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Size Does Matter! Mucuna Counters Estrogenic Assaults & Doubles Testosterone. High Hair Cortisol, CVD & Diabetes. Catabolic Laziness. Health & Obesity = Incompatible

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While it may be debatable, whether and in which contexts size really matters, 20% of the women in a Dutch study state that they length of the best part of their partner was "important" (Franken.. 2002)
While the debate whether or not "size matters" is probably never going to end, researchers from the Universidad Autónoma del Estado de Mexico have now found that your male offspring could "fall short" if they are exposed to phtalates during pregnancy. For their study, the scientists had collected urine samples of 174 mothers-to-be and analyzed them for phtalate residues. Bustamante-Montes et al. did then correlate the phtalate content of the urine of those mothers who gave birth to male newborns (N=73) to their sons' best parts and found that "prenatal exposure to mono-2-ethylhexyl phthalate exposure was associated with a reduced distance from the anus to anterior base of the penis (-0.2 mm/µg), reduced penile width (-0.04 mm/µg) and a reduced stretched penis length (-0.2 mm/µg).

Now this SuppVersity Figure of the Week certainly sounds pretty funny, but if we go by the maximal phtalate levels in the study at hand, the boys with the highest exposure had a 36% "disadvantage" compared to Joe... ah well, maybe rather Juan Average ;-)

Enough of the saucy science! Let's get to the "serious" stuff!

I have, just as about every week compiled a colorful potpourri of news, but contrary to the last weeks, I am trying to keep things short and simple. I mean "short news" should be short and not shortened versions of the full-articles you're served over the rest of the week, right?

  • Will the correlation between heart disease and diabetes risk and cortisol in scalp hair also hold for you? While it seems unlikely that the figures would be identical you can bet that highly elevated hair cortisol and thus chronically elevated systemic cortisol levels are a significant risk factor for cardiovascular disease and diabetes irrespective of a person's age.
    Cortisol in scalp hair provide a pretty accurate image of heart disease and diabetes risk -- If you are trying to elucidate the diabetes risk of your grandma or grandpa a blood-draw may not even be necessary. According to the results of a soon-to-be-published study from the Netherlands, all you'd have to to is go to their bathroom and grab a hair from the brush or comb.

    If the cortisol level in the hair is high (>30.6 pg/mg hair), chances your grandparents' heart and pancreas are probably not in the best shape. With a +170% increased risk of cardiovascular disease and +220% increased risk to suffer from / develop type II diabetes, the correlations Manenschijn et al. observed underline the profound negative effects of chronically elevated cortisol levels (Manenschijn. 2013). 

    • The anti-catabolic effects of laziness -- At least in the elderly it takes no more than 2 weeks of reduced physical activity to reduce the already inferior (compared to young individuals) rates of myofibrillar protein synthesis.

      Kaatsu may be beneficial for people who don't tolerate hard workouts (learn more), but in a TV chair, it won't work - regardless of your age!
      Leigh Breen and his colleagues from the McMaster University in Hamilton, Ontario (Canada) report in their latest paper that a 75% reduction in daily step count does not only hamper the postprandial insulin sensitivity (-43%) of healthy older adults (72±1 yr), it also increases the levels of TNF-α and CRP by ∼12 and 25%, the total amount of trunk fat by 7% and decreases the lean leg mass by ~4% and the postprandial muscle protein synthesis by a whopping 26% - somehow this reminds me of the good old saying "If you don't use it, you lose it!"

    • Healthy but obese? Not really... it's just a question of time until the ugly blubber will make you sick -- You know that I could go off the deep end, whenever I see headlines like "being fat is healthy" or "being fat does not mean that you are sick". A recent paper by a group of Spanish researchers does now clearly indicate that media messages like these are downright dangerous (Soriguer. 2013).

      The analysis of data from the Pizarra Study a large scale epidemiological study involving 1051 individuals representative of general population were whose health and body composition was evaluated in ~5 year intervals clearly shows that being "healthy but obese" is just an intermediate state which is associated with a 720% increased risk of developing diabetes within the next 11 years. 

    • Mucuna pruriens protects male fertility against estrogenic assaults & restores testosterone levels  -- I an interesting rodent experiment researchers from the Division of Endocrinology at the Council for Scientific and Industrial Research-Central Drug Research Institute were able to show that oral supplementation with 300 mg/kg mucuna pruriens or 20 mg/kg BW of l-dopa (Singh. 2013). With the latter being the equivalent of the l-dopa content of Indian mucuna pruriens it is particularly interesting to see that only mucuna, but not l-dopa went far beyond restoring the testosterone levels after 2 weeks on an endocrine disrupting dose of 3mg/kg ethinyl estradiol - it almost tripled them!
      Figure 1: Testosterone, FSH and LH levels 2 weeks, 4 weeks and 6 weeks into recovery; data expressed relative to non estradiol treated healthy control (Singh. 2013)
      According to the scientists the beneficial effects on sperm quality, LH, FSH and testosterone were brought about or at least accompanied by reductions in ROS level, the restoration of mitochondrial membrane potential, a normalization of apoptotic processes and overall increase in the number of germ cells.

      If we assume the effects translate to human beings, a daily dose of 3-4g of mucuna (while this is the HED of the dose used in the study, but probably you'd need lower doses - after all you don't take estrogen, do you?) could protect you against the constant assault of environmental estrogens and come particularly handy, when you "messed up" your endocrine system with other compounds ;-)



    That's it for today! It's Saturday and time to celebrate that spring is finally there. So after you've checked out the latest SuppVersity Facebook News you better switch off the computer and enjoy whatever spring activities you like best... ;-)

          References:
          • Breen L, Stokes KA, Churchward-Venne TA, Moore DR, Baker SK, Smith K, Atherton PJ, Phillips SM. Two weeks of reduced activity decreases leg lean mass and induces 'anabolic resistance' of myofibrillar protein synthesis in healthy elderly. J Clin Endocrinol Metab. 2013 Apr 15. [Epub ahead of print]
          • Francken AB, van de Wiel HB, van Driel MF, Weijmar Schultz WC. What importance do women attribute to the size of the penis? Eur Urol. 2002 Nov;42(5):426-31.
          • Bustamante-Montes LP, Hernandez-Valero MA,  Flores-Pimentel D, Garcıa-Fabila M, Amaya-Chavez A, Barr DB, Borja-Aburto VH. Prenatal exposure to phthalates is associated with decreased anogenital distance and penile size in male newborns. Journal of Developmental Origins of Health and Disease. April 2013 [Epub ahead of print]
          • Manenschijn L, Schaap L, van Schoor NM, van der Pas S, Peeters GM, Lips P, Koper JW, van Rossum EF. High Long-Term Cortisol Levels, Measured in Scalp Hair, Are Associated With a History of Cardiovascular Disease. J Clin Endocrinol Metab. 2013 Apr 17. [Epub ahead of print]
          • Singh AP, Sarkar S, Tripathi M, Rajender S. Mucuna pruriens and its major constituent L-DOPA recover spermatogenic loss by combating ROS, loss of mitochondrial membrane potential and apoptosis. PLoS One. 2013;8(1):e54655. 
          • Soriguer F, Gutiérrez-Repiso C, Rubio-Martín E, García-Fuentes E, Cruz Almaraz M, Colomo N, Esteva de Antonio I, Ruiz de Adana MS, Chaves FJ, Morcillo S, Valdés S, Rojo-Martínez G. Metabolically healthy but obese, a matter of time? Findings from the prospective Pizarra study. J Clin Endocrinol Metab. 2013 Apr 4. [Epub ahead of print]
             

          True Or False: Glutamine For Glycogen Repletion. Enzymes Instead of NSAID. Drumming Burns More Kcal Than Jogging

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          Ever wondered how the "Modern-Day Samurai" of the Drummers of Japan keep in shape? Today's installment of True or False holds the answer to this and other questions ;-)
          True or false? That's the title of this no longer new series at the Suppversity and it is the question I want to answer after you read the following three statements: (1) "You can use glutamine instead of carbs to replete your glycogen stores", (2) "The only ones who benefit from the use of enterically coated and purportedly systemically acting enzymes are the the manufacturers of respective supplements" and (3) "Drumming burns about as much energy as fast jogging"... hmm, I see you're scratching your head!?

          Well, the unwritten rules of the game require that you make your prediction before you read the following paragraphs. So, true or false?

          You can use glutamine instead of carbs to replete your glycogen stores

          True. There is yet one big caveat. The gluconeogenic pathway, i.e. the transformation process of glutamine to glucose, delivers the lion's share of its end product directly to liver (Meijer. 1992). Therefore glutamine is rather an adjunct (to feed the liver) than a true carbohydrate alternative.

          And what about Sustamine(R) & co? Whether the use of allegedly superior glutamine dipeptides like alanyl glutamine does provide an additional edge remains questionable. Aside from a slightly more pronounced increase in muscle glutamine with chronic Ala-Glu supplementation (Rogero. 2006), there is little evidence for theoretical and almost no evidence for real-world advantages of combining our bodies favorite gluconeogenic amino acids, glutamine and alanine into a dipeptide. A detailed analysis of the available literature, would yet be a topic for another installment of True or False - if you want that, suggest "Alanyl-glutamine is well worth the extra bucks", as a topic for a future installment in the comment area ;-)
          What is yet worth mentioning is that the combination of carbohydrates and glutamine has been shown to actively promote the storage of skeletal muscle glycogen (Bowtell JL. 1999). Slightly superior effects than for l-glutamine alone have yet been observed by Hall et al. who supplied the participants of their study with 0.8g/kg glucose and iso-caloric amounts of whey or wheat hydrosolates (wheat is naturally high in glutamine; Hall. 1998).
          Figure 1: Relative increase in muscle glycogen after the workout (Hall. 1998)
          As the data in figure 1 goes to show you, both, whey and wheat hydrolysate shoveled an allegedly non-significantly greater amount of glycogen into the skeletal muscle of eight well-trained male cyclists in the course of the 3h recovery phase after a combined HIT glycogen depletion + HIIT workout - an effect that was probably facilitated by the ~2x higher increase in insulin.

          Bottom line: I guess, no one of you will want to miss on the protein anabolic effects of a whey protein after your workout, right? Against that background the replacement of the latter with glutamine is not really an option. The existing increases in glycogen synthesis due to glutamine are thus practically irrelevant, since you will achieve just the same (if not superior) results with a complete protein source.

          Systemic enzyme therapy is only beneficial for the manufacturers of respective supplements

          Not necessarily. While the available literature is scarce and in large parts either official sponsored or suspiciously focused on certain products, the results would suggest that enzyme complexes such as Mucos Pharma's Phlogenzym, an enteric-coated formula that contains pancreatin (100mg), trypsin (24mg), chymotrypsin (1mg), bromelain (45mg), papain (40mg) and rutin (50mg) is on par if not superior to low-dose pharmacological therapies with NSAIDs (e.g. 2x50mg of diclofenac; cf. Tilwe. 2001).
          Figure 2: Relative improvements in pain and joint tenderness and swelling after seven weeks on enzymes vs. conventional NSAID treatment in fifty 40-75year old subjects (Tilwe. 2001)
          Similar results have been reported by Akhtar et al. and Singer, Singer and Oberleitner in 2004 and 2001, respectively. Contrary to Tilwe et al., Singer and his Austrian colleagues also observed that the beneficial effects of Phlogenzym lasted for three weeks after the therapy was ceased. The effects of the diclofenac control (identical dosing as in Tilwe, 2001), on the other hand, wore off immediately after the 63 patients in the Singer study stopped taking the drug.

          No cheap alternatives? Scientific evidence for the efficacy of alternative non-enterically-coated enzyme preparations for the treatment of osteoarthritis & co is totally lacking. There are however some generic preparations which should have very similar effects. Selazym N, for example, has a similar ingredient profile, added selenium and costs less than 50% of the "original" (~$43 per month).
          Despite the fact that the data in figure 2 would suggest that Phlogenzym should be the treatment of choice, the patients and physicians ranked diclofenac slightly higher on the efficacy and tolerability scale. Moreover, the authors of a Cocrane Review on the issue point out that
          "In spite of the large number of publications in this area, there are few randomized controlled trials. Furthermore, most trials comparing two or more NSAIDs suffer from substantial design errors [...] Had studies employed appropriate doses of comparator drug, most would have been sufficiently powerful to detect clinically important differences in efficacy." (Watson. 2000; review awaiting update)
          In view of the negative side effects of NSAIDs, it still appears as if the "natural" enzyme therapy would be the preferred first choice for everyone with osteoarthritic pain. If that does not work out, you can still resort to the classic NSAID-based therapy regimen.

          Bottom line: Despite promising results in some studies, the fact that larger scale studies investigating the effects of Phlogenzyme on lateral ankle ligament injury (Kerkhoffs. 2004) could not confirm previously observed benefits in studies conducted by Hollmann et al. (1998) and Van Dijk (1994) support the notion that the ~$95 a month "on" Phlogenzyme at the respective effective dose of 6 tabs per day would cost you (estimate based on current price of €72.50 here in Germany) are wise-spent only if you suffer from chronic pain. Healthy physical culturists, on the other hand, should rather spend their money on other stuff.

          Drumming burns about as much energy as fast jogging

          It's about time for spring cleaning anyway: So if you are not into drumming, even cleaning can easily "burn" 1/4 of the calories you'd be expending on a jog/run + it has to be done, anyways (Puyau. 2004)
          True! You know I am no advocate of calorie counting - not with respect to the energy content of foods and even less as far as the amount of energy you burn during a workout is concerned. If we do yet assume, ... just hypothetically obviously, that you want to burn as much energy as possible within the next 60 minutes, you would be ill-advised to go for a light jog if you got a drum kit in your basement.

          As a soon-to-be-published paper from the UK shows, the estimated energy expenditure of a drummer during a live concert performance amounts to 623±168 kcal/h (8.1±2.2 METs). This is at least on par with a very paced jog.

          And if you also take into account that the subjects of the study achieved peak heart rates of 186±16 bpm and 78.7±8.3% of their cycle ergometer peak oxygen uptake, the drums do probably even have an edge over a regular jog as far as their conditioning effects are concerned (De La Rue. 2013).

          Bottom line: The scientists are absolutely right, when they write that "Rock/pop drumming should be considered as a viable alternative to more traditional forms of physical activity." And guess what, drumming is by far not the only largely underestimated "sportive activity" - other much more common activities, like my very own bike rides to the job, for example (learn more in the last installment of the Science Round Up) will likewise effect your general fitness level, energy expenditure and body composition - and that in a much more sustainable way than the "beat-me up" workouts of the average "It's quitting time!" gymbro.

          And what's more, it's the regular, not the extraordinary energy expenditure that can cut your risk of biting the dust prematurely by almost 70%. According to a 2006 paper from the Journal of the American Medical Association (JAMA), for example, spending an additional 287kcal/day on "free-living activity" (that's 27min of drumming) can reduce the mortality risk of elderly individuals by -32% (Manini. 2006)!



          As unfortunate as this may sound, but that's it already! Trust me, I do enjoy these "True or False" sessions about as much as you (hopefully) do, but one thing of which I know that it's true even without having to apply the sniff-test is that you'd not be waiting for the next installment to be published that eagerly, if I put out 10 of these items every day ;-) So be patient and enjoy the rest of your weekend - there are going to be more truths revealed and myths to be busted in the future.

          References:
          • Akhtar NM, Naseer R, Farooqi AZ, Aziz W, Nazir M. Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee--a double-blind prospective randomized study. Clin Rheumatol. 2004 Oct;23(5):410-5. 
          • Bowtell JL, Gelly K, Jackman ML, Patel A, Simeoni M, Rennie MJ. Effect of oral glutamine on whole body carbohydrate storage during recovery from exhaustive exercise. J Appl Physiol. 1999 Jun;86(6):1770-7.
          • De La Rue SE, Draper SB, Potter CR, Smith MS. Energy Expenditure in Rock/Pop Drumming. Int J Sports Med. 2013 Apr 4. [Epub ahead of print]
          • Hollmann W. Efficacy and safety of hydrolytic enzymes and rutin in patients with distortions of the ankle joint. Clinical study report MU-694411, Idv-Datenanalyse und Versuchsplanung Gauting, 1998.
          • Kerkhoffs GM, Struijs PA, de Wit C, et al. A double blind, randomised, parallel group study on the effi cacy and safety of treating acute lateral ankle sprain with oral hydrolytic enzymes. Br J Sports Med 2004;38:431.
          • Manini TM, Everhart JE, Patel KV, Schoeller DA, Colbert LH, Visser M, Tylavsky F, Bauer DC, Goodpaster BH, Harris TB. Daily activity energy expenditure and mortality among older adults. JAMA. 2006 Jul 12;296(2):171-9. 
          • Meijer AJ, Baquet A, Gustafson L, van Woerkom GM, Hue L. Mechanism of activation of liver glycogen synthase by swelling. J Biol Chem. 1992 Mar 25;267(9):5823-8.
          • Puyau MR, Adolph AL, Vohra FA, Zakeri I, Butte NF. Prediction of activity energy expenditure using accelerometers in children. Med Sci Sports Exerc. 2004 Sep;36(9):1625-31.
          • Rogero MM, Tirapegui J, Pedrosa RG, Castro IA, Pires IS. Effect of alanyl-glutamine supplementation on plasma and tissue glutamine concentrations in rats submitted to exhaustive exercise. Nutrition. 2006 May;22(5):564-71.
          • Singer F, Singer C, Oberleitner H. Phlogenzym versus diclofenac in the treatment of activated osteoarthritis of the knee. A double blind prospective randomized study. Int J Immunotherapy 2001;XVII:135–41.
          • Tilwe GH, Beria S, Turakhia NH, Daftary GV, Schiess W. Efficacy and tolerability of oral enzyme therapy as compared to diclofenac in active osteoarthrosis of knee joint: an open randomized controlled clinical trial. J Assoc Physicians India. 2001 Jun;49:617-21.
          • Van Dijk CN. A double blind comparative study on the efficacy of MU-410 vs. placebo in patients with acute disruption of the anterior fi bulotalar ligament. Study Nr. 4903XV, Amsterdam, 1994.
          • Watson MC, Brookes ST, Kirwan JR, Faulkner A. Non-aspirin, non-steroidal anti-inflammatory drugs for osteoarthritis of the knee. Cochrane Database Syst Rev. 2000;(2):CD000142.

          Diet + Exercise + Kitchen Sink Fat Burner Promote Weight Loss in Two-Months Study on Overweight Adults. Additional 2kg Fat Loss - Are Ozzy's Raspberries to "Blame"?

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          No this is not Liza Oz after taking Mehmet's beloved RK supplements ;-)
          The Journal of the International Society of Sports Nutrition is one of the few "major" scientific journals, where scientists can actually publish those studies, "healthy freaks" (no, not "health freaks", but people who are still healthy and thus freaks ;-) like us are interested in. Studies such as the one Hector L Lopez and his colleagues conducted; studies that investigate the effects and effectiveness of dietary supplements such as Prograde Metabolism (TM), a proprietary blend "fat burner" containing your usual blend of B-vitamins, chromium, caffeine, citrus aurantium, ginger, garlic, capsaicin, l-theanine and piper nigrum... ah, and of course as the #1 ingredient on the label Raspberry-K(TM).

          Too much blubber? "Grab the rasp and berry it off!" Ah, well...

          Hold on, another of those "proprietary blend studies"? Can we even trust the data? Allegedly, the authors Lopez and Ziegenfuss have worked for raw material suppliers, nutraceutical and dietary supplement companies in the past and openly declare that in the paper at hand, but guess how many of the authors of studies on medications have worked for the pharma industry and were / are still involved in the development of the respective drugs? If we really started to question the results of each and every study on the basis of the mere assumption that it was a product pimp job, we would probably have to discard 95% of the currently available research. Just remember: In 99.9% of the cases it's the conclusions and interpretations that can be problematic, and not the data, itself.
          If we take a closer look at the ingredient profile of "METABO", we notice that Dr. Oz's beloved raspberry ketones are right on the top of the ingredient list of the 1,000mg proprietary blend single 2-cap serving of the product contains. With caffeine and a 10% synephrine extract from citrus aurantium, which are usually dosed at around 200mg and 100-150mg (to deliver 10-15mg of synephrine as part of the Advantra-Z formula; cf. Seifert. 2006), respectivley, being the #2 and #3 on that list, we can safely assume that the maximal amount of Razberi K in a single serving of the supplement is 600mg.... that's actually quite nice, because that's so little that we do not even have to use a calculator to know that this is hilariously underdosed compared to what the rodents in the heavily cited anti-obesity (I repeat: anti-obesity, not weight loss) trials by Morimoto et al. reaceived as part of their regular chow (1-2% of the whole chow was nothing but pure raspberry ketones; cf. Morimoto. 2005)
          Figure 1: Body weight, fat mass, lean mass and waist circumference after 4 and 8 weeks of dieting + exercise + supplement / placebo (Lopez. 2013)
          In the end, that's yet good news. Firstly, we can safely assume that this is way too little to induce any of the anti-androgenic effects Ogawa et al. observed in their 2010 in-vitro study (Ogawa. 2010).

          And secondly, the low dose of raspberry ketones left some room for the other ingredients, of which you can see in the data I plotted in figure 1 that they were very well capable of promoting the weight loss success of the 70 "obese but otherwise healthy subjects" in the Lopez study.

          Effects? Yes! Effects due to raspberries? Questionable.

          There is no debating that the combination of multiple "thermogenic", appetite suppressing and anti-oxidant / insulin sensitizing weight loss adjuvants in METABO did promote the loss of fat mass over what the diet + exercise progra alone could achieve. The former, i.e. the diet, had by the way been designed by a "state-licensed, registered dietitian" to provide three meals and two snacks per day (the latter are obviously useless; cf. Whybrow. 2007) and a total energy intake that would deliver approximately 500 kilocalories per day less from a 40% carbohydrate, 30% protein and 30% fat diet than the subjects actually "required" (dietary requirements that were calculated with the Mifflin-St. Jeor equation and an activity factor of 1.2; learn more).

          This dietary regimen was accompanied by an 8-week workout regimen of which I would usually write that it was "surprisingly sound". In view of the fact that the study, appeared in the Journal of the International Society of Sports Nutrition and not Obesity or JAMA it is yet only "sound" and not surprising that the subjects had to work out three times per week for 60 minutes of which not a single minute was wasted on steady state cardio in the non-existing fat-burning zone. Instead, they performed a...
            It sure sounds ufair, but women have a harder time shedding fat. Against that background it's all the more important for the average "I don't eat meat" lady to get her share of fat burning protein - after all a reasonable amount of protein speed fat loss in both sexes (learn more).
          • 10 minute warm-up (i.e. walking, light jogging, or biking),
          • 30 minutes of circuit training (upper and lower body each session, which consisted of a combination of 
            • mountain climbers, squat thrusts, 
            • jumping jacks, squat kickouts, walking lunges, 
            • push-ups, dips, 
            • resistance band elbow flexion, extension and 
            • shoulder presses, 
          • additional 10 minutes abdominals/core work, and 
          • a subsequent 10 minutes cool down/stretching
          Against that background it is however "surprising" that the fat loss in the placebo group was pretty pathetic (~115g per week), after all the participants had more than enough (32.6kg) of fat to lose.

          Dieting alone "fails", the supplement "works" - what's more surprising

          Now, the first thing that comes to mind, whenever a diet fails, is a bogey called "non-adherence". With the supervised and controlled exercise protocol and the official data on the energy and nutrient intake not showing significant inter-group differences, it is however difficult to pin the success / failure of the groups exclusively on non-compliance. The consistently higher food cravings in the placebo group do yet put another questionmark behing behind the accuracy of the already notoriously unreliable self-reported food intakes.
          Figure 2: Cravings for energy, sweets, fatty fast food, fat in general, carbs and healthy foods in the subjects in the placebo and MTEABO group (Lopez. 2013)
          According to the latter, the subjects in the placebo group consumed almost the same amount of energy, which does not appear totally unlikely in view of the fact that the cravings in the placebo group were so real that they even started to crave "healthy foods" (figure 2, orange) - a tell-tale sign that diters are seriously hungry and don't just want to satisfy their food-cravings.
          Significant fat loss without significant health benefits? Surprisingly, the measured markers of glucose and lipid metabolism, namely total cholesterol, HDL, LDL, cholesterol/HDL ratio and TAG did not show significant improvements in any of the groups. There was however "a strong trend (p < 0.07) for TAG concentrations to decrease more in the  METABO group (-15.9%) compared to the placebo group (-2.6%)" (Lopez. 2013) and a significant decrease in leptin that was likewise observed exclusively in the supplement group.
          Since hunger is associated with increased ghrelin levels and those have only recently been confirmed as a significant correlate and potential cause for weight loss interventions to fail (Liu. 2013), it may in the end not even matter, whether the subjects gave in to their cravings and "cheated" or whether they starved and their bodies simply stopped shedding body fat - the net result would have been identical in both conditions and if a single agent or the synergy of all of the ingredients in METABO was responsible for the satiety effect the weight loss advantage would in fact have been brought by the dietary supplement.



          If you clicked on the links that redirect you to the overviews of SuppVersity articles on capsaicin, piperine, citrus aurantium etc. you will have realized that many of them were also on my list of PPAR-gamma antagonists (learn more).
          Bottom line: The most likely explanation for the beneficial effects Lopez et al. observed as a result of 2,000mg of the proprietary blend are thus the...
          1. fat loss benefits (I initially wanted to write "effects", but that's probably an exaggeration) of ingredients such as caffeine (Greenway. 2001), capsaicin (Snitkner. 2009), citrus aurantium (Bent. 2004; Stohs. 2012), ginger (Mahmoud. 2013), piperine, and / or 
          2. satiety effects of caffeine (Westerterp-Plantenga. 2005a), capsaicin (Westerterp-Plantenga. 2005b), ginger (Mansour. 2012), ...
          ... I guess you see the picture that's emerging here. It is, as the scientists point out, "the combination of ingredients with potentially complementary and interactive mechanisms of action" (Lopez. 2013) which does the trick.

          Against that background it is pretty useless to single out any of the ingredients, but if we wanted to do just that, it would certainly be the raspberry ketones which are the least-proven weight-loss adjuvant in Prograde Metabolism - an ingredient celebrated as the goto fat burner by the uneducated mainstream and an ingredient without any scientific backup from human studies. So, if I had to answer the gonzo rhetoric question in the title of this article in a binary = yes/no fashion, the most likely answer would be "no!" ;-)

          References:
          • Bent S, Padula A, Neuhaus J. Safety and efficacy of citrus aurantium for weight loss. Am J Cardiol. 2004 Nov 15;94(10):1359-61.
          • Greenway FL. The safety and efficacy of pharmaceutical and herbal caffeine and ephedrine use as a weight loss agent. Obes Rev. 2001 Aug;2(3):199-211.
          • Ogawa Y, Akamatsu M, Hotta Y, Hosoda A, Tamura H. Effect of essential oils, such as raspberry ketone and its derivatives, on antiandrogenic activity based on in vitro reporter gene assay. Bioorg Med Chem Lett. 2010 Apr 1;20(7):2111-4.
          • Lopez HL, Ziegenfuss TN, Hofheins JE, Habowski SM, Arent SM, Weir JP, Ferrando AA. Eight weeks of supplementation with a multi-ingredient weight loss product enhances body composition, reduces hip and waist girth, and increases energy levels in overweight men and women. Journal of the International Society of Sports Nutrition. 2013; 10(22).
          • Mahmoud RH, Elnour WA. Comparative evaluation of the efficacy of ginger and orlistat on obesity management, pancreatic lipase and liver peroxisomal catalase enzyme in male albino rats. Eur Rev Med Pharmacol Sci. 2013 Jan;17(1):75-83. 
          • Mansour MS, Ni YM, Roberts AL, Kelleman M, Roychoudhury A, St-Onge MP. Ginger consumption enhances the thermic effect of food and promotes feelings of satiety without affecting metabolic and hormonal parameters in overweight men: a pilot study. Metabolism. 2012 Oct;61(10):1347-52.
          • Morimoto C, Satoh Y, Hara M, Inoue S, Tsujita T, Okuda H. Anti-obese action of raspberry ketone. Life Sci. 2005 May 27;77(2):194-204.
          • Snitker S, Fujishima Y, Shen H, Ott S, Pi-Sunyer X, Furuhata Y, Sato H, Takahashi M. Effects of novel capsinoid treatment on fatness and energy metabolism in humans: possible pharmacogenetic implications. Am J Clin Nutr. 2009 Jan;89(1):45-50. 
          • Stohs SJ, Preuss HG, Shara M. A review of the human clinical studies involving Citrus aurantium (bitter orange) extract and its primary protoalkaloid p-synephrine. Int J Med Sci. 2012;9(7):527-38. Epub 2012 Aug 29.
          • Westerterp-Plantenga MS, Lejeune MP, Kovacs EM. Body weight loss and weight maintenance in relation to habitual caffeine intake and green tea supplementation. Obes Res. 2005a Jul;13(7):1195-204.
          • Westerterp-Plantenga MS, Smeets A, Lejeune MP. Sensory and gastrointestinal satiety effects of capsaicin on food intake. Int J Obes (Lond). 2005b Jun;29(6):682-8.
          • Whybrow S, Mayer C, Kirk TR, Mazlan N, Stubbs RJ. Effects of two weeks' mandatory snack consumption on energy intake and energy balance. Obesity (Silver Spring). 2007 Mar;15(3):673-85.

          Citrulline as Substrate Switch. Galactose as Workout Fuel, Glycogen Repletion Not Urgent, 2x a Day 6x a Week = Too Much For Your Antioxidant System, Astaxanthin For IgA

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          Actually it's not the burn during the workout that matters, but I don't have to tell you that, do I? (pic i-am-beast.com)
          What do you do with a whole host of interesting exercise-related nutrition news that are piling up in your archive, but are too good to be "burned" as short links with one sentence of text on the SuppVersity Facebook Wall?

          Right! You compile all those news into a potpourri, attach the label "SuppVersity News Potpourri" to it and blow them out in a blogpost of their own. A post that covers the whole peri-workout window as well as the short-/long-term effects on exercise on your anti-oxidant and immune system.

          Sounds good? Well, then go ahead...
          • Immediate post-workout glycogen repletion in endurance athletes probably useless (Carlsohn. 2013) While the hormonal response and the long-term effects of running around with depleted glycogen levels are a totally different animal, the latest research from the University Outpatient Clinic Potsdam in Potsdam, Germany, clearly suggests that the immediate post-run glycogen-repletion with 1.5g/kg body weight of fast acting carbs per hour is useless...

            Do you remember my "Glycogen-free muscle growth" post(s) from 2011?
            ...at least with respect to the 5,000m running performance of the twelve recreational runners (4m/8w; 1.73 ± 0.11 m, 69.1 ± 13.4 kg). who were involved in Carlsohn et al.'s study.
            "Running time during 5,000-m time trials did not differ between bTT (1,305 ± 140 s), following CARB (1,276 ± 125 s) or PLA (1,285 ± 124 s, p= .85). There were no differences in RPE (bTT 18.3 ± 0.3, CARB 18.7 ± 0.3, PLA 18.8 ± 0.9; p= .48), bLa/min, PLA 187 ± 3 beats/min; p= .96).
            In view of these results it should actually not necessary to formulate a "bottom line", but alas...

            Bottom line: "[T]he rationale of recommending immediate carbohydrate intake following exhausting exercise to 5,000-m runners might be questioned" (Carlsohn. 2013). Please keep in mind though that not repleting your glycogen stores at all is not an option - the myth that's been partially busted by the study at hand is that you must do that as fast as possible to maintain maximal performance - not that you must do it at all. 
          • "High" galactose foods ?
            Honey3.10g
            Fermented yoghurt1.30g
            Beets, canned, regular pack, solids and liquids0.80g
            Celery, raw0.66g
            Cherries, sweet, raw0.59g
            Bockwurst, pork, veal, raw0.48g
            Corn, sweet, yellow, canned, whole kernel, drained solids0.36g
            Beans, navy, mature seeds, raw0.34g
            Snacks, pretzels, hard, plain, salted0.22g
            Spices, curry powder0.21g
            Spices, mustard seed, yellow0.20g
            Spices, paprika0.19g
            Babyfood, fruit, plums with tapioca, without ascorbic acid, strained0.19g
            Spices, ginger, ground0.19g
            Spices, basil, dried0.19g
            Kiwi fruit, (chinese gooseberries), fresh, raw0.17g
            Cereals, oats, instant, fortified, plain, prepared with water (boiling water added or microwaved)0.16g
            Cheese, mozzarella, whole milk0.15g
            Spices, cloves, ground0.15g
            Cheese, parmesan, grated0.15g
            Spices, oregano, dried0.15g
            Fast foods, cheeseburger; single, regular patty, with condiments0.15g
            Plums, raw0.14g
            Peas, green (includes baby and lesuer types), canned, drained soilds, unprepared0.14g
            Cereals, oats, instant, fortified, plain, dry0.13g
            Fish, fish portions and sticks, frozen, preheated0.13g
            Figs, dried, uncooked0.13g
            Babyfood, plums, bananas and rice, strained0.12g
            Egg, whole, raw, fresh0.11g
            Avocados, raw, all commercial varieties0.10g
            Crackers, saltines0.07g
            Snacks, tortilla chips0.07g
            Egg, white, raw, fresh0.07g
            Snacks, tortilla chips, nacho cheese0.07g
            Peaches, raw0.06g
            Melons, cantaloupe, raw0.06g
            Galactose as alternative workout fuel (Duckworth. 2013) - A recent study from the Leeds Metropolitan University in the UK demonstrates that
            "ingesting a solution containing galactose before and during exercise can positively affect postexercise satiety and energy balance throughout the day, compared to a more readily available and widely consumed form of carbohydrate" (Duckworth. 2013)
            The scientists conclude that based on the observations they made, when they provided nine recreationally active eumenorrheic females (mean age 22y; weight 63.3kg) with either 45g galactose (GI~20) or glucose (GI~89) drinks prior to (300 ml) and at every 15 min during a low intensity steady state jog at 65% of their VO2Peak
            Note: I guess, it goes without saying that 45g of galactose this is more galactose than you can stomach from ingesting any "high galactose" foods; see table on the right, data in g/100g).
            The scientists measured the substrate oxidation, postexercise satiety and subsequent energy intake on three occasions (GLU, GAL, placebo) and found that
            • the plasma glucose levels were significantly greater throughout the exercise and in the rest period, when the subjects ingested the glucose drink,
            • there were no differences in carbohydrate oxidation, and
            • perceived hunger was significantly lower throughout the galactose compared to both the glucose and placebo trials
            What may yet be most significant for the average trainee trying to shed some weight is the difference in net energy balance, i.e. the difference between energetic costs of the workout, on the one hand, and the energy intake from the glucose / galactose supplement and the food intake during the post-exercise ad-libitum test lunch and the remainder of the day, which was negative only in the placebo and the galactose trial.
            Bottom line: If you want to shed some body fat and cannot go without an intra-workout beverage pick galactose over glucose, but do a "test run" before you try that in public - the monosaccharide is notorious for its socially not acceptable effects on the evaporations from your gastrointestinal tract ;-)
            "Does the Usefulness of Vitamin E Supplementation Depend on Your Activity Level?" It is possible that only those benefit who are already overtaxing their system and will thus need additional protection (learn more)
          • Exercise is stressing, but the long-term results are what's associated with improved antioxidant capacity (Lundström. 2013) The data Lundström et al. have collected in their recent 3-week trial involving fourteen 26-year-old volunteers who performed two "strenuous" (intensity targeted to 75% of VO2max) endurance training sessions per day (6 days a week) does in a way underline the validity of the hormesis hypothesis. Despite the fact that the increase in oxidative stress in response to the the allegedly hefty (for non professional athletes) two-sessions a-day, 6-days a week was not significant, the latter was facilitated / buffered by highly significant declines in the total plasma antioxidant capacity (AO).

            However, aside from the fact that the AO levels did not fully return to baseline after the subsequent 4-week recovery period, the most intriguing results of the study at hand is the highly significant negative (meaning "if A is high, B is low") correlation between fat-free mass and oxygen uptake, on the one hand, and oxidation stress, on the other.
            Bottom line: With both of the former, i.e. fat-free mass and oxygen uptake while you exercise, being hallmark features of physical fitness you cannot increase without working out, the balancing act, every trainee has to master is to find the exact i +1 load of stress that allows for adequate recovery and super-compensation in the time to the next workout / mesocycle.
          • Low Immunoglobuli, high cortisol and health While there appears to be a general relation between suppressed sIgA and high cortisol levels, on the one hand, and ill-health effects on the other. The latter is not sports-specific (Volkmann. 2006), and elite athletes are, despite suppressed IgA levels capable of normal responses to novel oral vaccinations, "indicating that mucosal immune mechanisms are intact" (Gleeson. 2000).
            Astaxanthin supplementation can ameliorate minor sIgA dump in athletes (Baralic. 2013) Study shows, supplementation with 4mg/day of astaxanthin can ameliorate the decrease in sIgA (marker of immune health) in young soccer players following 2h of exercise.

            There are yet two things you have to consider, when you read studies like these:  (a) Scientific evidence of the significance of immunoglobolin measures is not fully conclusive, and (b) the changes placebo group were not even significant.
            Note: In view of the fact that "[t]he clinical significance of [immunoglobolin changes] in acquired immunity with acute exercise and training remains unknown" (Walsh. 2011), the scientists' conclusion that "astaxanthin supplementation might serve as a countermeasure to sIgA changes associated with continuous intense training", must be taken with some caution wrt to its real-world benefits. 
          • Citrulline shifts substrate utilization towards carbs (Faure. 2013) With this last item in today's Exercise Science Potpourri, we are actually coming back to the an issue that has been in the SuppVersity news pretty regularly as of late: the amount fat / glucose you burn during a workout. I guess, I have made my personal perspective that fatty acid oxidation rates during exercise are hilariously overrated pretty clear. This does yet not stop me from pointing you towards the results of a soon-to-be-published study from the Université Paris Descartes the results of which would suggest that supplemental citrulline could work as a "fuel switch".

            Do you remember the December 2011 SuppVersity news on citrullines anti-catabolic effects (go back!)
             The significant downregulation of oxidative enzymes from the Krebs cycle and mitochondrial respiratory chain, the French scientists observed in a group of male Sprague-Dawley rats, when theyy re-fed them after a 12-week period of dietary restriction with a citrulline supplemented diet (+5g/kg chow and thus equivalent to what human studies have been using) compared to the standard chow with an iso-caloric mix on non-essential amino acids added) would at least suggest that "citrulline supplementatio [...] seems to induce a switch in muscle energy metabolism, from aerobia towards anaerobia" (Faure. 2011).

            Now, I did already point out that this is not necessarily a bad thing, but they cannot - as you may speculate now - explain the beneficial effects the original NO-supplement ingredient l-arginine on blood glucose management (learn more), because Faure et al. were able to show that "citrulline action is not direct and is not related to arginine" (Faure. 2013).
            Figure 1: Activity of enzymes involved in the oxidation of fatty acids; data expressed relative to baseline levels  on ad-libitum diet (Faure. 2013)
            Against that background another effect that was brought about by the high citrulline diet could yet be even more of a major metabolic disadvantage: The increase in metabolically highly glucoes guzzling unflexible type-IIb fibers (see figure 1; learn more), which has been associated with low / non-existent adiponectin levels by Krause et al. (2008).
            We have to be careful though, with respect to the interpretation and potential implications of these results. Why? Well, there are actually countless reasons: (a) Human beings are no rodents and normal rodents are no athletes, (b) the potential impact of a higher baseline protein intake or the absence of the calorie restriction before the supplementation period (c) different short (study at hand = 1 week) vs. long-term effects, (d) the possible (beneficial ?) involvement of mTOR, which has been shown to be activated by citrulline in previous trials (cf. SuppVersity Dec 28, 2011 and/or Le Plénier. 2011) (e) the fact that some athletes may benefit from the same shift towards glucose and the relative increase in type IIb fibers (not bodybuilders, though!) (f) ... I could go on with this list, but I guess you will see that there is no reason to panic.

            Take the Faure study as further evidence for our lack of understanding of the the complex effects and interplay of nutritional and supplemental amino acids on our health and don't forget to come back to the SuppVersity if you want to keep up with the "state of the art" ;-)



          That's it for today! I hope you enjoyed the "ride" and stay tuned for future exercise, nutrition and health science potpourris - write-ups of which I believe they are a necessary and interesting intermediate between the mini-items on Facebook (don't forget to head over there and check out today's 9+ news items) and the elaborate "regular" SuppVersity articles.

          References:
          • Baralic I, Đorđević B, Đuričić I, Šobajić S, Stanković I, Dikić N (2013). Salivary IgA response to astaxanthin supplementation in young soccer players. Proceedings of the Nutrition Society, 72, E7.
          • Carlsohn A, Heydenreich J, Engel T, Kratzenstein S, Mayer F. Does immediate carbohydrate intake following glycogen-depleting exercise affect next day’s 5000 m time trial performance? International Journal of Sport Nutrition and Exercise Metabolism.  2013; 23(S1 -S15).
          • Duckworth LC, Backhouse SH, Stevenson EJ, O’Hara JP. Effect of galactose ingestion before and during exercise on substrate oxidation and subsequent energy intake in females. International Journal of Sport Nutrition and Exercise Metabolism.  2013; 23(S1 -S15).
          • Le Plénier, S., Walrand, S., Noirt, R., Cynober, L., Moinard, C., Effects of leucine and  citrulline versus non-essential amino acids on muscle protein synthesis in fasted rat: a common activation pathway? Amino Acids. 2011.
          • Krause MP, Liu Y, Vu V, Chan L, Xu A, Riddell MC, Sweeney G, Hawke TJ.Adiponectin is expressed by skeletal muscle fibers and influences muscle phenotype and function. Am J Physiol Cell Physiol. 2008 Jul;295(1):C203-12. 
          • Stuart CA, McCurry MP, Marino A, South MA, Howell ME, Layne AS, Ramsey MW, Stone MH. Slow-Twitch Fiber Proportion in Skeletal Muscle Correlates with Insulin. Responsiveness. J Clin Endocrinol Metab. 2013 Mar 20. 
          • Volkmann ER, Weekes NY. Basal SIgA and cortisol levels predict stress-related health outcomes. Stress and Health. 2006; 22: 11–23. 
          • Walsh NP, Gleeson M, Shephard RJ, Gleeson M, Woods JA, Bishop NC, Fleshner M, Green C, Pedersen BK, Hoffman-Goetz L, Rogers CJ, Northoff H, Abbasi A, Simon P. Position statement. Part one: Immune function and exercise. Exerc Immunol Rev. 2011;17:6-63. Review.

            Baking Soda & Beta Alanine Synergistically Promote Upper Body Power Output by 14%. Body Part, Dosage or Subject Specificity? What Behind the Newly Found Synergism?

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            Finally, beta alanine passes the baton to sodium bicarbonate ;-)
            The hypothesis that the combination of an "internal" (as in inside of the cell) and an external H+ buffer would be a perfect match is unquestionably straight forward. What was yet about as straight forward were the results of a study by Ducker et al. you've read about, here at the SuppVersity on March 28, 2013: While the combination looks perfect on paper, the real-world results were more than just disappointing. The additional beta alanine did not only fail to promote the ergogenic effects of baking soda (NaHCO3), it did in fact thwart them (learn more).

            New study, new participants, new protocol, new results

            Now, I am pretty sure Gabriel Tobias and his colleagues from the University of Sao Paulo (Brazil) and the Nottingham Trent University in the UK, had not heard about the results Ducker et al. reported a couple of weeks ago, when they set out to test the effects of beta alanine (BA;  CarnoSyn(TM) 6.4 g/day for 28 days), sodium bicarbonate (SB aka baking soda, aka NaHCO3; 500 mg kg/day for 7 days) and the combination of both supplements on high-intensity performance, using an intermittent upper-body exercise as the performance assessment model in well-trained athletes.

            The study at hand is yet by no means a duplicate of the Ducker study, and I guess I don't have to point out, that the subject characteristics 
            Figure 1: Experimental design of the randomized placebo controlled study. 
            • 40 non-vegetarian, non-smoking, well-trained, experienced judo (n=19) and jiu-jitsu (n=21) male competitors (age 26, body weight 77-80kg; training volume 340-410min per week) vs. team-sport athletes in the Ducker study
            and, at least to a certain degree, the exercise protocol
            • 4 bouts of a 30-s upper-body Wingate Test vs.lower body repeated sprint tests in the Ducker study
            make it pretty attractive for the average muscle head whose sets usually don't last much longer than those 30s and who does (unfortunately) often neglect / 'undertrain' his legs in favor of his bis, chest and the rest of his upper body.

            "And it does work!"

            As you can see in the graphical outline of the experimental design in figure 1 the participants were randomly assigned to the individual study arms. While this eliminates cross-over effects of BA / SB residues, the sample size (N=10 per group) is pretty low and intra-personal comparisons are not possible.
            Increase in total work (kj/100) compared to pre-supplementation levels, rate of perceived exertion and magnitude-based inferences for total work done in three of the four experimental groups (Tobias. 2013)
            The effect size was yet still large enough to say with 100% certainty that the combination of BA + SB yields ergogenic benefits in terms of statistically, as well as practically relevant increases in total work-load during the upper body Wingate Test (BA and SB alone increased the total work done by +7 and 8 %, respectivel, together they achived an increase of +14%). The decrement in rate of perceived exertion was almost identical in all three groups treated with SB and/or BA (-11%), but reached statistical significance only in the BA + SB group.

            Now the question remains. What makes the difference?

            And what I mean by difference, here, is the difference between the Tobias and the Ducker study, of which Tobias, Benatti, Painelli and the others obviously weren't aware, when they wrote:
            Figure 2: The effects of beta alanine (top) and baking soda (middle) "preloading" on mean power during exercise bout 1-4 add up (Tobias. 2013)
            "To date, only two studies have examined the additive ergogenic effects of BA and SB. While neither the Sale et al. (2011) nor Bellinger et al. (2012) studies were able to detect a clear additive effect of the combined supplemen-tation (although Sale et al. 2010, 2011 did report 70 % probability of a meaningful effect), our data show that co-supplementation of BA and SB were more effective at increasing the total work done over the four bouts of exercise than these supplements taken individually. The main methodological difference between the present study
            and those by Sale et al. (2011) and Bellinger et al. (2012) relate to the exercise protocol used to assess performance (i.e. upper-body high-intensity intermittent exercise in the current study vs. continuous single-bout high-intensity leg-exercises in previous studies (Sale et al.2011; Bellinger et al.2012), which may have accounted for the discrepant results. " (Tobias. 2013)  
            Referring to studies by Hermansen (1972) and Belfry (2012), Tobias et al. further point out that there is in fact evidence that multiple bouts of supra-maximal exercise results in higher muscle acidosis than continuous supra-maximal exercises. And while this would apply to the Ducker stud, which did likewise use supra-maximal bouts, as well, previous studies by Robertson have clearly shown that
            "arm exercises are more sensitive to performance improvements induced by increased buffering capacity (via sodium bicarbonate ingestion) than leg exercises, possibly because the former leads to greater blood H+ concentration" (Tobias. 2013)
            Other confounding factors are training status and the familiarity with the type of exercise that's used during the testing procedure. Already super-compensated carnosine stores in highly trained athletes (this was suggested by Bellinger et al. in  2012, but would not be compatible with the results of the study at hand, where 8/9 athletes did respond to beta alanine),  and obviously different supplementation regimen.



            Sodium bicarbonate can also supercharge creatine (learn more)
            Bottom line: The body part specificity, as well the higher average dosage of beta alanine and finally the chronic vs. acute NaHCO3 supplementation of the study at hand could well explain the initially mentioned differences between the Tobias and the Ducker study. Overall, the results Tobias et al. present in their most recent paper speak in favor of the initial hypothesis that the combination of BA + SB would constitute an ideal ergogenic that could help basically every athlete competing in a sport where H+ buildup can limit maximal exercise performance.

            The range of athletes (cyclists, sprinters, team sports athletes competing in sports, where intermediate sprints matter, fitness junkies, body builders, etc.) who can benefit from supplementing with both 500mg/kg sodium bicarbonate and 6g time released beta alanine per day is actually high enough to combining them may be well worth a try for most of you - just don't expect instant gratification as with caffeine& co.

            References:
            • Belfry GR, Raymer GH, Marsh GD, Paterson DH, Thompson RT, Thomas SG. Muscle metabolic status and acid-base balance during 10-s work:5-s recovery intermittent and continuous exercise. J Appl Physiol. 2012; 113:410–417. 
            • Bellinger PM, Howe ST, Shing CM, Fell JW The effect of combined b-alanine and NaHCO3 supplementation on cycling performance. Med Sci Sports Exerc. 2012; 44:1545–1551 
            • Ducker KJ, Dawson B, Wallman KE. Effect of beta-alanine and sodium bicarbonate supplementation on repeated-sprint performance. J Strength Cond Res. 2013 Mar 21.
            • Sale C, Saunders B, Harris RC. Effect of beta-alanine supplementation on muscle carnosine concentrations and exer-cise performance. Amino Acids. 2010; 39:321–333.
            • Sale C, Saunders B, Hudson S, Wise JA, Harris RC, Sunderland CD. Effect of b-alanine plus sodium bicarbonate on high-intensity cycling capacity. Med Sci Sports Exerc.  2011; 43:1972–1978.
            • Tobias G, Benatti FB, de Salles Painelli V, Roschel H, Gualano B, Sale C, Harris RC, Lancha AH Jr, Artioli GG. Additive effects of beta-alanine and sodium bicarbonate on upper-body intermittent performance. Amino Acids. 2013 Apr 18. [Epub ahead of print]

            Acoustic Gear: An Overview of the Ergogenic Effects of Music + Things to Keep in Mind, When Compiling a Playlist

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            Breakdance is not the only, but probably the most obvious example of the perfect synergy of "exercise" and beats per minute.
            Today's SuppVersity article is one of those pieces which grew organically and in fact, it was Primalkid aka Alex, who shot me a mini "True of False" item on the music and it's effect on exercise performance, a couple of days ago and thus planted the idea to revisit the effects of music on exercise performance in my brain. While Alex' mini-item was concise and to the point (see blue box towards the bottom of this article), I did remember that I had read about the ergogenic effects of music several times in the past, so I told him, I would expand his "True or False" piece "somewhat", before posting it... well, nerdy as I am, one study came to the another and I ended up with way too much information for a single "True or False" item.

            The SuppVersity Soundtrack of your Workout

            Instead of simply telling you that the right music can have a beneficial impact on your workouts, I have thus decided to provide you with a brief overview of more or less randomly selected studies to give you an idea of what would make a good addition to your next MP3 purchase.

            • The bad news first: As beneficial as it may be for the average trainee, the pro and everyone who needs to focus can also be distracted by an upbeat workout soundtrack (Brownley. 1995). Everyone who has ever participated in any type of competition will know that: Races, matches etc. if you don't zone in 100% on what you are doing, you lose... and if you will, that's exactly what the 1995 study from the Department of Psychology at the University of North Carolina I deliberately picked to kick this summary off, confirms.

              Picking the right music the easy way: In this day and age, you are probably not surprised that a group of researchers over at the Philips Research Center in Eindhoven and the Vrije Universieit in Amsterdam (both in the Netherlands) have already come up with a gadget that's going to do the job for you. The IM4Sports music system consists of a portable player with in-ear phones, heart rate sensor belt, acceleration sensors and a personal computer that will automatically select the "best" music to match your workout (Wijnalda. 2005).

              Data on the real world performance increases that can be achieve by using the prototype the Dutch scientists developed is yet unfortunately not available - the same applies (at least to my knowledge) for the commercial availability of a similarly sophisticated device, although the current generation of mobile phones would actually only be hooked up to a bluetooth heart rate sensor to get the job done.
              In a series of standardized submaximal cycle tests, Kimberly A. Brownley and her colleagues exposed 8 trained and 8 untrained runners to "no", "sedative" (commercially marketed stress management seletion), and "fast" (selection from pop, rock and movie soundtracks) music and measured heart rate, blood pressure, skin temperature, rating of perceived exertion, cortisol release, respiration, general feeling (ranging from “very bad” to “very good”, corresponding to -5 to +5) and time to exhaustion of their participants.
              "Repeated measures ANOVA revealed increased respiratory frequency during fast music as compared to the no music and sedative music conditions (p < 0.01). Plasma cortisol levels did not differ at baseline across the music conditions; however, following high intensity exercise, higher cortisol levels were associated with fast music as compared to no music and sedative music (music X intensity interaction, p < 0.01) [...] there was a music x group x intensity interaction (p < 0.05) in which untrained subjects reported more positive affect compared to trained subjects while listening to fast music during low and high intensity exercise. Data collected at voluntary exhaustion revealed significantly more positive affect and higher skin temperature (p values < 0.01) in untrained compared to trained subjects." (my emphases in Brownley. 1995)
              While it is debatable whether the increase in cortisol in response to the fast music has to be considered an advantage or disadvantage (learn why), the statistically significant positive effect of the fast music on the affect of the untrained subjects (+1.6 vs. -0.1 in the trained subjects) during both low and high intensity exercise, suggest that untrained individuals benefit to a greater extend from taking their iPods to the gym than the pros, who may even be distracted by the music, lose focus and thus feel annoyed by listening to fast music.

              The latter is also supported by a slightly more pronounced but statistically non-significant increase in time to exhaustion that's not mentioned in the scientists' summary of the results quoted above.
              Bottom line: For trained athletes exercise performance is not only limited by physical, but also by mental factors, the same music that energizes his untrained peers can therefore be annoying for the better trained athlete.
            • Rocky and/or Top Gun are the "top dogs" among the workout soundtracks - both before / and during HIT (Yamamoto. 2003). There is a reason "The Eye of the Tiger" always hits bullseye (stupid pun intended). It's the 52% increase in plasma epinephrine that sets you into fight an flight mode, when you listen to Rocky's anthem before your next PR.

              It may not be ergogenic, but it is unquestionably motivating: The Anthem from Metro-Goldwyn-Mayer's 1976 master piece "Rocky" (photo © 1976 MGM)
              Ok, ok, ... I have to admit a 52% increase is just what the researchers from the Nagoya University measured in their six healthy university students (24.0 ± 4.1 years, 172.2 ± 2.6 cm, 70.2 ± 5.4 kg and 23.7 ± 0.7 kg/m) after listening to the soundtrack for 20min and right before a supramaximal cycle ergometer test. The exact effect size will probably be different for you, but the principle remains the same.

              If we know assume that the general trend holds in the case of the power output as well, this would unfortunately mean that you won't get any actual performance increments out of it. After all, in the study at hand, neither the slow (Chopin) nor the fast music had any measurable effects on the mean power output during, or the blood lactate, ammonia or plasma catecholamine levels following the exercise.
              Bottom line: Despite existing physiological effects (catecholamine release), the Rocky and/or Top Gun soundtracks are obviously rather psycho- than physiostimulants. The latter could obviously entail motivational benefits, which could come handy on those days you don't really feel like adhering to your workout schedule.
            • If you are interested in a couple of tips on designing the optimal HIIT vs. MIIL routine, check out the SuppVersity HIIT-Series
              Medium intensity interval listening can be a superior alternative to a constant stream of music (Beckett. 1990). I guess I will first have to explain what "medium intensity interval listening" (MIIL) is, before I get to the actual benefits this way of listening to your favorite music only intermittently can have on your exercise performance.

              The principle is actually quite straight forward. Just as you would jog for 5 min and walk for another 5 min on a medium intensity interval training protocol, you simply pick your favorite radio station / playlist, listen to it for 5 min and then continue training for another 5 min without music.

              If you work anywhere similar to the 32 students (age 18-22) who particpated in Amy Beckett's 1990 study, the above protocol can increase the distance you'll cover during 30 min of walking by 43%/14% (women) or 38%/29% (men) compared to not listening to music at all (first figure) or a steady stream of pop/rap/rock/techno or whatever music you prefer (second figure).
              Bottom line: Maybe you remember what I wrote about the inflation of "True or False" posts here at the SuppVersity a couple of days ago? How they would lose their appeal if I kept bombarding you with daily TOF items!? Well, I guess it's the same for the music - the on/off scheme avoids that the beneficial effects wear off.
            • Earplugs can be ergogenic - at least, if you train in gym where they play music you don't like (Nakamura. 2010). Why? Well according to a 2010 study from the São Paulo State University having to listen to music you don't like can have downright ergolytic effects. That's at least what  the scientists observed in their subjects, when they cycled at critical power while listening to "non-preferred" music.

              Don't hesitate and wear ear-plugs during a spinning class, when you feel that the music hampers your performance (learn more about HIIT vs. LISS, DHT and fat loss & more). 
              Compared to the trial in the course of which the 15 subjects listened to their preferred music, the participants of the Nakamura study covered a 28% lower distance and still felt significantly more fatigued, when they had to listen to Justin Bieber.(the "non-preffered music is not specified, but I thought this would be a good example ;-).

              As long as you can tolerate the music in your gym, it does yet appear as if it does not really matter, if you're training with fast upbeat music, classical music or self-selected music in the background. At least that's what the results of a previous study from the University of Kansas would suggest.

              In the said study by Potteigner et al., "[e]ach type of music resulted in a reduced peripheral, central, and overall RPE" (Potteigner. 2000) during 20 minutes of cycling at 70% of the VO2max, when compared with a no-music condition.
              Bottom line: As the results of the Nakamura study shows, your ear-plugs can also have "anti-ergolytic" (=anti performance decreasing) effects in certain environments. Another reason to have your MP3 player fully charged all the time?!
              Let's be honest, guys. These days you really don't have to be ashamed if you wear earplugs or headphones in the gym - regardless of your age.
            • The general usefulness of music does not depend on age (Becker. 1994). In view of the fact that you see relatively few pensioners walking along the street with the earplugs of their iPods in their auditory canals, it may sound surprising, but research shows: Children, adults and seniors all benefit from listening to music before a short (2min) exercise trial.

              Moreover, neither the type of the music mellow vs. frenetic, nor  the baseline activity levels and thus physical fitness of the participants influenced the beneficial effects on mileage in the study from the Ursinus College in Collegeville.
              Bottom line: Let's be honest, 10 years ago, age may have been a reason to refuse running around with an MP3 player in the gym, but these days it certainly isn't. So, if you want to be extraordinary and distinguish yourself from your sedentary, increasingly obese, pre-diabetic age-mates and do something for your health and overall fitness, simply follow the example of your grandchildren: Get yourself an MP3 player.
            • If you recall Sunday's installment of "True or False", you will be aware that things work differently if you perform the music yourself. For the drummers in the De La Rue study, for example the heart rate peaks (186bpm were much higher than the average beats per minutes of the songs they were playing (learn more)
              Music tempo and heart rate / exercise intensity should be in sync (Karageorghis. 2006;  2011)  The results of the 2006 and 2011 studies by Karageorghis et al. indicate that "preference for fast tempo increased, relative to medium and very fast tempomusic, as exercise intensity increased" (Karageorghis. 2011).

              In view of the fact that it appears as if a close match between the heart rate and the beats-per-minute was the confounding factor here, it is not really surprising that the slow music condition with <80bpm was depreciated by all subjects in the two studies from the Brunel University in London. 80bpms is after all roughly identical to the target heart rate during the low intensity exercise trial (40% HRmax) in the study and way below the target heart rates during the medium and high intensity conditions.
              Watch out, the BPM <> HR connection is not linear: As sensible as it may be to matching the bpm of your workout songs to your heart rate, the relationship is not clearly linear (see figure from Karegeorgis 2012). Rather than that, the optimal bpm increases from >120bpm for low intensity exercises to <140bpm for high intensity exercise in the 80% HRMax range, when the heart rate of the young study participants would be in the >160bpm range, already.
            • If you are in sync with the music this will optimize your movement patterns (various)In the jargon the innate human predisposition to synchronise movement with musical rhythms is called "rhythm response".

              There is more, for example the study Alex' covered in hit True Or False: "According to researchers at the Department of Kinesiology, California State University, self-selected music increased squat jump explosiveness and feelings of vigor, tension, and reduced fatigue (Biagini. 2012). Of course the 20 college age athletes also performed bench press reps to failure with no difference between the music and silence groups, suggesting that music may enhance acute power performance but not multiple-set strength training. So next time you sprint, bring some headphones and a good song ;-)"
              According to Karageorghis it has been studied "since the turn of the twentieth century" and refers to the "commonalities between movement frequency during exercise and music tempo" of which Schneider et al. have been able to show in 2010 that it is reflected by the frequency (approximately 3 Hz) of electroencephalographic delta activity in the brain:
              "Results of this study give reason to speculate that a strong relationship exists between intrinsic and extrinsic oscillation patterns during exercise. A frequency of approximately 3 Hz seems to be dominant in different physiological systems and seems to be rated as pleasurable when choosing the appropriate music for exercising. This is in line with previous research showing that an adequate choice of music during exercise enhances performance output and mood." (Schneider. 2010).
              Now those 3hz = 3 beats per second translate to 180 beats per minute and are thus slightly above the previously discussed upper limit of the optimal BPM scale.

              More recent fMRI studies by Kornysheva et al. have broadened our understanding of the underlying mechanisms and led to the conclusion that activity in the ventral premotor cortex, which links motor and cognitive function, is enhanced when we are working out to music within the optimal BPM margin. According to the German researchers their results confirm the notion that ...
              "[...] the premotor activity increase during preferred tempo is the result of enhanced sensorimotor simulation of the beat frequency. This may serve as a mechanism that facilitates the tuning-in to the beat of appealing music." (Kornysheva. 2010)
              Most intriguingly, previous reports by Roerdink et al. (2008) suggested that the synchronous use of music may also reduce the metabolic cost of exercise by promoting greater neuromuscular or metabolic efficiency - an observation that would stand in line with a theory by Smoll & Schultz, who speculated in 1982 that a regular kinaesthetic pattern may require less energy to replicate owing to the absence of minute adjustments within the kinetic pattern, while offering a greater relaxation which comes from the precise expectancy of the forthcoming movement (Smoll. 1982).
            The examples I compiled in the previous paragraphs are certainly not all-encompassing, but by now you should actually have a basic understanding of the different levels at which music can effect your performance and psychological well-being / motivation while you work out. The emphasis on positive results may however evoke the unwarranted impression that you'd just have to bring your iPod to the gym if you wanted to set one PR after the other. That's however not the case. As the first item on the list already suggested,
            "[...] music is a beneficial accompaniment to exercise in most circumstances,  [but] it is contraindicated under certain conditions: (a) when it may distract users from safety-relevant information (e.g., on public roads); (b) when exercisers need to focus their full attention on learning a demanding motor skill (e.g., a power clean); and (c) when exercising at high intensities that require an associative attentional style (i.e., ‘listening to the body’)." (Karageorghis. 2012)
            There is also more than just a handful of studies where neither fast, nor slow beats had any, or at least no significant impact on the exercise performance of the study participants (e.g. Schwartz. 1990; Pujol. 1999). 

            No bottom line, but factors to keep in mind when you're setting up your playlist

            Regardless of the fact that music is probably not going to be the solution to all your performance and motivation problems in the gym and elsewhere, it is still absolutely worth experimenting with your iPod or whatever other device you use to listen to music before, during and maybe even after  your workouts (the latter to calm down and kickstart recovery) and the following list of things to keep in mind may help you with your N=1 experiments.
            What makes a song "workout compatible"? According to Costas Karageorghis, an associate professor of sport psychology at Brunel University in England, who created the Brunel Music Rating Inventory, the most important determinant of the "workout compatibility" of a song is its tempo, which should be between 120 and 140 beats per minute.
            This applies to a wide range of commercial dance music, and many rock songs and it corresponds roughly to the average person's heart rate during a medium intensity workout. Karageorghis mentions "Push It" by Salt-N-Pepa and "Drop It Like It's Hot" by Snoop Dogg, but also the dance remix of "Umbrella" by Rihanna as examples that would make a good addition to a playlist you would listen to during a cardio session. For a high-intensity workout like a hard run, he suggested Glenn Frey's "The Heat Is On."
            Personal preference is yet also important: According to a NY Times article (Kurutz. 2008), Haile Gebrselassie, the Olympian from Ethiopia, for example, often requested that the techno song "Scatman," which has a BPM of around 135, be played over the sound system during his races.
            The same article cites Flex senior writer Shawn Prine who says: "The vast majority of bodybuilders are fans of heavy metal, if not in their personal life at least in the gym". Perine believes that it "keeps you elevated, especially in between sets", but personally prefers to work out listening to hip-hop songs.
            In the end, it is thus probably a combination of the compatibility of the M-BPM and H-BPM (music and heart beats per minute), the rhythmicity of the music and the type of exercise and - of course - your personal prefercenes that makes a song "workout compatible".
            personal characteristics / preferences & coherence
            • obvious confounding factors are age and socio-cultural upbringing of the individual
            • the lyrics can increase motivation even if respective references to exercise, performance, power etc. are only indirect
            • beat matching, style matching, artist matching, era matching, etc. is important in terms of formulating a cohesive music mix
            • the coherence of the playlist increases if you pick pieces from the same era, the same genre, or by the same artist when moving between the pre-, in-, and post-task phases (Terry. 2011)
            exercise environment / demographics (with groups)
            • en vogue pop songs have been shown to be specifically motivational for the "average trainee"
            • in group exercise classes, where music is used synchronously, it appears that the rhythmic abilities of participants warrant careful consideration in the sequencing of music selections (De nora. 2000)
            • concerting the workout program with the music can be highly beneficial; e.g. a change or absence of music can be an effective marker of the next exercise phase or unit, such as the progression from a cardiovascular segment to a warm-down phase
            desired outcomes (e.g. performance, relaxation, etc.)
            •  > 120 bpm for stimulation
            • < 80bpm for sedation
            • 60–70 bpm (around resting heart rate) for post workout recovery
            • the inclusion of natural sounds, such as breaking waves, bird song or a babbling brook, may benefit recovery, as well (Karageorghis. 2012)
            exercise intensity / heart rate / movement pattern
            • it is advantageous for the rhythm of the music to approximate the motor patterns of the workout (Crust. 2008; Schneider. 2010)
            • as a result of segments that involve syncopation or span musical measures certain parts of a song can provoke increased synchronicity and thus improved motor coordinationindependently of the baseline rhythm (Styns. 2007)
            In view of the fact that it has been shown that no "motivational" music programme designed by someone else can ever match the efficiacy of a self-selected and constantly revised playlist (Karageorghis. 2012), you will probably understand that I will leave it with that and won't provide you with something like an "official SuppVersity Workout Soundtrack"... trust me, you will find what works for you if you incorporate some of the principles you've learned about in this article.


            References:
            • Becker N, Brett S, Chambliss C, Crowers K, Haring P, Marsh C, Montemayor R. Mellow and frenetic antecedent music during athletic performance of children, adults, and seniors. Percept Mot Skills. 1994 Oct;79(2):1043-6.  
            • Brownley KA, McMurray RG, Hackney AC. Effects of music on physiological and affective responses to graded treadmill exercise in trained and untrained runners. Int J Psychophysiol. 1995 Apr;19(3):193-201. 
            • Crust L. Perceived importance of components of asynchronous music during circuit training. J Sports Sci. 2008 Dec;26(14):1547-55. 
            • DeNora T. Music in everyday life. Cambridge, UK: Cambridge University Press; 2000. 
            • Karageorghis CI, Jones L, Low DC. Relationship between exercise heart rate and music tempo preference. Res Q Exerc Sport. 2006 Jun;77(2):240-50.
            • Karageorghis CI, Jones L, Priest DL, Akers RI, Clarke A, Perry JM, Reddick BT, Bishop DT, Lim HB. Revisiting the relationship between exercise heart rate and music tempo preference. Res Q Exerc Sport. 2011 Jun;82(2):274-84.
            • Karageorghis CI, Priest DL. Music in the exercise domain: a review and synthesis (Part I & II). Int Rev Sport Exerc Psychol. 2012 Mar;5(1):44-84.
            • Kornysheva K, von Cramon DY, Jacobsen T, Schubotz RI. Tuning-in to the beat: Aesthetic appreciation of musical rhythms correlates with a premotor activity boost. Hum Brain Mapp. 2010 Jan;31(1):48-64. 
            • Kurutz S. Choosing the best music for exercise. NY Times - Healthscience. January 10, 2008.
            • Nakamura PM, Pereira G, Papini CB, Nakamura FY, Kokubun E. Effects of preferred and nonpreferred music on continuous cycling exercise performance. Percept Mot Skills. 2010 Feb;110(1):257-64.
            • Potteiger JA, Schroeder JM, Goff KL. Influence of music on ratings of perceived exertion during 20 minutes of moderate intensity exercise. Percept Mot Skills. 2000 Dec;91(3 Pt 1):848-54.
            • Pujol TJ, Langenfeld ME. Influence of music on Wingate Anaerobic Test performance. Percept Mot Skills. 1999 Feb;88(1):292-6.#
            • Roerdink M. Anchoring: Moving from theory to therapy. Amsterdam: IFKB; 2008.  
            • Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000 Jan;55(1):68-78. 
            • Schneider S, Askew CD, Abel T, Strüder HK. Exercise, music, and the brain: is there a central pattern generator? J Sports Sci. 2010 Oct;28(12):1337-43.  
            • Smoll F.L., Schultz R.W. Accuracy of motor behaviour in response to preferred and nonpreferred tempos. Journal of Human Movement Studies. 1982;8:123–138.
            • Schwartz SE, Fernhall B, Plowman SA. Effects of Music on Exercise Performance . Journal of Cardiopulmonary Rehabilitation. September 1990.
            • Styns F., van Noorden L., Moelants D., Leman M. Walking on music. Human Movement Science. 2007;26:769–785.  
            • Terry P.C., Karageorghis C.I. Music in sport and exercise. In: Morris T., Terry P.C., editors. The new sport and exercise psychology companion. Morgantown, WV: Fitness Information Technology; 2011. pp. 359–380.
            • Wijnalda G, Pauws S, Vignoli F, Stuckenschmidt H. A Personalized Music System for Motivation in Sport Performance. Pervasive Computing. July–Sep 2005.

            Science Round-Up Seconds: The Macro-Mineral Alphabet & the Potential Health Hazards of Diet-Induced Latent Acidosis

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            You lose 600x more sodium than magnesium during a workout. The RDA is yet only ~3-4x higher (Montane. 2007).
            If you already listened to the podcast of yesterday's installment of the SuppVersity Science Round Up (if you have not already done so, you can dowload the podcast, here), you may have noticed that I confused the minimal potassium (K) to sodium ratio (Na), which is probably ~1:1, and the "original" K:Na ratio in the "paleo diet".

            According to Sebastian et al. (2002) the latter is ~8-9:1 in other words: 8-9 mols of potassium per mol of sodium. That's miles apart from the 1:2-3 ratio the average Westerner (the exact ratio varies depending on which study you refer to) uses as a springboard to hypertension ;-)

            The (un-)definite mineral synergism / antagonism chart

            Another thing you may have noticed with yesterday's show is the fact that the show was pretty "topic centered". My personal feeling is that it has a much better flow this way and that not despite, but because Carl and I did not cover such a broad range of topics. I cherish the hopefully non-futile hope that you feel the same, but am obviously open for any constructive criticism from your side

            The SuppVersity macromineral chart provides a general overview of the complex interactions that exist between calcium, phosphorus, magnesium, sodium, chloride and potassium (compiled based on various sources)
            . This, by the way, does also apply to the corresponding installment of the Seconds, of which you will soon realize that it is not a non-related add-on, but will expand, explain and summarize interesting aspects we've covered in the live show (note: from next week on the Science Round-Up will air at 12PM EST, same URL as usual).

            On that note, let's start with an "expansion" I already promised to deliver towards the end of the show: some information on the synergism and antagonism of the macrominerals. It's a pretty complex matter and the following illustration is based on generalizations. Some of them, like the low-level exception to the antagonism between calcium and magnesium, of which I believe that it is important to know are explicitly mentioned, others are not.

            A very good example of the former, i.e. the important second order interactions is the influence sodium has on the antagonism between potassium and magnesium. The latter disappears, when sodium levels are high and magnesium is needed as a sodium antagonist. Similarly, the often-touted antagonism between magnesium and calcium is actually a co-factor relation, where any "antagonism" is only the result of imbalances between the two.

            The good, the bad and the ugly: Just a question of the "wrong" perspective

            One thing that should actually be obvious, but is often ignored in all the hoopla about the "good" and "bad" guys among the macro-minerals is that "antagonisms" do not contradict the essential nature of all of the electrolytes, which are - antagonistic or not - in the end all actors in the same metabolic play.
            Figure 1: Average ratio of mineral content (new:old) of 20 vegetables and 20 fruit: data based on comparison of  UK Government’s Composition of Foodsdata at two time points separated by approximately 50 years (Mayer. 1997)
            I mean, take calcium and phosphorus as an example, they are both essential for the structural integrity of your bone and the fact that calcium has a reputation of being the "good guy", while phosphorus is the "bad guy" is just a necessary consequence of the overabundance of the latter, i.e. phosphorus from grains, soft drinks, dairy products, meats, fish, seeds, nuts, eggs and due to the change in mineral ratios (cf. figure 1) even most fruits and vegetables in the food chain of Mr. Joe Average, these days.

            According to a 2009 paper by Dana Cordell et al. this may well change in the not all too distant future, after all "the quality of remaining phosphate rock is decreasing and production costs are increasing" (Cordell. 2009). With estimates saying that the demand for phosphorus is going to double within the next 40 years, it stands to reason that the decried overabundance of phosphorus, which is, among other things, also responsible for lowering the zinc content of the produce (cf. Peck. 1980) may be partly reversed within the next decades... I mean, we all know that nothing is as "convincing" as with financial interests, right?

            The strong ion difference determines your pH levels

            What's the difference between macro-minerals and their "little brothers" the trace minerals? Calcium, sodium, potassium, phosphorus, magnesium, chloride and sulfur are macro-minerals, because you need them in amounts that are greater than 100mg per day. Of the trace minerals, on the other hand you need less (in most cases much less) than 100mg per day. That does not mean though that Iron, zinc, copper, chroium, flouride, manganese, iodine, molybdenum and selenium were less important - it's merely a quantitative distinction.
            While it stands to reason that there is a reason, calcium, sodium, magnesium and potassium are also called "electrolytes", astonishingly few people can actually give an ad hoc explanation why this is the case - and that despite the fact that their lives depend... no, not on the answer, but on the existence and physiological function of electrolytes ;-)

            If you have listened closely to your physics teacher, you will yet probably be aware that an "elecrolyte" (electro- ~ charge, -lyte ~ carrier) is a positively or negatively charged molecule (ion) and nothing out of the ordinary in nature.

            In your body electrolytes are used to establish ionically charged gradients, similar to the gradient that exists between the positive and negative pole of a battery. These gradients are situated on the cell embranes in excitable tissues, such as muscle and verve, where they facilitate or hinder the influx / efflux of other charged particles.

            One of these gradients, in fact probably the physiologically most significant one, by the way, is established by positive sodium (Na+) and potassium (K+) ions and their negative counterpart chloride (Cl-) - exactly those electrolytes you've heard about in yesterday's show (remember: whenever you hear "salt" it actually means Na + Cl).

            The electrolytes are not the only charged particles ...

            From your chemistry lessons you may remember that there are are not just ionic atoms, but also ionic molecules and that the electron configuration of these particles will determine how they bind, interact and react. But I guess, we have had more than enough complicated theory for today, so if you want to know how the anions and how the strong ion difference (SID) is calculated, check out this brief overview over at acid-base.com.

            Rather than going into the details of the mechanism, I decided that it would probably of greater value to wrap the Seconds up with a brief overwiev of the downstream effects of a metabolic state, of which Pizzorno, Frassetto and Katzinger point out that it is not necessarily characterized by acidemia, i.e. pH levels below the "magic" (if we were honest, we'd you'd have to write arbitrary, here) cut-off limit of pH 7.35:
            High intensity exercise can also lower your blood pH, an effect you can counter with sodium bicarbonate
            "Acidosis only becomes acidaemia when compensatory measures to correct it fail. To illustrate the difference between acidosis and acidaemia, take the following example: two processes occurring simultaneously in the same individual, such as a respiratory acidosis combined with a metabolic alkalosis. In this case, if the respiratory trend toward acidosis is greater than the metabolic trend, a pH of less than 7·35 may be reached, and would be considered acidaemia, despite the presence of a metabolic alkalosis. The intensity of each ‘process’ will determine the pH, but the terms themselves (acidosis, alkalosis) do not indicate a certain pH." (Pizzorno. 2009)
            In other words, you don't have to suffer from diabetic or otherwise pathogenic "acidosis", to suffer from one of the following ill health-consequences:
            • Hip fracture incidence per 100,000 study participants; aggregated data from cohorts from 33 countries (Frassetto. 2001)
              Calcium loss, bone loss, osteoporosis - Unfortunately, this is not only the best known side effect of "being too acidic", it's also the only one people take serious. In that, scientists and laypress alike have zoned in on the high intake of animal proteins as the main confounding factor. But despite the fact that the high sulfur content (methionine, cysteine & co) does certainly contribute to the problem, the data in the figure at the right should make it quite clear that the stuff we eat and don't eat with our meats is at least as much to blame for the misery. In view of the fact that
              "[...] cereal grains themselves are net acid-producing and alone accounted for 38% of the acid load yielded by the combined net acid-producing food groups in the contemporary diet" (Sebastian. 2002)
              the average (processed) grain addicted US citizen with his/her quasi non-existent vegetable intake would end up way on the left side of the x-axis of the graph on the right hand side, even if he ate not a single gram of animal protein - we would just have to relable the axis to "vegetable / acid forming food intake (including grains!)".
            • Increased renal nitrogen excretion and hampered protein synthesis - One of the less known effects of an increased acid/base ratio is an increase in nitrogen excretion that will obviously not simply hamper your gains, but can also set you up to sarcopenia (age-induced muscle loss).

              Correcting a diet-induced low grade metabolic acidosis with K-bicarbonate reduces the nitrogen loss of 750mg - 1000mg per day (per 60kg BW) in post- menopausal women (Frassetto. 1997)
              In the end, the excretion of nitrogen is nothing, but an adaptive mechanism and a consequence of the catabolism of tissue protein. It is, if you will, a basic necessity for your body to rob your muscle and other tissue of glutamine and all other amino acids, that can be convert to glutamine in the liver, from where it is delivered to the kidney where it's used to synthesize ammonia and excrete the potentially toxic acid load. This will obviously mitigate the severity of the acidosis, it does yet also entail a net loss in muscle and organ protein that cannot be compensated for by an increase in acid forming protein in your diet.

              As the data in the figure to the right goes to show you this is a process that's regulated on a day to day basis and the relief in nitrogen loss (data in mg/day/60kg) provided by bicarbonate supplementation (days 0-18) is transient and disappears as soon as you return to your regular low-base, high acid diet (days 19-30).
            • Impairments of the growth hormone / IGF-1 axes - Brunnger et al. tested in 1997 whether experimental acidosis would have an effect on the growth hormone / IGF-1 axis and observed a "significant decrease in serum IGF-1 concentration without a demonstrable effect on IGF binding protein 3", which points towards an acid induced "primary defect in the growth hormone/IGF-1 axis" that occurs "via an impaired IGF-1 response to circulating growth hormone with consequent diminution of normal negative feedback inhibition of IGF-1 on growth hormone" (Brunger. 1997). Interestingly, Mahlbacher et al. were able to show that the administration of IGF-1 can in turn ameliorate acidosis and thus correct the previously discussed nitrogen wasting (Mahlbacher. 1999).

              Learn more about the effects of GH, IGF1 and it's splice variants MGF & co and their influence on skeletal muscle hypertrophy in the respective part of the Intermittent Thoughts on Building Muscle (go to the overview).
              In fact, potential physiological effects of the acid-induced impairment of the GH / IGF-1 axes had been observed much earlier, already. McSherry et al. for example report in a 1978 article in the Journal of Clinical Investigations that children with short stature and classic renal tubular acidosis developed normally, when they were treated with adequate amounts of alkalizing agents.

              That similar negative effects can be observed even in the presence of "low-grade 'tonic' background metabolic acidosis" was confirmed by Frassetto et al. who observed statistically significant increases (+11%) in 24-hour mean growth hormone secretion in post-menopausal women with diet-induced low-grade metabolic acidosis, when their dietary acid load was neutralized with adequate amounts of potassium bicarbonate (Frassetto. 1997).

              In a subsequently published study the scientists argue that the concomitantly observed increases in osteocalcin and bone metabolism would confirm the physiological significance of these changes (Frassetto. 2001). The effects on bone add to the well-known beneficial metabolic effects of growth hormone ( and line up with the recently reported association between low growth hormone levels and memory impairments (Wass. 2010).

              In view of the bad press GH and IGF1 are getting, it is important to point out that we are talking about a normalization of the GH/IGF-1 axis, here. It is therefore unlikely that the restoration of a normal acid-base balance will have any of the anti-longevity and pro-cancerous (see next bulletin point) effects of growth hormone and IGF-1 you may have read about in the pertinent literature.
            • Potential protective / anti-cancer effects - While conclusive scientific evidence for the involvement of low-grade acidemia in the etiology of cancer is still missing, it has long been speculated that the genetic and epigenetic perturbations, which will turn normal cells into cancer cells may be triggered (among other factors) by disturbances in the acid-base equilibrium. As Ian Forrest Robey points out in his 2012 review of the literature, a diet induced
              "[a]cid-base disequilibrium has has been shown to modulate molecular activity including adrenal glucocorticoid, insulin growth factor (IGF-1), and adipocyte cytokine signaling, dysregulated cellular metabolism, and osteoclast activation, which may serve as intermediary or downstream effectors of carcinogenesis or tumor promotion." (Robey. 2012)
              If you want to learn more about the "state of the art research" on the potential link between latent dietary acidosis and the development of cancer, I suggest you simply read the free fulltext of the paper on PubMed
            I guess, now that you've learned about some of the intricacies of adequate mineral intakes and balances, the acid / base balance, nitrogen and bone loss, growth hormone and cancer, and listened to the interactions of sodium blood pressure, blood glucose and insulin on yesterday's show, it's about time to come back to the simple things that work - the bottom line, so to say...


                "What was that about the nutrient sufficiency of the vegetarian / vegan diet, you said on the air?" The above figure shows the % of omnivores, vegans and vegetarians who meet the RDAs  for protein and fiber and selected vitamins and minerals (DiMarino. 2013)
                Bottom line: A whole foods convenient-"food" free with the right balance of vegetables, protein, and a reasonable amount of complex largely unprocessed carbohydrates, fats and fruits - call it "ancestral" or "paleo", if you will - is going to provide you with all the minerals you need, it will contain them in the right ratios and supply your body with all the co-factors it needs to use them. It will stabilize your pH levels, normalize your growth hormone / IGF-1 axis and is beyond any doubt the most effective way to get and stay in shape, to reduce your cancer risk, ward off diabetes and lead a life that's not simply long, but also worth living

                If you adhere to these simple rules, there is no reason to be worried about "not getting your minerals" and other essential nutrients. After all, this is what distinguishes you from the "average" western omnivore, vegetarian or vegan who fails to meet most of his or her nutrient requirements (see figure to the right).

                References:
                • Brungger M, Hulter HN, Krapf R. Effect of chronic metabolic acidosis on the growth hormone/IGF-1 endocrine axis: new cause of growth hormone in sensitivity in humans. Kidney Int. 1997; 51:216–221
                • Cordell D, Drangert J-, White S. The story of phosphorus: Global food security and food for thought. Global Environ Change. 2009;19(2):292-305.  
                • DiMarino A. A Comparison Of Vegetarian Diets And The Standard Westernized Diet In Nutrient Adequacy And Weight Status. The Ohio State University. A Thesis Presented in Partial Fulfillment of the Requirements for Graduation with Distinction from the School of Health and Rehabilitation Sciences of The Ohio State University. 2013. 
                • Frassetto L, Morris RC, Jr., Sebastian A. Potassium bicarbonate reduces urinary nitrogen excretion in post-menopausal women. J Clin Endocrinol Metab. 1997: 82:254–259.
                • Frassetto L, Morris RC Jr, Sellmeyer DE, Todd K, Sebastian A. Diet, evolution and aging--the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001 Oct;40(5):200-13.
                • Mahlbacher K, Sicuro A, Gerber H, Hulter HN, Krapf R. Growth hormone corrects acidosis-induced renal nitrogen wasting and renal phosphate depletion and attenuates renal magnesium wasting in humans. Metabolism. 1999; 48:763–770
                • May RC, Kelly RA, Mitch WE. Metabolic acidosis stimulates protein degradation in rat muscle by a glucocorticoid-dependent mechanism. J Clin Invest. 1986. 77:614–621.
                • Mayer AM. Historical changes in the mineral content of fruits and vegetables. British Food Journal. 1997; 99(6):207 - 211
                • McSherry E, Morris RC, Jr. At tainment and maintenance of normal stature with alkali therapy in infants and children with classic renal tubular acidosis. J Clin Invest. 1978; 61:509–527. 
                • Montain SJ, Cheuvront SN, Lukaski HC. Sweat mineral-element responses during 7 h of exercise-heat stress. Int J Sport Nutr Exerc Metab. 2007 Dec;17(6):574-82.
                • Peck NH, Grunes DL, Welch RM, MacDonald GE. Nutritional Quality of Vegetable Crops as Affected by Phosphorus and Zinc Fertilizers Agron. J. 1980; 72: 528–534.
                • Pizzorno J, Frassetto LA, Katzinger J. Diet-induced acidosis: is it real and clinically relevant? Br J Nutr. 2010 Apr;103(8):1185-94.
                • Sebastian A, Frassetto LA, Sellmeyer DE, Merriam RL, Morris RC Jr. Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors. Am J Clin Nutr. 2002 Dec;76(6):1308-16.
                • Wass JA, Reddy R. Growth hormone and memory. J Endocrinol. 2010 Nov;207(2):125-6.
                • Williams B, Layward E, Walls J. Skeletal muscle degradation and nitrogen wasting in rats with chronic metabolic acidosis. Clin Sci. 1991; 80:457–462

                Energy Drinks Before Workout Make You Thirsty. Single HIIT Session Every 14 Days Maintains Fitness in the Off-Season. Postprandial Walk Decreases HbA1c by 5%. Cardio Before Weights Increases pAKT +87% Over Weights Alone

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                You simply cannot start "working out" too early - even if it's just child's play.
                "Three for one!" No, I am not trying to sell you three bottles of "uberpotent" test-boosters for the rat of one. Three for one that's the SuppVersity Figure of the Week and it is the ratio of the decrease in breast cancer risk in women and the hours of physical activity per week during their adolescence.

                According to a 2004 review by Lagerros, Hsieh and Hsieh, each additional* hour of weekly physical activity is associated with a -3% risk of developing breast cancer later in life (Lagerros. 2004)

                Needless to say that the "additional" hours are in addition to the low physical activity in the laziest of the study participants, who had a 20% higher risk of developing breast cancer than their most active peers.

                So what else do we have today? With this primer on the importance of physical activity esp. in the critical periods of your / your children's and grand-children's lives, let's delve right into a "special edition" of the Saturdaily "Short News" with a focus on a selection of very recent results from exercise-related studies.
                • Energy drink before a workout make you thirsty. don't enhance performance (Tanskanen. 2013) While the mantra of the "intra-workout" beverage producer that you need at least a small amount of carbohydrates to optimally absorb the added salts, a recent study from the University of Jyväskylä in Finland showed that the ingestion of both high- and low-carb (33g vs. 10g) caffeine-containing energy drinks before the workout resulted in a temporary increase in thirst compared to to both caffeinated (106mg, just as the two energy drinks) an non-caffeinated water.

                  With +1kg Fat in 4 Weeks from less than 2 energy drinks/day, thirst may be the least problem you will have if you guzzle "energy drinks" (learn more).
                  The fact that the increase in thirst was only transient, and decreased in the course of the 60min cycling exercise (60% VO2max) the healthy young adults had to perform, as well as the non-existent differences in hydration status between the groups do yet show that these effects were practically irrelevant. Incidentally, the latter has to be said for the promised / expected performance enhancing effects of energy drinks - with the relatively low amount of caffeine in the drinks, there were no significant differences between the the time the 10 participants cycled on an incremental test to exhaustion that followed the "steady-state-cardio" during each and every of the four testing days of this randomized, crossover study.
                  Putting things into perspective: The fact that previous trials yielded different results, esp. wrt to the performance enhancing effects of caffeine, is probably attributable to a the low dosage of caffeine. Another very recent study by Ranchordas & Kenzie, for example has just confirmed that a compbination of 32g of carbs and 300mg of caffeine can "enhance some aspects of soccer-related fitness including acceleration, maximal velocity, 20-m sprint speed, speed-endurance, and lower RPE during repetitive sprints compared with CHO-only and PLA beverages." (Ranchordas. 2013)
                 
                • Remember the "Iranian HIIT Solution" - 9% body fat in 12 weeks? Perfect evidence: HIIT is not for athletes, only.
                  It does not take much to stay fit, a single every other week HIIT session is enough (Rønnestad. 2013) Right from the former Olympia "Metropolis" *rofl* Lillehammer comes a study which shows that trained athletes like semiprofessional soccer players can maintain their baseline fitness levels in the off-season by no more than a single HIIT session, which consisted of five bouts of 4 min running at 87–97% of age-predicted maximum heart rate, every other week.

                  The overall loss in the distance the subjects covered during the 20-m shuttle run did obviously decline (-8% ± 6%), but the difference to the control group that performed the same HIIT sessions on a weekly basis was non-significantly different from the every-other-week group.Moreover, both groups maintain their VOmax over the whole six week study period.
                  Bottom line: A little of HIIT can go a long way ... wait, this is almost the title of a previous SuppVersity post, i.e. "Some HIIT For Life & Less LISS For More! How to Burn 27,300 Kcal Extra W/out Losing a Single Extra Pound of Fat!", of which I would really suggest you read it now, in case you are still not convinced that a reasonably dosed amount of HIIT makes a valuable addition to almost every trainees regimen.
                 
                • Hit the weights! If you want to do more than just increase your daily activity levels to lower your HbA1c, don't waste your time on the treadmill. Increase your daily activity level and lift weights! Three supervised resistance training sessions per week for 10 weeks have been shown in a 2009 study by Bweir to be significantly more effective in lowering the Hb1Ac levels than in adults with type II diabetes than an isoenergetic (=spending the same energy during the workout) treadmill exercise (Bweir. 2009).
                  The postprandial stroll in the bark is an effective means to lower your HbA1c (Nygaard. 2013) While the former post on the conservation of the conditioning of a trained athletes by HIIT does confirm the notion that "aerobic exercise" in the original sense of the meaning, which would imply that you increase your body's exercise capacity (as evidenced by VO2max), another recently published study shows that metabolic benefits of exercise can be achieved with much lower intensities.

                  At least in the in the South Asian immigrants with high risk of type 2 diabetes who participated in a recently conducted 12-week intervention, it took nothing but the figurative "walk in the park" (30min+ of physical activity of any sort) after a meal, to reduce their HbA1c levels - a marker of long(er) term glucose levels - by allegely relatively unimpressive, but statistically highly significant ~3% (p = 0.012). That the intervention in the course of which the average subject increased his / her daily activity by 40min compared to the control group did not yield any significant changes in body composition should yet be as evident as the fact that it was 100% side-effect free.
                  Bottom line: It really depends on where you are and if you are a sedentary slob, even 40min of extra (light) activity a day can make a difference. After all, previous studies have shown that each 1% increase in HbA1c is associated with a 1% increase in cancer risk (data fro 25,476 patients with type 2 diabetes registered in the Swedish National Diabetes Register; cf. Miao Jonasson. 2012). 

                • Rodent study says: Cardio does not hamper anabolic signalling (Souza. 2013) While the comprehensive review by Wilson et al. you've read about here at the SuppVersity several times (e.g. April 2012, January 2013, etc.) found that there is a
                  "significant negative relationships between frequency (-0.26 to -0.35) and duration (-0.29 to -0.75) of endurance training for hypertrophy, strength, and power." (Wilson. 2012)
                  a very recent study from the Universidade de Sao Paulo would suggest that the negative influence of endurance training on the anabolic stimulus of restistance training is either
                  1. species specific and occurs only in humans, but not in rodents,
                  2. occurs only with chronic high volume trainging, or
                  3. is at least not related to changes in the AMPK, TSC2, mTOR, or p70S6K1 ratios
                  Now while each of the former is certainly possible, my best bet would be that the training volume, i.e. 5 sets of 10 reps on a "rodent leg trainer" and a 60min endurance workout on the treadmill, and the fact that the protocol was performed only once are the main reasons that the AMPK, TSC2, mTOR, or p70S6K1 ratios were identical.
                  Doing cardio before strength workouts results in a higher testosterone:cortisol ratio after the workout (learn more)
                  One thing is remarkable, however: The scientists observed a pretty remarkable +87% increase in Akt phosphorylated/total ratio that occurred 2h post only in those rodents who performed a 60min bouts of treadmill running before their leg workout. What? Yeah, that's actually what Carl and I have been talking about in the past - "pre-workout glycogen depleting cardio as intensity technique" (learn more)



                So what's left to do now? Ah, yes of course. The best wishes for the weekend and a brief link-list for those of you who can't be without SuppVersity news for another 24h.
                • "Going Nuts On Berries: Ellagic Acid in Rasp- and Blueberries, Pecans, Walnut & Co Protects Against Visceral Obesity" - I hope you are not one of the guys who spits the tiny seeds of the raspberries out. That is not just disgusting, you would also spit away ~90% of their ellagic acid content (learn more).
                  Do you stand right? Scientists investigate the influence of dynamic vs. static posture on leg stiffness and future risk of fall (read more)
                • Anabolic steroid use has distinct effects on tendons. Scientists speculate that the increased stiffness and higher modulus contribute to the frequent ruptures in chemical athletes (read more)
                • Oldie but goldie: Do you cook the creatine out of your steaks? A mid 20th century paper shows that cooking degrades creatine to creatinine (read more)
                • More walnut lovin' Despite the fact that you have to be careful with what you say about the health effects of walnuts, these days a group of reseachers does not fear the repressions from the FDA and says: "We found two novel mechanism that explain why walnuts are good for your heart!" (read more)
                These and other news are already waiting for you on Facebook and you can bet that there will be at least half a dozen additional ones posted before the next official SuppVersity article will see the light of the day, tomorrow.

                References:
                • Bweir S, Al-Jarrah M, Almalty AM, Maayah M, Smirnova IV, Novikova L, Stehno-Bittel L. Resistance exercise training lowers HbA1c more than aerobic training in adults with type 2 diabetes. Diabetol Metab Syndr. 2009 Dec 10;1:27. doi: 10.1186/1758-5996-1-27.
                • Miao Jonasson J, Cederholm J, Eliasson B, Zethelius B, Eeg-Olofsson K, Gudbjörnsdottir S. HbA1C and cancer risk in patients with type 2 diabetes--a nationwide population-based prospective cohort study in Sweden. PLoS One. 2012;7(6):e38784.
                • Nygaard H, Grindaker E, Rønnestad B, Holmboe-Ottesen G, Høstmark AT. Long-term effects of daily postmeal physical activity - Preliminary results.International Journal of Sport Nutrition and Exercise Metabolism,2013, 23, S1 -S15.
                • Ranchordas M, Kenzie J.Effect of carbohydrate only and carbohydrate plus caffeine co-ingestion on a battery of reliable soccer-specific tests. International Journal of Sport Nutrition and Exercise Metabolism,2013, 23, S1 -S15.
                • Rønnestad BR, Slettaløkken G. High-intensity interval training every second week maintains VO2max in soccer players. International Journal of Sport Nutrition and Exercise Metabolism,2013, 23, S1-S15.
                • Souza EO, Tricoli V, Bueno Junior C, Pereira MG, Brum PC, Oliveira EM, Roschel H, Aoki MS, Urginowitsch C. The acute effects of strength, endurance and concurrent exercises on the Akt/mTOR/p70S6K1 and AMPK signaling pathway responses in rat skeletal muscle. Braz J Med Biol Res. 2013 Apr 19:0.
                • Tanskanen M, Heikkinen T, Linnamo V. Effects of caffeine drinks on endurance performance, fluid balance, and subjective feelings. International Journal of Sport Nutrition and Exercise Metabolism,2013, 23, S1 -S15.
                • Wilson JM, Marin PJ, Rhea MR, Wilson SM, Loenneke JP, Anderson JC. Concurrent training: a meta-analysis examining interference of aerobic and resistance exercises. J Strength Cond Res. 2012 Aug;26(8):2293-307.

                Do You Have the Gut(s) to Lose 8% Belly Fat in 12 Weeks? Lactobacillus gasseri (LG2055) Can Fix Your Gut Problems

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                As a diligent student of the  SuppVersity, you'll obviously know that beer is not the main cause of the eponymous belly (Bobak. 2003). Although..., when when you come to think about it: For every glass of beer you drink, you're probably drinking a glass of probiotic yogurt less ;-)
                You've done everything you could and still feel like a whale? You've been low-carbing, even have made sure you are in ketosis by consuming an only 10% protein diet and still the fat won't disappear? Well, I guess it sounds unfair, if I do now tell you that you YOU JUST DON'T HAVE THE GUTSit takes to get rid of that pouch that blocking the view on your toes, when you are standing.

                Now calm down, I am not talking about not being able to curb your insatiable appetite or skipping 90% of your workouts, here. I am talking about your gut(s), literally! Your digestive tract and it's inhabitants. Those critters which are also at the heart of the soon-to-be-published paper by scientists from the Milk Science Research Institute in Fukoaka, Japan (Kadooka. 2013) - a paper, the results of which I am about to present in the next few paragraphs.

                Probiotic in fermented milk shred visceral fat

                I am not telling you something new, when I say (or write) that scientists have long identified the modulation of the gut microbiome, i.e. the bacterial ecosystem in your intestines, could be the long-sought-for lever to get rid or at least ameliorate the negative effects of the way we live and eat promotes the expansion of the highly inflammatory "stress fat" that fills the room between the organs in your trunk. Most of the hitherto published peer-reviewed research has yet been conducted in rodents. The existing evidence from well-controlled human studies, on the other hand is scarce.

                Suggested read: "Probiotics for Athletes: The Supplemental 10 Billion CFS Leaky Gut Solution for the Fermented Food Refusinek?" (read more)
                One of these studies has been conducted by Kadooka et al. in 2010 (Kadooka. 2010). In the pertinent paper the researchers from the Milk Science Research Institute in Japan reported that the provision of 200g/day of fermented milk containing 10^8 colony-forming units (cfu)/g of Lactobacillus gasseri strain SBT2055 (LG2055) led to significant reductions in visceral fat in male and female subjects with " higher body mass index" (BMI: 24.2-30.7 kg/m²) who had been randomized to the active arm of the study. Now, roughly three years later, are about to publish a follow-up paper with great practical relevance, as it summarizes the results of what Kadooka et al. say is the first human trial that examines the effect of different doses of probiotics on abdominal adiposity.

                "We know that it works, but we don't know how much we need to elicit the desired effects"

                The design of the study at hand is essentially identical with the one in the 2010 trial. It is based ona multi-centre, double-blind, parallel-group RCT with 210 healthy Japanese adults with large visceral fat areas (80.2–187.8 cm²), who were now randomly assigned to three instead of two groups who consumed 200g of fermented milk with either 1,000,000 CFU (1m), 10,000,000 CFU (10m) or just the normal yogurt probiotics (control)per gram for 12 weeks.

                The intention was to determine whether the effect of LG2055, which is by the way a probiotic lactic acid bacterium that originates from the human intestine, would be observed with lower / more realistic dosage regimen as well and whether possible reductions in the effect size would be dose-dependent.
                Figure 1: Reduction in visceral and subcutaneous adipose tissue, as well as waist circumference after 8 and 12 weeks on 1,000,000 CFU/g or 10,000,000 CFU/g yogurt drink; data expressed relative to group baseline (Kadooka. 2013)
                If you take a look at the results, the first thing that strikes the eye in figure 1 is that the lactobacilli did their job and that in both the low and high dose group:
                • Even in the 10x and 100x lower dosages there was a significant reduction in the amount of visceral fat the  33/36 respectively 36/35 men and women in the in the 1 million and 10 million CFU/day groups, respectively.
                • The effect size of both dosages of LG2055 was identical, so that it would not actually matter if you consume just 100g or 1kg of an imaginary commercially available milk drink with 1,000,000 CFU of LG2055 per 100g.
                In view of the >8% reduction in visceral fat mass, it should not come as a surprise that the reduction in waist size was likewise statistically significant - both on its own, as well as in comparison to the control group, What is yet not so obvious and probably somewhat disappoint for you is the fact that the reduction in the ugly, but benign subcutaneous fat was statistically and practically non-significant.

                "Visceral fat loss, only? But what about my thigh fat?"

                Not all probiotics are created equal: As the scientists emphasize in the discussion, the "it is also worth noting that the test FM containing both LG2055 and yogurt cultures reduced abdominal adiposity when compared with the control FM containing yogurt cultures alone, even though the bacterial counts of LG2055 (106 and 107 cfu/g) were lower than those in the yogurt cultures (109 cfu/g)." (Kadooka. 2013) The observed superiority of this particular strain of bacteria stands in line with previous rodent studies and is imho one of the reasons we are seeing so much research in this area. How's that? Well, easy: If you came up with a particularly potent strain and patented that, this would be the literary cash machine.
                If you are no newbie to the SuppVersity you will yet be aware that it is by no means extra-ordinary that "healthy fat burners", which work their weight loss magic mostly by modulating local and/or whole body inflammation, have little or no effects on the amount of subcutaneous body fat.

                If you discarded any statistical shenanigan and simply went by the height of the small bars in the middle of figure 1, you could yet probably argue that it appears as if there was a trend towards greater subcutaneous fat loss in the high(er) dose LG2055 group. If you went a step further and made the unwarranted assumption that you could simply compare the results from the study at hand to those of the aforementioned 2010 study b Kadooka et al. you could support this argument by stating that there was a clear trend here with 1.2%, 2.6% and 3.3% reductions in subcutaneous fat with LG2055 at concentrations of 1, 10 and 100 million CFU per gram of the fermented milk drink.

                In the overall context it is yet important to point out that it is as of yet unknown whether the composition of colonic microbiota has a direct influence on abdominal and/or subcutaneous adipose tissue (Hildebrandt. 2009; Conterno. 2011). Moreover, ...
                "[...] environmental factors, including genetics and age, makes it difficult to discuss the causal relationship between adiposity and intestinal microbiota." (Kadooka. 2013)
                The latter are particularly difficult to access in a study like this, where the subjects maintain their habitual mode of living, including diet, and no strict dietary control is applied. Kadook et al. are thus right to point out that "the relation ship between adiposity and intestinal microbiota" has to be investigated more closely "under a strict diet, together with the latest methodology" (Kadooka. 2013) to finally make some progress in our understandings of the intricate interaction between the human gut microbiome and our metabolism.



                Even the nicest subtenants can become a real problem, when they come over without being asked. Unfortunately, all sorts of gut bacteria (even the "good" ones) have a similarly nasty habit of translocating through a leaky gut wall into parts of your body, where you don't wont them (learn more)!
                Bottom line: In view of the fact that the subjects shed the superfluous body fat in the absence of a reduced energy intake and/or exercise / increases in physical activity, the results are unquestionably impressive. To speak of "probiotic fat burner" would yet still not be warranted. After all, the subjects were all overweight and had an average body fat content of 32%, the baseline diet does - at least by the available data - not look really optimal (protein intakes of 0.8g/kg; macro-composition of 15/57/28% from protein, carbs and fats) and the non-disclosed insulin and HbA1c levels as well as the markers of inflammation will probably have left more than enough room for the "get healthy lose weight" effect.

                Against that background I have my doubts that you can expect anywhere similar effects in lean, let alone athletic individuals. This does yet not negate the general usefulness of probiotics, after all, health is something you take for granted only, when you've never been sick - if you want to avoid that, the incorporation of fermented foods makes sense for everyone from the sedentary slob to the elite level athletes*...

                * Note: I am writing the above although it gives me tummy aches (pun intended). Specifically with respect to the use of high dose probiotic supplements, I am asking myself, whether we really know enough about the potential downstream effects of long-term / high dose supplementation. In that, I am particularly concerned about shifting the balance from an "A"-dominant and unhealthy state in which the attributes "good" and "bad" are all of the sudden reversed and the previously dominant "bad" strain X gets totally replaced by the allegedly "good" strain Y that will then turn out to be just as nasty as X, once its natural arch enemy X is no longer present.

                References:
                • Bobak M, Skodova Z, Marmot M. Beer and obesity: a cross-sectional study. Eur J Clin Nutr. 2003 Oct;57(10):1250-3.
                • Conterno L, Fava F, Viola R, et al. Obesity and the gut microbiota: does up-regulating colonic fermentation pro- tect against obesity and metabolic disease? Genes Nutr. 2011; 6:241–260.
                • Hildebrandt MA, Hoffmann C, Sherrill-Mix SA, et al. High-fat diet determines the composition of the murine gut microbiome independently of obesity. Gastroenterology. 2009; 137:1716–1724.
                • Kadooka Y, Sato M, Imaizumi K, Ogawa A, Ikuyama K, Akai Y, Okano M, Kagoshima M, Tsuchida T. Regulation of abdominal adiposity by probiotics (Lactobacillus gasseri SBT2055) in adults with obese tendencies in a randomized controlled trial. Eur J Clin Nutr. 2010 Jun;64(6):636-43. 
                • Kadooka Y, Sato M, Ogawa A, Miyoshi M, Uenishi H, Ogawa H, Ikuyama K, Kagoshima M, Tsuchida T. Effect of Lactobacillus gasseri SBT2055 in fermented milk on abdominal adiposity in adults in a randomised controlled trial. Br J Nutr. 2013 Apr 25:1-8. [Epub ahead of print]
                   

                Dietary Zinc & Copper Improve Glucose & Lipid Metabolism. High Cortisol Amplitudes Counter Belly Fat. Hypoxic Hearts Love Creatine + Ribose. Apples Counter Cancer & Obesity

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                I guess this is about as close as we have hitherto gotten to understand why we got fat. Wrt to the hilarious pace at which we got fat and are still getting fatter, we are much better informed though.
                After you've learned about the general importance of exercise for your health and a couple of tweaks that may or, as in the case of sugary "energy drink", may not help you maximize the benefits and performance gains on Saturday. The focus of today's SuppVersity article is on the results of non-exercise related studies that highlight non-exercise related confounders of your health.

                Before we get to the actual news, I would yet like to invite all of you to take a look back at the increasingly obese history of the US... I suppose those of you who have not yet seen the link on my Facebook wall, will enjoy the animated obesity map in the Atlantic article from April 11. I mean, even if we still don't have anything but over-simplistic cookie-cutter "explanations" of why we get fat, the map shows that we do at least know how fast we got fat!

                You don't feel knowing about how fast we got fat is good news? Ok, maybe you'll like one the following results from recent studies better:

                • Dietary zinc & copper influence glucose & lipid metabolism in women (Shab-Bidar. 2013) According to a recent study from the Obesity Research Center at Shahid Beheshti University of Medical Sciences in Tehran, Iran, there is a gender specific effect of copper and zinc in the diet on glucose and lipid metabolism of men and women in Iran - statistical significant effects were observed only in women with...
                    Odds ratios for the MetS and low HDL across quartiles of copper intake (Shab-Bidar. 2013)
                  • higher zinc intakes being associated with higher HDL-C, lower triglycerides (TG) and lower 2-hour blood glucose, and 
                  • higher copper intake correlating with higher HDL-C, lower fasting blood glucose (FBG), significantly lower TG and a huge 81% reduction in the risk for suffering from metabolic syndrome (highest vs. lowest copper intakes)
                  These observations stand in contrast with the current notion of the "bad" copper and the "good" zinc and reamphasize the importance of both nutrients for metabolic health.
                  Remember: Two questions that will still have to be resolved pertain to (a) the gender-specificity of the effects and (b) confounding effects of food quality / choice and thus whether the same beneficial effects would be observed with the standard American diet.
                  For both, but espicially for copper a little more than the RDA does not appear to hurt: What's particularly interesting, is that contrary to the zinc intakes in quartile 4 (>14mg/day; RDA 9mg/day) the copper intake in quartile 4 was more than 3x higher than the current RDA for women (0.9 mg). In fact, even the copper intake in the lowest quartile ~1.5mg/day was way above the RDA. If that's something we have to be surprised about is yet questionable, after all, there is not exactly much research on "optimal copper nutrition" (much contrary to zinc, by the way) and the RDA is based on age-old depletion-repletion studies and will thus probably reflect the absolute minimum to maintain "normal" serum levels.

                • Evidence from human study: Flat cortisol profile not averages or spikes are associated with increased adiposity and visceral obesity (Sharp. 2013) In their most recent paper that's soon going to be published in the American Journal of Human Biology Dan S. Sharp and his colleagues from the Center for Disease Control and the State University of New York provide conclusive evidence for the irrelevance of mean cortisol levels with respect to the purported negative effects of cortisol on visceral obesity.
                  Associations between sextiles of within-subjects cortisol standard deviation (SD) in 217 Buffalo policemen and adjusted lean-mass trunk index (Sharp. 2013)
                  As the data in the figure above clearly shows, the police officers with the greatest cortisol fluctuations (spikes and troughs) had the highest ratio of lean body mass to trunk mass. It is thus, as the scientists phrase it,
                  "not the average level of salivary cortisol among 18 specimens on each officer that drives the association; it is the variation among specimens."
                  The oral cortisol measures were taken on 3 subsequent days in standardized procedures that involved a venipuncture and a standardized high protein meal as "challenges", on day 1, six measures that were taken by the police officers over the course of the day, on day 2, and series of tests that was taken after a dexamethasone challenge after waking on day 3 (the subjects had ingested 0.5mg of dexamethasone the night before).
                  Bottom line: While the scientists are careful in pointing out that it will still have to be established that the results translate to other populations. The results corroborate the uselessness (if not potential detrimental effects) of "cortisol blockers", I've discussed in my previous in the Science Round Up Seconds on March 29, 2013 (read more).

                • Combination of creatine and d-ribose heals damaged, but unscarred rodent-hearts (Caretti. 2013)While the many of the "daggered" claims* on the boxes of various "advanced" creatine products (learn more about their uselessness) are probably a little overblown (*the dagger refers to the "not verified by the FDA"), that's nothing compared to the absolutely disappointing results trainees had with d-ribose. Meanwhile, it seems as if even the last jerk knew that the unbearably sweet simple sugar is nothing worth spending his/her money on.

                  Ribose regulates the novo synthesis and restoration nucleotides, can relieve the energy toll of ischemia  and its usefulness in the context of CVD is backed by rodent and human studies (Shecterle. 2011)
                  In view of it's physiological role in the recovery of ATP levels (Helsten. 2004), it was assumed that supplementatal D-ribose would ameliorate the ATP depleting effects on exercise and improve endurance in glycolytic and/or long endurance activities, yet...
                  "[...s]tudies examining the effect of ribose on performance during intense intermittent exercise and rowing have not been able to demonstrate improved performance in humans." (King. 2012)
                  Other than the non-existence of side-effects, pertaining studies, which used up to ∼40 g/day, as well as acute and chronic supplementation regimen did  yet not yield any positive results

                  Now, the aforementioned studies on the ergogenic effects of d-ribose were conducted in healthy individuals, in whom the ATP re-synthesis obviously does not depend (and not even benefit) from the provision of the monosaccharid that was discovered by Emil Fischer in 1891, when he analyzed the carbon structure of gum arabic (Prince. 2012). "Healthy" would yet not be the correct term to describe the rodents in the recently conducted study by Caretti et al. who observed that five week-old mice who were exposed to an atmosphere containing 10% O2 for 10 days in order to induce right ventricle hypertrophy and left ventricle apoptosis did not show any signs of cardiac damage, when they were gavaged creatine + D-ribose, every day.

                  And while both phenotypes, i.e. the hypertrophy of the right and apoptosis of the left ventricle, were blunted to a certain degree by creatine or d-ribose, only their reversed the pathogenic changes to the heart muscle "almost" completely, by normalizing the expression of AMPK and Akt signaling in the hearts of the rodents.
                  Light micrograph of representative nuclear pro-files (background, red = atypical, green = normal nuclei; my emphasis) and volume (%) of atypical cardiac cells in anterior left ventricle of rodents on caffeine + nicotine + ephedrine combo (learn more)
                  Bottom line: While they may not be beneficial for the average trainee, people "on" the literally heart-breaking combination of nicotine + caffeine and ephedrine, could be able to reduce their detrimental effects on the heart (learn more), by adding this combination of proven (creatine) and disproven (d-ribose) ergogenics to their supplement regimen. People with sleep-apnea and other conditions which will leave the heart poorly oxygenized for longer time-periods should obviously benefit, as well.

                  Based on the likewise promising results of previous studies in (human!) subjects with congestive heart failure (e.g. Omran. 2003), a daily dose of 5g d-ribose, along with the tried an proven chronic ingestion of 5g of creatine appears to be a good starting point, until respective human trials have been conducted.

                • Further evidence for the "An apple a day..." theory (Rago. 2013) In an allegedly methodically complicated, but very comprehensive analysis of the effects of raw, whole apples on the plasma metabolome of rodents, researchers from the University of Copenhagen found
                  Total antioxidant activity (µmol vitamin C equivalents/g) of various fruits (Boyer. 2004)
                  "that the intake of fresh apple in rats has a considerable and specific impact on the plasma metabolite profile, reflecting altered gut microbial metabolism, retarded lipid- and protein catabolism, and lowered metabolic, oxidative and steroid-related stress". (Rago. 2013)
                  These results stand in line with the recent observations a group of Spanish researchers made, when they added a polyphenol extract from apples to the chow of rodents on an obesogenic high-fat + high sugar (HFS) diet:
                  "Our results from histological studies demonstrated that supplementation of HFS with AP markedly reversed the enlargement of adipocyte volume induced by HFS diet intake in the epididymal fat pad, reducing it by almost 28% [...it also] reversed the increase in the population of large epididymal adipocytes, especially with diameters higher than 130m." (Boqu. 2013)
                  The visceral specific effects of the apple polyphenols in the Boqué study could thus be interpreted as supportive evidence for the real-world significance of the metabolomic changes Rago et al. observed in the afore-cited study.
                  Bottom line: No reason to be scared of the "high fructose fruit" apple. It comes with all HFCS sweetened beverages don't have. Polyphenols, vitamins, minerals and most importantly a flesh from which the fructose is extracted only slowly. Still, I have to warn you: Apple consumption can have profound beneficial effects on your health, such as (random examples)
                  •  - 17% colorectal cancer risk (Michels. 2006)
                  •  - 37% wheeze risk in your offspring (Willers. 2007)
                  •  - 21% reduced risk for cancers of the oral cavity and pharynx (Gallus. 2005)
                  •  - 25% reduced risk for oesophagus (Gallus. 2005) 
                  •  - 18% / -15% / -9% risk red. for breast / ovary / prostate cancer (Gallus. 2005)
                  and obviously the - 15% reduced breast cancer risk, the if you want to avoid these, you should thus better keep obsessing about the high fructose content of apples and stick to sausages and lard ;-)

                References:
                • Boqué N, de la Iglesia R, de la Garza AL, Milagro FI, Olivares M, Bañuelos O, Soria AC, Rodríguez-Sánchez S, Martínez JA, Campión J. Prevention of diet-induced obesity by apple polyphenols in Wistar rats through regulation of adipocyte gene expression and DNA methylation patterns. Mol Nutr Food Res. 2013 Mar 25.
                • Boyer J, Liu RH. Apple phytochemicals and their health benefits. Nutr J. 2004 May 12;3:5.
                • Caretti A, Bianciardi P, Marini M, Abruzzo PM, Bolotta A, Terruzzi C, Lucchina F, Samaja M. Supplementation of creatine and ribose prevents apoptosis and right ventricle hypertrophy in hypoxic hearts. Curr Pharm Des. 2013 Apr 10. [Epub ahead of print]  
                • Gallus S, Talamini R, Giacosa A, Montella M, Ramazzotti V, Franceschi S, Negri E, La Vecchia C. Does an apple a day keep the oncologist away? Ann Oncol. 2005 Nov;16(11):1841-4. 
                • Hellsten Y, Skadhauge L, Bangsbo J. Effect of ribose supplementation on resynthesis of adenine nucleotides after intense intermittent training in humans. Am J Physiol Regul Integr Comp Physiol 2004;286:R182–8.
                • Michels KB, Giovannucci E, Chan AT, Singhania R, Fuchs CS, Willett WC. Fruit and vegetable consumption and colorectal adenomas in the Nurses' Health Study. Cancer Res. 2006 Apr 1;66(7):3942-53. PubMed PMID: 16585224.  
                • Omran H, Illien S, MacCarter D, St Cyr J, Lüderitz B. D-Ribose improves diastolic function and quality of life in congestive heart failure patients: a prospective feasibility study. Eur J Heart Fail. 2003 Oct;5(5):615-9.  
                • Price, NPJ. The Name of the–ose: An Editorial on Carbohydrate Nomenclature. J Glycobiol. 2012; 1(e105).
                • Rago D, Kristensen M, Gözde G, Federico M, Morten P, LarsOve D. LC–MS metabolomics approach to investigate the effect of raw apple intake in the rat plasma metabolome. Metabolomics. 2013; 1573-3882.
                • Shab-Bidar S, Hosseini-Esfahani F, Mirmiran P, Mehran M, Azizi F. Dietary intakes of zinc and copper and cardiovascular risk factors in Tehranian adults: Tehran Lipid and Glucose Study. Nutrition & Dietetics. 2013
                • Sharp DS, Andrew ME, Fekedulegn DB, Burchfiel CM, Violanti JM, Wactawski-Wende J, Miller DB. The cortisol response in policemen: Intraindividual variation, not concentration level, predicts truncal obesity. Am J Hum Biol. 2013 Apr 20.
                • Shecterle LM, Wagner S, St Cyr JA. A sugar for congestive heart failure patients. Ther Adv Cardiovasc Dis. 2011 Apr;5(2):95-7.
                • Willers SM, Devereux G, Craig LC, McNeill G, Wijga AH, Abou El-Magd W, Turner SW, Helms PJ, Seaton A. Maternal food consumption during pregnancy and asthma, respiratory and atopic symptoms in 5-year-old children. Thorax. 2007 Sep;62(9):773-9. Epub 2007 Mar 27.
                   

                Switch From Chicken to Lamb to Rid Yourself of Belly Fat, Reduce Your Triglyceride and Basal Insulin Levels

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                If you consider this, i.e. you suprailaic body fat (here measured by a caliper, just as it was done in the study at hand), ditching the chicken for some lamb, may be one of the myriad factors that could help you "solve" the problem.
                Chicken, rice and broccoli. That is stillthe dietary paradigm, most people have on their minds, when average Joes and Janes are talking (often with some disdain) about what "healthy eating must look like".

                Now, a recent study from GENUD, the "Growth, Exercise, Nutrition and Development" Research Group at the Universidad de Zaragoza in Spain (Graffe. 2013) suggests that at least item #1 on that list, namely chicken, would have been better replaced with a protein source of which I suspect even most of you won't be consuming on a regular base: Lamb!

                That a proper sleep hygiene is of utmost important for your health and body composition is something you, as a SuppVersity veteran will be highly familiar with (if you are a newbie read yourself smart, here).

                "Switch out the light and dish up the lamb, bro!"

                That the second part of the jovial imperative in the above headline could be another factor to take into consideration, on the other hand, is true news (even for me) and should - with only one study backing it up - be considered more of an empirically grounded hypothesis than a "100% certain scientific result".

                Table 1: Cooking methods for both lamb and chicken (Graffe. 2013)
                Nevertheless, the observations, María Isabel Mesana Graffe and her colleagues made, when they put a group of healthy 16-26-year old "men" and "women" (I know, when I was sixteen, I thought I was a man, too - little did I know ;-) from Teruel and Zaragoza on an 8-week dietary regimen containing either...
                • 150 grams of chicken, three times per week, or
                • 150 grams of boneless lamb, three times per week,
                ... are quite intriguing. The participants received their otherwise (roughly) identical diets in in their local university accomodation halls:
                "To ensure harmonisation, product-rich diets were served during lunch time and with each chef of the designated university accommodation halls were given instructions on the cooking methods." (Graffe. 2013; cooking methods, see table on the right)
                The whole study design was in fact pretty straight forward and resembles an ideal world, where the citizens obey to dietary recommendations like "eat at least three meals with 150g of lamb per week" as if their lives depended on it (is it ironic or just sad that it actually does depend on the pathetic advice people are given?).

                After an initial visit at which the medical history of all participants was assessed, a first blood draw, as well as anthropometric, blood pressure and heart rate measures were undertaken. After an 8-week period, all subjects came in for a second visit and the second testing session and crossed over to the other other group, i.e. subjects who had been consuming chicken for the first 8-weeks were then assigned to eat lamb and vice versa.

                2x 8 weeks + an intermediate 5-week washout later...

                Thus, after 8 weeks on diet A, a 5-week washout and another 8-weeks on diet B, all subjects had been consuming one or the other diet for 8 weeks, when they eventually arrived for the third and last assessment of their cardiovascular risk markers, body composition, blood pressure and heart rate.
                Figure 1: Changes in skinfold thickness (before vs. after) and corresponding arm, hip and waist circumferences in the participants after 8 weeks on the "chicken" vs. "lamb diets" (Graffe. 2013)
                As I know that "looking good naked" is much sexier (in the literal, as well as the figurative sense), than being healthy, we'll take a look at the anthropometric data, first (see figure 1). It probably doesn't take much explaining on my side. The general trends speak for themselves and I guess, you won't complain that it is in the change of the amount of fat that's covering the abs, where the scientists observed the only significant inter-group differences - do you?
                Figure 2: Changes in blood lipids cardiovascular parameters, glucose and insulin levels during the 8-week chicken / lamb diet phases; only non-pastel bars are statistically significant  (Graffe. 2013)
                With the fat mass differences being most significant in the abdominal area, it is also no surprise that the major changes among the cardiovascular risk parameters were (a) reduced triglyceride levels and (b) improved insulin levels - exactly those parameters that are usually most closely related to abdominal obesity and "all things metabolic syndrome".

                Not chicken or lamb, "chicken or egg" - that's the question!

                These observation do obviously rise the usual SuppVersity question: "What's the mechanism, here?" What is certain is that the beneficial effects on abdominal fat, trigs and insulin are not due to the clenbuterol residues in chicken (up to 224ng/g; cf.Malucelli. 1994) cyclists love to use as an excuse, when they have once again been busted for the abuse of beta-agonists. Why? Well than eating chicken should help not hinder leaning out. Could it be the remnants of antibiotics in the chicken meat, as proposed by eg. Nicholson et al. (2005)? Or is it simply the bad arachidonic acid chicken common wisdom will tell you that it was so high in chicken meat?
                Figure 3: Fatty acid composition of beef, lamb, pork, chicken, duck and turkey in % of total lipids (left) and arachidonic acid content in mg/100g (Li. 1998)
                If you peek at the data in figure 3, which is obviously not based on the dietary intake of the subjects in the study at hand, but displays the general fatty acid composition of various meats, including lamb and chicken (both marked with grey boxes) as they were reported by Li et al. in 1998, it would appear as if "everybody's favorite devil", the essential omega-6 fatty acid arachidonic acid can hardly be blamed for the superiority of lamb - after all there is about the same amount of it in lamb as there is in chicken (for Ducks and dark poultry things are different!)

                Did you know that lamb is the #1 dietary source of CLA?

                Lamb contains 5.6 mg/g CLA, whereas beef and veal contain only 2.9–4.3 mg/g and 2.7 mg/g, respectively.

                Non-ruminant meats such as chicken and pork, contain 0.9 mg/g and 0.6 mg/g, respectively (Mulvihill. 2001).

                Eggs contain no CLA, at all - unless the chicken are fed with CLA enriched diets and the yolk between 3mg and 14-32mg/100g total fat (Jones. 2000; Raes. 2002).

                Whether the CLA is at the heart of the effects in the study at hand is yet questionable, after all one of the side effects is insulin resistance and that's the opposite of what the sign. decrease in insulin would suggest.
                What could be a culprit, though is the overall higher n-6/n-3 ratio of chicken. There is no debating that there is a statistically significant difference between chicken with 9.73g of omega-6 fatty acids per omega-3 vs. lamb in which every omega-6 fatty acid is "appropriately (?) buffered" with 0.57g of omega-3s (the corresponding n3/n6 ratios are 1.59, 1.78, 13.92, 9.73, 10.82 and 10.53for beef, lamb, pork, chicken, duck and turkey, respectively; data based on Li. 1998).

                But is it really that easy? The n3/n6 ratio - again!? I 'd say no. Also, or rather particularly in view of the relatively lose dietary control... I mean, if you have to eat chicken at least three times a week in the canteen, you are certainly more likely to grab a burger with "red meat" (or whatever it is they put in-between the patties) on the weekends or in the evening.

                This and other confounding factors would obviously negate neither the previously mentioned n3/n6 ratio hypothesis, nor the scientists' very own hypothetical explanation that the "the presence of unsaturated fats [...], such as oleic acid and conjugated linoleic acid" which are naturally high in ruminant meat (see infobox on the right), can have figured here, as well. It should however remind you that there is, if anything, only one single reason that "we are fat" and that's the way "experts" base their advice on observations like these, cherry pick those they like and discard the ones they don't like until the various net result - call it the "XY diet" or the "dietary guidelines" - confuse the hell out of the poor average Janes and Joes who are looking up to those "experts" to rescue them before the obesity pandemic carries them off just like the 35.7% of the US adults who are already obese (the latest data is still based on figures from 2009-10; cf. Ogden. 2012)



                If you work anyway similar to a male rodent, 4g/day Tongkat Ali, could help with the abs, your testosterone levels and "other issues", as well (learn more)
                Bottom line: My personal take away message from the study at hand is not "never eat chicken again" or "eat lamb everyday", but rather: "Don't forget about how lucky we are that we have so many foods to chose from." So don't get stuck on only one of them - and that regardless of what common wisdom, recognized or unrecognized experts or individual studies may suggest would be "best" for the way you look and feel!

                There is no magic bullet and no singular reason that "we" are fat and I am 100% sure that eating chicken instead of lamb is the smallest obstacle standing between your and a shredded set of abs.

                 References:
                  • Jones S, Ma DW, Robinson FE, Field CJ, Clandinin MT. Isomers of conjugated linoleic acid (CLA) are incorporated into egg yolk lipids by CLA-fed laying hens. J Nutr. 2000 Aug;130(8):2002-5.
                  • Li D, Ng A, Mann NJ, Sinclair AJ. Contribution of meat fat to dietary arachidonic acid. Lipids. 1998 Apr;33(4):437-40.
                  • Malucelli A, Ellendorff F, Meyer HH. Tissue distribution and residues of clenbuterol, salbutamol, and terbutaline in tissues of treated broiler chickens. J Anim Sci. 1994 Jun;72(6):1555-60.
                  • Mulvihill, B. Ruminant meat as a source of conjugated linoleic acid (CLA). Nutrition Bulletin. 2001; 26: 295–299. 
                  • Ogden CL et al. Prevalence of Obesity in the United States, 2009–2010. NCHS Data Brief No. 82 January 2012.
                  • Nicholson JK, Holmes E, Wilson ID. Gut microorganisms, mammalian metabolism and personalized health care. Nat Rev Microbiol. 2005; 3:431–438.
                  • Raes K, Huyghebaert G, De Smet S, Nollet L, Arnouts S, Demeyer D. The deposition of conjugated linoleic acids in eggs of laying hens fed diets varying in fat level and fatty acid profile. J Nutr. 2002 Feb;132(2):182-9.

                  You Want Maximal Performance & Size Gains + Complete Thigh Development? Then Full Squats are For You!

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                  So you got to squat?! But how?
                  I guess that many of you will be missing more recent news on training programming and exercise selection. And I would in fact love to write about these topics more often, but with 37% of the US population being overweight, 99% of the studies deal with the question: "How can exercise help the overweight, obese and morbidly obese survive?" The interest or rather the funds for research as into such profane things as the effect of range of motion in heavy load squatting on muscle and tendon adaptations, on the other hand, are so scarce that K. Bloomquist's, H. Langberg's, S. Karlsen's, S. Madsgaard's, M. Boesen's, T. Raastad's latest paper is almost an exotic bird and that in a journal with the auspicious title the European Journal of Applied Physiology.

                  Interesting studies on specific exercises are rare

                  In their latest study, the researchers from the Copenhagen University Hospital in Denmark and the Norwegian School of Sport Sciences tried to elucidate, whether the deep (DS) and shallow (SS) squatting would have a differential effect on specific adaptations in the front thigh muscles, the patellar tendon and the 17 male particpants in their early twenties.
                  Table 1: After an initial familiarization (week 1) and pretesting week (week 2) the subjects preformed the above workout; submax exercises were preformed for 8 reps with a weight the subjects could lift for 13-14 reps (Bloomquist. 2013)
                  Yet while all subjects were sports students, the scientists excluded those who had been squatting regularly within the last six months (probably to see statistical significant effects):
                  Learn about the efficacy of other exercises in the SuppVersity EMG Series (learn more)
                  "During the intervention, subjects were requested not to participate in endurance sports more than three times per week, or to engage in strength training of the lower extremities. After a 1-week familiarization period, subjects were tested and paired according to their initial DS strength. From each pair one subject was drawn, by envelope, into either the DS or SS group with the other member of the pair allotted to the opposite group."
                  After the 14-week (effectively only 12w) training period the subjects performed a follow up test in the course of which the researchers evaluated the 1-RM and isometric strength, the cross sectional area of the front thigh muscle, the total lean body mass, the collagen synthesis in the patellar tendon and the jump performance.
                  Figure 1: Changes in muscle power / performance (jump squat & counter movement jump) and size in the shallow squat and deep squat group (Bloomquist. 2012)
                  I guess a brief glance at data figure 1 should suffice to see that performance wise the full-squat (0–120 ° of knee flexion vs. 0-60° for shallow squats) play in a whole different league:
                  Bicarbonate buffered leg workouts last longer (learn more)
                  • much higher torques (not shown), slightly more pronounced gains in 1RM strength (not shown)
                  • greater increase in leg mass, significantly higher increase in CSA with increases in CSA on all not just the proximal sites
                  • greater jump squat & counter movement jump (CMJ) performance increases
                  In view of these favorable results the only reason not to deep squat would probably be that it could hurt your patellar tendon, but contrary to what the scientists had expected,...
                  "[...] neither group elicited gains in patellar tendon CSA or collagen synthesis.[...] Though not expected, these results are in accordance with several resistance training studies that have shown that increases in strength were not accompanied by increases in tendon CSA. Rather, a markedly altered elastic modulus was found in these studies, implying a change in the composition of the tendon structure instead of the size."
                  In trained athletes / sport students a picture perfect deep squat may thus be considered a save and highly efficient way to build bigger and stronger wheels.



                  Did you know that you can use your 1-RM squat to calculate your training weight on hamstring exercises? Ebben et al. found the following equations to yield reliable results: (1) seated leg curl load = squat load (0.186) + 10.935 kg, (2) stiff leg deadlift load = squat load (1.133) - 86.331 kg, (3) single leg stiff leg deadlift load = squat load (0.443) - 3.425 kg, and (4) good morning load = squat load (0.961) - 105.505 kg (Ebben. 2010). I have my doubts that this will work for all of you, but give it a try, it's free ;-)
                  Bottom line: So if you "got to squat" as the imagine next to the introductory paragraph clearly suggests, the deep squat is the way to go? Well... compared to the shallow squat to a knee angle of 90°, I would fully subscribe to that (as long as you know what you are doing and not hurting yourself by squatting with improper form), when it comes to the "to parallel" vs. 90° knee angle questions, the advantage of the full squat may well start to melt away.

                  Yet while the data in the SuppVersity EMG Series suggests that this is the case for the quads, it is highly questionable if the glute development the aformentioned slightly sexist image is unmistakably hinting at will not still suck if you don't squat to a 120° knee angle. Try it for yourself and feel the glutes working. If it's the pretty behind you are after, you won't get around squatting "deep" as far as the squat is concerned. But hey, who says you got to do that with weights that are so heavy that they put you at risk of injury?

                  References:
                  • Bloomquist K, Langberg H, Karlsen S, Madsgaard S, Boesen M, Raastad T. Effect of range of motion in heavy load squatting on muscle and tendon adaptations. Eur J Appl Physiol. 2013 Apr 20.  
                  • Ebben WP, Long NJ, Pawlowski ZD, Chmielewski LM, Clewien RW, Jensen RL. Using squat repetition maximum testing to determine hamstring resistance training exercise loads. J Strength Cond Res. 2010 Feb;24(2):293-9.

                  Adelfo Cerame: Simple Recipes to Go With a Sensible Diet. A Practical Follow Up on the "Beach Ready Program"

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                  Adelfo's latest pictures... believe it or not - after the Jr. Bacon Cheeseburger ;-)
                  With the last installment of his blogpost series here at the SuppVersity in the back of your heads, you should actually have a decent idea of how to train and split your macros to get "beach ready" in time. There is yet one thing of enormous practical importance that did remain somewhat in the dark. Where do you get those macros from? As Adelfo did of course point out, you are supposed to put a primer on whole foods, but I guess few of you will be happy with eating everything raw out of bag you carried with yourself home when you did your groceries at the farmer's market, supermarket or wherever you like to buy your foods... Are you the gal/guy who still feels that "healthy eating" equals downing blunt chicken breast, tuna and rice an nibbling on rice cakes as a "cheat"?!

                  Then today's follow up on Adelfo's highly popular "Adelfo Cerame's Beach Ready Program: A Blueprint to Shed The Winterfat in Time. Sample Workout + Diet Guide" from April, 18 2012 is for you and there is little for me (=Adel) to do, but lean back and have you enjoy Adelfo Cerame's cookery & nutrition class ;-)

                  Simple recipes to go with a sensible diet…

                  Now that you've got an idea of your daily overall energy requirements (depending on your goals) and the corresponding macronutrient goals, that you have internalized that you are supposed to prioritize protein and fiber in all of your meals and have - hopefully - finally realized that all foods are “OK” to eat - including those that contain carbohydrates! You don’t have to deprive yourself any more of certain foods because they are deemed evil.

                  My off-season macros
                  • Kcal: 2570
                  • Fats: 45-55g
                  • Carbohydrates: 250-300g
                  • Protein: 190-220g
                  • Fiber: 25-55g
                  Vegetables + fruits: At least 1 serving of both per day (and that doesn’t mean one cherry tomato!)
                  My current goals: Packing on lean muscle (off-season)
                  If you approach your nutrition with balance, moderation and consistency, you will be succeed - whatever your goals may be and no matter how long it takes!

                  I will take my own current dietary intake as an example to illustrate how to put all these important principles into practice. A sensible and above all flexible approach to what is - in my case - an off season diet.

                  I have outlined my current macro-nutrient intake as well as a handful of stats and my current goal in the infobox on the right hand side of this paragraph. It's advisable that you write a similar "primer" for yourself, especially when this is the first time you are dieting this way. This help you stay accountable and combine foods in a way that will allow you to "hit your macros" and grow, lose fat and/or increase your performance (or whatever other goals you had in mind, when you came up with the "rules") - for me the net result of this process looked like that:

                  • This was my food log from yesterday

                    Meal 1 – Pre-Workout Meal/ Macros: 24g fat/ 51g carbs/ 44g protein/ 5g fiber


                    I was out meeting with a client at a local coffee shop and by the time it was over I realized that it was time for me to train in an hour or so. So I knew that I would be caught for time and wouldn’t have time to cook, so I stopped by the nearest fast food spot and grabbed myself a jr. bacon cheeseburger that I knew would fit within my macronutrient goals for the day… went home and made myself a quick protein shake and grabbed an apple to go with that as well, along with my multivitamins, fish oil and vitamin D3, so still prioritizing protein and fiber and getting in my serving of fruit when breaking my fast. (don’t let the cheeseburger fool ya!) And it’s off to train I go!

                    Meal #2 Post-Workout meal/ 20g fat/ 142g carbs/ 68g protein/ 11g fiber 

                    After my workout, I was having the urge for some loco moco (it’s a Hawaiian dish) it’s pretty simple to make but can be pretty fattening if you order from a restaurant, so I made my own so to make sure that I would stay within my fat intake for the day. Your traditional loco moco dish uses white rice, burger patties, whole eggs and brown gravy – the only adjustments I made was using a leaner burger patty (96/4 extra lean) and used brown rice instead of white because more fiber in brown rice (again… prioritizing fiber!) I also threw in 200g of mixed greens on the side so I can get my serving of vegetables for the day as well ;-)

                    Meal #3 before bed/ 7g fat/ 104g carbs/ 78g protein/ 22g fiber

                    By the end of the night, I pretty much hit my goals for getting at least one serving of fruit, at least one serving of veggies and the majority of the 25-55g of fiber listed in the info-box a couple of paragraphs above.

                    The only thing I had left to hit was my protein intake and that’s usually pretty easy - if nothing else, you just grab a protein shake or quest bar.

                    Once I hit my goals for the day I usually use the rest of my energy allotment for the day to eat I have left in the fats and carbs department from whatever I feel likeon a given day.
                  So at first glance, especially with the Jr. Bacon Cheeseburger I ate pre-workout…. You’re probably thinking ...

                  "WTF?! He eats like shit!!!"

                  An overview of my macronutrient intake for the day - de facto intake vs. goals.
                  But hold on there kemosabe… If you look below at my totals I stayed well within my macronutrient goals and hit more than enough fiber for the day.

                  In the end you will have to concide that "my approach" definitely has it's beauty, right? After all, I ate the foods I wanted, just as long as I stayed within my goals for the day.

                  Ah, and in case you're asking yourselves "What happened to the intermittent fasting? Didn't Adelfo follow an IF routine so successfully?" I still incorporate an intermittent fasting meal protocol into my regimen, because I love having my big Viking style feasts!



                  Bonus: Adelfo's recipe of the week

                  Before signing off, I leave you with the recipe to one of my favorite post-workout meals. I call it the“Ahi Tuna Bacon Sashimi Bowl”– don't worry it sounds complicated, but is in fact very simple to make:
                    Healthy food does not have to taste blatant, it does not have to be difficult to prepare and it does not have to consist of chicken, broccoli and rice only. Adelfo's Ahi Tuna Bacon Sashimi Bowl is an excellent example, but by no means the only delicious and healthy food you can prepare in no time even if you are no Michelin-starred chef.
                    Ingredients (*):
                    • 10 oz. sashimi grade wild caught Ahi Tuna
                    • 1 strip of center cut bacon
                    • 400g of mixed greens (romaine, spinach, herb, slaw…)
                    • 2 (85g) baby beets
                    • 100g of sliced roma tomatoes
                    • rice wine vinegar, Ponzu sauce, Sriracha sauce
                    • 1 tbsp. sesame oil, sesame seeds
                    • Directions: (1) Throw in all your greens in bowl (2) Pour some rice wine vinegar and ponzu sauce with the mix and toss (3) Layer the baby beets and diced tomatoes on top of the greens (4) Layer the sliced and diced ahi tuna next (5) Sprinkle the bacon that you fried and cut into pieces (6) Pour your tbsp. of sesame oil on top of everything (7) Top it off with sriracha hot sauce and sesame seeds (8) Eat (9) Wash it down with a shot of sake and a cold Sapporo ;-)
                    *These portions are based on my macronutrient goals for the day, so measure accordingly to yours… and shot of sake and glass of Sapporo is optional ;-)

                    Breaking the Fast, Cardio & Your Brain: Cardio on Empty is Fatiguing. Fasting Without Exercise, However, is Nootropic

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                    Boking: Every endurance athletes knows and fears it, so wouldn't just that happen when you do your cardio on empty in the morning? And what about the effects on your brain power? Will your gray matter bonk, as well? And if so, what can be done about it?
                    Today's SuppVersity post is a little different from the usual "Training on empty? Yes / No / Maybe!" debate that flares up every now and then on almost every fitness related bulletin board of the World Wide Web. And in as much as I would like to say that this was all the credits belong to me, the fact that the the following dissertation may actually make a practically relevant contribution is due to the experimental design of the latest study from the Northumbria University in Newcastle, Tyne and Wear, in the UK (Veasey. 2013).

                    Why is that? Well, contrary to the majority of breakfast "yes or no" studies this one has both an exercise and and a cognitive performance aspect. Since I suppose that most of you are not living to train, but training to live, this is practically highly relevant. I mean, what's the use of "looking good naked" due to the purported benefits of working out "on empty" first thing in the morning if that reduces your cognitive performance in a way that you risk being fired?

                    Now that I've got everyone's attention, let's look at what exactly R.C Veasey and her colleagues did to find out whether having / not having breakfast before morning cardio or rest will impact cognitive performance and mood later in the morning. To this ends, the researchers recruited 12 healthy, active men in their early 20s with an average BMI of 24.5 ± 2.0 kg/m², who had to abstain from rigorous exercise and alcohol consumption prior to the exercise trials before they reported back to the lab after a 12h fast.
                    Do the online stroop testto get an idea of what the subjects in the study had to do and why it may in fact not be ideal to have breakfast when you are not exercising. After all, the results of the study at hand clearly suggest that the the accuracy in the stroop performance test decreases significantly in the "no exercise, but breakfast" condition.
                    "After confirming compliance to the study restrictions, a baseline completion of the cognitive tasks and mood scales was then undertaken, before participants were administered the test breakfast or remained fasted. During the 2 h rest period which followed, cognitive performance and mood were measured at 60 and 120 min. In between these periods, participants were allowed to read, write or watch a DVD. In the exercise trials (NB E and B E), participants then completed a treadmill run at 60% of their VO2, until 2.9MJ had been expended with heart rate and rate of perceived exertion (RPE) measured at 10 min intervals throughout. [...] On rest days (NB NE and B NE), participants rested for the equivalent amount of time. Cognitive performance and mood were reassessed before participants were administered a test drink, followed by a 90 min rest period where cognitive performance and mood was assessed at 30 and 75 min. This was followed by an ad libitum lunch where participants were asked to consume enough food to feel satisfied to a normal level. After lunch, they completed the cognitive tasks and mood scales for a final time and were then free to leave the laboratory." (Veasey. 2013)
                    "Hah?" Yeah, that was my initial reaction to the overcomplicated study protocol, but don't worry, after you've taken a peak at the following overview I guess, you will be able to identify how this corresponds to getting up, driving to the gym, working out and head to your working place with or without breakfast.
                    Illustration 1: Outline of the allegedly somewhat difficult to understand study protocol (Veasey. 2013)
                    You see? It's not so complicated as the scientists description of the protocol made it appear. Four conditions, total, two conditions with and two without 72g syrup flavor porridge oats with 360ml milk, each repeated twice with or without exercise after the initial rest period - that's all.

                    "Ok, whatever... what were the results? "

                    As the scientists had expected, the consuming breakfast prior to exercise did in fact elicit the most beneficial cognitive performance and mood effects following in the exercise conditions.
                    Figure 1: Cognitive performance, mental fatigue and tension in the four trials (Veasey. 2013)
                    The data in figure 1 does yet also reveal that having breakfast before rest had detrimental effects on the ability of the study participants' ability to rapidly process visual information and omitting breakfast improved their performance on Four Choice Reaction Time test.



                    Whey and carbs as cognition booster and stress buffer for breakfast: In view of the results of a soon-to-be-published paper from the University of Helsinki clearly shows that a combination of whey and carbs for breakfast improves coping with mental tasks in healthy subjects compared to the "breakfast" used in the study at hand (Sihvola . 2013), it would appear prudent to remember that, when you rise and shine and decide to have breakfast - regardless of whether you intend to work out, or not (the increased protein intake may even help with the performance decline in the "breakfast, no exercise" condition - emphasis on may and assuming you don't ingest it in isolation just to end up hypoglycemic). Apropops, don't forget: Low GI carbs are your brain's friends (e.g. Micha. 2010; Cooper. 2012)
                    Bottom line: According to the results of the study at hand, you do have two options to maintain / optimize your "desk performance" (cognitive performance at the job) in the morning hours:
                    • either you fast and refrain from working out or
                    • you have breakfast and work out
                    It goes without saying that even minor changes in the protocol, e.g. the omission of the 120min rest period (I gather you don't need that long in the bathroom before you either leave the house and go for a jog, sit on your cycle ergometer or drive to the gym), for example could skew the results in a favorable way for the "non-breakfast condition", if  you don't stick to a meager 250ml of chocolate milk after your workout but indulge a real breakfast (see box on the right for a scientifically warranted suggestion)...

                    The latter is by the way a practice that has always worked pretty well for me. I did however have to realize that this does only work if you really eat and don't just down a protein, let alone whey shake that will only spike your insulin and send you down into the abyss of borderline hypoglycemia. A state which is certainly nothing your cognitive performance can benefit from (Lindgren. 1996).

                    Highly suggested read: "Circadian Rhythmicity - "Breakfast" or "Breaking the Fast"? Fasting as Zeitgeber & All About King, Prince & Pauper" (read more)


                    References:
                    • Cooper SB, Bandelow S, Nute ML, Morris JG, Nevill ME. Breakfast glycaemic index and cognitive function in adolescent school children. Br J Nutr. 2012 Jun;107(12):1823-32. 
                    • Lindgren M, Eckert B, Stenberg G, Agardh CD. Restitution of neurophysiological functions, performance, and subjective symptoms after moderate insulin-induced hypoglycaemia in non-diabetic men. Diabet Med. 1996 Mar;13(3):218-25. 
                    • Micha R, Rogers PJ, Nelson M. The glycaemic potency of breakfast and cognitive function in school children. Eur J Clin Nutr. 2010 Sep;64(9):948-57.
                    • Sihvola N, Korpela R, Henelius A, Holm A, Huotilainen M, Müller K, Poussa T, Pettersson K, Turpeinen A, Peuhkuri K. Breakfast high in whey protein or carbohydrates improves coping with workload in healthy subjects. Br J Nutr. 2013 Apr 16:1-10.
                    • Veasey RC, Gonzalez JT, Kennedy DO, Haskell CF, Stevenson EJ. Breakfast consumption and exercise interact to affect cognitive performance and mood later in the day: a randomized controlled trial. Appetite. 2013 Apr 19.

                    Sex-Dependent Low GI Advantage(s) & Vasodilating Effects of Insulin. Diet-Dependant Effects of Active Vitamin D on Glucose Metabolism. Plus: Supplemental Flaxseed Oil?

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                    It seems as if the glycemic index of her diet during puberty could determine on which side of this photoshopped divide a will end, when she's a young woman. Intriguingly, the association between high GI diets and high waist circumferences and obesity risk was not observed in the boys whose 5-year follow up data the researchers analyzed.
                    "145mm" that's the SuppVersity figure of the Weekand the number of additional millimeters the waist circumference of a 12-year old girl is going to increase until she's 17 for each 1-SD increase in dietary GL. In conjunction with the observation that each 1-SD increase in dietary fiber intake was associated with a concurrent 0.44 kg/m² decrease in mean BMI, in girls and a 145mm lower increase in waist circumference, in boys, these results from a soon-to-be-published paper clearly support the notion of the fattening high GI carbs for girls (Gopinath. 2013).

                    The data does yet also raise the question, whether a higher activity level, a greater muscle mass or whatever something totally different is responsible for the non-significant effect the consumption of a high GI diet appears to have on the "strong sex". After all, even the devilish sugar sweetened soft-drinks which were associated with 4.45% higher body fat levels in girls who consumed one or more servings of the sugary glue per day, did not make a difference for the "young men" (suggested read: "Women Have a Much Higher Time Losing Body Fat Than Men")... ok, so let's see what else we've got "in the news today".

                    The vasodilatory effects of insulin could be life saving 

                     (Hornstra. 2013) -- As a SuppVersity reader you are way beyond the stage of bro-science and thus fully aware that insulin not the villain everybody believes it was. Aside from the fact that it prevents catabolism, which is probably the only thing the average bro knows about, it helps nourish your cells, it keeps your blood from turning into a sweet slurry and has potent vasodilatory effects (ever wondered why you cannot get a decent pump ever since you went low carb?)

                    You don't still believe in the urban myth that adding fat to a high carb meal would blunt, the subsequent insulin spike, do you? Oh, you do? Well, in that case I recommend you take a look at one of the more recent installments of True or False (learn more)!
                    There is just one downside to it: Insulin does these and all the other good things only to people like yourself. People who work out, eat clean and remain insulin sensitive. In that, you do however have overweight company, that's at least what the results of a recent study from the Department of Internal Medicine at the VU University Medical Center in Amsterdam clearly suggest. In order to elucidate the hitherto only partially understood local microvascular vasoactive effects of insulin and their impact on systemic vascular resistance. J.M. Hornstra and colleagues conducted a cross-sectional studied in 37 healthy, overweight subjects (age 25 – 55 years, BMI 25 - 30 kg/m²), in whom they measured the local insulin-mediated vasodilation in response and transcutaneous iontophoresis of insulin and compared them to the local effects of acetylcholine and sodium nitroprusside, a potent pharmacological vasodilator.

                    What the researchers found was a clearcut inverse relationship between insulin-mediated vasodilation (r=-0.50; p<0.01) and the subjects' vascular resistance - a finding that was maintained after adjustment for age, sex, blood pressure and smoking and was not associated with local microvascular effects of acetylcholine.

                    Bottom line: The results of the study at hand do thus corroborate to the notion... or I should better write "the proven fact" that insulin is not solely the fattening villain the current mainstream Internet paradigm says it was. It is a powerful hormone with physiological importance well beyond it's role in glucose management and the increased risk of cardiovascular diseases in type II diabetics and the average non-insulin sensitive overweight Westerner is not due to having too much insulin floating around in the system, but due to the non-responsiveness of the cells of the ever-increasing number of pre-diabetics.

                    Low GI diets helps to shed >10% more during three months exercise intervention 

                    (Solomon. 2003) -- In a way, you could say that the results of a soon-to-be-published study from the Department of Pathobiology at the Cleveleand Medical Clinic stands in line with both the SuppVersity Figure of the Week and the previous post on insulin's role in peripheral and systemic vascular resistance.

                    In the study at hand, the ingestion of a low glycemic index diet, as it was prescribed to the 20 older, obese individuals who participated in a 3-months fully-supervised aerobic exercise program will did (a) improve the weight loss success of the subjects in the low GI (LoGIX) vs. high GI (HiGIX) groups by +10.5%, (b) improved their insulin sensitivity and should (this was not measured) thus have have had a beneficial impact on the vascular resistance of the overweight individuals and (c) promoted a lower respiratory exchange ratio (a low RER which is the ratio of glucose / fat oxidation is an indicator of in creased fatty acid and/or lowered glucose oxidation) during exercise and did thus help them to decrease the amounts of lipids floating around in their system.

                    Study probes whether "Hitting Your Macros" is all that counts (read more)
                    Bottom line: In the end, the results of the study at hand are not new, they only confirm what you will probably have known all along: The modulatory effects of low GI diets on the substrate utilization during exercise is highly relevant for the overweight and/or insulin resistant individual (skinny fat people included). With it's ability to improve and conserver insulin sensitivity, it is yet likewise important for the active individual and/or athlete trying to maintain his insulin naturally high insulin sensitivity without having to compromise his/her performance and endocrine health by running around glycogen depleted 24/7.

                    All of you who did not see the discussion revolving around the necessity of high GI carbs and thus insulin spikes for glycogen repletion after a workout, I suggest you take a peak at the corresponding graph on I posted on Facebook earlier this week (go to the SuppVersity Facebook Wall). One thing you should keep in mind though, is the fact that "high GI diets" are not characterized by the occasional ingestion of "fast carbs" in the postworkout window - this alone is thus unlikely to cause the same ill health effects as a dietary protocol that does not even give your body the chance to clear the steady and rapid influx of glucose from the bloodstream (the "GL", i.e. the glycemic load may in fact be a better measure here, learn more)

                    Diet- and tissue-specific effects on transcriptional regulation of glucose metabolism 

                    (Alharfy. 2013) -- In what is unfortunately yet another rodent study on vitamin D, researchers from the College of Pharmacy at the , King Saud University in Riyadh, Saudi Arabia, took a closer look at the differential effect vitamin D (1,25-(OH)2D3, Rocaltrol(R)) supplementation exerts on the transcriptional regulation of insulin-sensitive in liver, muscle and adipose tissue in Male C57BL/6J mice on regular low fat or obesogenic high fat (+high carb) chow.
                    Figure 1: Effect of vitamin D treatment on transcript levels of insulin sensitive genes in low-fat diet (LFD)- and high-fat diet (HFD)-fed mice (Alharfy. 2013)
                    If you take a closer look at the data in figure 1, you see that in muscle tissue of LFD-fed mice, vitamin D treatment increased vitamin D receptor (VDR, not shown) to 2.03-fold and insulin receptor substrate (IRS-1) to 1.5-fold. An even more pronounced increase in IRS-1 (+140%; IRS proteins play a key role in transmitting signals from  insulin receptors to the intracellular pathways, as well as growth promotion) expression occurred in the mice that were fed the obesogenic high fat diet - in this case, the increase was yet accompanied by a -50% reduction in VDR expression (not shown) without having downstream effects on GLUT4 expression.

                    Maybe some of you remember that I covered a study in which vitamin D3 lead to increased obesity levels in rodents back in October 2011 (learn more)
                    In the liver of the mice receiving the species-appropriate low-fat diet, the provision of supplemental 150 IU/kg calcitriol (the active form of vitamin D!) did not induce any statistically significant trancriptional changes, whereas the -85% decrease in exogenous IRS-1 level in the HFD group and the concomittant upregulation of the hepatic vitamin D receptor expression (+260%) show that the liver could be a major target for the previously observed anti-obesity effects of active vitamin D (see "Active vitamin D does what vitamin D3 doesn't do"; read more). In lean mice, on the other hand, similar effects were absent and the expression of glucose transporters /GLUT-4) decreased by -30%.

                    The decrease in hepatic GLUT-4 was yet still small compared to the rapid decline in GLUT-4 expression in the adipose tissue of the LFD group. Whether this could precipitate high blood glucose levels is yet about as uncertain as the implications of the highly elevated GLUT-4 expression in the HFD group. Theoretically the latter would help reduce blood glucose levels, but at an expense of profound increases in adipose tissue - that this is not very unlikely, is something you have read about here at the SuppVersity in October 2011, already (go back)

                    So what do the scientists say?

                    In view of the necessity to convert supplemental vitamin D3 to it's active form, it is questionable, whether the provision of the former would induce any of the changes Alharfy observed in the study at hand - learn more in a previous installment of the short news!
                    As Alharfy et al. point out the absence of significant changes in GLUT-4 expression in response to the adminstration of physiologically highly significant amounts of the active form of vitamin D provides further evidence that the "insulin action in mammalian tissue is not a direct one" but are brought about by "intracellular mechanisms of insulin action mediated by IRS-1 and VDR" in the absence of any immediate effects on "glucose transport across major insulin-sensitive tissues, including adipose and liver in mice under LFD and HFD conditions". Consequently, the...
                    "[...] antidiabetic effect of vitamin D may be directed through its anti-inflammatory action in obese conditions. Reduction in inflammatory cytokines production by vitamin D may play a role in decreasing insulin  resistance." (Alharfy. 2013)
                    The scientists' conclusion does therefore stand in line with the observations of Waldron et al. about which you've probably read on the SuppVersity Facebook Wall about a month ago (Waldron. 2013).

                    Based on the 25OHD response (remember: 25OHD is the precursor to calcitriol and will thus be lowered, when more calcitriol is produced from this 'storage form') the researchers from the New Cross Hospital, in Wolverhampton in the UK observed in response to inflammatory assaults, they were among the first to propose that "serum 25-(OH)D is a negative acute phase reactant [... and h]ypovitaminosis D may be the consequence rather than cause of chronic inflammatory diseases" (Waldron. 2013)

                    Bottom line: While we are still far away from a proper understanding of the exact mechanisms which underly the observed correlations between low vitamin D levels and all sorts of (eventually) inflammatory diseases, the results of the study at hand corroborate the notion that D3 levels (=passive storage) have little to no direct effects on the etiology of the diabetes, cancer, and what not.

                    Figure 2: Reductions (!) in all risk mortality calculated on the basis of NHANES data for each 10ng/ml increase in vitamin D up to the "magic" 21ng/ml margin from the Amer study (Amer. 2013)
                    This would also explain why the vitamin D deficient ballet dancers from yesterday's SuppVersity Facebook news did benefit from supplementation, while the 10,000 participants in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2004 in another recent study by Amer et al. did not have lower risks of all cause mortality, once their 25OHD levels were just above lowest margin of the normal range (see figure 2 + today's SuppVersity Facebook news; Amer. 2013). What it does not explain, though, is the fact that we see similarly increased risk of all-cause mortality among women with low (20 ng/mL) as well as high (50 ng/mL) levels of serum 25(OH)D (Melamed. 2008) or the 50% increase in mortality Michaëlsson et al. observed in 1194 elderly men (mean age at baseline, 71 years) with vitamin D levels below 18.5ng/mL and above 39.4 ng/mL during a median follow-up of 12.7 years (Michaelsson. 2010).

                    In the end, studies such as the one at hand, would have to be conducted over long enough periods in human beings to finally identify the mechanism behind the non-linear effects of vitamin D on mortality and metabolic health in the these and other studies. Personally, I would hope that studies like the one by Amer et al. get some more mainstream attention and raise people's awareness of the simple paradigm "test first, supplement second".

                    Flaxseed oil does not offer metabolic advantages over olive oil  

                    If you don't like the feminine look and the size of certain body parts of this Greek statuette, you just found another reason to avoid flaxseed - at least if you are and want to stay male (learn more)
                    (Kontogianni. 2013) -- With all the hype around fish oil, flaxseed oil has more or less been forgotten. If you ask the average Joe or Jane, about whether you should rather use olive or flaxseed oil if you wanted to improve your lipid metabolism and reduce inflammation, many of them will probably still answer: "Flaxseed, of course!"

                    According to a recent study from the Harokopio University in Greece this is yet nothing but another urban myth. In their randomized cross-over study (2x6 weeks + 6 weeks washout in-between), the scientists found that it did not make a physiologically significant difference whether the 37 normal weight young subjects (age: 22 years) consumed 15 mL/day of either flaxseed oil or extra virgin olive oil.

                    When it comes to the differences the scientists observed in response to the olive oil vs. flaxseed oil supplemented diet, you better have a magnifying glass ready, as the only highly visible change was allegedly not significant:
                    Figure 3: Relative levels of inflammatory and biochemical parameters before and after the interventions; all data expressed relative to baseline / after washout = pre-crossover values (Kontagianni. 2013)
                    Even the fatty acid composition in the cell membranes differed only in terms of the amount of alpha linoleic acid (short-chain omega-3), while the amount of what people often falsely label as "fish oil", namely the long-chain omega-3 fatty acids, DHA and EPA, did not change in either group.

                    Oleuropein in olive oil is a natural testosterone booster (learn more)
                    Bottom line: Aside from statistically non-significant decreases in total and LDL cholesterol in the flaxseed oil group and a physiologically irrelevant increase in the ALA content of the in the erythrocyte membranes,  there were surprisingly little differences between the two study arms.

                    Now, you can certainly argue that the changes and potential benefits would have been more evident if the amount of flaxseed oil in the diet had been higher. On the other hand, you all should be aware that flaxseed oil goes rancid in no time, cannot be heated and tastes like a$$... this limits it's use as a regular part of your diet. What's more, if you take close look at the levels of hs-CRP in figure 3, you will have to admit that more flaxseed oil could also equal an increase in inflammation.



                    That's it for today: Why? Well, I simply had no time to write more earlier today and other than briefly posting this no additional time to spend writing up additional short-news... but judged by the visitor counts on the last weekends, you are probably busy enjoying the weekend, as well. Enjoy your weekend, everyone!

                    References:

                    • Amer M, Qayyum R. Relationship between 25-Hydroxyvitamin D and All-cause and Cardiovascular Disease Mortality. Am J Med. 2013 Apr 17. 
                    • Brown LJ, Midgley AW, Vince RV, Madden LA, McNaughton LR. High versus low glycemic index 3-h recovery diets following glycogen-depleting exercise has no effect on subsequent 5-km cycling time trial performance. J Sci Med Sport. 2012 Nov 12.  
                    • Gopinath B, Flood VM, Rochtchina E, Baur LA, Louie JC, Smith W, Mitchell P. Carbohydrate nutrition and development of adiposity during adolescence. Obesity (Silver Spring). 2013 Mar 21.
                    • Hornstra JM, Serné EH, Eringa EC, Wijnker MC, de Boer MP, Yudkin JS, Smulders YM. Insulin's microvascular vasodilatory effects are inversely related to peripheral vascular resistance in overweight, but insulin-sensitive subjects. Obesity (Silver Spring). 2013 Mar 20.
                    • Kontogianni MD, Vlassopoulos A, Gatzieva A, Farmaki AE, Katsiougiannis S, Panagiotakos DB, Kalogeropoulos N, Skopouli FN. Flaxseed oil does not affect inflammatory markers and lipid profile compared to olive oil, in young, healthy, normal weight adults. Metabolism. 2013 May;62(5):686-93.
                    • Melamed ML, Michos ED, Post W, Astor B. 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med. 2008;168(15):1629-1637. 
                    • Michaëlsson K, Baron JA, Snellman G, et al. Plasma vitamin D and mortality in older men: a community-based prospective cohort study. Am J Clin Nutr. 2010;92(4):841-848.
                    • Solomon TP, Haus JM, Cook MA, Flask CA, Kirwan JP. A low glycemic diet lifestyle intervention improves fat utilization during exercise in older obese humans. Obesity (Silver Spring). 2013 Mar 20. 
                    • Waldron JL, Ashby HL, Cornes MP, Bechervaise J, Razavi C, Thomas OL, Chugh S, Deshpande S, Ford C, Gama R. Vitamin D: a negative acute phase reactant. J Clin Pathol. 2013 Mar 1.

                    300mg CoQ10 Boost Peak Power Increases in Young Elite Athletes. Plus: 140ml of Beet Root Juice, That's all it Takes to Minimize the Oxygen Demands During a Workout

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                    Athletes from various sports train at the Olympic Camp, where the CoQ10 study was conducted.
                    As unfortunate as it may sound, the number of "next big things" in the area of performance enhancing (legal) substances - at least in large parts - a line-up of supplemental non-starters. Against that background it is all the more surprising that today' SuppVersity article features not one, but two already available supplements that could in fact make a valuable contribution to your workout regimen. And while we are going to take a brief look at the latest research on the ergogenic effects of beet root juice later, we will start out with a study the results of which did actually surprise me - in a positive sense, that is.

                    • Reduced CoQ10 (ubiquinol) increases peak power in trained athletes (Alf. 2013) -- While previous studies on the efficiacy of CoQ10 demonstrated at best inconclusive and statistically, but mostly practically insignificant benefits, the latest study from the Olympiastützpunkt Rhein-Ruhr in Essen, Germany, reports a whopping +11% increase in peak power per kg body mass in the 53 males and 47 females young German athletes (average age 19.2 years, height 181 cm, weight 78 kg) who consumed 5x 60mg ubiquinol, the completely reduced form of CoQ10, which comes in three redox states, i.e. fully oxidized (ubiquinone), semiquinone (ubisemiquinone), and fully reduced (ubiquinol), on a daily basis day as a supplemental adjunct to their 6-week training regimen.
                      Figure 1: Progress of absolute peak power in the placebo and 5x60mg ubiquinol group (Alf. 2013)
                      While it is not possible to tell, whether it was the comparatively long study period (CoQ10 needs week to build up in the tissue; cf. Cooke 2008), the high dose of ubqiuinol (previous studies with 150mg did not yield comparable results, cf. Svensson. 1999) or a combination of both thats responsible for the ergogenic effects you see in figure 1 cannot be said for sure. What is however certain and actually pretty remarkable, if you take into account that these young athletes were all training regularly at the Olympic Training Camp Rhein-Ruhr in Essen and that many of them have been competing at the Olympic Games 2012 in London., is that the supplemented athletes did make 2.5% more out of  their 6 weeks at the camp.
                      Addendum: In view of the fact, that Rick just asked about potential side effects on facebook and I assume that, smart as you are, you will immediately spot the 2009 study by Sumien et al. talking about detrimental effects on cognitive function, I want to point out that the human equivalent of 2.6mg/g chow the high dose group received would exceed an ubiquinol intake of >6g even for the lightweights of you. With 1/4 of the dosage not producing any long-term negative sides in the same rodent study, you are thus probably on the save side w/ 300mg/day. This hypothesis is by the way backed by a 2008 review by Hidaka who report a no-observed-adverse-effect level (NOAEL) of 1200 mg/kg/day derived from a 52-week chronic toxicity study in rats that would translate to 720 mg/day for a person weighing 60 kg (Hidaka. 2008)
                      Moreover, the way in which the gap between the supplement and placebo group widens only in the last weeks of the intervention seem to support the previously mentioned "pre-loading hypothesisand raises the hope that the ergogenic effects will persist for more than just 6 weeks.

                      CoQ10 did work in previous studies, but affected mostly serum markers not performance (learn more)
                      The researchers also speculate that "older athletes and “weekend warriors” might profit even more from CoQ10 supplementation than young, well-trained athletes", as both age and the lack of training are associated with a lower mitochondrial density, of which Alf et al. suspect that it may be compensated for by the provision of CoQ10. In view of it's purported beneficial effects on ATP and creatinine phosphate synthesis, this may well be the case. I would yet still refrain from buying a year-long supply of the ubiquinol before respective evidence from independent trials is available. I mean, with the current price tag on ubiquinol, even an N=1 experiment with a 6-weeks supply of 300mg of ubiquinol per day would cost you ~$60 which is not exactly cheap, but could be worth a try - assuming you have the patients to wait for the results.

                    • 280ml beet root concentrate have well-established ergogenic effects, more is not necessary (Wylie. 2013) -- Right from the Exeter University comes a new study on the ergogenic effects of beet root juice. While the main message of the paper is that beet root juice supplementation can effectively increase nitric oxide levels and physical performance, the real interesting part of the paper deals with the dose-response relationship.

                      There are a couple of important confounding factors which will determine whether or not you or anyone else can benefit from nitrate supplementation. Sex is yet - as far as I know know - not one of them... ah, by the way, there may be other benefits to nitrates that are "sex-specific", but in this case the semantics are somewhat different (learn more in a previous post on beet root  juice here at the SuppVersity ;-)
                      Lee J. Wylie and his colleagues found that the provision of 70, 140 or 280 ml of concentrated beet root juice (BR), with 4.2, 8.4 and 16.8 mmol NO3- on six separate occasions increased the plasma concentration of NO2- in a dose-dependent manner, with the peak changes occurring at ~2-3 h. Of the three dosing regimen,
                      "[...] only the higher dosages (140ml and 280ml) reduced the steady-state VO2 during moderate-intensity exercise by 1.7% (P=0.06) and 3.0% (P<0.05), whilst time to task failure was extended by 14% and 12% (both P<0.05), respectively" (Wylie. 2013)
                      As the scientists point out, these results indicate that "there is no additional improvement in exercise tolerance after ingesting BR containing 16.8 compared to 8.4 mmol NO3-".

                      The dreaded carb overload that may have popped in your head, whenever you heard about using a natural NO3- supplement should not keep you from taking advantage of nature's very own "nitric oxide supplement" ;-)



                    Bottom line: In view of the fact that ubiquinol and beet root juice act via totally different pathways, a direct comparison of the two obviously doesn't make sense. A combination of both on the other hand would. I would not expect any synergistic affects, but it is relatively save to assume that the effects will add up.One thing you should keep in mind, thoug,h is that only the beets will have acute effects and provide the instant gratification everybody seems to be striving for, these days. The effects of coqu10 n the other hand will manifest only weeks after you started taking it, so that you will - for want of an independent control you will thus simply have to beleive that its working ... after all, you don't know how much progress you wouls make without it.
                      References:
                      • Alf D, Schmidt ME, Siebrecht SC. Ubiquinol supplementation enhances peak power production in trained athletes: a double-blind, placebo controlled study. J Int Soc Sports Nutr. 2013 Apr 29;10(1):24. 
                      • Cooke M, Iosia M, Buford T, Shelmadine B, Hudson G, Kerksick C, Rasmussen C, Greenwood M, Leutholtz B, Willoughby D, Kreider R: Effects of acute and 14-day coenzyme Q10 supplementation on exercise performance in both trained anduntrained individuals. J Int Soc Sports Nutr2008, 5:8.  
                      • Hidaka T, Fujii K, Funahashi I, Fukutomi N, Hosoe K. Safety assessment of coenzyme Q10 (CoQ10). Biofactors. 2008;32(1-4):199-208.
                      • Sumien N, Heinrich KR, Shetty RA, Sohal RS, Forster MJ. Prolonged intake of coenzyme Q10 impairs cognitive functions in mice. J Nutr. 2009 Oct;139(10):1926-32. doi: 10.3945/jn.109.110437.
                      • Svensson M, Malm C, Tonkonogi M, Ekblom B, Sjodin B, Sahlin K: Effect of Q10 supplementation on tissue Q10 levels and adenine nucleotide catabolism during high-intensity exercise. Int J Sport Nutr1999, 9:166–180. 
                      • Wylie LJ, Kelly J, Bailey SJ, Blackwell JR, Skiba PF, Winyard PG, Jeukendrup AE, Vanhatalo A, Jones AM. Beetroot juice and exercise: pharmacodynamic and dose-response relationships. J Appl Physiol. 2013 May 2.

                      Fish Oil Compromises, Fish Improves Adiponectin Levels in "Overweight, But Healthy" Individuals. None Promotes Weight or Fat Loss Within a 4-Week Study Period

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                      Fish are smart, they tell you about the good things "omega-3" fatty acids will do, without pointing you to the fact that eating them will yield a more favorable DHA:EPA ratio than popping pills that are made from the same remnants of their deceased relatives the fishery industry has dumbed for decades.
                      With the vitamin D news the other day (go back), you are now probably thinking "hell, no Adel's other favorite topic to rant about"... an yes! You are right: I just like to rant against mainstream stupidity and one-size-fits-it all approaches everybody loves because they are so "easy"! Take your fish oil! And everything is going to be all right. Much easier and so much more compelling, than my advice to eat fatty fish at least once, better twice or thrice a week to promote, not magically achieve metabolic health.

                      And while you've heard about the anabolic and blood pressure lowering benefits of fish protein in previous articles, here at the SuppVersity, it is more than unlikely that you've already gotten wind of the latest study from the Smart Foods Centre, School of Health Sciences (you got to love that name!) at the University of Wollongong, New South Wales, Australia (Neale. 2013)... and that despite the fact that it took - just as with the egg study, showing only beneficial effects on blood lipids (learn more) - suspiciously long for the study to make it from an "accepted manuscript" into a print article in the scientific journal Metabolism.

                      Scaled fish or capped oils - is that even a question?

                      In what is by no means the first, and certainly not going to be the last paper comparing the metabolic effects of fish oil caps to the food item, the oil is supposed to be delivered with (the fish ;-), Elizabeth P. Neale and her colleagues recruited 18–65 year old volunteers, who were willing to consume fish, but had a low- or moderate habitual fish intake to begin with (<3x per week). The subjects had to have a BMI somwhere in-between 25 and 37 kg/m² and a chubby midline with awaist circumference of >94 cm for men, >80 cm for women. Exclusion criteria were pregnancy, diabetes mellitus, impaired renal function, smoking, not weight stablefor the past six months, food allergies or habits inhibiting compliance with the study design, illiteracy and inadequate conversational English; plus, they were excluded if they were currently taking medications including thiazolidinediones, valproic acid, ACE in-hibitors, and glucocorticoids.This left the researchers with N=30 subjects who were randomized to consume either
                      • fish providing 1.86 g of LC n-3 PUFA (812mg EPA +1044 mg DHA)per day -- three serves of 135 g salmon (Birds Eye Atlantic Salmon Fillets, Simplot Australia), two serves of 66 g sardines (adjusted for percentage fish in total canned product; John West Sardines in Tomato Sauce, Simplot Australia) and one serve of 55.1 g tuna (adjusted for percentage fish; John West Tuna Tempters Lemon and Cracked Pepper, Simplot Australia) per week, or
                      • supplemental fish oil (Blackmores Omega Daily) containing the same amount of LC n-3 PUFAs, yet - and this is a consequence of the low DHA/EPA ratio in fish oil vs. real fish - 1055.1 mg EPA and only 744.9 mg DHA
                      for 4 weeks, on a daily basis. And while the participants in the supplement group were "not expressly told to avoid fish", they were not "encouraged to consume it in preference to other protein sources", either (Neale. 2013).

                      What did the scientists want to measure?

                      The primary outcome parameter of the study were the differential effects of fish and fish oil on the plasma total and high molecular weight adiponectin levels in overweight humans and, secondary, to identify the genetic variations in participant's ADIPOQand FTO genes that may influence that response.
                      Figure 1: Relative changes in weight, BMI, waist, body fat (%), glucose, insulin and EPA + DHA levels in serum from t = -2 weeks (i.e. before the 2-week run in in which the diets and activity levels were standardized to 25% protein, 45% carbohydrate, and 30% fat) to t = 4 weeks (Neale. 2013)
                      As the data in figure 1 goes to show you this did not stop the scientists from evaluation the effects the intervention had on anthropometric parameters (waist, body fat, etc.) of their subjects, as well. Neither of these, nor the effects on blood glucose and insulin showed any significant inter-group difference. If we discard the identical changes in the EPA and DHA levels of the subjects, the dietary / supplement intervention had absolutely zero effects on any of these "extra-parameters" - no weight loss, no visible improvement in glucose metabolism.

                      No reduction in body fat or waist circumference in with fish or fish oil

                      Reason enough to ask yourself, whether we should not go back to baseline and ask "is fish / fish oil even good for you"? Certainly not - or I should say, only if you put faith in the hilarious promises of "instant weight loss, improvements in glucose metabolism" and what not, if you finally jump aboard and take your "essential fish oil supplements" that are plastered all over the Internet. If you discard these advertisment claims or simply apply some critical thinking skills, it should be obvious that you got to content yourself with changes in your potential to shed fat / improve glucose metabolism by simultaneously committing to lifestyle that's juxtaposed to the way of living that has gotten you into all the trouble to begin with.
                      Figure 2: Total and high molecular weight adiponectin levels expressed relative to the levels after the 2-weeks run-in (left) and the ratio of the absolute values after 4 weeks (right; Neale. 2013)
                      The changes in adiponectin expression in figure 2 are such an indicator of a change in the potential of getting rid of the blubber, the high blood glucose - and it is obvious to see that fish oil is inferior to fish, when it comes to inducing these changes.
                      "The results of this study suggest that short-termconsumption of fish and fish oil supplements does not have the same effect on HMW adiponectin levels in overweight humans. [...] This was due to a small increase in HMW adiponectin in the ‘fish’ group, whilst the ‘supplement’ group exhibited a significant decrease in HMW adiponectin concentrations. A similar pattern was seen for total adiponectin; however this did not reach statistical significance." (Neale. 2013)
                      As mentioned in the previous paragraph, these changes were not associated with differential effects on body weight, insulin levels and body fat mass, all of which "remained relatively constant" (Neale. 2013)



                      Fatty acid content in g/100g of wild and farmed salmon (left) and respective omega-3 to omega-6 ratios; learn more about making the "right fish choices", here
                      Unfortunately(?), the underlying mechanisms behind the differential effects on HMW adiponectin are as of now not known. Neale et al. do yet also subscribe to the "synergy hypothesis" I alluded to earlier in the first paragraphs of this article. The proven benefits of fish protein on insulin sensitivity and chronic inflammation (Soucy. 1999; Ouellet. 2007; Pilon. 2011), as well as the "other components present in fish such as selenium and vitamin D [, which] have also been associated with a range of health benefits in humans" [Rayman. 2000; Garland. 2006)...

                      ...Oh, no! I know what you are thinking now. "I got all those in my multi! And I guess whey will do just as well as fish protein..." - come on, are you serious? Synergy is about ratios, about competition, about ups and downs, about co-factors and adjuvants. It's not about a kitchen sink supplementation approaches that try to reunite what has been ripped apart in a helpless effort to "make things easier" for the lazy consumer who does not like his fish and does not want to spend some of his daily screen time on buying fresh foods and preparing them... sorry, now I am really ranting ;-)
                      Handpicked suggested reads:
                      • Study on Krill Powder Suggests: There is More to Seafood Than Fat - Can Krill Give You What Fish Oil Can't? Plus: Krill Protein's EAA Content More Than an Able Match to Whey (read more)
                      • Phospholipid or Triglyceride? What's in Your Fish Oil Caps? Only Phospholipid Based DHA+EPA Reduces Fat Cell Growth & Elevated Insulin Levels Despite Obesogenic Diet (read more)


                      References:
                      • Moroi M, Akter S, Nakazato R, Kunimasa T, Masai H, Furuhashi T, Fukuda H, Koda E, Sugi K, Jesmin S. Lower ratio of high-molecular-weight adiponectin level to total may be associated with coronary high-risk plaque. BMC Res Notes. 2013 Mar 6;6:83. 
                      • Neale EP, Muhlhausler B, Probst YC, Batterham MJ, Fernandez F, Tapsell LC. Short-term effects of fish and fish oil consumption on total and high molecular weight adiponectin levels in overweight and obese adults. Metabolism. 2013 May;62(5):651-60.
                      • Ouellet V, Marois J, Weisnagel S, et al. Dietary cod protein improves insulin sensitivity in insulin-resistant men and women: a randomized controlled trial. Diabetes Care 2007;30(11):2816.
                      • Pilon G, Ruzzin J, Rioux L-E, et al. Differential effects of various fish proteins in altering bodyweight, adiposity, inflammatory status, and insulin sensitivity in high-fat–fed rats. Metabolism 2011;60(8):1122–30. 
                      • Rayman MP. The importance of selenium to human health. Lancet 2000;356(9225):233–41.
                      • Soucy J, LeBlanc J. The effects of a beef and fish meal on plasma amino acids, insulin and glucagon levels. Nutr Res 1999;19(1):17–24.

                      Full ROM = More Growth, More Strength, More Structural Changes & More Sustainable Gains & Fat Loss - Insights from Realistic 8 Weeks Leg Training + 4 Weeks Detraining

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                      "That's not 90°, yet. Do deeper!"
                      I guess you will be remembering last week's post on the superior growth effects of full vs. partial squats, hah? Now, the results of the Bloomquist study certainly raise the question, whether the same or similar effects must be observe with different exercises or even different body parts, as well. After all, it would be bro-science at its best to generalize the result "full squat = full quad development" to "partial ROM  = partial strength and hypertrophy response" without the least hint of evidence that this hypothesis is more than just the "proposition or principle put forth or stated (without any reference to its correspondence with fact) merely as a basis for reasoning or argument" ("hypothesis, n.". OED) the word "hypothesis" implies - right?

                      The good news is that it appears as someone has heard my lamentations about the scarcity of respective research, or - what's in this case more probably - feel the same about the necessity to generate data that would be necessary to base our workout protocols on more than just "hearsay", hypothesis and "N=1 experiences" and a single study.

                      Ok, enough kiddin' around let's get to the facts

                      Table 1: McMahon's interpretation of an "ecologically valid resistance training program"; * denotes static holds for time in s, DL = double, SL = single legged (McMahon. 2013)
                      Despite the fact that the study I tried to make tempting to you in the introduction is again build around a leg training routine, it has two major advantages compared to the Bloomquist study: (1) The participants performed a complex, multi-exercise leg-training protocol, (2) the study used the vastus lateralis as yardstick for the size gains, (3) the effect of full vs. short ROM (range of motion) on strength, muscle structure and body fat were also measured and (4) the study had an active training part (8 weeks on the protocol outlined in table 1) and - and this is pretty unique - a subsequent 4-week follow-up in which the subjects did not train (detraining) that allow us to determine whether the persistency of the gains will also depend on whether you achieved the training with a limited 50° vs. a "full" 90° specific angle of knee flexion (McMahon. 2013).

                      With the the specified angle being defined as the "position at which the training load is held isometrically for two seconds",
                      • the 50° regimen involved a shorter ROM (SR) in the dynamic phase of the exercise and thus a shorter ‘average muscle length’, whereas
                      • the 90° regimen involved a longer ROM (LR) in the dynamic phase of the exercise and thus a longer ‘average muscle length’
                        *you will learn more about the importance of muscle lengthening later this week, so stay tuned!
                      McMahon & Onambélé-Pearson hypothesized that the group training "at longer muscle length" (90°) would undergo a greater amount of skeletal muscle hypertrophy and concomittant strength development and that these differences would be "due to increased physiological stress and stretch on sarcomeres compared to the group training at 50°" (McMahon. 2013) and that these effects would be evident even during / after the deloading phase.
                      Figure 1: Cross sectional area (CSA) of the vastus lateralis measured at 25, 50 and 75% of the femur length for the full range (LR), partial range (SR) and a non-exercised control group (McMahon. 2013)
                      If we take a peak at changes in muscle cross sectional area (CSA) in figure 1 this hypothesis appears to be roughly accurate. There are however significant differences in the growth response the scientists measured at 25%, 50% and 75% of total femur length (VL25-75), with a statistically non significant advantage for the high(er) load, short-ROM approach (the higher load is a natural consequence of the RM prescription) and a highly significant advantage for the low(er) load, full-ROM approach, when it comes to that part of the muscle you want to shine, as it contributes to that massive "tear-drop look".
                      "CSA increased significantly (p<0.05) relative to baseline following training at all sites in both training groups. The significant training effect remained during the whole detraining period in both training groups at both 50% and 75%, but was not evident at 25% of femur length after week 10. There was a trend for LR to exhibit greater relative gains in a CSA compared to SR at all sites, which was significant at week 8 at 75% of femur length. It was found that there was not only a main training effect (p<0.05) but a main group effect after week 8 (p<0.05) with LR exhibiting a 59±15% compared to SR showing 16±10% increment in VL CSA." (McMohan. 2013)
                      To the surprise of the researchers, the "following the first two weeks of detraining the group effect was no longer evident (p=0.07)" (McMohan. 2012). In the end, the existing advantage of training over the full-ROM, as pronounced as it may be at the CSA75 site, is thus short lived in this group of previously non-resistance-traind 26 volunteers (14 males and 12 females). The fasicle length, which increased by
                      23±5%, 19±4%, 16±4% at weeks 8, 10 and 12 in the LR and by only 10±2%, 6±2% and 2±2% in the SR group (data not shown), on the other hand, were persistent - yet only in the full range (LR) group.

                      "And body fat? What about the body fat"

                      Crossfit doesn't fit well with everyone. In  fact, you have to be pretty fit already if you intend to benefit - specifically if you don't have someone who tailors the workouts to your specific needs. If you the shed 8% of your already low 16% body fat in 10 weeks workout routine I wrote about in February, chance is you'll just get injured or burned out (learn more)
                      The local reduction in subcutaneous fat that was likewise assessed based on the ultra-sound images the scientists used to evaluate the structural changes and CSA increases did not show significant group effects at 25%. The relative changes of 5% in the partial (SR) and 22% at the 50% measuring mark in the full ROM (LR) groups, clearly suggest that "going all the way" would still be the way to go if you don't want to look hypermuscular, but lean (ladies?). The latter is particularly true in view of the facts that the ...
                      "[...] main effect of group remained during weeks 10 and 12, as SR regressed toward baseline by week 12, whereas LR still possessed significant losses at this phase (-10±6%)" (McMahon. 2013)
                      and that there was a similar trend seen at 75% where a main effect of both group and training existed at week 8 (p<0.05) - even if the latter vanished in the course of the 4-week detraining period 7±3% SL and 9±1% LR).

                      Regional growth and angle-specific strength gains
                      Contrary to all previously reported values, which were - if they were group specific at all - regionally different, the changes in strength showed - as you would expect it - an angular specificity. While both groups did increase their strength, there were more than just minute differences between the partial (SR) an the full ROM (LR) groups:
                      • at the end-ranges, the maximal volunary contractive force increased 5±10 for SR at 50° and 30±5% for LR at 90°, respectively
                      • there was evidence of angular specificity of training in both groups with SR significantly (p>0.05) increasing MVCs at 50, 60, 65, and 70° , only, wheres the participants in the LR increased their MVCs values over the entire angular range.
                      What's remarkable, yet non necessarily beneficial, is the fact that the angle of peak torque which had been 75° at the beginning of the training intervention decreased to 70° within 8 weeks of training over the short ROM (SR) and remained there for the duration of the detraining (i.e. the change was at least persistent, if not permanent). No such effect was observed in the LR group.
                      "By week 10, both groups displayed an average 6±2% strength reduction (relative to the post-training strength values), with SR not significantly above baseline (0±2%) in contrast to LR remaining significantly above both baseline (p<0.05) and SR (p=0.027) at weeks 10 and 12."
                      Overall, the changes in contractile force and the angle at which they were elicited reflect the structural changes that were brought about by the more pronounced muscle lengthening that's a prerogative of training over the full range of motion (ROM).



                      To ensure that all participants conducted the complex exercises at the correct knee angle a goniometer was attached to their knees (photo velamed.com)
                      Bottom line: As far as the practical implications of his findings are concerned McMahon and Onambélé-Pearson reemphasizes that the specific muscle mechanics are of paramount importance, "when choosing a range of motion for a resistance training protocol." (McMahon. 2013)

                      With resistance training protocols that enforce a full range of motion having the ability to influence force and power production to a greater extent than protocols where the range of motion is not as extensive, he is therefore right to point out that it would be a mistake to allow your ROM to be compromised "in order to accommodate a greater absolute external load, in an attempt to increase the stress of mechanical loading" and advises coaches to "reinforce a more complete ROM, even when absolute load maybe reduced, in order to provide a greater internal stress and more potent stimulus for adaptation" (McMahon. 2013).

                      Aside from the fact that  this advice is obviously as relevant for trainees, like yourself. The one thing I would like to add to McMahon's "bottom line" is a reference to the structural changes and their importance in view of maintaining the strength gains you achieved. Moreover, it is, as you will be learning in an article I am still working on, likely that the extend of the observed and accompanying, but not evaluated changes in muscle structure facilitate future muscle gains. Therefore, you would in fact be ill-advised not to "leave your ego at the door" if you want persistent size gains and increases in strength over the full range of motion that do not vanish, when you are taking 2 weeks off.

                      Handpicked suggested reads:
                      • The Jack-of-All-Traits Leg Workout from the Sáez de Villarreal study I discussed on July 15, 2012, would also be something you may want to look into if you need some inspiration for your own routine.
                        You Want Maximal Performance & Size Gains + Complete Thigh Development? Then Full Squats are For You! (read more)
                      • SuppVersity EMG Series - Gluteus maximus, Quadriceps femoris, Gastrocnemius, Soleus & More: The Very Best Exercises for Tree-Trunk Legs and Herculean Calves (read more)
                      • The Step-By-Step to Your Own Workout Routine Guide (read it)
                      • All posts leg training at the SuppVersity (read them)

                      References:
                      •  "hypothesis, n.". OED Online. March 2013. Oxford University Press. 6 May 2013 <http://www.oed.com/view/Entry/90588?redirectedFrom=hypothesis>.
                      • Eugene McMahon G, Onambélé-Pearson G. Impact of range-of-motion during ecologically valid resistance training protocols, on muscle size, subcutaneous fat and strength. J Strength Cond Res. 2013 Apr 26.[Epub ahead of print]

                        (Mis-)Managing Hypothyroidism: 7% Reduction in Energy Expenditure & Fat Oxidation in Patients on Levothyroxin (T4) Mono Therapy. Plus: Alternative Dessicated Thyroid?

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                        The thyroid is a real diva. You better treat her with utmost care (learn more)
                        I guess, ... no, I know that a couple of you have to deal with all sorts of thyroid problems. I know you won't like to hear that, but if you read the SuppVersity Athlete's Triad Series you should know that there is more than just the remote possibility, that food and rest would be everything to "heal" your underactive ductless gland (=thyroid). Good indicators are you train everyday, (1) you eat a high protein, low carb, low to at best medium fat diet with a constant caloric deficit, and (b) your TSH level is low to normal, your free T4 level is low to normal but your free T3 level is sub-par. In consequence you will feel sluggish, look sluggish, train sluggish and won't achieve either your fat loss, performance or muscle building goals.

                        If that's you, there is need for meditation, not medication, for stress management, not pills. In fact, throwing the "inactive" precursor T4, the textbook treatment for hypothyroidism into the equation, could make things even worse, as your body is going to convert the lion's share of it to the metabolic emergency break rT3, to avoid that increasing levels of the active metabolite T3 start gnawing away on your undernourished muscle and exacerbate the chronic stress you are exposing yourself to.

                        Is being "euthyroid" really the same as having normal TSH levels?

                        Data from the The Colorado Thyroid Disease Prevalence Study indicates the risk of suboptimal thyroid function & hypothyroidism is more pronounced in women (Canaris. 2000); associations w/ certain contraception meds, pregnancy & menopause in other studies point towards estrogen / progesteron issues as confounding factors.
                        Interestingly enough, a recent study from Division of Endocrinology and Metabolic Medicine, Policlinico di Monza and the Department of Biomedical Sciences for Health at the Università degli Studi di Milano, bothobviously in Italy, did now reveal that it does note necessarily take overtraining + undereating to end up in a 'metabolically and mentally sluggish euthyroid state'. This became evident, when the Italian researchers compared the body composition and resting energy expenditures of 30 hypothyroid women with an average BMI >25 kg/m² and normal serum TSH levels (<3.5 μU/ml; text-book says: "Your patient has optimal thyroid function, doctor!") who had been on the "gold standard" (*rofl*) replacement therapy with L-T4 (levothyroxin = synthyroid; mean dose: 73±34 μg/d) for at least 2 years to the same parameters in a control group with matched age, BMI, menopausal state and life-style habits (P>0.3 for all).

                        While neither the average TSH levels, which were 1.92±1.06 µU/ml in the T4 and 1.87±0.89 μU/ml in the control group (P=0.91), nor the body composition (body fat: 41.4±7.4 vs 42.1±8.3%; LBM 58.6±7.4 vs 57.8±8.3%; P>0.7 for all) revealed a statistically significant inter-group difference, the resting energy expenditure of the the hypo- / after medication "euthyroid" women on levothyroxin did:
                        • Click on the image to learn how to calculate (I should rather say estimate) your resting energy expenditure using different scientifically verified formulas and why it is important not to go below a certain threshold (learn more)
                          In absolute terms, the women in the T4 group had a -7% lower REE than the controls (1347±171 vs 1447±154 kcal/d; P<0.05).
                        • The -7% difference remained the same and had an even higher statistical significance (P<0.02 vs. P<0.05), when the resting energy expenditure was expressed relative to the the subjects lean body mass (28.3±2.6 vs 30.5±3.0 kcal/kg LBM die; P<0.02).
                        • A smaller yet still significant difference was observed when the actual resting energy expenditure was compared to the "supposed" resting energy expenditure calculated by the means of the Harris-Benedict Equation(91±7 vs 95±7%; P<0.05).
                        The most significant difference (P<0.01) was yet observed, when the scientists analyzed the respiratory quotient (also respiratory exchange rate, short: RER) of their subjects. The latter is a direct measure of the ratio of glucose to fat your body is using a substrate to fulfill its energy requirements, in particular,...
                        • Suggested read: Maximal Intra- & Post- Workout Fat Oxidation With Pause or 90min LISS Between 2x40min Incremental Exercise Bouts? (read more)
                          higher RER levels indicate a greater contribution of glucose, while
                        • lower RER levels indicate a greater contribution of fats
                        • A RER of ~1.0 would be observed in healthy individuals, only, when they are engaging in highly glycolytic + brief exercise bouts like sprinting.
                        • Many "fat burners" work in part by decreasing the RER. When you are in a caloric deficit (and only then) this is an advantage because you will spare glucose and burn fat. 
                        • Other supplements like creatine, for example,  gear your metabolism towards an increase in glucose expenditure, which can be beneficial in all sorts of activities that rely heavily on short sprints / brief muscle contraction
                        In fact, the women on T4 (only) had a 11% higher respiratory exchange ratio (0.92±0.07 vs 0.86±0.06; P<0.01), of which even the scientists have to admit that it's clearly suggesting an "impaired fasting lipid oxidation in hypothyroid women" and would thus support "the view that additional interventions may be necessary to fully revert the entire set of hypothyroidism-related metabolic alterations." (Martucci. 2013)

                        Aren't there better alternatives? T4+T3 or dessicated thyroid?

                        In a way it is funny - or should I say tragic(?) - that this is the first study in years that bothers with the metabolic and often psychological downsides of T4 only regimen in a way that goes beyond the analysis of TSH levels. After all, the Internet and the waiting rooms of medical practitioners all over the world are full of (mostly female) patients complaining about the non-existent benefits and / or side effects of levothyroxin, only, therapies.

                        It should be obvious that some of those patients may belong to the initially referred to group of people who suffer from self-induced hypothyrodism in response to undereating and/or overtraining, while others may have confounding, often undetected pathologies that are responsible for their compromised metabolism, their inability to lose weight, their sluggishness, brain fog etc.

                        Suggested read: "Dietary Thyroid Treatment: Beef, Green Vegetables, Full-Fat Milk & Butter Normalize TSH in Subclinical Hypothyroidism " (read more)
                        If you do however put the results of the study at hand in perspective with previous studies comparing "T4 only" vs. "T4+T3" treatments and the overall patient-preference of the latter, and combine that with the results of a very recent comparison of levothyroxin vs. natural dissicated thyroid treatment, in the course of which researchers from the Department of Endocrinology at the Walter Reed National Military Medical Center and the University of Health Sciences in Bethesda observed significant weight (I highly suspect fat) loss in the 70 18–65 year-old patients with primary hypothyroidism who had been on a stable dose of T4 for 6 months, when the subjects were given desiccated thyroid extract (DTE) instead of levothyroxin (1 mg DTE ~ 1.667 g L-T4; cf. Hoang. 2013).

                        Interestingly, the patients had significantly lower rT3 levels, higher total T3 levels, lower otal and free T4 levels and that in the presence of higher, but normal TSH levels (inter-group difference p=0.032) during the DTR part of the 2x16 week cross-over trial. A health hazard, as it is often argued that it would be the result of depressed TSH levels is thus a weak argument against using an alternative treatment strategy, of which I would highly suspect that it could resolve part of the metabolic dysadvantages arising in the context of T4 monotherapy and which was preffered by 34 of the patients in the Hoang study.



                        Bottom line: Whether using T4 + T3 or natural dessicated thyroid as the treatment method of choice is necessary or the best strategy for everyone is something that remains to be seen. Something that stands out of question, though, is that the stubborn adherence to the textbook standards, the blind reliance on TSH tests and the ignorance doctors display towards the complaints of their patients is not going to solve an increasingly prevalent problem (+3% increase in congenital hypothyrodism per year in the US, esp. in white and hispanic newborns; cf. Hintnon. 2010)

                        References
                        • Canaris GJ, Manowitz NR, Mayor G, Ridgway E. The Colorado Thyroid Disease Prevalence Study. Arch Intern Med. 2000;160(4):526-534.
                        • Hinton CF, Harris KB, Borgfeld L, Drummond-Borg M, Eaton R, Lorey F, Therrell BL, Wallace J, Pass KA. Trends in incidence rates of congenital hypothyroidism related to select demographic factors: data from the United States, California, Massachusetts, New York, and Texas. Pediatrics. 2010 May;125 Suppl 2:S37-47.
                        • Hoang TD, Olsen CH, Mai VQ, Clyde PW, Shakir MK. Desiccated Thyroid Extract Compared With Levothyroxine in the Treatment of Hypothyroidism: A Randomized, Double-Blind, Crossover Study. J Clin Endocrinol Metab. 2013 Mar 28.
                        • Martucci F, Manzoni G, Lattuada G, Perseghin G. Overweight/obese women with primary acquired hypothyroidism in appropriate levothyroxine replacement therapy are characterized by impaired whole body energy metabolism. Endocrine Abstracts (2013) 32 P1004 | DOI:10.1530/endoabs.32.P1004 Share on facebook Share on twitter Share on digg Share on stumbleupon Share on delicious Share on linkedin | Share on email Share on print

                        The "20 / 30 Principle" Sheds 15% Body Fat in 6 Months, Boosts Testosterone & Sexual Performance in Overweight Men. Plus: Six Signs You're Doing Too Much, Already.

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                        One out of four men with newly diagnosed erectile dysfunction is under 40 (more)
                        You will probably remember the post about the increasing prevalence of erectile dysfunction in young(er) men on Facebook, the other day (learn more)!? As of now, one out of four patients who are newly diagnosed with erectile dysfunction are 40 years or younger. That's an alarming trend that certainly cannot be reversed by the use of adulterated OTC libido boosters with high amounts of pharmacological PDE-5 inhibitors that are not listed on the label (read more on the SuppVersity Facebook Wall and listen live to today's installment of the Science Round Upstarting at 12PM EST!). With  30-40% of the overweight men not being able to achieve an erection of maintain it long enough to engage in seual intercourse, it stands out of question that the root cause for the exploding numbers of impotent young men is diabesity.

                        Against that background it is only logical that Joan Khoo and his colleagues from the Department of Endocrinology at the Changi General Hospital, the Departments of Sports Medicine and Rehabilitative Services at the Changi General Hospital assumed that diet and exercise should be more than an alternative to drug interventions. The latter has in fact been established in numerous previous studies, already. In obese Australian men who lost an average of 10% of baseline weight from caloric restriction alone using meal replacements or a low-fat diet and in men after 2 years of weight loss using Mediterranean diet and exercise, for example, the test scores in the International Index of Erectile Function 5-item (IIEF-5) improved by ~20% (Khoo 2011; Esposito. 2004).

                        Exercise works, but how much exercise does it take?

                        What has been missing up to know is yet a study that would establish the amount of exercise that's necessary to boost the existing benefits of energy restriction. And guess what!? That's exactly what Khoo et al. set out to do - conduct a trial that would compare the effects of 24 weeks of ...
                        • low volume medium intensity exercise training (<150 minutes/week) and
                        • (relatively) high volume medium intensity exercise (>200m/w) training
                        on the body weight, waist circumference (WC), body composition, International Index of Erectile
                        Function 5-item (IIEF-5), International Prostate Symptom Scale (IPSS) (for LUTS), and 36-item Short Form Survey version 2 Instrument (SF-36) (for QoL) scores, plasma testosterone, sex-hormone binding globulin, glucose, insulin and lipids, and endothelial function (by Reactive Hyperaemia Index [RHI] using finger plethysmography) of 90 abdominally obese Asian men (BMI >27.5 kg/m²; WC>90 cm; mean age 43.6y), who ha not moved an inch all day long in the past years (average amount of "exercise" ~80 minutes/week).

                        Freedom of choice: Exercise when and where you want

                        The aerobic only *sigh* exercise program could be performed on whatever equipment / sportive activity the subject like - stationary cycling, treadmill, elliptical crosstraining, brisk walking, jogging, cycling, and swimming, all were eligible for 90–150 minutes/week - the subjects were free to chose and pick, but they had to record type and exercise duration and make sure that they would hit their target heart rates of 55–70% of their individual maximal heart rate (HRmax=220-age) on whatever they did.
                        Figure 1: Absolute (body composition) and relative changes (lipids, sex hormones & erectile function); after 6 months on the diet + low vs. high volume exercise regiment;LUTS = lower urinary tract symptoms; IIEF-5 = International Index of Erectile Function 5-item questionnaire; IPSS = International Prostate Symptom Scale; SF-36 PCS and MCS = 36-item Short Form Survey version 2 Instrument Physical Component Summary and Mental Component Summary scores (Khoo. 2013)
                        In combination with the obligatory reduction in energy intake (-400kcal/day; ~15-20% of their baseline intake) both groups made significant progress. In comparison to the -4.7kg of body fat the guys in the "high volume" group (I use the quationmarks to emphasize that I would not consider ~30min of exercise/day exorbitantly high, considering the fact that the this was cycling, walking or swimming at a relatively moderate intensity) lost in the course of the 6-months intervention, the -1.1kg of total fat mass the guys in the low volume group dropped do yet look pretty pathetic.


                        "Doing more" for total & free testostosterone!?

                        What are signs that you are already doing too much ?
                        • constant fatigue that does not disappear, when you take a day off and get enough sleep (too much volume)
                        • inability to fall asleep (too much high intensity work)
                        • inability to sleep through (too much volume)
                        • getting up to pee every 1-2h (too much volume, too few carbs vs. too much protein)
                        • the 4am wake-up call = inability to sleep through (see above, fasting in the evening)
                        • no fat loss despite caloric deficit (eating too little + high training volume)
                        • losing muscle, not fat (too much volume, too much medium intensity cardio)
                        • low sex hormones / drive, low thyroid function, high rT3 (too much volume, too much protein, too little fat & carbs, not eating enough)
                        If you want more insights, you can find them in the Athletes Triad Series.
                        If we take a look at a couple of other parameters the scientists evaluated, you will notice a clear dose-response relationship. Much contrary to the participants in the Rosenklide study, I wrote about in 2012, which had a much higher training volume and intensity, doing more did - within this narrow relatively low volume moderate intensity regimen - did thus really yield superior results. Even more, the dose-response relationship is almost linear: 2x more exercise, 2x more weight loss, 2x more fat loss, 2x greater reduction in insulin, 2x greater reduction in blood glucose.

                        For testosterone (>2x more) and free testosterone (almost 5x more), the benefits were even more pronounced and the difference between the ratio of fat and lean mass lost 6.7 for the high vs. 5.5 for the low volume group are certainly not to be scoffed at, either.

                        Still, we just have to go back to the counterproductive effects Rosenkilde et al. observed in their study (go back and learn more), to see that the 30 minutes of exercise per day are probably not the end of the flagpole, but a very happy medium beyond which previously untrained individuals, and experienced trainees who work out at a correspondingly higher intensity level, could hit a wall and spiral down into the abyss of chronic overtraining - especially when exercise habits like that are combined with a diet that does not only induce an energy deficit of 20% but does at the same time make it particularly hard for the body to use the energy it gets... yep, I am talking about the notorious high protein, low carb, low fat diets the scaremongerism on both sides of the low-carb vs. low-fat divide have made so popular (learn more).



                        Bottom line:Diabesity, erectile dysfunction and hypogonadism? The solution to this triad is there! It's not complicated, but it requires commitment, it requires discipline and it will cut your daily screen time by 30 min... if you or your overweight friends don't feel that this is worth it, let them waste their money and risk their health by jumping from one "quick fix" solution and diet (e-)book to the other. If not, write the numbers "20/30 x 6" on a DinA4 sheet and pin that to your or your friends' fridge to remind yourself or them that it takes a caloric reduction of 20% + 30min of moderate intensity exercise and the stubbornness to adhere to that protocol for 6 months day in day out (I guess 90% compliance would even be enough) to take a huge step on your way towards normalizing your body composition, glucose and lipid metabolism and endocrine and erectile function... and on a last note: I bet this works for overweight women with PCOs, as well.

                        References:
                        • Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D’Andrea F, D’Armiento M, Giugliano D. Effect of lifestyle changes on erectile dysfunction in obese men: A randomized controlled trial. JAMA 2004;291:2978–84.
                        • Khoo J, Piantadosi C, Duncan R, Worthley SG, Jenkins A, Noakes M, Worthley MI, Lange K, Wittert GA. Comparing effects of a low-energy diet and a high-protein low-fat diet on sexual and endothelial function, urinary tract symptoms, and inflammation in obese diabetic men. J Sex Med 2011;8:2868– 75.
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