.
    • Schulze et al.. for example, observed that l-arginine speed up the triglyceride-lowering effect of simvastatin in patients with elevated plasma triglycerides (Schulze. 2009)
    • El-Kirsh et al. found that both, L‐arginine and L‐citrulline supplementation ameliorated the biochemical parameters and blunted arthesclerotic lesions in high‐fat and high‐cholesterol‐fed rats (El-Kirsh. 2011)
    Other studies report beneficial effects on blood pressure and - as discussed in the anti-diabetes series - an ameliorating effect on the blood glucose levels of diabetic and/or insulin resistant individuals (McKnight. 2010; Dong. 2011).

    So, the results of this most recent study don't really come as a surprise

    In view of what we already knew about l-arginine, the results of the Nascimento study, i.e. reductions in  LDL cholesterol and NEFA levels, in response to the ingestion of 3x2g of pure l-arginine per day in this double blind, randomized crossover study don't come as a surprise.
    Figure 1: Changes in triglycerides, total & LDL cholesterol and NEFA levels in response to exercise, only (control) and exercise + arginine (arginine) supplementation; figures in boxes ind. inter-group diff. (Nascrimento. 2014)
    What's "news", though, is the interaction with exercise that sheds a whole new light the good old NO-Xplode (learn more, but keep in mind that one characteristic feature of this products is and was being totally underdosed) and its identical clones! I mean, who would have expected that he was buying a health supplement that potentiates the beneficial effects of exercise, in this case...
    • The official SuppVersity Supplement Shoot-Out!
      The longstanding veteran, NOXplode AVPT,
      is challenged by a clone of its own, 
      NOXplode 2.0 Advanced Strength -
      which will be the last pre-workout standing?
      four acute, machine-based resistance training sessions
    • stretching + general warm-up and cool down before / after sessions
    • three sets of 12 repetitions; 60% of the 1RM; 60s rest between sets
    • starting with large, ending with small muscle groups
    • large muscle groups: Chest press, leg press, pull down, leg extensions
    • small muscle groups: Deltoid machine, leg curl, biceps curl, triceps pulley
    ...on the potentially artherogenic low-density lipoprotein (LPL) and the amount of pro-diabetic non-esterified fatty acids in his bloodstream? You did? Well... I should have anticipated that, Mr & Mr Smar Alec ;-)
    There is one question left to answer: What exactly is the mechanism here? I know that some of you won't care - as long as it works - but let's be honest, wouldn't it be nice to know? Well, acute and chronic exercise increase have already been shown to increase the activity of lecithin-cholesterol aciltransferase (L- CAT), the enzyme responsible for the cholesterol ester transfer to HDL, which will then evacuate the cholestrol from the circulation. If this effect is either increased or the transport facilitated by l-arginine, this would explain the reduction in LDL the researchers observed in the study at hand.

    Figure 2: The short-term improvements in adiponectin Nascrimento et al. observed stand in line with the well-known long-term improvements in blood glucose management.
    Moreover, studies by Tan et al. (2011) suggest that L-arginine will have direct effects on the expression of fat-metabolic genes in skeletal muscle and white adipose tissue, which favor lipogenesis in the muscle (not a problem if those lipids are subsequently burned as fuel during workouts) and a reduced storage of fat in the adipose organ. In conjunction with its proven ability to stimulate mitochondrial biogenesis and brown adipose tissue development (McKnight. 2010) and the previously discussed effects on WAT,  hyperphagia,  improved insulin sensitivity and - much contrary to nitrate (learn more) - increased energy expenditure (albeit only on low protein diets; Clemmensen. 2012). In sum these effects would appear to be profound enough to explain the observations in the study at hand, and those I reported in previous SuppVersity articles on l-arginine - specifically those discussing the potential fat burning (more) and anti-diabetic / glucose lowering effects (more).

    Whether that's reason enough for you to begin supplementing again, is yet probably a question of your current metabolic state... if you are by no means like the seven overweight, hypertensive men, non-smoking and sedentary with a mean age of 46±5 yrs and a body weight of 93.1±12.0 kg, ain't insulin resistance, or have high cholesterol levels, it's pretty unlikely that you will see huge benefits.
    References:
    • Clemmensen, Christoffer, et al. "L-Arginine improves multiple physiological parameters in mice exposed to diet-induced metabolic disturbances." Amino acids 43.3 (2012): 1265-1275.
    • Dong, Jia-Yi, et al. "Effect of oral L-arginine supplementation on blood pressure: a meta-analysis of randomized, double-blind, placebo-controlled trials." American heart journal 162.6 (2011): 959-965.
    • El‐Kirsh, Amal Ashmawy Ahmed, et al. "The effect of L‐arginine or L‐citrulline supplementation on biochemical parameters and the vascular aortic wall in high‐fat and high‐cholesterol‐fed rats." Cell biochemistry and function 29.5 (2011): 414-428.
    • McKnight, Jason R., et al. "Beneficial effects of L-arginine on reducing obesity: potential mechanisms and important implications for human health." Amino acids 39.2 (2010): 349-357.
    • Schulze, Friedrich, et al. "L-Arginine enhances the triglyceride-lowering effect of simvastatin in patients with elevated plasma triglycerides." Nutrition research 29.5 (2009): 291-297.
    • Tan, Bie, et al. "Dietary L-arginine supplementation differentially regulates expression of lipid-metabolic genes in porcine adipose tissue and skeletal muscle." The Journal of nutritional biochemistry 22.5 (2011): 441-445.

    There is More To Glucose Control Than Carbohydrates (3/?): Non-Carbohydrate Nutrients And Their Effects On Blood Glucose Management ➲ Vitamin D - The Sunshine Vitamin

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    Is the vitamin D you produce at the beach you're visiting only rarely the secret to perfect glucose control?
    In the past two weeks you've learned much about the unquestionably beneficial effects of protein on glucose metabolism and the ambigous, since "context depend"effects of various fatty acids. Today, in the third installment of this series, we are leaving the "macros" behind and turning our heads towards the micronutrients.

    I have long thought about the micros I would include in today's installment, started out with vitamin D and realized: "Damn! 50% of my Sunday gone already." In other words, you will have to live with the fact that today's installment of this series is an homage to the hype.
    You can learn more about this topic at the SuppVersity

    Proteins, Peptides & Blood Glucose

    SFA, MUFA, PUFA & Blood Glucose

    Vitamin D & Diabetes

    Read these ➲ while waiting

    16 Weeks High Fat Diet

    Fat to Blunt Insulin?
    Vitamin D unquestionably is a top candidate for the "micronutrient with the most bullshit science published", and contrary to what the mainstream media articles would suggest, it's by no means the panacea as which it is depicted even in "scientific" reviews, of which I am pretty sure that 90% of them are solely written to get published - I mean, every editor wants a vitamin D article in his journal, right?

    Before this whole article turns into a rant, I'd suggest we take a look at the facts: It's beyond doubt that there are clear-cut (epidemiological determined) correlations between low vitamin D levels, insulin resistance and type II diabetes (Need. 2005). As a SuppVersity Reader you do yet know better than some of the previously mentioned scientists who will - without the blink of an eye - make the transition from "There is a correlation between low vitamin D levels and insulin resistance in our data" to statement like these:
    • Vitamin D is an acute phase reactant - but what are the impli- cations? Firstly, this would imply that serum 25-hydroxy- vitamin D is an unreliable biomarker of vitamin D status after an acute inflammatory insult (for the obese, even a meal is an acute inflammatory result; Blackburn. 2006). Secondly, hypovitaminosis D may be the consequence rather than the widely purported cause of a myriad of chronic diseases (Gama. 2012).
      "Low vitamin D causes / triggers insulin resistance." -- An excellent example of someone confusing correlation and causation. What is often accepted as a scientific fact, is possible. In view of the fact that vitamin D has recently been shown to act as an acute phase reactant in inflammatory conditions, it is yet rather unlikely. In fact, it appears more likely that what we are seeing here is a correllative reduction of vitamin D, whenever someone - like a type II diabetic, for example - is chronically inflamed (Waldron. 2013)
    • "Vitamin D supplements can be used to ameliorate insulin sensitivity." -- In an assertion like this, the authors go even one step further. After making the unwarranted conclusions that vitamin D triggers the onset of insulin resistance, they assume that supplemental vitamin D (usually D3), of which the current evidence shows that it does not elevate the levels of 1,25-hydroxy vitamin D, i.e. calcitriol, the only form of vitamin D, of which we actually have some rodent data that it's exogenous administration produces the anti-diabetic + weight loss effects everyone appears to expect from "regular" D3. An immediate effect of calcitriol on glucose uptake does yet not appear to exist - at least not in healthy individuals (Fliser. 1997).
    When you're looking at the previously cited study by Filser, you could rightly argue that it is unrealistic too expect an already "optimal" insulin sensitivity to improve... and you are right! Studies like the one by Fliser et al. can thus hardly serve as a yardstick to gauge the usefulness of vitamin D
    Figure 1: If we compare the fat "loss effects" of vitamin D supplementation in the studies by Zitterman (2009) and Salehpour (2012) in Figure 1 (left), and invoke the results of the latest meta-analysis by Pathak, et al. (2014) in Figure 1 (right), it is hard to argue Pathak's conclusion that the divergent results from previous trials would suggest that "Vitamin D supplementation did not decrease measures of adiposity in the absence of caloric restriction" (Pathak. 2014).
    The studies we have to look for are studies with subjects who have a compromised glucose metabolism or full-blown type II diabetes (note: we cannot look at studies in type I diabetes, because any benefits vitamin D would provide here are most likely related effects on the immune system). Studies like these, for example:
    • Inomata (1986) - 1-alpha (OH)D3 (active vitamin D) administration improves glucose tolerance in diabetic subjects
    • Nilas (1983) - No effect of vitamin D or its analogues on body weight or glucose management in post-menopausal women
    • Orwoll (1994) - No effect of calcitriol (active vitamin D) on glucose homeostasis in non-insulin-dependent diabetes mellitus
    Figure 2: The latest meta-analysis says: No long-term improvement in blood glucose management w/ vitamin D supplements (George. 2012).
    I could add one study after the other, but I know what you are thinking right now: Who cares about studies on vitamin D sufficient individuals?

    You're right. If we don't make the totally irrational, yet not uncommon assumption that the initially mentioned correlation between low vitamin D and low insulin sensitivity would apply beyond deficiency levels. There is thus no reason to assume that supplementation would help anyone with normal vitamin D levels so that we have to focus on those individuals with an impaired insulin resistance who are actually vitamin D deficient.
    "Our results suggest that hyperinsulinemia and/or insulin resistance are directly responsible for decrease of 25(OH)D levels in obesity." (Pergola. 2013)That's the logical conclusion from a closer analysis of the correlation between low vitamin D and insulin resistance that revealed that 25(OH)D levels are negatively associated with inflammatory parameters such as CRP and C3 and C4 levels, but not independently of BMI, body fat distribution, insulin levels, or insulin resistance.
    Unfortunately (for the average vitamin D enthusiast), the situation is not entirely unambiguous in this population either. Even in studies on vitamin D deficient subjects, you will find quite impressive null results (impressive, because the D-levels increase significantly, but nothing happened), though. Tai et al., for example, found no improvements in insulin sensitivity in spite of the fact that the vitamin D supplement they had administered to their 33 vitamin D insufficient subjects (serum 25-hydroxyvitamin D concentration ≤50 nmol/L; 12 with impaired glucose tolerance) increased their 25OHD levels from 39.9 ± 1.5 (SEM) to 90.3 ± 4.3 nmol/L (Tai. 2008).

    Rule of thumb: If anyone is actually likely to benefit, though, it's the overweight, inflamed (pre-)diabetic, for whom George et al. calculated a small effect on fasting glucose (−0.32 mmol/l) and a small improvement in insulin resistance (standard mean difference −0.25), but no improvements in long-term glucose management (HbA1c, see Figure 2) in response to vitamin D supplementation (George. 2012).

    Figure 3: No improvement in insulin sensitivity in people w/ normal, min. effects in those with compromised insulin sensitivity w/ vitamin D supplements, says meta-analysis (George. 2012).
    As with every "rule" there are exceptions to this one, as well. Nagpal et al. for example observed that the provision of three doses of vitamin D3 (120 000 IU each; supplemented group) improved the postprandial glucose excursions of the abdominally obese, but allegedly "apparently healthy" subjects (Nagpal. 2009). The results of a paper by Belenchia from 2013, on the other hand, violate the "no improvements in long-term glucose management rule". The scientists from the University of Missouri School of Medicine did after all find that adding 4,000IU/day of vitamin D to a standard life-style intervention lead to significant improvements in blood glucose management in their adolescent subjects with low baseline vitamin D levels (Belenchia. 2013).

    For someone with an established (=tested) vitamin D deficiency, supplementation does therefore appear to be clearly indicated. As long as you stick to reasonable amounts (see Recommendation I, below) there is little to no risk of doing any harm (although I know from anecdotes that some people react with fatigue to relatively slow quantities of vitamin D).

    Recommendation #1: Unless you are a sun-worshipper living in a country near the equator, you want to make sure to get ~1,000IU, if you are normal-weight and light-skinned, or 2,000IU, if you are overweight and/or dark-skinned (Gallagher. 2013; Ng. 2014), vitamin D per day from food or supplements.

    Figure 4: Increase in vitamin D levels in response to supplementation w/ different amounts of vitamin D3 in caucasian (!) women according to BMI categories (Gallagher. 2013)
    In that, it does not matter, if you get to those 7,000-10,000 IU per week by taking a single cap of a high dose vitamin D supplement once a week, or adding enough cod liver (oil), fatty fish, fortified dairy, oysters, or eggs (remember there is active vitamin D in eggs | learn more) to your diet. What is important, though is recommendation #2, which is:

    Recommendation #2: Get a 25OHD test done today and start supplementing with 20,000IU per week for 3 months, if the test comes back low - that's the dosage that has brought the low D3 levels of 30 club-level athletes in Close et al. (2013) back to the official and certainly not unreasonable target of >50 nmol/L.

    Needless to say that recommendation #3 would be to retest either after 3 months, in case you had low baseline levels and want to make sure your supplementation regimen brought them back up, or after 6 months, as part of a bi-annual checkup of all relevant health parameters, including the standard blood panel and HPTA function.
    Why shall I make sure my level is normal, if low vitamin D does not cause insulin resistance? That's a warranted question and I have an comprehensive answer. If vitamin D acts as an acute phase reactant this may mean that it protects your body from further pro-inflam- matory assaults - it's making a martyr of itself, so to say. If you have almost no "vitamin D martys" to sacrifice, this will accelerate your progress from insulin resistance to diabetes (cf. Forouhi. 2008)
    Bottom line: Things are, I am sorry to say that yet again, complicated. My personal assessment of the contemporarily available evidence is that the reduced vitamin D levels are correlatively and not causally linked to insulin resistance. We've known forever that chronic inflammation is a if not the most common cause of insulin resistance (Johnson. 2013) and vitamin D, whether it is an acute phase reactant or the panaceum everyone is trying to tell you it was, is reduced under inflammatory conditions.

    In view of the fact that the provision of additional vitamin D and restoration of "normal" (whatever that may be) levels of 25OHD3 in serum does not necessarily entail an improvement in insulin sensitivity, we must therefore assume that both, low vitamin D and insulin resistance have the same underlying cause and are thus complementary. Dies this mean, you should ignore low vitamin D levels? Probably not, but it certainly means that you better take a look at the way you eat, sleep and train if you are insulin resistant - irrespective of your vitamin D levels, by the way.
    References:
    • Belenchia, Anthony M., et al. "Correcting vitamin D insufficiency improves insulin sensitivity in obese adolescents: a randomized controlled trial." The American journal of clinical nutrition 97.4 (2013): 774-781.
    • Blackburn, Patricia, et al. "Postprandial variations of plasma inflammatory markers in abdominally obese men." Obesity 14.10 (2006): 1747-1754. 
    • Close, Graeme L., et al. "The effects of vitamin D3 supplementation on serum total 25 [OH] D concentration and physical performance: a randomised dose–response study." British journal of sports medicine 47.11 (2013): 692-696.
    • Fliser, D., et al. "No effect of calcitriol on insulin‐mediated glucose uptake in healthy subjects." European journal of clinical investigation 27.7 (1997): 629-633.  
    • Forouhi, Nita G., et al. "Baseline serum 25-hydroxy vitamin d is predictive of future glycemic status and insulin resistance the medical research council ely prospective study 1990–2000." Diabetes 57.10 (2008): 2619-2625.
    • Gama, Rousseau, et al. "Hypovitaminosis D and disease: consequence rather than cause." BMJ 345 (2012): e5706-e5706.
    • Gallagher, J. Christopher, Vinod Yalamanchili, and Lynette M. Smith. "The effect of vitamin D supplementation on serum 25OHD in thin and obese women." The Journal of steroid biochemistry and molecular biology 136 (2013): 195-200. 
    • George, P. S., E. R. Pearson, and M. D. Witham. "Effect of vitamin D supplementation on glycaemic control and insulin resistance: a systematic review and meta‐analysis." Diabetic Medicine 29.8 (2012): e142-e150. 
    • Johnson, Andrew MF, and Jerrold M. Olefsky. "The origins and drivers of insulin resistance." Cell 152.4 (2013): 673-684.
    • Inomata, S., et al. "Effect of 1 alpha (OH)-vitamin D3 on insulin secretion in diabetes mellitus." Bone and mineral 1.3 (1986): 187-192. 
    • Nagpal, J., J. N. Pande, and A. Bhartia. "A double‐blind, randomized, placebo‐controlled trial of the short‐term effect of vitamin D3 supplementation on insulin sensitivity in apparently healthy, middle‐aged, centrally obese men." Diabetic Medicine 26.1 (2009): 19-27.
    • Need, Allan G., et al. "Relationship between fasting serum glucose, age, body mass index and serum 25 hydroxyvitamin D in postmenopausal women." Clinical endocrinology 62.6 (2005): 738-741.
    • Ng, Kimmie, et al. "Dose response to vitamin D supplementation in African Americans: results of a 4-arm, randomized, placebo-controlled trial." The American journal of clinical nutrition (2014): ajcn-067777.
    • Nilas, L., and C. Christiansen. "Treatment with vitamin D or its analogues does not change body weight or blood glucose level in postmenopausal women." International journal of obesity 8.5 (1983): 407-411.
    • Orwoll, Eric, Matthew Riddle, and Melvin Prince. "Effects of vitamin D on insulin and glucagon secretion in non-insulin-dependent diabetes mellitus." The American journal of clinical nutrition 59.5 (1994): 1083-1087.
    • Pathak, K., et al. "Vitamin D supplementation and body weight status: a systematic review and meta‐analysis of randomized controlled trials." Obesity Reviews (2014).
    • Salehpour, Amin, et al. "A 12-week double-blind randomized clinical trial of vitamin D3 supplementation on body fat mass in healthy overweight and obese women." Nutr J 11.1 (2012): 78.
    • Tai, Kamilia, et al. "Glucose tolerance and vitamin D: effects of treating vitamin D deficiency." Nutrition 24.10 (2008): 950-956.
    • Waldron, Jenna Louise, et al. "Vitamin D: a negative acute phase reactant." Journal of clinical pathology 66.7 (2013): 620-622.
    • Zittermann, Armin, et al. "Vitamin D supplementation enhances the beneficial effects of weight loss on cardiovascular disease risk markers." The American journal of clinical nutrition 89.5 (2009): 1321-1327.

    More Than -2kg Body Fat in 4 Days? Manic Exercise and a 4-Day x 5,000kcal Energy Deficit on Whey or Sucrose Based Starvation Diet Yield Astonishingly Long-Lasting Fat Loss

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    Actually, even cherry tomatoes were not allowed in the first 4 days ;-)
    Wow! If that's what you thought, when you read the figure in the headline you know what I thought, when I spotted the latest paper from the University of Las Palmas de Gran Canaria in the "ahead of print" section of the Scandinavian Journal of Medicine & Science in Sports (Calbet. 2014).

    I mean, the title of the study, "a time-efficient reduction of fat mass in 4 days with exercise and caloric restriction", sounds pretty harmless. Too harmless for what happened to the 15 subjects the researchers recruited for an experiment that was almost as extreme as its astonishing results.

    Wake up, work out, starve and sleep

    I would say the above summarizes pretty well what I was referring to, when I said "something happened to the subjects" in the first 4 days of the study, the 15 not exactly lean study participants (mean BMI ~30kg/m²; body fat 31%) started their days with 45min of an arm cranking exercise (at 15% maximal intensity; see Figure 1).
    Figure 1: Schematic overview of the different phases of the diet + exercise intervention (Calbet. 2014)
    When they were done, they spend most of the remaining waking hours day walking - 8 h of walking at 4.5 km/h (35 km/day) 4 days in a row and on a diet delivering meager 3.2 kcal/kg body weight from a shake that contained either pure whey protein or pure sucrose.

    This can't really be the whey to go? Right?

    What sounds like some mad survival program did, as you can see in Figure 1, produce quite impressive weight loss effects. Unfortunately, this is "weight", as in fat and muscle and that at an almost 1:1 ratio - certainly not the type of "weight loss" any of you should strive for.
    Figure 2: Lean mass (left) and fat mass (right) development during the four phases of the intervention (Calbet. 2014)
    Now, the fat rebound in the sucrose group would initially suggest that your gut feeling was right. Eventually, it's yet unlikely that this was more than a mere coincidence and the shocking loss in lean mass that occurred during the 4-day of manic dieting + walking, normalized withing days, when when the subjects returned to their regular energy intakes (+ obligatory 10,000 steps a day).

    The latter obviously suggests that most of the "muscle loss" was actually water + glycogen and thus easy to restore (see Figure 3, right, as well).
    Suggested Read: "Cell Swelling Keeps Muscles "Pumped" For More Than 52h - Could It Even Help You Build Muscle?" | read more
    Lean mass can be tissue, water and glycogen: Early "muscle loss" is mostly water + glycogen (esp. on low carb diets; Kreitzman. 1992). In view of older studies on the muscle-building mechanisms of creatine (Persky. 2001) and the latest research on the involvement of muscular (hyper-)hydration in skeletal muscle hypertrophy Ribero et al. (2014), the loss of water and glycogen - as benign and as far as the glycogen goes, even metabolically beneficial (leaves room to store glucose ➲ improves insulin sensitiviy) as it may be - could hamper your gains.
    What I cannot explain - at least not without telling you that my answer is of hypothetical nature and would thus require experimental confirmation - are the impressive long(er)-term weight loss effects.
    Usually you would expect the subjects to jojo back up, right away - in the worst case to body fat levels that are higher than those nasty 31%, where they were initially coming from. If you take a look at Figure 3, it's yet plain to see that the opposite was the case.
    Figure 3: Progressive changes in body fat and lean mass (in kg) over the course of the study period (Calbet. 2014)
    In spite of the fact that the subjects returned to their regular energy intakes, they lost an additional body fat - at quite an impressive rate, by the way. Now, an as previously mentioned hypothetical explanation for these observations is the use of body fat as a substrate and energy source to refill the previously mentioned glycogen stores in muscle and liver.

    Even if we take into consideration that the release (lipolysis) and oxidation of fats and the storage of glucose from dietary carbohydrates (it's not impossible (Kaleta. 2012), but unlikely that the stored body fat is used as an energy source for glyconeogenesis) in form of glycogen are energetically costly, the 2,000kcal would equal no more than max. 300g of stored body fat, which is more than the additional 450g even the whey protein group dropped during the 4-day aftermath.
    That's quite astonishing: Would you have expected that this "4-days of madness" diet would generate a total fat loss of -3.8kg (2.8kg of those from the potentially life-threatening trunk fat) and thus produce an outcome of which the researchers rightly say that it "is better than several interventions combining low-calorie diets and exercise lasting from 12 weeks to 1 year (Garrow. 1995; Shaw. 2009)" and bet the largest randomized control trial for the response to 8-month resistance training, aerobic training, or combined aerobic and resistance training (Willis et al., 2012)? Certainly not, right?

    Figure 4: Weight loss (not fat loss!) maintenance in Calbet et al. and the average US dieter according to a meta-analysis by Anderson et al. (2001)
    Well, considering the fat that the mean fat loss here is greater than that achieved by the latest pharmacological intervention, i.e. the administration of glucagon-like peptide-1 (GLP-1) agonists for 20 weeks (which gave a weighted mean loss of 2.9 kg in 21 trials involving 6411 participants; Vilsboll. 2012), I am actually happy that there was a one year follow up to show that a short-term intervention can never replace permanent life-style changes... although, when you look at the whey protein group, who regained a meager 1.09kg in Phase V and thus significantly less than the 50-80% the average subject on a medically supervised weight loss diets (Anderson. 2001; see Figure 4), I do have to admit this is not just surprising.

    This is damn impressive, even if the comparison is unfair, due to longer follow ups in the average study in Anderson's meta-analysis. Still, there is one thing I would like to see before I'd recommend this type of diet to anyone who doesn't have to lose another 2kg of fat before a physique show or photoshoot at the end of the week: A comparison of the health benefits of successful whey-based(!) crash dieting.
    References:
    • Anderson, James W., et al. "Long-term weight-loss maintenance: a meta-analysis of US studies." The American journal of clinical nutrition 74.5 (2001): 579-584.
    • Calbet, J. A. L., et al. "A time-efficient reduction of fat mass in 4 days with exercise and caloric restriction." Scandinavian Journal of Medicine & Science in Sports. (2014). Accepted Manuscript. doi: 10.1111/sms.12194 
    • Garrow, J. S., and C. D. Summerbell. "Meta-analysis: effect of exercise, with or without dieting, on the body composition of overweight subjects." European journal of clinical nutrition 49.1 (1995): 1-10.
    • Kaleta, Christoph, Luís F. de Figueiredo, and Stefan Schuster. "Against the stream: relevance of gluconeogenesis from fatty acids for natives of the arctic regions." International journal of circumpolar health 71 (2012).
    • Kreitzman, Stephen N., Ann Y. Coxon, and Kalman F. Szaz. "Glycogen storage: illusions of easy weight loss, excessive weight regain, and distortions in estimates of body composition." The American journal of clinical nutrition 56.1 (1992): 292S-293S.
    • Persky, Adam M., and Gayle A. Brazeau. "Clinical pharmacology of the dietary supplement creatine monohydrate." Pharmacological Reviews 53.2 (2001): 161-176.
    • Ribeiro, Alex S., et al. "Resistance training promotes increase in intracellular hydration in men and women." European journal of sport science ahead-of-print (2014): 1-8. 
    • Shaw, K., et al. "Exercise for overweight or obesity." Cochrane Database Syst Rev 4 (2006).
    • Vilsbøll, Tina, et al. "Effects of glucagon-like peptide-1 receptor agonists on weight loss: systematic review and meta-analyses of randomised controlled trials." BMJ: British Medical Journal 344 (2012).
    • Willis, Leslie H., et al. "Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults." Journal of Applied Physiology 113.12 (2012): 1831-1837.
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